Bandwidth & the BCG

As has been mentioned before, I am no longer a n=1 business.  One of my proudest achievements of the last 12-18 months is the emergence of a team of focused, committed, high-performing associates who deliver my stuff at least as well as me.  Not only do my colleagues treat the work as seriously as I ever did, their fresh eyes see innovations and opportunities that have been passing pass me by.

I deliberately hand over interesting projects and not only when I can’t be in two places at once.  In the medium term this should expand our active client base but for the moment I am embracing personal financial pain in order to radically change my working life.

I am freeing up bandwidth to chase opportunities in an entirely new domain; by this time next year I plan to describe myself as the CMO of a tech start-up.  I will still own and operate a pharma consulting company but it will no longer be the first line of my LinkedIn profile.  In BCG matrix terms I am relegating my old business to ‘cash cow’ status in order to make room for a ‘star’.

I’m excited at the prospect of solving brand new problems in an unfamiliar commercial space.  I’m looking forward to being ‘inexperienced’.

I’m reminded of advice given to me by an improviser in 1991, the year I quit working for other people...

Enjoy not knowing

Babies. Making idiots of us all since, well, forever

We have a baby.  Our daughter born six months ago is a happy, smiley constant source of joy to my wife and me. The story of her provenance is a long and tortuous one but no matter, this is not that tale.  She is here now and is exactly as she should be. 

Today's thought is a follow-on from last week's idea that one of the roles played by my smarter self is to remain vigilant in the face of the dumber version.  There are recognisable patterns: fatigue levels differ on Tuesday morning as against Thursday night and I try to allocate tasks appropriately.

One definition of 'experience' might be to identify, and to operate within, the rhythms of one's working life.

But babies are arrhythmic.  The edicts of Gina Ford notwithstanding, they only know what they want when they want it.  We do our best to anticipate and shape our daughter's rotating need for food, clean clothes, attention, distraction and sleep.  'Shaping' being a euphemism for ignoring her demands for food and attention for at least a little while.  

Thus my carefully calibrated plans to get the tough work done whilst the house is quiet are more often stymied than realised.  My daughter doesn't care whether she's being fed by the smarter or dumber version of her father.  She just wants the food.  

(cue: hollow laughter from my wife whose entire life is presently subsumed by the feeding-changing-cleaning-bathing-washing-feeding cycle)

One partial solution will be the creation of a discrete workspace, either on our property or elsewhere.  This is a work in progress.  Another is to (further) improve my smart-me:dumb-me ratio by staying fit, rested and out of the pub.  A third has been to hire someone to help out with the myriad tasks that are usually entrusted to my dumber self.  The beginning of the end of Headcount: 1?

But mostly my response must be attitudinal.  Our daughter was so longed for for so long and I am blessed with a career that lets me stay close to home for more of the time than most breadwinners.  So I count that blessing.

A final thought: I have nothing but respect for single parents.  The sense of grinding isolation must be close to overwhelming almost all the time, especially if the child is too young to be anything other than demanding.

Protection against my dumber future self

I'm at the end of an absolutely brutal week of travel.  In the office all day Monday.  Night flight to the US to make a pitch presentation on Tuesday.  It went well enough. Night flight back for a full day of work on Wednesday.  Day trip to Switzerland yesterday.  Be careful what you wish for and all that.

No complaints.  As I've said in these pages many times, 'If I'm not on planes I'm probably not getting paid'.  The real challenge is how to keep functioning in amongst these waves of fatigue.  A partial answer may be this: -

Be aware that sometimes you are smarter than usual and sometimes you are dumber.  The job of your smarter self is to protect you against your dumber self for the foreseeable future.

My dumber self forgets things.  He fires off emails with spelling and grammatical errors or worse.  He packs badly and eats poorly. He mis-prioritises and has overly emotional reactions to simple setbacks.  Whether because he's tired, jetlagged or just hungover he is an idiot.

He is an idiot and my smarter, I'd like to say 'normal', self has to mitigate against him.  We all know this.  We've all stood in the middle of a supermarket feeling like an idiot for not writing up a shopping list.  We curse our would-be smarter selves for not thinking this one through.

My smarter self writes lists and sets alarms.  He allocates tasks commensurate with my fluctuating IQ to various times of the day and week.  Aren't we all that much are smarter on Monday morning than on Friday afternoon?  My smarter self is mindful of my tendency to react emotionally when fatigued and plans accordingly.  My smarter self works hard so that the dumber me can lean against a wall in the sunshine with a pint of beer in hand.

