Wednesday, January 9, 2013

Rugged Vermonters

Sam has been in the computer business for 25 years and is finally sick of the stress. He quits his job and buys 50 acres of land in Vermont as far from humanity as possible. Sam sees the postman once a week and gets groceries once a month. Otherwise, it's total peace and quiet.
After six months or so of almost total isolation, he's finishing dinner when someone knocks on the door. He opens the door to find a big, bearded Vermonter standing there.
"Names Enoch...your neighbor from four miles over the ridge...having a party Saturday...thought you'd like to come."
"Great," says Sam. "After six months of this I'm ready to meet some local folks. Thank you."
As Enoch is leaving he stops, "Gotta warn you there's gonna be some drinkin'."
"Not a problem...after 25 years in the computer business, I can drink with the best of 'em."
Again, as he starts to leave, Enoch stops. "More 'n likely gonna be some fightin' too."
"Damn", Sam thinks. "Tough crowd." "Well, I get along with people. I'll be there. Thanks again."
Once again Enoch turns from the door. "I've seen some wild sex at these parties, too."
"Now that's not a problem" says Sam. "Remember, I've been alone for six months! I'll definitely be there. By the way, what should I wear?"
Enoch stops in the door again and says, "Whatever you want, just gonna be the two of us."

Tuesday, January 8, 2013

Ever Wonder Why?

The US standard railroad gauge (width between the two rails) is 4 feet, 8.5 inches. That's an exceedingly odd number. Why was that gauge used? Because that's the way they built them in England, and the US railroads were built by English expatriates.
Why did the English build them like that? Because the first rail lines were built by the same people who built the pre-railroad tramways, and that's the gauge they used.
Why did "they" use that gauge then? Because the people who built the tramways used the same jigs and tools that they used for building wagons which used the same wheel spacing.
Okay! Why did the wagons have that particular odd wheel spacing? Well, if they tried to use any other spacing, the wagon wheels would break on some of the old, long-distance roads in England, because that's the spacing of the wheel ruts.
 So who built those old rutted roads? The first long-distance roads in Europe (and England) were built by Imperial Rome for their legions. The roads have been used ever since.
And the ruts in the roads? Roman war chariots first formed the initial ruts,  which everyone else had to match for fear of destroying their wagon wheels. Since the chariots were made for (or by) Imperial Rome, they were all alike in the matter of wheel spacing.
The United States standard railroad gauge of 4 feet, 8.5 inches derives from the original specifications for an Imperial Rome war chariot. Specifications and bureaucrats live forever. So the next time you are handed a specification and wonder what horse's ass came up with it, you may be exactly right, because the Imperial Rome war chariots were made just wide enough to accommodate the back ends of two war horses. Thus, we have the answer to the original question.
Now for an extra-terrestrial twist:
When you see a photo of the Space Shuttle sitting on the launch pad, there are two big booster rockets attached to the sides of the main fuel tank, These are solid rocket boosters, or SRBs. The SRBs are made by Thiokol at their factory in Utah. The engineers who designed the SRBs might have preferred to make them a bit fatter, but the SRBs had to be shipped by train from the factory to the launch site.
The railroad line from the factory had to run through a tunnel in the mountains. The SRBs had to fit through that tunnel. The tunnel is slightly wider than the railroad track, and the railroad track is about as wide as two horse's behinds.
So, the major design feature of what was one of the world's most advanced transportation systems was determined over two thousand years ago by the width of a horse's ass.
Next time you are wondering why something is a particular way, the answer may be something like this.

Saturday, November 17, 2012

When you find yourself going through Hell, keep going.

The title of this piece is a quote from Winston Churchill, one of my favorite historical figures. Great Britain was fortunate to have Churchill as its' leader during World War II (as we were fortunate to have Roosevelt). Churchill's advice probably served him well most of the time, but his political career had its' ups and downs, so it is probably an approach that should be used with some discretion.
When Vermont State Hospital was flooded by Tropical Storm Irene and forced to close, we were all faced with a huge problem (actually multiple huge problems). We had two basic choices: deal with it or quit and walk away. The day after the flood, when the hospital was evacuated, and staff went with the patients to multiple locations throughout the state. People stepped up because it was an emergency and it was the right thing to do. As days, weeks, and months passed, though, the "emergency" became chronic. Some people left to go elsewhere to provide some stability in their lives, other left because a political decision left them without a job.
The last year has taught us to be creative, to be frustrated, to be hopeful, to be disappointed, to feel appreciated and respected, to feel discarded, to feel tired, to name a few. Not every day has been bad, but not everyone wants to follow Winston and keep going (nor should they). We are not the organization we once were. Vermont State Hospital is gone for good, although some of the people remain to start over in a new adventure. For those who don't want to continue, I respect the decision; it is a personal choice that people are free to make, especially since we are not in a crisis at the moment.
During the flood, Winston's advice was the right thing to do. Now that time has passed, and decisions have been made (some we thin are OK, others not so much), people can and do choose not to "keep going".
Regardless of the path we choose, many of had the opportunity to share an experience that will stay with us forever, and that we kept going when we needed to.

