Thanatoeconomics and Healthcare Reform

I was going to write a post about Nataline Sarkisyan, the young woman who died while waiting for a liver transplant - because Cigna Healthcare, her family's medical insurer, was practicing thanatoeconomics - a.k.a. "business as usual" -

but someone else already has.

Thanatoeconomics

Approximately 12 years ago, having recently passed the age of 40, I was thinking about my "life experiences" and about the changes I'd observed in U.S. society since my childhood.

Among the things I'd observed were that:

- it usually requires at least one traffic death to get a new stoplight installed at a dangerous intersection or crossing

- food banks and 'charity clinics' tend to be open, at least in my area, during 'upscale retail' shopping hours only [viz., M - F 10 - 4] while the people who need these places most are generally locked into 7 - 4, 8 - 5, or 9 - 6 subsistence jobs with no paid leave, and lack personal transportation to reach these places quickly even if they were free to make the attempt

- although our society claims to deplore domestic violence, it is virtually impossible for a battered woman to obtain a protection order on any weekend or holiday, because the family court system is closed at those times. However, these are precisely the times when domestic violence is most likely to break out, and women are most likely to be in need of protection orders

- many 'social services' in my area that I had begun to investigate first hand [as someone dealing with multiple simultaneously terminally ill loved ones] operated under 'restrictions' that effectively disqualified me, my loved ones, and others like us, from being able to use them. For instance, hospice, respite, and elder transport care available on a county by county basis only, when my loved ones were dying in one county, and I was living in the next one over.

- while insurance and healthcare costs were skyrocketing, more and more people seemed to be losing coverage for paradoxical reasons - such as actually filing a claim on their policy if, say, a tree fell on their house, or their 11-year-old was diagnosed with leukemia

- and good luck to you if you experience a natural disaster, love your pets, and refuse to abandon them. Years before Hurricane Katrina, a local ice storm knocked out power to the entire two-city metropolitan area in which I live; people metro-wide were risking hypothermia and house fires, because 'official shelters' and 'warming centers' refused to allow them to bring their animals, insisting that they abandon their pets to freeze alone in the dark, if they wanted care for themselves.

Meanwhile, I'd been observing for years that every time a corporation threw employees to the sharks [aka, had layoffs], its stock, obscenely, increased in value [an observation that resulted in my decision not to own stocks in any firm, ever, that did not grant all employees profit-sharing, and did not make layoffs the option of last resort. No, I don't own much stock.]

When I put these things - and more - together, I reached two very harrowing conclusions:

[1] we live in a society that is shockingly abusive and even more shockingly unaware of the fact

[2] and to all appearances, our economy places money and its accumulation so far above basic citizen welfare that it essentially rests on a foundation of human sacrifice.

Lest you think I am being unduly harsh, ask yourself what it takes to get your school district or county to install a traffic light or pedestrian crossing signals. Virtually always, someone must be either killed or injured, right?

And if you were to discover, tomorrow morning, that an identity thief had stolen every penny of your life savings and cleaned out every other account you have on record, then you got pink-slipped in the office five minutes after your doctor told you that it looks like your child has leukemia, who do you think would pay for your mortgage, your health insurance, your child's medical bills? Do you think you'd have a house in three months' time? Would your child survive? Really?

If you're a regular churchgoer, who's the most recent person in your congregation to lose his or her job, and do they still attend? If they do, are they being welcomed and supported, or avoided? Have they been told that they're suffering these things because they're somehow defective - somehow wrong, bad, sinful?

I could not un-see what I was seeing. The evidence was all around me, and it was all-pervasive. I coined the term, "Thanatoeconomics" to describe it.

An economic system that depends on death.

Literally or figuratively.

I will be posting more on this topic here, at Potemkin's Office. It's the real purpose for which this blog was originally created.

Meanwhile, for further thoughts on this topic, please see TH in SoC's blog The Well Run Dry in which he discusses issues that relate directly to thanatoeconomics, and I finally get over my reluctance to share my thoughts on this subject, and post a comment in which I use the term. TH has already done a lot of thinking on the topic, and also finds the term "Thanatoeconomics" entirely suited to what he sees. Seeing the term in actual use, clearly respected and taken seriously, brought tears to my eyes.

TH is a brilliant writer, researcher, and expository journalist. And, as an engineer, he has plenty of scientific street cred.

He most definitely does the subject justice --

-- and justice, with mercy, are what we all so desperately, desperately need.

Obvious Questions

Just as he apparently feared, Michael Jackson has died prematurely. His death at 50 may have resulted from overuse of prescription painkillers, or from a drug interaction involving them. Presently this is only conjecture, but it's not improbable given the incredibly grueling, demanding comeback tour he was planning, his age, and his apparent prior history of painkiller misuse.

Until the autopsy results are in, let us suspend judgement; and after they are in, let us not be too smug in our assumed superiority to the dead Boy King.

