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Pinnacle 2021 Quick Take: ‘Think outside the shoe’ to assess, solve leadership challenges

Jessica Cox shared lessons of resilience and courage to inspire EMS leaders during the Pinnacle EMS keynote presentation

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Jessica Cox, born without arms, and the world’s first licensed armless pilot, opened the 2021 Pinnacle EMS leadership conference with a message of inspiration and encouragement.

Jessica Cox/Twitter

PHOENIX — Jessica Cox, the world’s first licensed armless pilot, opened the 2021 Pinnacle EMS leadership conference with a message of inspiration and encouragement.

Each year, Pinnacle chooses a leader from outside EMS to help focus attendees for a week of learning and networking. Cox, born without arms, shared how she became a Taekwondo black belt, certified SCUBA diver and licensed pilot. Drawing on the lessons she has learned and her positive approach to life, Cox gave attendees approaches to tackle the challenges they are facing.

Memorable quotes From Jessica Cox

Some of the most basic things we take for granted, like putting on a headset or buckling a four-point harness, presented initial challenges for Cox. As Cox explained how she became a pilot, she used a mix of practical demonstrations and humor. Here are a few memorable quotes from Cox’s presentation:

  • “Trial and error are a huge part of my life.”
  • “When we reinvent new ways of doing things, we pave the way for so many.”
  • “If there is something you want to accomplish don’t let anything stand in your way.”
  • “I challenge you to never let fear stand in the way of any opportunity.”

Key takeaways on resilience

Jessica showed attendees how to tackle challenges with commitment and resilience. Here are four key takeaways from Cox’s presentation:

1. Change your perspective

Cox described the process in which she learned to tie her shoes through hundreds of attempts. Because Cox had to learn to tie her shoes before putting her foot in the shoe, her mindset became to “think outside the shoe.”

Cox encouraged attendees, even when met with resistance and negativity, to “think outside the shoe” when addressing the pervasive challenges EMS leaders and providers face. The SHOE acronym is how Cox labels the negativity that can hold people back. Those things are:

  • Self-limited beliefs

  • Habits

  • Over complication

  • Excuses

2. Antidote to negative beliefs

When faced with a challenge, like learning to drive, or negativity from people who have questioned her ability or dedication, Cox applies the THINK acronym:

  • Tear up the challenge

  • Heighten awareness

  • Insist on finding a way

  • Non-stop re-evaluation, repurposing or reinventing

  • Kick out the habit of excuses

3. Stretch yourself to innovate

Cox has approached life with an “I can” attitude. Once she decided to become SCUBA certified or learn to fly, Cox set to figuring out how to accomplish her goals by changing her perspective, trying lots of approaches, and patiently working through potential solutions.

4. Be your true self

Cox concluded her presentation by explaining why she doesn’t use prosthetic arms. She recalled how she felt when she decided to stop wearing the prosthetic arms she had used from age 3 to 14. As she boarded the bus on the first day of high school without those prosthetic limbs she felt like her true self and more ready than ever to face the world. Ever since, empowered by being the person she was meant to be, Cox has accomplished her goals and inspired others.

Learn more about motivation and resilience

Learn more about Cox’s accomplishments and work as a motivational speaker at and learn more about motivation and working through challenges with these EMS1 resources:

Greg Friese, MS, NRP, is the Lexipol Editorial Director, leading the efforts of the editorial team on Police1, FireRescue1, Corrections1 and EMS1. Greg served as the EMS1 editor-in-chief for five years. He has a bachelor’s degree from the University of Wisconsin-Madison and a master’s degree from the University of Idaho. He is an educator, author, national registry paramedic since 2005, and a long-distance runner. Greg was a 2010 recipient of the EMS 10 Award for innovation. He is also a three-time Jesse H. Neal award winner, the most prestigious award in specialized journalism, and the 2018 and 2020 Eddie Award winner for best Column/Blog. Connect with Greg on LinkedIn.