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I cannot bear people who try to patronise others by using incomprehensible jargon. Especially when it usually covers up their own lack of understanding of what is going on. So herewith my list of phrases that I find particularly annoying, although I am sure there are plenty more that can be added to the list!

Top Ten Annoying Business Terms Translated in to Real English

  1. Going forward ; in the future/from now on
  2. Big ask; something that may involve working past 6 pm
  3. Stakeholder management: ensuring everyone is “bought in” to the project so the finger doesn’t point at you
  4. Bought in: convincing people your idea is a good idea so that they can share the blame when the shit hits the fan
  5. Empowerment :  the futile delegation of meaningless decision making by a boss to try to make you feel more important
  6. To action deliverables: to do your job
  7. We are on the same page; I have no idea what you just said but I just want to move on
  8. Indicative: complete fucking guesswork
  9. I hear you : I don’t give a shit what you think.
  10. Scope that out for us : Just shut up, fuck off to a room and come back when you’ve thought it through a bit more.

And one that I actually like:

  1. Al desco:  eating by your computer

Some patients I never forget

September 30, 2012

As a medical student one has little actual responsibility for the care of the patients one sees as obviously qualified doctors are overseeing everything. We are superfluous to requirements and there to learn rather than contribute. On the whole most patients were generous enough to let me study them. In fact, I don’t remember anyone ever refusing. Perhaps they were worried the doctors wouldn’t treat them as well if they did. I hope not. It isn’t the case.

My favourite firm as a medical student was Oncology. The cancer ward. I had already done Cardiology and Metabolic Unit, and hated the latter. It was run by two dry Consultants; one an academic expert in these rare diseases we were seeing and the other old and boring. The juniors called him ‘Shifting Dullness’  – a medical term relating to fluid in the abdomen but one which perfectly described his ward rounds.

Oncology on the other hand was brilliant. The consultant was fantastic. Inspiring. And the patients were incredible. Two I remember in particular. One of our jobs as students attached to oncology was that we had to administer all the intravenous chemotherapy . Nowadays one gets gloved up and puts safety googles on to handle these toxic chemicals, but we were just sent off to the treatment room to try to work out what to do by ourselves. Some of these medicines would cost hundreds of pounds  a vial. Even then.  Nobody taught us how to draw up intravenous drugs so we didn’t realise they were vacuum packed. What that means in practical terms is that if you stick your syringe in to the bottle to try to draw up the liquid you can’t pull the plunger back as the vacuum is fighting against you. What you have to do is inject air in to the bottle to break the vacuum and then withdraw the same amount of drug as you have just injected in air. If you don’t do this correctly the whole thing can explode and spray toxic chemicals all over the room. Yes, guess who managed to do that….
So we would spend quite a bit of time on the wards with the patients and get to know them well. And of course in the oncology ward, many of them had life-threatening diseases.

The first patient to make a fundamental impression on me was a man in his 80s. I can’t tell you his name although I’d like to so that he would get the recognition he deserves. But confidentiality extends post mortem so I can’t. I can see him now. Sitting up in his bed, leaning forward trying to catch his breath. He had lung cancer and at that time there were no successful treatments for the type he had. I was assigned him and had to take his history and examine him.

He had various scars and so I had to ask him what they were from. It turns out he had fought in the First World War. He was in the battle of the Somme. He watched thousands of men be killed or mortally wounded. He was in the medical corps. He was stationed at a kind of triage post where the casualties would come or be brought and he would decide whether to send them on to get proper treatment, giving them basic first aid as needed or if there was no point sending them on, then just making them comfortable. He had administered to thousands of young men and they still haunted him. He had tears in his eyes as he talked about the horrors of war.

The more he told me the about the awful the things he had witnessed, I was amazed he had managed to come out of it, get married, have a family and a normal life. The huge burden of trauma he was still processing sixty years later was humbling. He had never talked about it to anyone, not even his wife, but now he was dying and I had started asking questions, he wanted to let people know how awful it had been. I wish I’d known more history to be able to ask more pertinent questions, but it seemed he would just talk about it without much prompting.

I only saw him a couple of times as he died within days of our starting on the ward. Much more quickly than I had anticipated. I was surprised how sad I felt, as if he were a close relative or friend. He had reminded me of something that I already knew but the arrogance of my youth had decided to forget; these ‘old people’ I was seeing were much more than simply a sum of their current symptoms and signs. They were living history and had experiences and feeling that could not be guessed at by looking at their frail frames.