It is Friday and the UK Met Office is predicting 26C and sunny.

Such a very long time between drinks

I see that I last wrote in these pages on February 11.  Seven months and God knows how many miles ago.  The reputation that I've assiduously built over the eight or so years in the UK now precedes me around the world.  I find myself in all sorts of priviledged positions.  I am an insider.  People who are new to a client company are told to make contact with me to learn what's going on.  I'm asked to give feedback to other agencies.  I have become, in some circles at least, a 'trusted advisor'.  This is the holy grail of consultancy.

It's doubtful that I gain anything by even stating as much in these pages.  Discretion is a big part of trust and even writing as I write right now feels like an impulse to self-sabotage.  Except that the internet is such a wonderful place to make huge mistakes in plain sight.  Better even than the Edinburgh Fringe Festival.

I am a consultant now and not much else.  No time for producing theatre or performing comedy.  No time even to consume it.  I wake up early and work online or I fly somewhere to do my thing in person.  A week without passing through an airport feels strange these days.

But soon I am to be something else besides.  After nearly ten years of trying I am to be a father.  A baby girl will enter our lives on Christmas Day, if not before.  And then everything must change.  Part of the reason that I've embraced the Global Loman lifestyle is that it's nice to be wanted and especially nice to be wanted in far-flung parts.  But soon I'll be wanted more at home than anywhere else on the planet.

I have no idea what that wll be like but I can't wait to find out.

Possibility v. Limitation

We are deep in the dark process of buying a London flat (apartment). Inevitably this oh-so-time-consuming process is happening as I'm busier than I've ever been.  Happily, my time poverty has forced me to identify a simple heuristic that has probably been there all along...

When I look at a potential place to live, do I first see possibilities or limitations?

Unless my initial, immediate reaction is 'possibility' I thank the estate agent for his time, turn on my heel and head back to the office.  If I experience no moment of excitement whatsoever when contemplating one of the biggest purchases I'll ever make then I'm in the wrong flat.   Life will force compromises aplenty on me before the sale goes through so I need to start with as much enthusiasm as I can manage.

I can look at other parts of my life through the same possibility / limitation heuristic.  I've pulled back from directing or performing improv comedy because where other, younger actors see infinite possibility in the form jaded old me sees only limitation.  Hopefully one day that'll revert and I can reimmerse myself in a craft I love but until then I stay away. Who wants to be cornered at the bar at the after show party with Captain Buzzkill?

It's important not to overthink the heuristic.  Perhaps in Daniel Kahneman's terms it would be System 1 (fast) thinking.  If the 'possibility' in a given project is that there's much money to be made then so be it.  But if any sense of possibility is overwhelmed in the very first instance by thoughts of 'limitation', be they artistic, social, moral, whatever, then the heuristic has spoken: the project ain't for you.

Holidays

 One way to get to grips with the opening premise of Friday’s post is to consider our attitudes to holidays.

Sometimes your ambitions move faster than the world.  Sometimes the world moves faster than you.

Holidays are an annual ritual in paying real money to calibrate our ambitions with the pace of the world.  If you want a week of sleeping, eating and reading you buy a ‘fly’n’flop’ at a child free resort somewhere sunny.  To reconnect with your preteen kids choose Euro Disney.  Because our own scarce resources (time and money) are at stake any dissonance aggravates us so much more on holidays than in usual life; “It wasn't like this in the brochure” is a near-universal lament.

 

For eight years my family ran a 3½-star hotel on Mission Beach in Far North Queensland. I looked after the marketing on a part-time basis, which was a pretty cool job.  How could it not be when this is your workplace?

In our day Castaways on the Beach was a pretty modest operation whose prime selling point was the location.   The property had a longstanding reputation for being ‘family friendly’, offering easy access to a vast waveless beach, lots of suites with in-room cooking facilities and a short walk to a town centre that featured lots of relatively inexpensive dining options and a small supermarket.  Our in-house restaurant also offered an extensive children’s menu.  As everyone knows (or should know), ‘family friendly’ is code for “There will be screaming kids everywhere.  If this is not want you want on your holiday then best you go someplace else.” Families with younger children were consistently our most satisfied customers, not least because our business plan didn't rely on corralling our guests into the dining room three times a day.  What parent doesn't find it galling paying for a full breakfast buffet when all the kid wants is a bowl of cereal?