Instead, let us ask some obvious questions - the ones few people seem interested in asking.

Question One:

If, as is being assumed, Mr. Jackson did in fact abuse prescription painkillers, and if this abuse did in fact contribute to his death, why is condemnation being directed primarily at him?

Prescription painkillers, after all, must be prescribed.

And those who prescribe them are, theoretically, bound by oath to 'prescribe regimens for the good of [their] patients according to [their] ability and judgement, and never do harm'.

Isn't it odd that the people who misuse these agents - and frequently die for it - are the ones we seem most interested in condemning? Wouldn't it be far more sensible for us to condemn those who prescribe, dispense, and sell prescription drugs to abusers, in the full knowledge that the drugs are being abused and their patients may be killed by them?

Question Two relates more closely to Question One than might at first be apparent.

Not only by report, but by obvious appearances, Mr. Jackson also seems to have inappropriately overused cosmetic surgery. The near-complete removal of his nose - that dear, brown, flared, snubbed, African nose! - cannot have been accomplished without his consent. Apparently it was a deliberate objective.

This type of surgically assisted self-disfigurement is not uncommon; Googling search strings such as 'celebrity plastic surgery' brings up photographs that will keep you sleep-deprived for weeks. I'm not going to link to any of them here, because I'm still having waking nightmares myself. But again:

Misuse/overuse of plastic surgery is not something that a person does 'all by themselves'. Much, much money is paid. Nurses and anesthesiologists and surgeons and hospital facilities are involved. So why is it, again, that we point and gabble at the patient, and never as much as frown at the 'doctor' - or any other component of this highly lucrative industry?

In other words:

This man, now dead, has been mocked and scorned for most of his adult life, at least in part for having enough money to pay licensed medical practitioners to mutilate and, possibly [pending the results of his autopsy] to poison him.

Shouldn't we instead have scorned and mocked his poisoners and mutilators?

Just a little?

For starters?

A Sad and Fatal Innocence

This blog is primarily about self-deceiving [and other-deceiving] systems and organizations, and the destructive impact of that deception on the members of such systems and organzations, and on society as a whole.

One area in which American society has suffered terribly, as a result of both deception and self-deception, is the area of 'personal finance' - of income, credit, and debt. News accounts of job losses and unemployment figures, bankruptcies and foreclosures, are easily 'tuned out' as dry statistics. But those numbers relate directly to human lives. And, sometimes, to human deaths.

I recently read about the tragic deaths of the Wood family, in Middletown, Maryland. There is an aspect to their deaths that terrifies me, beyond and quite separate from the brutal, horrific acts that took their lives. Beyond and separate from the husband's mental status and possible medication use.

I have read Francis Billotti-Wood's blog.

It's an innocuous, sweet-natured series of little posts, written by a woman who loved her life. And it scares me silly.

You see, Chris Wood's gross income was about $97K at the time of his death. Using a strict estimate, he was going to bring home about $80K this year, if he had lived. Yet his family's debt was $450,000. Half of which, apparently, was on credit cards. And Francis Wood was a stay-at-home-mom.

One man, one woman, three children, a dog and a cat. A house. Two cars.

$450,000 in debt.

They married in 2003. She left her office job in October 2006. Within six years of their marriage - or 31 months of his becoming their sole wage-earner - they were looking at a debt load it would take him 5+ years of his entire 2009 net income to repay - without interest. If they spent nothing, nothing at all, on anything else. Which would, of course, be impossible.

I am trying to imagine debt amounting to five years' net salary, as the sole wage-earner for a household of two adults, three children, and two animals. The thought alone is enough to make me dizzy and sick... yet while these debts were mounting, Francis Wood was innocently posting about $16-a-bottle designer shampoo. [She loved it.]

She and her husband were nearly half a million dollars in debt, with a house going into foreclosure in Florida, hundreds of miles away from their rented house in Middletown; and she was innocently posting about wanting to buy another house.

Reading these things in her blog, while knowing their true situation and her ultimate fate, is horrifying.

I saw no apparent concern about their debt, nothing that even acknowledged its existence. Nothing about the fact that their existing house in Florida had not sold and was going into foreclosure, or that they were still legally liable for the costs associated with that house. Not a word about any concerns that these situations would normally produce.

How can it be possible?

How could this quiet, charming, good-natured soul - who worked full time herself until three years ago - have been unaware of the financial quicksand her entire family was floating upon? Of the horrendous strain that situation MUST have created for the man she married, upon whom she and her children and pets depended for their very livelihoods?

When an entire family dies at the hand of one parent, people often avoid thinking about the event via the oversimplification that "something just snapped" in the perpetrator. I usually think that "something just snapped" should be translated as "he was a complete abuser, a total sociopath, and fooled us completely; and we would rather die than admit that, so this is our method of avoiding the truth".