The other patient from that firm (as we called our time on a given unit) who stays in my head was a 26 year old with leukemia. She was amazing. Life affirming. Positive. Wasn’t taking this lying down. Shaved her head and sometimes dyed it bright punkish colours. Had to undergo horrendous chemotherapy which I would administer in to her bloodstream and she would feel atrocious for days. She was an inpatient for a long time and as she had no working immune system one had to get gowned up to go in to her side ward to try to minimise the risk of her getting an infection. So she didn’t have lots of people popping in to see her. But she was always great. I loved going to see her as it was like seeing a mate. We would chat about all sorts; men mostly. She was always smiling and laughing but she knew she was very ill. She wasn’t in denial, but coping incredibly well. Except very occasionally she would let the mask slip. I was probably too inexperienced to be any help to her, whereas she was able to help me understand the feelings she was wrestling with. And there would be tears.

After I finished the oncology rotation I still popped up to the wards to see if she was around and have a chat. Sometimes she would be well enough to go home, which was great for her, but I would be disappointed not to be able to chat to her. She died about eighteen months later. I hadn’t known she’d been admitted and had been on a rotation up in Bedfordshire so hadn’t been in for a couple of months. I was gutted. I felt guilty I hadn’t seen her during her final days and weeks. She had been a similar age to me, a fighter, had the best possible care and yet she had been taken. It was so bloody unfair.

I realised it was nothing more than luck that I was on this earth and she was not.

Responsible adults?

September 28, 2012

I’m lucky enough to be a freelance consultant. I work for myself (and my family if we’re having to be touchy -feely, nicey, nicey), but basically I am my own boss. I stand and fall by what I deliver. Or not. I get new contracts on the basis of what people know of me. (Similarly, I presume I don’t get offered other contracts on the basis of what people know of me, but I never hear about them!).

I am employed to give people the benefit of my opinion and experience. I advise them on what I believe is the right thing to do in a given set of circumstances. I put my head above the parapet, my neck on the line and more than a toe in the water. Basically I say what I think. And even more shockingly for some organisations, I am prepared to put it in writing.

More and more I am finding people reluctant to give an opinion. People wait for others to speak first. Not out of politeness, but out of fear. Fear of saying the wrong thing. Fear of having to explain what they mean, or why they came to that conclusion. Fear of taking responsibility. Fear of it affecting their prospects.

Let alone writing it down. That is another can of worms altogether. Obviously one has to ensure one writes with clarity and specificity and in a way that cannot be taken out of context or misconstrued. But senior people refusing to put anything in writing makes it difficult for juniors to have robust guidance on how to do the right thing. Driven, I suspect, by fear of litigation and losing their job. But it makes the juniors clam up even more.

It drives me absolutely fucking bonkers.

And it feeds a paralysis. An inability to take individual responsibility. Teams are formed; sub teams, cross functional teams, project teams. Lots of collaboration. Lots of meetings. Lots of keeping each other up to speed. Lots of waiting for one team to report back before another team can be ‘tasked’ (agggh, another word I hate) to do something.

But no fucking action.

Materials go round and round. Supposedly being reviewed by all team members but not actually being read by anyone. Everyone assumes someone else will pick up the mistakes, point out the inadequacies, make suggestions for improvement. But they don’t. Because they don’t feel it is their individual responsibility. If it’s that important someone else will pick it up. And anyway, they’ve probably got another meeting to go to so they haven’t the inclination to spend time reading and thinking. (see previous posts about saying what they mean or meetings being an alternative to work)

This move away from individual responsibility is great for ineffectual people who can hide in a morass of committees and workstreams. But it is frustrating for people who actually want to deliver because they feel disempowered to take decisions and drive things forward. It’s the same as when parts of the NHS stopped assigning specific patients to individual nurses. Or wards to individual sisters or charge nurses. Care suffered. Job satisfaction decreased.

But gradually even great drivers, movers and shakers can get ground down by an organsisation that insists on everything being collaborative. And they either leave the organisation or become part of the establishent they railed against.

Perhaps as a doctor I am used to making decisions based on the evidence I have and I am used to being prepared to defend them. The dying patient cannot wait whilst a ‘cross-collaborative strategic optimisation team’ meet and consider the various treatment options, so perhaps I am hard-wired to avoid procrastination. But it doesn’t mean there isn’t team working – it’s just that team members are assigned individual, specific tasks for which they are solely responsiblie. It concentrates the mind.

