Sunday, 14 April 2019

Remarkable people, a Black Hole and Kindness

Hats off to the young computer scientist Katie Bourman, whose work helped bring us the amazing picture of a black hole last week.  She is just 29 years old. Just six years ago, she was a PhD student at the Massachusetts Institute of Technology (MIT). There she led on the creation of an algorithm that could take the masses of astronomical data collected by eight radio telescopes and produce one coherent image. The eight telescopes, located across the world, ‘acted’ as one telescope, the so-called Event Horizon Telescope. It was this telescope that brought us the picture of the black hole and opened up a whole new stream of scientific questions to be answered.  It was a truly amazing moment. In anyone’s book, Katie Bourman is a remarkable person, and she was part of a fantastic team. 

Last week, I was also privileged to meet two other remarkable people. It happened on Thursday, as I chaired a selection panel hoping to recruit a new Consultant in Acute Medicine. It was the first time I had been part of such a panel and I wasn’t sure what to expect. On my side of the table were four consultants, one of whom was the Medical Director, the Chief Executive and a representative from HR. It was a formidable interviewing panel. After we rearranged the Board Room tables and chairs to make the room look less intimidating, we started on the process of deciding who would ask what questions, and in what order. My role turned out to be almost ceremonial. I was there to chair the interview, explain what was going to happen, who would speak and when, explain how we would let the candidates know the outcome of the interview and generally try to ensure a fair and equitable process was undertaken. I was allowed one question, more of which later.  

Although we had several vacancies, there were only two candidates - a man (Tom) and a woman (Joan) - (not their real names!), both of whom were already consultants. However, one had 18 months experience as a consultant, and the other almost some 11 years. Joan was interviewed first. Now I might be getting older and everyone looks younger than they did in my day, but Joan looked amazingly young to have already developed her career in clinical practice and medical education. She was a breath of fresh air. Self-confident, assertive, knowledgeable and able to draw upon her experience in responding to the questions. 

I was surprised that there were no actual medical questions asked. It appeared that Joan’s qualifications, of which there were many, stood as a given testament to her clinical knowledge and experience. Instead the questions centred around team working, ethics, avoiding heroic interventions, health economics and managing scarce resources, improving patient flow and commitment to research and development of acute medicine. None of the questions fazed her at all. She even took on the Medical Director and challenged him over the different approach they would both adopt in dealing with a complex case. 

My question was the last one asked by the panel. I asked, ‘can you give us an example of a time when you were kind to a patient?’. There was silence. That complete, and to some, an excruciating silence. Just as I could sense the Chief Executive leaning forward to intervene, Joan started telling us of an elderly patient she had been looking after. The patient had a terminal illness and was being provided with end of life care. Each day, Joan would talk to the lady on her ward round. One day she asked whose was the cat in the picture that she kept on her bedside table. The patient told Joan it was her cat; a cat she had looked after for many years, and here in hospital she missed holding and stroking the cat. Despite protests from her Infection Control colleagues, Joan arranged for the cat to be brought in, so her patient could spend some time with her again. Soon after the lady died. 

It was the panel’s turn to be silent. But not for long. I said thank you and that her story resonated with all of us on the panel. Back in 2014, we were also providing end of life care to an elderly lady. She had kept horses all her life and had mentioned to one of the nurses how much she missed not seeing her favourite horse every day. You guessed it, the Deputy Director of Nursing arranged for the horse to be brought to the hospital and the patient to be taken outside in her bed to meet her horse. The horse clearly recognised the patient and walked up to her and nuzzled her face. The moment was captured on someone’s smartphone and the picture and the story went viral over the following 24 hours.  

Tom’s interview followed a similar path, and although his response to my kindness question was more situated in the realms of compassion, it was an equally compelling story. Both Joan and Tom, in different ways were remarkable people. Like Katie Bourman, they understood what effective team work could deliver.  All three of them brought to life the notion that often in life it’s the little things that can make the biggest difference. 

And yes, subject to the usual checks, both Tom and Joan were offered posts in the hospital. 

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