On hierarchy

One of the things that really bothered me when I was working in the public hospital system is the pronounced (and revered) hierarchy of the medical industry. In short, it is what people call “top heavy”. If you’ve ever read ‘The House of God’ by Samuel Shem, even if you know nothing about it from personal experience, you’ll realise that this is a universal system of our industry. There’s an almighty, infallible boss at the top of the pyramid who ‘makes the big bucks’ and has his name attached to the patients “in his care” – even though he may not even be aware of these patient’s existence. Then there’s the half-bosses, charged with making all the hard decisions and often physically doing some of the too-hard things. He makes reasonable money, and you see him once or twice a day, but he also rarely sleeps. Then there’s the minions, working for scraps of money, working for almost every minute of every workday, being dealt all sorts of unpredictable tasks, and who is for the majority of the time a secretary with a medical degree.

If a scenario came up where the minion has just walked across a desert fighting off bullets and helping out injured civilians; he is met at the difficult battles by the half-boss who takes an armoured vehicle from one hard battle to the next (but driving by the lesser battles); and they are met at base camp in an air-conditioned shelter by their godly boss who has been driven in by chauffeured limousine from his 5-star hotel only seconds ago – who do you think will be offered a chair and a cold glass of water? Not the dehydrated, wounded minion with blisters on his feet. No. The boss will take the chair and the glass of water and not even thank anyone for it – he is the boss, apparently he deserves it more than the others.  And that’s life. That is not just the medical industry or the military, it is probably most industries! And that is why I had to get out of the public hospital system.

There’s also another story I don’t often tell about my experiences in the hospital system, and it is related to the above concept, but also about a certain type of discrimination. See, another thing about working in a hierarchy is that you have to respect and worship the hierarchy. You have to! Otherwise how are you ever going to make it to the top if you don’t play by the hierarchy’s rules, worshipping the people above you for their pity, grace, and reward? This is where I went wrong. My mistake was choosing to be honest, and choosing to be true to my own convictions. My mistake was also to be born flawed – but I’ll get to that later.

I was working in a team that was just like any other hierarchy I just described. I was a minion, of course. One day, through no fault of my own, I got sick and couldn’t come in to work. Oh my mistake! I received a reprimand from a (half) boss for staying home sick – how dare I?! But my mistake went even further than that. My mistake was that I refused to kiss ass, or to apologize for being human, to give an excuse or apology for being unwell that day. And I told the boss quite clearly that I would not apologize for being sick. So began my downfall. The next day when I arrived at work I was “kindly invited” to a surprise evaluation of my performance, a discussion led by my boss before a panel of hospital “Gods”. Oh, what a terrible worker I was! Late in the mornings, slow, lazy, absent on so MANY occasions, time-waster, friendly with too many other staff members, too well-like by administration and ward staff, etc. etc. I guess you can’t really say “she’s an insolent b*tch who won’t kiss my ass like she should” so you have to phrase it differently, even if slanderously.

I was then politely asked my opinion to his allegations. Needless to say, I was speechless. One day I am away sick at home, and the next - without warning – I am asked in a panel if I dare to contradict the guy who grades my assessment and who can end my career right then and there if he chooses to. Yep, seven years of university training, a $70,000 student debt, and a lifetime of passionate pursuit of this career on the balance. I kept quite. Even if I could speak, I’d had no time to prepare my defence (aka, stating the truth correctly). In my silence, the man hearing the case, summarised my case based on what was said about me. Clearly I was ALWAYS late to work. Clearly I had TOO MANY days off sick. Clearly I LACKED ENTHUSIASM for my job and my team. Clearly I was SLOW. Clearly I was LAZY. Clearly it meant I was WASTING TIME becoming friends with the people I worked with every day. Clearly I was guilty, because the boss who is higher up in the hierarchy than me said so. I then made only one comment; I said “it sounds like you’ve already made up your mind”. Yes, yes, the panel had. Never mind the fact that I had been working on this team for over 3-4 months with no complaint made about me, that no complaint had ever been made of my performance ever, and that these statements were great generalisations of that one time I was away sick. Was it a coincidence that all these allegations came to light from the man I had apparently disobeyed by being human and being sick, and that they came to light the day after I had refused to kiss his ass? Apparently so.

But before the panel “discussion” was over, one final point was raised. Was it not true that I suffered what is commonly called depression? After all, this can lead to increased work absenteeism, to tardiness, to lack of enthusiasm, to general slowing down… Oh, this is when I lost it! Talk about discrimination – and coming from the same profession that should be advocating against this type of prejudice. It didn’t matter that the things that I was accused of in an act of spite, of revenge, to put me in my place, to hurt me, were false; what mattered was that I had a condition which obviously must apparently make the allegations true. And I lost it because you can’t wash these things off. Did I not suffer depression? Yes. ‘Well, then that must mean that you are slow and lazy and unenthusiastic and take a lot of days off work…’ The only thing getting in the way of that theory was that these allegations weren’t true in the first place. And I was completely symptom-free at the time this all happened. But I couldn’t say no; that would be a lie. It was to me like being asked “isn’t is true that your skin is brown?” or “isn’t it true that you’re Latin?” or “isn’t it true that your native language is Spanish?” But I won’t be ashamed of my skin or my culture or my language, I wouldn’t deny them. It seemed to me at that point that in this world it is politically incorrect to be racist, but not so to discriminate against those with a history of mental illness.

I must admit I have had times where I wish my defect was in my skin or in a spot I could just have surgically repaired and then be on my way. It’s not that easy. If you have a mole on your face that everyone stares at when they look at you, it makes you uneasy. But at least you can have that removed and be more appeasing to those that are superficial and judgemental. What so many people wouldn’t give for a solution that easy.