Which is why it is so refreshing and invigorating to work in teams where there is enthusiasm and ownership. Where there is no fear of a blame if things go wrong, but a culture of support and learning from mistakes. Where people celebrate success and mitigate the effects of failure.

Preferably in the bar 🙂

King Lear at the Almeida

September 27, 2012

Overdosing on Shakespeare, we went to see Jonathan Pryce as King Lear. I have to admit I wasn’t looking as forward to it as I had been Twelfth Night. But I really enjoyed Pryce’s performance as a tyrannical, abusing father who flicks between seeming good grace and humour and vengeful, threatening animosity. His madness and moments of lucidity made him more human and vulnerable than previous productions I’ve seen.

Unfortunately none of his three daughters (or their husbands) did anything for me, and these are key roles and relationships to make this play ignite. But their acting was somewhat overegged and one-dimensional. Which is a real shame as this prodcution introduced the idea that Lear had abused his daughters, and would do so again if he didn’t get his way.

The fool was excellent, as was Gloucester who gets his eyes gouged out, and the lighting made me truly believe there was a raging storm – wonderful. Edmund too deserves praise for his humour and lightness of touch that endeared himself to us. The first ‘half’ –  90 minutes – is  much better than the second  – 50 minutes – which seems to enter in to a world of ham acting and comedy simply to tie up lose ends and get it over with. I might have rested my eyelids for a moment during one of the numerous deaths. But over all three stars. Good, but not great.

And the seats in the Almeida are bloody uncomfotable for a production as long as this!

Mortifying moments

September 25, 2012

For those of us used to being in control, having children can be a very rude awakening. Not just when they are tiny and do not seem to understand the requirement to sleep soundly through the night, but as they get older and start to ask searching questions of you.

Of course different children require different information at different times, but they never ever ask the questions when you are ready for them. Small children particularly seem to  have some inner compass that can spot a mortifying moment maker and will ask their burning question as you queue in the supermarket on a dull Thursday afternoon on the way home from school.

Or, as in the restaurant queue on the cross channel ferry one of ours piped up loudly, “Why is that woman so fat?”  It was said not out of malice or approbation, but simply out of curiosity. Trying to laugh it off and half pretending one hasn’t heard doesn’t wash with four year olds. They just keep asking. And will formulate their own theories as to why if you don’t actually give them something to think about.  One has a desire not to offend, but also to educate the children. One cannot simply lie. Ineffectual PC- isms that ” People come in all shapes and sizes,” or “Don’t say fat, it’s rude” cut no mustard. Unusually for these kind of questions, my husband was actually there at the time .  I think it is virtually the only one he’s ever had to answer as they always seemed to come up when I was with them and he was at work. .

Anyway, he did his usual “Dad Fact” routine, where he gives an explanation with authority and the kids believe it. Despite it often being a crock of shit. But this time he did actually tell the truth, after he pulled out  his trump card.  “I studied nutrition at university” (Gillian McKeith eat your heart out – it may have been a module on ruminant digestion tbh), and went on to explain if you eat more than you exercise, eventually you get fat. And he was able to do this whilst steering the children out of earshot of the assembled masses. Masses being the operative word. So that one went pretty well I’d say, although the child had no doubt unintentionally  emabarrased the overweight person in the queue.

Everyone anticipates the standard   “Where do I come from?’ at some point, but less common ones like “What does sex feel like?” ,  ” What’s a blow job?” and “How do you know if you are ready to have sex?” can require some forethought to give an answer that bears repeating. And they will be repeated. All explanations by parents get repeated. Not just to their mates, but also when you are out with friends or grandparents  and a related subject comes up. Like kissing. And a seven year old will say “You kiss Daddy’s willie don’t you Mummy? That’s what Mummy’s do when they love someone isn’t it?” And the aforementioned explanation of a blow job can somehow seem precocious and you wish you’d just told them to ‘Run along and play’ instead of actually answering the question.

And even seemingly inocuous statements can sound like you have bizarre conversations when it is repeated by an eight year old. Talking about flavoured sparkling water with her new teacher, our very well spoken and polite daughter informed her teacher that her dad said peach water tasted like cockroach vomit. There’s not really much he could say to that.

