What the hell was all that about?

His importance so overwhelmed him that he forgot to breathe..

Long into my career and after three years in senior leadership I found myself sitting in the Top Office on the wrong side of the desk. Opposite sat what appeared to be the entire Board, flanked by a large number of suits. Some of them I recognised from their carefully curated (Photoshopped?) media shots, others I’d met face to face a few times. I doubt anyone remembered those encounters though.

To my right I had two ‘companions’ both senior ranking-Grey Suit and Blue Suit. But I was still unclear about who was there to support who. As far as I knew, and despite best efforts, neither seemed remotely familiarised with, or even interested in the detailed brefing I had on the laptop nestling on my knees. Was this all part of the game? They looked relaxed, matey, and I felt marginalised already. As we waited to start I had a rising sense of panic that they fully intended to blag their way through a meeting varioulsy billed as ‘check- challenge’, ‘stress-test’ or, I sensed, cluster-fuck.

My co-workers, similarly of limited experience, had cheerfully launched me in there with the expectation that our perfectly formed thing would be either tyre kicked or tested to destruction..

“So don’t mess it up, you will be fine-ha ha ha!” Pat, pat, shove.

Eyes skyward-“Ha fucking ha indeed..”

But the clinician in me also sensed something a bit off, the kind of feeling you get when a patient suddenly does something unexpected like have a generalised convulsion, cardiac arrest, vomits on your shoes or just lunges out and punches you in the face for no good reason. The week before the boss had summarily dispatched two key deputies in a blaze which sent rumours flying of a major shake up in the Board.

Inexplicably, both individuals now sat opposite me looking sanguine and ready for a fist fight. When I was a kid, perpetually bullied by the yobs I went to school with, I would normally cross the road to avoid such encounters.

No such luck here though. Trapped, I tightened my fists, ready to bruise knuckles and spill some blood.

My brief had been to set out the detail of new implementation plans. There was a lot of money and reputation on the table and it seemed we all felt the weight of getting these new commitments, the plans I had spent the last year assembling, delivered into front line clinical practice.

The Board looked tired and grey. We all did-years of sunlight deprivation probably hastening return to our reptilian origins. More people edged in behind me, more chairs were wedged in. Some were left standing. We all shuffled up, knees touching. Cast of thousands. The boss glanced up, flashed acknowledgment round the room then dived back into his iPad, fingers jabbing. Grumpy? Disinterested?

At the last minute a prima-donna appeared-gliding to rest amid the throng, ready to support or anihilate depending on how things played. Smiles and hushed chortles exchanged, comfortable and unthreatened. Bathed in carefully circumscribed adulation. I tried not to glare, failed and smiled, conscious that when I do so my face still looks angry, my irritation on full show.

I was a novice in these settings but others were clearly in their element. Caught completely unawares, I was still casually admiring the sunlit view of the City’s hazy skyline as we set off, cantering through the preliminaries before too quickly rounding the first sharp bend. Like a three legged horse I stumbled to keep up, laptop smugly logged off, papers skittering out of reach under the table. And then the real fun started.

Imperceptably the boss had signalled for his primary deputy to take the lead. The first punch landed hard and fast to my extreme right.

“Page 17. The survey from 2016. A few years old now. Says you have 50% coverage at baseline?”

Grey Suit bouncing to my right dived straight in-a bit too quickly I thought: “Yes that’s right-you know this already, err.. common knowledge, come on -let’s err, move on”. Smile. Grin. Smile with menace, eyebrows raised. I had worked with this character for the last few months. While erudite and an intellectual, the supercilious dismissals always came thick and fast. Think Pythonesque Roman Emperor.

Many of those surrounding Grey were all too happy to characterise the more extreme behaviours as those of a person of questionable sanity, possibly with no grip on reality, given to talking in riddles, sending minions scrambling for unfathomable classical tracts from which they hoped to decode the messages that would guide them to the promised land. Lesser courtiers appeared perpetually confused, a few frankly terrified.

As a moderately well informed health professional I could not disagree that this person’s tendancies were at best extremely amusing and at times somewhat alarming.

I had, a few months before, challenged Grey during a standing lunch and seen how quickly the the lip curling snide arrogance jumped out. With a height advantage, I was peperred with scorn, ridicule, and partially chewed sweetcorn-mayonaise casually stuffed into Grey’s mouth while still swaying beligerently on the launch pad.

In full flight it must be said Grey was a rather spectacular sight-shoulders back, lips pouting, nostrils flaring, hair spikily aloft, rapidly gaining height and defying gravity until raised en pointe, the tumult finally spat forth in a hail of bluster and nonsensical riddle.

The effort expended in doing this, I had witnessed, seemed to leave Grey sapped and dishevelled, a limp, spent body slumping back under gravity to whatever convenient landing site lay beneath. At this point the Emperor’s hand would emerge from the wreckage, wafting away any residual sparks of discontent which might threaten to immolate the spectacularly opaque verbiage that had just spewed out. A learing grin would spread across Grey’s clown-like face as fearful followers scattered to gather up the nuggets of wisdom before they evaporated. It was from this carnage that we were expected to hastily assemble a new fabulous project.

“No-I don’t want to move on”. Second Dep stared hard.

“Page 19: the delivery trajectory-so in five years you will be at 28% implementation?”

“Ha ha..HA!” engines firing “If you listened to what I said, we are starting at FIFTY percent!”

Second Dep grabbed the brief off the table, flipped back and forth: “So is that 28% of 50% then, are we going backwards? Or 28% on top of 50%?”