But in this case, I suspect that something did snap in Chris Wood's mind.

I think he was an increasingly frightened, desperate man; a man who had his back to the wall, pushed so hard, perhaps, by his own desire to be 'a good provider' that he forced himself too far away from too much that really mattered to him. With his parents in FL, wife and children in MD, and a 50-mile commute [one way]...

... in pursuit of more money...

... to service more debt.

Because that is what the "American Dream" had become, and he and his wife, like so many other couples, were simply pursuing that American Dream.

I think he lived in increasing terror and increasing exhaustion for months, perhaps years. Alone with it.

And while starvation and bankruptcy drew inexorably nearer and nearer in his mind, his happy, innocent wife saw none of these things. Or, if she did see the debt, she did not really comprehend its meaning.

I think that in one horrific instant Chris Wood went 'over the edge'. "Flipped" from terror to fury, from flight to fight, and mistook that madness for lucidity.

Struck at his loved ones in their innocent sleep, struck them down horrendously.

Then - rightly - could not live with what he had done and become.

I am afraid - very afraid - that what killed Francis Wood, before the bullet ever touched her in her innocent sleep, was a tragic, terrible failure to recognize, to understand, to see the financial peril that her husband saw no possible way to escape.

That became for him, and thus for them all, a literal deathtrap.

Lord, have mercy.

For Friends Twice Bereaved at Christmastime

Not for you, this year, the easy laughter,
The feasting and teasing and drowsy smiles,
Wading through mountains of discarded wrapping paper
To find the child asleep in the box her treasure came in.

This year the cat will curl on your lap
And reach up his paw to touch your cheek,
Because he knows that wetness does not belong there;
This year the child, now grown, will rest her head
Against your knee, and weep, all gifts pushed away.

That song the angels sang
Will be a clashing, rending dissonance;
Not for you, this year, the hymns of hope and love.

Jesus wept
At the passing of Lazarus,
Wept though He knew his friend would soon live again,
Wept though He knew this new life would be His doing,
Wept though He knew as none other could
How truly all mourners shall be comforted.

It is too soon to think of comfort now.
Never be ashamed to weep.
He who has the right to scoff at Death and Time together
Wept for them both, long years ago.

Today, tears are the proper sacrament.
But as you weep, believe, as best you can:
There will be a tomorrow.

Widowmakers

I originally intended to start this post with a link to an online definition of the term "widowmaker"; but to my surprise, all the definitions I found were either depressingly literal, or depressingly limited in scope.

Loose branches.

Things that kill husbands.

So I'll have to start out by defining the term myself. A widowmaker is just about what you would imagine, from the word: loose branches, say, that kill husbands when they fall.

But not only.

It's an occupational - or extreme recreational - hazard that literally kills the unwary; a military mission from which you are not expected to return; a rogue beast; a 'perfect storm'; a dangerous or defective device or machine that frequently kills its operators; a lethal weapon [the term is often used with great pride, in this context, by owners of same].

But not only.

A widowmaker is also: an insurmountable obstacle, an impossible task, a career-destroying assignment; something that cannot possibly be managed or completed to the satisfaction of all interested parties - if it can be managed or completed at all - and that must be so managed, or completed, as a condition of said assignment or task.

Not infrequently, those who set such tasks, or make such assignments, do so knowingly. Not always out of malice; often, out of laziness, or a desire to escape responsibility themselves.

I have seen a fair number of widowmakers in my time, and have been handed a few of them. Consider, for instance, being responsible for quality assurance, on just about any production line. If there's a problem, and you halt the line [or reject the lot, or whatever action suits the particular product - anything from ballpoint pens to auto chassis to cancer medication] - you're Holding Up Progress and Costing Money. But, of course, if you don't Hold Up Progress And Cost Money, and then something horrible happens to someone...

Widowmaker. Pure widowmaker. You're an Enemy Within, and there's no way you can't be.

I spent years [this embarrasses me now, for reasons that will shortly be clear] trying to figure out how to de-fang my own particular occupation, which was a widowmaker par excellence. Eventually I realized that it was not possible. My very line of work was a widowmaker. It required me to do a job that was impossible from the outset. Hence the embarrassment: it took much longer for me to realize this, or, probably, to admit it to myself, than it should have. I wanted to believe that I did a job my employers genuinely wanted done; even now, with all of this years in the past, I wish it had been so.

Once you've realized, though, that [a] there are widowmakers aplenty in the World of Work, [b] many people in management know this, and [c] the only way to win is not to play, it does become possible to avoid at least some of them, at least some of the time.

I still fondly remember my one Great Escape from a widowmaker in the guise of a Great Opportunity: wouldn't I like to be put in charge of Special Department X? It would involve a promotion, etc. etc.