 

Our least satisfied customers were always honeymooners who had locked onto the picture on the website and the 3½-star tariffs but (often willfully) ignored the ‘family friendly’ signals.  Signals that included the literal words ‘family friendly’ on all our brochures, billboards, website, etc.  We accepted that our offering couldn't match the ambitions of most loved-up newlyweds and instructed the booking staff to gently warn off such customers.  Over the years we invested quite heavily in improvements to the property but intentionally stuck to the 3½-star bracket.  We were happy with our positioning at the ‘family friendly’ end of the market.

 

I have no children and a relatively high disposable income but we never attempted to build an offering that would appeal to people like me and in 2007 my family sold a thriving business.  The new owners, who have far more access to far more capital than we did, spent an actual fortune taking the place ‘upmarket’.  They refurbished the public areas, reduced the pool size to increase the bar area, added a day spa, removed most of the in-room cooking facilities and upped the tariffs by about 60%.

 

I was back in Mission Beach last July and to my childless eyes the place looks amazing.  But to a family on a budget with a brood of young kids the whole package screams “Stay Away!”  The word around town is that Castaways Resort & Spa is for up sale again.

 

The need to purchase a world that temporarily matches our ambitions is the reason why we expend so much energy researching our holidays.  We only get to spend this time and money a few times a year and it's personal.  This is why holidaying with any but the closest of friends is rarely a good idea ("It’s my holiday too, y’know") and why most of us revisit those trusted holiday places again and again and again.

Advice for the self-employed (January edition)

Sometimes your ambitions move faster than the world.  Sometimes the world moves faster than you.

I finished my last job of last year the week of Christmas.  I never have paid consulting work that late in the year.  The preceding months are a blurred pastiche of meetings, telecons, airports and familiar hotel rooms in cities I'd never visited before.  Back in August my business accelerated and by December I was tumbling down the chute that opens with exhilaration then descends through fatigue, helplessness and exhaustion before bottoming out in tangible, physical illness.  Be careful what you wish for.

 

Sixteen days later I'm in a more familiar state of mind: my ambitions moving faster than my world.  I'm back to wanting more than what's on offer.  I'm impatient and paranoid.  Am I being deliberately excluded?  Are potential clients buying my old book instead of hiring the new me? The glass between me and a shining future is smudged with my greasy noseprints.  I read the Euro crisis stories and fret that last year was my financial high water mark. Then I worry that a smarter, savvier me would look at the state of the world and see where there's a quid to be made from all this chaos.  A fortnight is a long time in self-employment.

 

I've been at this Headcount:1 game a long time now (viz. my previous post.) so here’s my advice to those underemployed self-employed folks out there who spent the Christmas-New Year interregnum drinking too much and ignoring the gnawing knowledge that you don't have guaranteed work lined up for January already.  Reinhold Niebuhr’s ‘Serenity Prayer’ is always a good place to start: -

God grant me the serenity to accept the things I cannot change,
Courage to change the things I can,
And wisdom to know the difference.

Self-employment means that is that there's no boss to impress, no underling to browbeat and no rivalrous colleague to outmanoeuvre.  The brutal truth is that only thing you get to change is you.

 

January 6 is just too soon to start badgering clients so you're tempted to run headlong at all those clichéd resolutions: diet & exercise,better sleep patterns and commendable reading habits.  This impulse is prophylactic at best; racking up cosmic credits for the next time the spiralling chute opens beneath you.  Except that there is no godly ledger balancing a January spent at the gym against a May-time diet of airport pizza and beer.  At worst these resolutions are symptomatic of the very mismatch between ambition and action that you're looking to escape.  Even as you sweat over The Economist some part of you knows that you're just waiting for the phone call that will fill your days.  Diet and exercise might be change but not the sort you can really believe in. 

 

Devoting all this excess time to your actual business can be more damaging still. Parkinson’s Law assumes at least some sort of deadline.

 

My advice to my time-rich client-poor comrades is as follows: -

Find some small, new, discrete thing and do it well.

Not some rambling yearlong project.  You have one of those already: building your business.  Rather that small thing that is affordable in terms of both your time and money but that doesn't require you waiting on anyone else.  A one-off class.  A lecture. A walk to a place you've never been before.  An afternoon taking photos.  A blog post. Don't reorganise your life but somehow extend it.  A measure might be this to complete some thing that allows you to greet your life partner at the door with, “Guess what I did today?” Achievement, no matter how minor, is not risible.