Grey: “Yes..err the last one, err second one..look. This thing is already pretty much there it just needs..” hands illustrating “sprr..ead..ing!”. Heavy emphasis on the ‘purr..’

Second Dep: “Which one?”

Grey: “What?”

Second Dep: “28% of 50% or 28% on top of 50%?”

Grey: “I just told you-whatever I just said-AND..err everywhere!”

Hurahh for that! Silence.

Second Dep: “28% of what?”

Grey: Irritable now and engines roaring-how much longer could the launch pad hold this force..? “Err..”

Second Dep: “So is that 28% of something, in which case, of what precisely? Or is it 28% of the country running at..” flips the brief “100%?”.

Blue suit to the rescue “In five years we expect to get to 28% on top of the existing 50%, so 78% everywhere”. Smug smile

Second Dep: “Of what?”

I wasn’t wholly sure but thought I heard Grey mutter “For fuck’s sake” before glancing around the room , finally alighting on the prima donna where knowing smiles were exchanged and the dark suits murmured into their laptops, puttering away at unseen spreadsheets.

Blue: Confident now “That would be 78% of a full service at all locations within 5 years.”

Second dep: “Have you got the investment to do that?”

Grey: Irritable “Yes.. AND.. it will be by the end of NEXT year!”

Second Dep: “Where does it say that?”

Grey: “It doesn’t-I just decided it..”. The laptop puttering went up an octave and suddenly there were a lot of faces visible, eyes blinking as they emerged from cyber-gloom.

As I stiffled laughter, or was it nausea, I suddenly realised that, entertaining though this was, I was actually supposed to be helping. It didn’t feel like it was going too well but the Board were hard to read and the Boss still immersed in his iPad-was he doing emails or playing Candy Crush? Hard to say from this angle. Quickly rehearsing my opening line and clearing my throat I decided to leap in, laptop at the ready-hurrah!

Me: ” Actually I do have the full clinical, financial and workforce modelling here and can explain exactly how this will work on the ground and over what timescale..”

The hand came up so quickly that I almost missed the executive call for time out.

The Boss: “Its OK, you’ve been very impactful, but I have this.” Silenced midflow. The prima donna smirked as I shrank back into my seat. My show was over. What a loser.

The Boss pointed to Third Deputy to resume the punch-up. The suits all closed in. Grey and Blue swung back off the ropes and into the ring, bouncing, ready for action, two against err.. fuck there were so many suits and so difficult to know who was on which side, or even if there were sides..

Third Dep: ” Says here you will have a full team at each site-so what exactly does a team look like, from a patient perspective?”

Blue: Confidently “Best to think of it in terms of a fluid arrangement, circumstances change according to patient need, service demand, time of year-but we have the models..” Grinning and elbowing me like we are best mates. Words failed me.

“.. and this all needs rostering-technically hard to do, and explain, but we ARE confident that this can be done at pace and the system is primed to go. In fact most are already on with it. Its really just a case of levelling up the laguards.” Grinning at Grey.

Third Dep: “Just trying to understand-so what does a team actually look like, for example, how many of each type of professional are we talking about, in an average situation, say..?”

Grey’s hand goes up. Engines firing again.. ideas sparking from both ears, this baby is going to BLOW!

Grey: Hands flying ” So we get a bunch of these and some of those and sprinkle in some of them..and err..”

Inching off the launch pad now, we are on our way to the fucking MOON here guys! This is AWESOME!!

Grey: Fully aloft: ” We put them in a blender, press GO and voilà-TEAMS!”

Oh my God, we’re fucked. The keyboard puttering is now at full fever pitch, I can actually smell stale aftershave and perfume as it breaks free from tightly buttoned collars on the other side of the room. Sweaty heads start bobbing up and down like coloured balls in a kids’ ball pit.

Second Dep: ” That sounds like shit-ade to me!”

The Boss looks up-“Let’s move on..err page 24 I think?” glancing over to Third Dep.

The one hour meeting grinds on and no one seems in a rush to get to the end except the prima donna who glides out all smiles and loveliness, leaving us still thrashing about in the carnage. School run or gym I ponder?

Then its all over. We are hastily ejected, the throng scatters. Grey plants a hand firmly in my back and we are shoved down the corridor into another office to re-group.

Grey: “Went pretty well..err all considered?”

Blue: Nodding “Got what we needed..yep..still a bit of tidying up..but err pretty much there I thought..”

I sit there listending to this wondering if I had somehow managed to be present in a different meeting. No-definitely in the same meeting.

Grey: Wafting and aloft-does the fuel ever run out? “So in actual fact the err..um investment is in fact the err..um um investment..when you take into account the err..” We were actually nodding trying to keep up- but I for one had no clue what was supposed to come next.

More wafting “Exactly…the inflationary uplift, cost recycling..err..et cetera..”

Blue: Impressed and enthusiastic “Yep-need to get on with all the detail now..” waving to me “So if you can, err, draft a one-pager setting this out as a straw man with deliverables, we can, err, kick it around via email-get it to them by..err..shall we say end of the week?”

Grey: Dialling a call and distracted, waving me out “Great-thanks!”.

Ejected back onto the corridor I am briefly alone, dizzy, dehydrated and fogged. As I set off in the wrong direction my co-workers pounce and shove me into another office.

“So..how did it go?”. Hopeful smiles..eager, excited. My stomach grinds.

” Hard to say-I think we are fucked. But I am the only one that seems to think that-so not sure. Grey wants a one-pager by the end of the week? Sorry guys”.

” Great! Well done! It will be fine-we’re already on it!”