Fortunately, I knew enough about X to know what I wasn't being told, which was:

-X needed about three times as much staff as it was ever going to be allocated;
-X was sufficiently complicated [not the same thing as complex: complexity = details; complicated = problems] that key managers were either bored with it or afraid of it [because they didn't want to expend any energy to understand it];
-X would therefore never receive sufficient attention from anyone important - because of that boredom / terror [laziness] factor;
-X was therefore doomed from the get-go.

In this particular situation, however, I also knew that someone I liked and respected was likely to be the Next Pigeon In Line, if I turned X down. I didn't want to see this person tied to an anchor any more than I wanted to experience it myself... in fact, I didn't think anyone should be tied to this particular anchor at all.

So I stalled, asked for time to consider the offer, and tried to figure out what to do. I realized that part of what made X a widowmaker was that it was cobbled together as a dumping ground for things Departments Y and Z didn't feel like dealing with. If I could somehow glamorize these things, there was a very good chance that management would suddenly decide that they were much too important to leave in the hands of a greenhorn like me [or the Next Pigeon In Line]; and if a management favorite was given X, then X might actually be given the resources and attention it needed to succeed.

As it turned out, I didn't succeed in 'repositioning' X to management. Completely by accident, I managed something better. I had decided to take a stepwise approach, so I first wrote a memo outlining the critical, central importance of the components of X, and the importance of highly seasoned managerial oversight of these components. My intended next step would have been a modest refusal of X, as a task for which I was simply not yet worthy - hopefully, positioning X as something far too important to be offered to the Next Pigeon In Line, or any other decent innocent in the vicinity.

I never had to write that modest refusal. My analysis of X was seized upon by the managers of Y and Z as a golden opportunity to inflate their budgets by taking over pieces of X - and then, of course, clamoring for the resources necessary to manage such high-value, critically important responsibilities. X was sensibly dissected, and its parts - with all associated personnel - re-allocated back where they should have been all along. Best of all, those parts of X now had sufficient snob appeal that there was no risk of either myself or the Next Pigeon being invited to take any responsibility for them.

I have little doubt that the managers of Y and Z, in carving up X among themselves, thought they were Taking Away Something - from me or the Next Pigeon - or Keeping Me/Us In My/Our Place, or something similar; many decisions in that organization seemed to me to be driven by similar impulses. And I don't want to come across as noble and self-sacrificing, or as some kind of Machiavellian enfant terrible. None of that was true. I was just someone who had finally figured out that employers often destroy their own employees, through favoritism, inertia and disinterest. I was desperately striving to avoid a career-destroying assignment, without simply ducking or throwing it at the person in line behind me, who didn't deserve it either. The only thing that was sacrificed was an illusionary 'success' that would have been certain failure.

It didn't work as I'd hoped. But it worked. And I actually had a ringside seat as hypercompetitive middle managers... wholly unintentionally, wholly unaware... protected the very people they thought they were 'keeping down'.

And that was glorious.

The Winner of our Discontent

Disgruntled (adj). 1: in a state of sulky dissatisfaction [syn: disgruntled, dissatisfied].

Against, annoyed, bad-tempered, beefing, bellyaching, bitching, browned off, complaining, complaintful, con, crabbing, crabby, cranky, croaking, cross, disappointed, disapprobatory, disapproving, discontent, discontented, disenchanted, disillusioned, displeased, dissatisfied, dissenting, envious, exasperated, faultfinding, fed up, griping, grouchy, grousing, growling, grumbling, grumpy, ill-humored, ill-tempered, indignant, irritated, low, malcontent, malcontented, moody, murmuring, muttering, opposed, opposing, out of humor, peeved, peevish, petulant, poor, put out, querulant, querulous, rebellious, resentful, restive, restless, sulky, sullen, testy, turned-off, unaccepting, unaccommodating, unappreciative, unapproving, uncomplimentary, uneasy, unfavorable, unfulfilled, ungratified, unhappy, unsatisfied, vexed, whiny.

Ahh, disgruntlement.

The workers' greatest sin.

When they protest the arbitrariness of 'employment at will' [whose will? Not the will of the employee; if we truly had the economic freedom to quit bad jobs 'at will', more than a few companies would lose their entire workforces].

When they catch the boss with both hands in the till up to the elbow, and try without success to find an authority that will take this seriously.

When they object to being accused of 'time theft' for taking an extra 30 seconds to clean their bottoms on a bathroom break, or for greeting a colleague on the display floor, while being forced to clock out for the evening before putting in hours of unpaid mandatory overtime. [Can you say... double standard? Projection? Abuse?]

There are companies in this country in which access to bathroom facilities is so savagely restricted that adult employees must resort to wearing diapers on the assembly lines.

Please note: in this country. Land of the free, home of the brave, birthplace of the American Dream. [Don't forget to wear your Depends to the office, dear; because although it makes a lovely myth, you are not free, not once you cross that threshhold.]

