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314. Standstill (V)

There was a time when to be a real surgeon—a real man, basically—you had to leave the surgical theatre covered in blood; if your gown was not good and bloody, you were not doing it right. If your gown was too clean the other surgeons would tease you; the initiation was not complete—just like the blood smeared on the faces of children who go on their first fox hunt, you were not really in the fraternity. Perhaps this was not so everywhere, perhaps it was only so in San Francisco—the place where the practice has been attested—but I would not be surprised if it was a universal initiation.

The surgeon and the butcher are not so disconnected from each other; probably the surgeon is the opposite to the psychiatrist: the psychiatrist is barely within medicine, barely scientific, and, perhaps, has more literary pretensions, whereas the surgeon rearranges the tissues and organs within the body with his own hands; in a sense he falls from the profession in another direction—he is the surgeon-barber, the barber-rian, who rends the flesh.

Now this surgical initiation, especially in San Francisco, came to a halt when AIDS became a prominent problem. To display your manliness by letting your colleagues know that you were a real butcher, really ruthless—really prepared to get your hands dirty, not like those fairies in general medicine—became too close to suicidal action. The order of the day became how to leave the theatre with minimum blood on the gown—all blood was suspect now. This ceremony—a status game—indicates how far an organisation or profession can deviate from its goal. I am no surgeon, but I would say, in general, the less blood a patient loses in an operation the better for him—yet the men with the scalpels judged each other by their bloody uniforms; it is not too hard to imagine that this initiation was fatal to weaker patients, but for man status will trump reason until his own safety is conclusively in doubt—and sometimes not even then.

This story should cause us to think about where real value lies in an organisation. I always like little parables about wise sages—hidden away on high mountaintops or in little caverns—to whom you may apprentice if you have sufficient devotion. The pearl of great price is always hidden, it must be sought for; and even if found will not easily give up its secrets. I would like to think that such men are real, perhaps they are real but have passed away in our time. Anyway, I can say for sure—boringly enough—that the metaphor is true. The real value in an organisation is rarely to be found on open display.

I have seen companies where there are many employees out front—young and apparently with excellent credentials—and yet, if you stay there long enough, you will discover that the real value in the company, the vital tasks, are performed by a handful of old codgers who are kept out of sight; perhaps they even work from home or only appear in the office once or twice a week. Apparently useless—often disdained by the younger staff—the organisation’s actual value is sustained by these few men, the material equivalent to the hidden sage.

The reason for this phenomenon is the same as those San Franciscan surgeons and their bloody robes: what we say we are doing—what think we are doing—is often nothing to do with what we actually do. For those surgeons, a bloody gown was an important element for a truly successful operation; although it had nothing to do with health. Similarly, companies that are burdened by entropic bureaucracy or elaborate displays of status will often depend, in essence, on a few obscure men to produce the real value; and this is why many people feel their jobs are valueless, they probably are—they have ornamental jobs, bloody gowns.


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