Tuesday, August 14, 2012

Lord Falkland's Rule

I learned a very important management lesson from this long-dead gentleman. Lord Falkland was at the height of his power in England in the 1740's, and the islands in the South Atlantic are named after him. While he was a powerful man, he learned the importance of using discretion in the exercise of his power.
What later became known as Lord Falkland's Rule: "When no decision needs to be made, it is important that no decision is made." Simple but, when one thinks about it, damned good advice. How many of us have been in situations where things were chugging along smoothly when someone higher up the chain thinks they can "tweak" things and make them even better, but turns the situation into a quagmire? For me, there are too many to count and I do my best to forget them. Power should never be used simply because one can, but we have all met so many who never learned this.
A recent example of this involves a co-worker who was asked to prepare a report involving data from a project she was working on. The deadline to complete the report was a couple of hours, and she worked feverishly to put it together. The individual who wanted the report went to the meeting without contacting her to get the report to take along; an obvious example of a decision that didn't need to be made.
While this is a simple, harmless example (annoying, maybe, but harmless), other examples are out there that are more dramatic. President Bush's decision to invade Iraq over the non-existent Weapons of Mass Destruction is a prime example of a decision that was made that didn't need to be. The decision by the FBI to storm the Branch Davidian Compound in Waco, Texas is another one. You can probably give a dozen other examples.
If people in positions of authority knew and practiced Lord Falkland's rule, life would probably be a lot better in many respects for most of us. Unfortunately, we don't have a lot of control over this, so being prepared for some occasional chaos is not a bad idea. On the bright side, it helps keep us from being complacent.

Saturday, July 28, 2012

Always sniff the carcass before you say "yes".

Did you ever learn an important lesson from someone that has stayed with you for the rest of your life? I first met Farhad Sholevar in 1990. I had started working at Lehigh Valley Hospital after nearby Easton Hospital decided to close their psychiatric unit, putting me out of a job. LVH offered me a position as an Assistant Nurse Manager on their psychiatric unit.
Dr. Sholevar was one of the attending psychiatrists that I met when I started working there. He was born in Iran and had served in the Shah's army before finishing medical school and emigrating to the United States. He had completed a psychiatric residency and had moved to Allentown to open a practice.
LVH had three distinct psychiatric units (two adult and one adolescent) with a Medical Director for each who was salaried as a part-time employee. The attending psychiatrists were not employees, rather, they had "privileges" meaning they could admit and treat patients, and they made their money by billing the patients they treated. One of the attendings, who is still there, was famous for admitting and "treating" up to 40 patients between the 3 units (we had a total of 54 beds). You can imagine how much quality time he spent with each patient, but they loved him and he managed to rent an apartment in Paris every summer for a month to vacation with his family, and had over 2000 patients in his outpatient practice.
The attendings took turns being "on call" at night. They did not get paid to do so, but it was a requirement for them to take call as part of being credentialed to be on staff. The mental health statute in Pennsylvania was modified in the late 1980's to require that anyone involuntarily committed had to be admitted to a community hospital, rather than a State Hospital. This meant that hospitals having someone sitting in their Emergency Department who required psychiatric admission would need to do a creative job of "selling" the patient to another hospital's psychiatric unit. If a particularly challenging patient was sitting in our own ED, they oftentimes came to us because no one else would take them. It was not unknown for some especially undesirable patients to sit in EDs for several days before some hospital (sometimes quite far away) could be convinced to take them.
The title of this piece comes from a conversation I had with Dr. Sholevar when he was sharing with me his philosophy about screening referrals for admission when he was on call. I'm sure it had it's origins in Iran from his earlier days, but the idea behind it makes eminent sense. When one is faced with an important decision, it is always a good idea to ask questions, to "sniff the carcass" in case things just don't smell right. Sometimes you had to take the patient regardless, but you also sometimes could avoid a train wreck.
So, the next time you are contemplating buying a house or car, moving, taking a new job, getting married, or anything else that's important, don't forget to sniff the carcass first.