What good could possibly come from disgruntlement?

Zippers.

The electric light.

Anaesthetic available to women during childbirth.

Smallpox vaccine.

Rabies vaccine.

Polio vaccine.

Catholic Worker Houses.

DNA forensic testing.

Hybrid automobiles.

Solar power.

Wind farms.

Whistleblower protection [such as it is].

Laws against domestic violence [such as they are].

Laws against the abuse of animals [such as they are].

Sex offender registries [Megan's Law].

"America's Most Wanted".

Mothers Against Drunk Driving.

The Susan G. Komen Race for the Cure.

Autism Speaks.

ACT-UP.

FDIC insurance for your bank account.

Traffic lights.

'Panic button' burglar alarm systems for bank tellers and convenience store clerks.

Waterproof matches.

Cybernetic prostheses.

Cochlear implants.

Surgical lasers.

Child labor laws.

Public education [such as it is].

Voting Rights for people of color and women regardless of color.

Vitamin C...

As a matter of fact, if you think about it with an open mind, you will soon realize an astonishing truth:

We actually must credit a vast number of the 'improvements' in our lives....

to disgruntlement.

To people who had the great good sense to be malcontents.

Long may they dwell among us, and may their tribe forever increase.

Potemkin Decency

The right thing is almost never the easy thing.

The easy thing is almost never the right thing.

This is especially true in human relations.

Ask almost any child, or any employee.

Rarely will a parent, teacher, minister, or boss take the time and make the effort to find out

who really did what,
to whom,
when,
and why it matters.

It's messy.

It takes time.

It requires thought, and the expenditure of effort.

It often involves ethical dilemmas.

It isn't any fun.

...why bother?

It's much easier to favor the one who yells the loudest.

The one who tells his story first.

The one who tells his story most.

The one who sucks up.

The one who cries most convincingly when other people are watching.

In the contest between decency and expediency, expediency will win almost every time.

The "Prakticline"

There is a physical phenomenon, seen in lakes and oceans, known as the thermocline.

It is the layer of water that exists as an interface between warm surface and cold bottom layers. It may be very shallow, or have considerable depth. Within the thermocline, temperature changes rapidly with depth; above and below it, the warm surface and cold benthic layers exist as separate strata; in the deep ocean, these strata do not mix.

There is a similar phenomenon in organizations, which I like to call the "Prakticline". The Prakticline is the interface between the uppermost layers of an organization, which tend to be focused primarily on stock prices, Sacred Deadlines, logos, mission and vision statements, Centers of Excellence, and other intangible, often mythical items, and the lower layers, in which the practical work of the organization, which must meet the Sacred Deadlines, support the stock prices, and bear the cost of all the company coffee mugs and stationery that carry the new logos, is actually done.

Simply put, the Prakticline is the corporate interface between fantasy and reality.

Not all organizations will have Prakticlines. Small companies, and those in which the top-level managers have risen from the shop floor without losing touch with realities on the ground, may not have them. But most organizations do, and the stratification and impenetrability is every bit as marked as if they were true oceanic thermoclines.

The management layers that comprise the Prakticline are extremely stressful places to be. There is, of course, a constant, inescapable tension between fantasy and reality, and the stratification and lack of mixing between the upper and lower layers exacerbates this tension. The shear forces acting on a mid-level manager who is trying to communicate to his or her higher-ups that something simply cannot be done in the way, or at the time, or for the price that is being demanded, can be incredibly destructive and demoralizing to any person of conscience.

In the late 1980s, a little allegory circulated in my place of employment, which beautifully illustrates the transition of information through the Prakticline. I reproduce it here, with kudos to whoever first thought of it; it deserves immortality.

1. In the Beginning, there was the Project, and there were the Assumptions.
2. And the Project was without form, and the Assumptions were void; and Darkness was upon the faces of the Implementers.
3. Then cried they out unto their Supervisor, saying:
4. "Lo, This Project is a Crock of ----; and Verily, it Stinketh."
5. And the Supervisor looked upon the Project, and saw that they spoke Truth.
6. Then went the Supervisor unto his Director, saying:
7. "Our Project is a Load of Manure, and my Workers cannot abide its Stench."
8. And the Director went unto her Vice President, saying:
9. "This Project is Pure Organic Fertilizer, and its Odor is Terribly Strong."
10. And the Vice President went unto the Executive VP, saying:
11. "This Project is Made of That Same Stuff, Which Causeth the Roses to Grow; None can abide its Strength."
12. And the Executive VP spake unto the CEO, saying:
13. "This Powerful Project Shall Stimulate the Growth of our Company."
14. And the CEO looked upon the Project,
15. And It was Good.

While this allegory is funny, in real life, the Prakticline can be deadly.

Just ask the crews of the Challenger, or Columbia.