Atmospheric setting at the Globe. And it stayed dry!

Last night we abandoned Australian rels to go to the first night of Mark Rylance and Stephen Fry in Twelfth Night at the Globe theatre. It marked Stephen Fry’s return to the stage after running away with stage fright (or was it after a bad review?) 17 years ago. So I expect he was nervous.

The Globe is just a magnificent setting and it was packed to the gunnells. And it was great. Played full on for laughs and they got them. An all male cast excelled as women dressed as men dressed as women. Yes, Twelfth Night is the one with the twins who each think the other has drowned at sea, so the girl becomes the male valet to the King and has to court Olivia for him. Olivia, in mourning for her brother, refuses to acccept his advances, but falls for the girl/boy messenger. Meanwhile Malvolio, Olivia’s servant is hopelessly in love with her, and the girl/boy valet in love with her boss…….. You get the idea. Oh what a tangled web we weave. When we also intoduce a drunken cousin, his friend who also tries to woo Olivia, Olivia’s maidservant and a fool, the longlost twin brother and his manservant we have near farce.

Yet again Rylance alone  is worth the price of the ticket. He plays Olivia and the stage lights up when he is on. He is absolutely fucking awsome. Dressed head to toe in a corseted black dress, with a high neck ruff and a black veil so we cannot see his face. Yet STILL he can convey every inuendo, every slight winsomeness, every beat of melancholy. He physically embodies the character as if he is transformed in to her. He glides across the stage as if on wheels. He plays with the language with such ease and accomplishment – tripping over words, stumbling as if they are just being formed in his head. One forgets entirely this is Shakespeare. This is sheer fun and enjoyment.

His maid (reminiscent of ‘Nursie’ in Blackadder) was also completely on the money – with marvellous expression and intonation. And perfect comedy timing. The final ‘woman’ – Viola – too was a complete victory – (s)he was played expertly and you could watch her falling in love with her boss and really believe it was happening.

But what about Stephen Fry? Well he was good. But not brilliant .Too much like Stephen Fry. Who I love. And I’m not meant to love Malvolio initially.  He was not unlikeable enough at first and then not quite smarmy and smiley enough after the trick is played on him. I think he needs to push it to the edge more and be more extreme in his portrayal, but this was his first night and I think he’ll warm in to it. The one that perhaps let them down was the jester – which is actually a big part and his diction wasn’t clear enough for me so I missed things particularly in the first half.

But if you get chance to see it do go – it’s Shakespeare as it should be.

Memory lane

September 20, 2012

So, four nights away in the Yorkshire Dales and I may have eased a bit too far away from the walking as I seem to have simply eaten. And eaten. And drunk. Without the self righteous justification of having been up and down a hill or two. I was too scared of reigniting the injuries (see posts passim) of our last walking weekend that His Nibs agreed to small strolls. On the flat. And one day he did a decent walk and I lazed about on the gold duvet and called for room service.

Two hotels for two nights each and luckily the second one was better than the first. It would have been a struggle doing it the other way round. But recommend the Traddock in Austwick if anyone wants a break. http://www.thetraddock.co.uk/

Even had good food – which is fair praise indeed coming from us. Lovely staff, beautiful surroundings, luxurious rooms and sumptuous toiletries. I always think it is a good sign when you see the full size bottles of Molton Brown in the shower. And a rolltop bath in our bedroom.

And on our first day we retuned to my old stomping ground  – the Friarage Hospital Northallerton. Completely unrecognisable. Half of it bulldozed down and rebuilt a huge modern looking place. But luckily the doctors residences still looked the same. They looked fairly shit then. And they looked fairly shit now. Some things don’t change.

And then we found the pub that we used to go to – even if we were on call. The switchboard would ring the pub and we’d answer it from the other side of the bar. Ah, those were the days.

Similarly for hubby, our route home took in a pub that he hadn’t been to in 32 years but apparently sold the best pint he’d ever tasted, and then revisiting his university halls, his local (that looked the grimmest dump you’d ever seen) and the house he shared for two years. Of course he’d never driven round Bradford before so he had no idea how to get between all these places unless walking ‘through a ginnel’ or across a green. But we got to see them all somehow. And he tried to persuade me that people have the wrong idea about Bradford, and the sun shone on the york stone buildings. But I wasn’t really convinced. I think perhaps you have to live it to love it.

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