During Robert Roncska's impressive twenty-eight-year career in the navy, he commanded a nuclear-powered submarine, led the largest submarine squadron in the US fleet, and even carried the nuclear football for President George W. Bush, who affectionately named him "Navy Bob." After retiring from the navy, Roncska applied the lessons he learned in leadership and reliability to enhance the culture and outcomes of one of the world's largest healthcare organizations. Having personally experienced toxic and legendary cultures, he now shares the pitfalls and discoveries he made along the way.