The Church of the Sacred Deadline

My first encounter with The Church of the Sacred Deadline came early in my working life. Proud of my recently earned doctoral degree, I was working in research and development when my group encountered an interesting, perplexing, but not insurmountable problem.

My department regularly sent representatives to project meetings and project review meetings, and I looked forward to learning how the 'wiser heads' would respond to the information we had prepared. We knew the cause of the problem, and we knew how to fix it, and we knew just about how long it would take. We were pleased, and we were proud. We had a solution in hand, and it would work.

What we didn't know was that the 'wiser heads' didn't want to know, or hear, or think about, any of this. They were fixated wholly on meeting an arbitrary deadline, developed from a model, created by a consultant, based on an idealized concept of assembly-line work. The fact that R&D has almost nothing in common with bolting car seats into place, and that the presupposition that everything will always happen on time [and perfectly] is sheer idiocy when applied to research of any type, was never, apparently, even considered when this conceptual model was evaluated and purchased.

And the reason for that, I understood much later, was that, to the 'wiser heads', the real product was not the product of our R&D; it was not the final product sold to consumers; it was, first and foremost, the Deadline.

Because from the Deadline cometh the Press Release, and the Press Release in turn begetteth the Stock Price. The whole, sole, and only object of the exercise was to Meet The Deadline so that the Stock Wouldn't Lose Value. The product itself was almost immaterial, except as a source of Good Press.

Based on my observations in this and similar environments, if it had been possible to advertise and market boxes filled with nothing but air, this option would have been eagerly embraced. Reality was not merely inconvenient; it was inimical, and those who insisted upon dealing with it - and mentioning it in public - were regarded as untrustworthy, if not subversive.

Consider this well when next you purchase... almost anything that required any thought to produce. And give thanks to the heretics unseen, who worshipped at the altar of Reality to produce a working product, while the Sacred Deadline was met at the cost of their time and sweat... and health... and happiness.

Potemkin Protection [Whistleblowers and Denial of Due Process]

The Semmelweis Society, named for Ignaz Semmelweis, is an organization founded by American physicians to combat workplace bullying disguised as peer review.

Ignaz Semmelweis, for those who have not heard of him, was the physician who first suggested that obstetricians wash their hands with disinfectant solution before treating each patient and after completing each procedure, as a means of preventing the spread of "childbed fever", a post-partum infection that was common, and often fatal, in the mid-nineteenth century. Although the mortality rate for new mothers dropped sixfold when his proposals were implemented in the hospital where he worked, he was ridiculed by his peers, lashed out at his profession in distress, and ultimately experienced a nervous breakdown. He died in an asylum at the age of 47.

After his death, Pasteur developed and proved the 'germ theory' of disease, and Semmelweis was belatedly recognized as the medical hero he had actually been. Much good it did him then... but many surgical patients and new mothers all over the world, for the last 150 years, owe their lives to this brilliant, vilified, tragic man.

Semmelweis' bullying was savage and direct, but the trigger - his willingness to identify, address, and oppose a destructive practice within his own profession and place of employment - was much the same then as it is for many bullied whistleblowers today.

The modern worker still faces ridicule and loss of standing when he or she identifies, addresses, and attempts to oppose destructive practices within his or her profession or place of employment. However, employers have made considerable progress since the 1850s. In theory, employees are now entitled to 'due process' when standing at risk of losing their jobs; in practice, the available forms of due process in many if not most workplaces today are shams, Potemkin edifices created to give the impression that due process is being followed, while carefully assuring that nothing remotely resembling a genuinely open, impartial assessment of the situation can ever take place.

Consider Bunnatine Greenhouse, demoted when she discovered, then attempted to expose, alleged fraud and abuse involving no-bid government contracts issued to Halliburton and to its subsidiary Kellogg, Brown, and Root. Contemplate Teresa Chambers, whose crime was that she honestly indicated that the U.S. Park Police lacked sufficient staff to meet all the security demands being placed on them in the wake of 9-11. Rather than provide her the necessary resources, the Department of the Interior chose to fire her.

Consider the fact that both these women were punished, when all is said and done, for the crime of doing their jobs.

As was Semmelweis.

The late Tim Field, a giant in the field of work abuse, described a number of examples of Potemkin Due Process on his Web site, explaining in detail how Human Resource departments and even their own unions seem to work against the interest of abused employees who turn to them for help. The poem below, taken from the Semmelweis Society's home page, was written by a physician who himself narrowly survived this type of workplace bullying - it captures perfectly the experience of such abused and isolated employees, whatever their profession, wherever employed.

On Sham "Peer Review" --   L.R. Huntoon, M.D.          

Run fast, my little gazelle,
Jump high, dart left and right.
Expect no help;
The herd will graze
And just maintain its poise.
Run fast, my little gazelle,
Jump high, dart left and right.
Sharp claws and teeth
A breath behind,
Your death will make no noise.