 

Create small ambitions that are under your control and sit them alongside those larger ones that are not. But do this small thing for its own sake, not with one eye fastened on the far side of the smudgy glass.

And don't worry too much about 2012.  My reading of the news is that we all, those with bosses and offices and those without, are going to hell in a handbasket of soon-to-be resurrected European currencies anyway.

 

Happy New Year.

Funny. And good in bed

My wife and I are back in Australia. We're staying with her mother and family in Sydney for a week or so. Almost everyone in the household is either self-employed or working for a start-up, which offers up some really interesting compare-and-contrast breakfast table conversations.

Hal has had several successful careers but now works from home as a foreign exchange trader. The arrangement is that he trades for himself but as part of a global cohort whose aggregate efforts are on behalf of an investment fund.  The business follows a sort of league table approach whereby as he proves his abilities the organisation allows him to trade larger amounts and so earn more.

After a year or so he's developed a keen sense of the market and is highly aware of the the combination of volume and volatility (driven by planned and unplanned news events) he needs to thrive and has climbed several rungs on the ladder already.  To do so he's adopted all the necessary professional behaviours that I would say are actually more important when working from home than anywhere else.  He'd no more trade with a hangover than I'd walk into a training room naked.

As I looked at the procession of charts and numbers flickering across the three screens on his desk I thought, "I could do that."

Of course I did. Men of my age and education all reckon we're the funniest guy at the party, a porn star in the bedroom, a Navy SEAL in a bar fight and a 'big swinging dick' in front of the trading screens

The peak of everything

Jean-Claude Carriere is possibly the most famous scriptwriter you've never heard of.  Since the 1960's he's lived a sort of Zelig-like existence, collaborating with some of the best and more interesting film and theatre directors of the last fifty years; Milos Forman, Luis Bunuel, Philip Kaufmann, Peter Brook and Jean-Luc Goddard.

I recently came across in old NYT love-piece from 1988 that describes Carriere driving across the Seine with the photographer Robert Doisneau (y'know, this guy): -

Carrière gazes through the windshield at the soft outlines of the fog-shrouded buildings. “J’aime bien ça,” he says contentedly. 

“That’s because you’re starting to get old,” Doisneau replies. “When you’re young you see only the details. When you grow up, you see both the details and the whole. That’s the peak of everything, it’s what you’ve lived for. When you get old, you forget about the details and see only the whole.”

Nice to think I feel that I might be at an age when I can see the details and the whole at once.

Dreading the week ahead

My 'To Do List' program, Things for Mac, crashed on Saturday morning. At first it was a simple failure to synch between desktop and iPhone but the usual solutions as suggested by the user forums not only failed to fix the fault but made things much, much worse. In trying to copy my database to back it up I managed to delete it altogether.

I've been ambushed by my beloved technology and I approach the week with a woefully imprecise idea of what needs doing.

Part of me

Part of me wants to stress over flight connections and the like. For the amount of emotional energy I expend in this way it's the only viable explanation.

Air travel: a procession of small humiliations.

Heathrow Express: your air travel experience starts here

Full of bile and venom

Last night's sleeplessness, Manila traffic and the ambient chaos of Niño Aquino International Airport had me arrive at the departure gate chock full of bile and venom.

Of the myriad vestigial rituals clinging to 'luxury' travel the procession of interruptions that are supposedly the hallmark of good service pisses me off the most.  As pointless as airline safety demonstrations may be I accept that a legal logic is in play.  But tell me why I must hear from multiple crew members on other topics?  Why is the captain as well as the purser compelled to make an announcement before take-off then again 'once we're airborne'? Why interrupt the inflight entertainment (wishfully claimed as a USP) to tell me that you're going to interrupt me again later?

Am I alone in measuring good service in terms of the least number of staff intrusions? Who was the last person actually pleased by hotel turndown service?  I don't understand the logic: if I'm out I most likely won't notice the alteration in bedlinen when I return.  If I'm in then whatever I'm doing is interrupted whilst I answer the door and say, "No thanks".  Not all porn channels have a pause function you know.

The threat of a hovering proprietor is the main reason I shun the English Bed & Breakfast.  Once you price in the energy expended gushing over the farm fresh eggs and the wasted ten minutes being shown the frankly troubling collection of objets d'art on the mantlepiece that country house hotel down the road looks like a bargain.