Saturday, July 7, 2012

Turd Polishing

The title of this piece comes from one of my fellow Psych nurses in New Zealand who was labeling something that was a waste of time. My management training called it "non-value added"; my former attorney called it "mental masturbation." Regardless of what you choose to call it, we have all experienced it.
One of my favorite fictional examples of this is a Monty Python skit entitled "Cheese Shop". In the skit, a man enters a cheese shop and asks the clerk for a particular kind of cheese. The clerk responds that they are out of that kind, and what follows is a back and forth of requests for other types of cheese (Stilton, Colby, Venezuelan Beaver Cheese, etc.) answered by a litany of excuses as to why there isn't any (the van broke down, it gets delivered on Tuesdays, the cat ate it, etc.). Exasperated, the customer finally asks if there is any cheese at all in the shop and is told there is "not a scrap; we're deliberately wasting your time."
All of us have probably been involved in situations where we are in the virtual Cheese Shop having our time wasted (at least from our perspective). That being said, one of the life lessons I learned the hard way is that, if some Vice President has an idea, it's a good idea, no matter how silly you may think it is. If you have worked in a large organization, and you are far from the top of the feeding chain, you have probably experieinced some of these "Cheese Shop" moments, although it was probably not safe to point out your views on the situation.
An example of this from one hopital where I worked was the "Leader Greeter" program. The Chief Operating Officer came up with the idea (it was, of course, a good idea) to have managers and administrators "volunteer" to spend a half hour at the entrance to greet people when they entered from the parking garage. For something like this, you would hope that there would be some measurable outcome or other reason for doing it. Even when my cat licks himself between his legs, he has a reason (because he can). For this one, though, I couldn't see any value. If I was one of the people coming in from the parking garage, I would be thinking "Don't you have anything better to do with your time?" Interestingly, after the COO got fired, Leader Greeter apparently died a quiet death.
Unfortunately for you, unless you are near the top of the ladder in your organization, Turd Polishing is likely to be a normal part of your existance. You may not like it, you may not be able to avoid it, but at least you can reconize it for what it is and value it accordingly.

Tuesday, July 3, 2012

Lying Pig-Dog Weasels

Mom and Dad taught me not to lie to people. Even though it has limited my career, my integrity is more important to me. While I will never get to be Vice President of anything, knowing that people can and do trust me is much more important.
I remember being told in one of my management training classes long ago that sociopaths or people with sociopathic tendencies often became very successful leaders of profitable corporations. I guess to sometimes be successful, one has to make decisions that sometimes do not favor the individual employee. Many people may remember the CEO of Fletcher Allen Health Care, who was convicted of lying to regulators and was sentenced to a year in prison. I have worked for others who were equally, if not more sleazy; they just didn't get caught.
What these people fail to realize (or don't care about) is that, if they lie to us and we figure it out, we aren't likely to believe anything they say going forward. As a manager of 25+ years, this was an important lesson for me. If I were to lie to my staff, I would have no credibility, and this was something that was unacceptable to me. Think about it. Who would you rather trust: someone who you knew to be honest, or deal with someone who you wouldn't trust if they told you the sky was blue?
Oftentimes, managers may be placed in a position where the actual situation should not or cannot be disclosed for some reason. Face it; we are not always free to speak about everything. Some managers I know have gone the route of shading the truth. My approach has either been to tell you I am not free to speak about the situation, or to tell you "This is what I know as of today." You may not have gotten the true story, but you also weren't lied to.
Many politicians would seem to fall into the category of Those Who Frequently Tell Whoppers. I moved to Vermont from Pennsylvania. While I was in PA, I was amazed at how corrupt a political system could be. When I go back to visit relatives, and read the local newspaper, it is a rare occasion when I don't read about a State Legislator or staffer either being arrested, on trial, or going to jail for corruption. Politics seems to be less about public service and more about how one gets re-elected. Congress has an abysmally low approval rating for a reason: they earned it. I have never voted in my life, and I can't imagine ever doing so. To me, the system is broken, and, even though I can't fix it, I can choose not to participate in enabling it to continue on it's dysfunctional path. My wife tells me I have no right to complain because I don't vote. I feel I have every right to complain because I didn't do anything to make the system continue as it is.
Even though I am destined to go no further in my career than being a middle manager, looking at some of the negative role models in my life, I don't consider that to be a bad thing. Mom and Dad: Thanks for raising me the way you did.