The Bigot's Two-Fer

Anne McGill Gorsuch [1942 - 2004] was an outstanding example of the Bigot's Two-Fer.

Ms. Gorsuch [Burford] was the first Reagan-appointed administrator of the Environmental Protection Agency, established under Nixon in 1970 and first headed by William D. Ruckelshaus. At a time when few women headed corporate or political organizations, she was a highly visible exception.

She was also a slash-and burn manager, using the powers of her office to do as much harm as possible to the organization she was appointed to head; while reducing her agency's budget by more than one fifth, undermining its enforcement powers, and openly expressing contempt for its basic mission, she populated the upper echelons of her management structure with political appointees drawn directly from the industries her Agency was charged with regulating. Her death of cancer at age 62, three years before the legal retirement age of 65, may be the most ironic result of her successful opposition to environmental protections.

A great admirer of the Reagan philosophy, Ms. Gorsuch [Burford] was undoubtedly surprised to find herself accorded the same treatment from Mr. Reagan, with regard to her own career, that she had so enthusiastically meted out to the organization in her charge. Appointed in May 1981, she was forced to resign in March of 1983 as a direct consequence of refusing to provide Superfund records for Congressional review -- under Reagan's orders. Not long thereafter, Reagan also withdrew all governmental legal support from her, in effect throwing her to the wolves he had encouraged her to enrage.

She subsequently commented: "When congressional criticism about the EPA began to touch the presidency, Mr. Reagan solved his problem by jettisoning me and my people, people whose only 'crime' was loyal service, following orders. I was not the first to receive his special brand of benevolent neglect, a form of conveniently looking the other way, while his staff continues to do some very dirty work."

This cluelessness is entirely characteristic of a Bigot's Two-Fer.

The Bigot's Two-Fer is a high-ranking organizational scapegoat with a twist, and he or she can be found in both the private and public sectors.

Ms. Gorsuch was appointed to her job precisely because she was a woman, a Washington outsider, insecure and sycophantic. This combination of factors made her perfectly willing to destroy her own organization in order to curry favor with political power. What she failed to foresee - what every Bigot's Two-Fer always fails to foresee - was that when the desired degree of destruction was attained, and she became a political liability, she would immediately be sacrificed - as in fact she was. And full advantage could also be taken of the fact that she was female. Look; we hired one of them; we even put it in charge of an entire agency. See what it did?

If you have doubts, consider this: Ms. Gorsuch demoralized her agency so traumatically that Ruckelshaus himself was ultimately called back from retirement to replace her [May 1983 - January 1985]. It would be ten years before another woman [Carol Browner] was appointed to head that organization.

Look; we hired one of them; we even put it in charge of an entire agency. See what it did?

In Search of Excellent One Minute Cheese: The Gospel of Corporate Happythink

A Quick and Easy Recipe for Business Book Success.

1. Always oversimplify. Organizations are complicated places and running them both efficiently and humanely is a hugely daunting task. Never admit or discuss this. Instead, write as though everything is simple, layoffs are happy things, and the Market is an omnipotent, omniscient, personal and benevolent God.

Reduce all significant issues to formulas and clichés, or dismiss them as insignificant by glossing over their potential impact. Always take the position that if a corporate drone has negative experiences, the drone caused them; the corporation is wholly and only nurturing and benign.

2. Idealize and oversimplify human nature. Write as though everyone is honest, nobody is greedy, decisions are always made for rational reasons, from lofty motives, and in the best interest of the organization, and serious personnel problems can be solved in one quick conversation if the right buzzwords are used.

Write as though nobody ever holds a grudge, is irrationally threatened by competence, or conducts a vendetta. If you must admit the existence of prejudice [whether related to age, sex, race / nationality, faith, competence, or sexual orientation], deplore it in theory, and minimize its prevalence and impact in practice.

You can't be accused of failing your audience if your advice only works in a perfect world - as long as you write as though your audience actually inhabited that perfect world, and their failures result only from their imperfection and lack of insight into just how truly fortunate they are.

3. Push magical thinking as the formula for success, always. Talk a lot about concepts such as 'reframing' and the need to be 'flexible' and 'positive'. Magical thinking is far quicker and cheaper than real thinking; whereas some form of effort is required to bring about genuine change, no effort beyond self-deception is required to bring about superficial 'change'.

If a company makes lousy widgets, it's much faster for them to designate one factory as a Widget Center of Excellence, and make no other substantive changes, than to invest time and money actually figuring out why the widgets are lousy, and what to do about it, and then doing what needs to be done. Call garbage excellent, and voilà! You now have an excellent product.

In addition to magical thinking, tout the benefits of consultants and new logos and slogans whenever possible. Call it a 'mission' or 'vision' statement; don't call it a slogan, although that's really all it is.

