Managerial threats and how to deal with them

I have been threatened with disciplinary action twice. If you are sure of your ground then stand up and be counted, but be aware that you may end up, like Stephen Bolsin, as the locally unacceptable face of whistleblowing even if you are right[1]. However bullies will go on bullying unless they are resisted.

Thus what you do may be determined by your seniority and subsequent risk (if junior) of isolation, if the herd decides to lie low and not back you up. Your career might be jeopardised, as an excellent storyline in the BBC series “Casualty” made clear in 2010 when Lennie, the dysfunctional trainee, backed down from exposing a drug trial scandal[2].

There are risks from confronting entrenched positions. A friend of mine (I won’t name him) told me that he was verbally abused and had his Wikipedia entry vandalised by a pressure group who considered his views (evidence-based though they were) undermined their own self-centred prejudices. The parents who think that MMR vaccine caused their children’s autism are another dangerous lot, as are those who don’t believe in what used to be called Munchausen by proxy; there are even some people still around who think that silicone implants caused their connective tissue disease. One of my patients was convinced of this, one day triumphantly bringing in a carrier bag from which she flourished a vile pot containing the remnants of her removed breast prosthesis (which had leaked and was all distorted and gunky, and it was just after lunch so I was nearly sick). The problem was that although she was convinced it had caused her scleroderma, there was no evidence at all that she had ever had scleroderma.

When I was a junior I worked in a famous London specialist hospital, where for the second half of my six months I served a tyrannical professor for whom everything had to be just so. Not only did I have to clerk admissions for them but I also had to admit another consultant’s patients, all of whom came in on a Sunday afternoon and required extensive prick and delayed hypersensitivity tests. My own boss’s patients were frequently on trials, so the protocol forms had to be written up, together with large numbers of pathology forms, often in triplicate. These patients came in on a Tuesday. Clerking them was difficult as the ward round was on Tuesday afternoon, and went on forever – and resumed on Wednesday morning at 8.30am. Woe betide you if the patients were not completely dealt with; you would be humiliated in front of an audience of worldwide visitors. Either you coped by living your entire life in the hospital, and ignored the world, or you unwound with much alcohol (or a girl, or both) or you had a nervous breakdown. I tried all except the last.

I was hauled in for a dressing-down and told I wasn’t doing my job well enough. I tried harder (often finishing around 11.30pm). I then realised that my immediate senior was coming into the hospital after I had left the wards and was running round the patients doing everything all over again. So I eased off, and perhaps unsurprisingly I was called in once more.

I lost my temper and said that there was not much point in my doing things if someone else came along later and did something different; so, if he was stopped from interfering, I would continue to do my best but otherwise would not bother. Finding someone standing up to them seemed to calm things down. However, when I asked for my additional hours form to be signed, I was told that I either got the money or a reference, but not both. I said in that case I would have neither.

Later I did a merciless counter-humiliation of said boss in the hospital Christmas show, and felt I had gained sufficient revenge. However I applied for a locum post to fill in before my next substantive post, for which there was a six week gap. I got it, only to have it suddenly snatched away a few days before I was due to start because “they had got someone else”. I am sure it was because my boss had put in a word. So I did not have the last laugh and that’s why I am neither a chest physician, nor a cardiologist!

Another example of this serves. Chris Pallis, neurologist at the Hammersmith, was an erudite man renowned for his very left-wing leanings, and was also one of those spontaneous people who disrupted the social schedule (and no doubt was a great nuisance to his long-suffering wife Jeanne) by suddenly announcing that the entire team must collect for dinner at his place – tomorrow night. They were great evenings. Chris fancied himself as an expert on comparative religion and one night I came back from a quick trip to the facilities to find him expounding on Zoroastrianism with great intensity. I suspect his interest in this minority religion had been stoked by an earlier Parsee colleague.

The only trouble was that he was getting it wrong (I should know) and in front of the assembled multitude I put him right. That led directly to the other trouble – for the next three weeks he relentlessly found fault with everything I did – clerkings, examinations, letters, the lot.

The moral is simple. If you are going to put down a senior colleague choose your time and place most carefully.

[1] Bolsin blew the whistle on the goings-on in the Cardiac Surgery department in Bristol, and found himself unable to get another job in the UK

[2] Casualty (BBC1); series 24, episode 46, 2010

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