A new slogan or logo ideally should cost thousands of dollars minimum and do nothing whatsoever to alter the realities on the ground [except for the incomes of the sloganeers and logo generators]. This taps into the 'investment fallacy' - people will defend any foolishness they've been suckered into investing time and money in, no matter how blatant, if they're sufficiently obsessed by image and appearances. Such people would rather spend a lifetime trapped by folly than admit to being fooled.

4. Never show the underbelly. Never, ever let readers know, for example, that there is an actual monetary value placed on human life, and that corporate legal departments sometimes work with accounting departments to determine how many people a company can afford to maim or kill before the associated liability exceeds the profits to be gained from doing a particular kind of harm. And definitely never let on that business schools teach MBA students how to do exactly this.

5. Never show the real world consequences of corporate 'happythink'. Nobody wants to hear about over-50s who are laid off to 'shed fat', lose their health insurance, spend their retirement savings on career counseling and job search scams, end up homeless and flipping burgers, and ultimately commit suicide as a result of untreated depression, while the ratio of CEO pay to worker pay hits 431:1. Nobody wants to see how mismanagement and empire-building and poor product development result in layoffs, but so do major successes... nobody wants to see how a company's stock price is directly tied to the economic misfortunes of its labor force [they lose their jobs, the stock gains value].

And nobody wants to hear about this less than the people who are most likely to experience it directly. Always encourage the prey to keep its head firmly buried in the sand.

6. Last but not least, never think about the people you are duping when you write these things. Shut their lives out of your mind. Don't think about the time and effort they will waste at abusive places of employment, convinced that if they just magically did everything perfectly, they'd be rewarded instead of abused, because you've told them so. Don't think about the near certainty that such people will be milked and exploited until they're on the verge of physical or emotional collapse, then 'let go' so that the company won't be liable for their pensions or health insurance. And don't think about the consequences for their marriages, families, lifetime plans, of being deceived and used in this crass manner.

7. Remember: your mission is to keep the prey in its place. When in doubt, refer to the Maxims of Orwell:

War is Peace; Freedom is Slavery; Ignorance is Strength.

Brownian E-motion

One of the most common American management fallacies is that it doesn't matter what you're doing, as long as you're in motion.

Look busy ... look energized ... look enthusiastic ... go, go, go! Run, run, run!

Of course, if you're thrashing about in a constant frenzy, there's one thing that you are most definitely not doing --

thinking.

The ubiquitous electronic leash, otherwise known as e-mail, cellphone, pager, or Blackberry, does nothing to help this situation.

Instead, interruptions, diversions, and distractions become a constant.

Gatekeepers are completely absent from the environment [there's no limit on the number of emails, demands, claims on one's time that can be made on any given day].

Attempts to prioritize tasks or focus on any particular task are undermined both overtly and covertly by the organizational culture [which usually seems to paint anyone who insists on taking time to think about what they are working on as 'inflexible', or somehow 'negative'. God help any poor soul who actually verbalizes a desire to work on anything without interruption].

As a result, the difficulty of ever getting anything actually done results in frantic corner-cutting to complete tasks before the next interruptor lands;

which in turn results in errors;

which in turn result in the need for amendments and revisions and corrections [updated reports, patches to the code, revisions to the plans, changes in the blueprints, etc.];

thus, in a self-fulfilling prophecy, assuring that it is impossible to ever get anything actually done.

And we wonder what causes burnout.

Marathon

Pheidippides fell,
Gasping for Marathon,
Spurned by the flame that some unnamed other
Raised from his cooling grasp.

This deed is remembered
Not by the name
Of the man who died,
But the place that killed him --

For it is always easy to name
The place where flame has passed,
Hard to recall
Distorted faces
Suffering under the light they bear.

© 1983

The General Façade

There is a story, largely apocryphal, that the Russian general Potemkin deceived Catherine the Great by instructing workers to build 'stage sets' of villages along the Dnieper river in the late 1780s.

These 'stage sets' were housefronts, storefronts, churchfronts, with nothing more substantial behind them than there is on any Hollywood backlot; locals were recruited to serve as 'extras', and were scrubbed and freshly clothed, and furnished with other trappings of prosperity, so that the Empress would be pleased with the condition of her people and the great things that her general [and minister] had wrought.

The original 'Potemkin villages' are now thought to be a pre-urban legend of sorts, but their counterparts certainly existed in the Soviet Union and Communist China - and even in New York City, where in the late 1980s anyone driving the Cross-Bronx Expressway could see artists' renditions of curtains and flowerpots bravely propped up in the blown-out windows of abandoned tenements.

Potemkin's Office is the organizational counterpart to the Cross-Bronx plywood paintings. It's any organization, sacred or secular, for-profit, non-profit, or official, in which appearance has become so much more important than reality that there is little or no reality remaining behind the façade ... or the reality behind the mask is very, very different from the painted illusion.