But whereas creepy B&B's can be avoided air travel is inevitable.  Scripted platitudes droned out in multiple languages (I've been on Korean Air lately) and of course the seatbelt sign is illuminated before it starts so we can't even bury our ears in headphones.  Any airline that starts from the assumption that I don't need to know by name the captain, first officer, whoever else is assisting them on the flight deck, the person heading up 'my' cabin service team and the rest of the crew will get my business.

Wow. One solitary solid week of travel and I'm whining like Tyler Brûlée.

Pricing jetlag into the fee

1am in Ortigas City, the affluent precinct of Manila where I've been staying since I arrived in the Philippines exactly 72 hours ago.  I'm wide awake and out of Stilnox (aka Ambien).  I've only eaten lightly, used the hotel gym and self-medicating with red wine will only make the waking hours harder.  I'm 50% through the project.  Tomorrow I fly to Seoul to repeat what I've just delivered only this time via a (client-sourced) interpreter who claims, but only when chased, that she still hasn't received my slide presentation.  Interpreters are often hard to deal with and this augers poorly for the rest of the week.

I tell myself to suck it up.  Self-employment means that in the end every problem belongs only to you.  The only sane response is to price interpreter angst and the inevitability of jetlag into the fee.

Don't pack drunk

Summer is done and I'm traveling again: Madrid, Edinburgh, Manila, Seoul and Zurich to begin with. No complaints: if I'm not on planes I'm not getting paid.

Travel means packing and packing always makes me feel stupid. Specifically, packing is an exercise in imagining my future self and experience has taught me that that guy is an idiot. Indeed most travel planning could be described as 'negating your inner idiot'.

These oh-so-unimpressive alternative selves exist inside each of us. Stress brings them out. As does fatigue, distraction brought on by overwork and alcohol.

I've learnt to mitigate these minor demons with low-level paranoia. Printing out and filing the limo pick-up instructions for Ninoy Aquino airport now means one less thing for the idiot-me to forget to do later.

In pre-travel mode I become a parent to myself. Lists are made and checked off. I run semi-conscious wargaming exercises like, 'If the programme was pulled forward to tomorrow would you be ready?' I update the weather app on my iPhone to flag destination cities (Manila, 30C, thunderstorms, if you're wondering).

And don't pack drunk. Turning up in Toronto in January equipped for summertime Sydney taught me that. Not unless you want fur-hatted Canadians pointing you out in the street.

Disappointed Bridge

Disappointed Bridge was the dumbest company name I ever came up with. The business in question was going to be the TV production arm of a theatre company we'd been running successfully in Sydney for a number of years. As part of this move the three founders invited Bryan to join us as a partner. He was a friend with a strong background in television but I suspect he really only came on board because of our cool offices.

And they were so, so cool; a former dance studio with a massive sprung wooden floor in a converted pier with panoramic views of the Sydney Harbour Bridge. The space was far too big for our meagre needs when we weren't actually rehearsing but when a friend offered us the chance to sublet, the wow factor was such that we couldn't turn it down.

Immediately after Bryan joined us we settled into the artfully spaced sofas and started brainstorming ideas for the new venture as a matter of urgency. Nothing so workaday as ideas for an actual television show mind; we needed a cool name for the business itself. And only a name as cool as our offices would suffice.

We ran an unsurprising gamut of obliquely clever and archly fey suggestions, including the obvious but taken 'Pier Productions', when I hit upon it, "Disappointed Bridge Productions!"

This was met with a predictable silence. I'd been reading James Joyce's Ulysses (which tells you everything you need to know about who I was at the time).

"There's a great joke in Ulysses: 'What's the definition of a pier? A disappointed bridge.'"

Genius, I thought; a company name that was apposite, witty and just a little off the mainstream. Just like the TV we planned to make.  Bryan, who knew me less well than the others but TV far better was withering in his sarcasm, "Yeah, because it's going to sound great when we're waiting in the lobby of Channel Nine and the receptionist calls up and says, 'The guys from Disappointing Bridge' are here to see you".

Bryan now makes lots of TV. I do not.

Waiting for a life-changing event

"A lot of farmers," said my brother-in-law, "won't move from their unsustainable farming practices until they have some sort of 'life-changing' event."

We were on a tour of the farm where I grew up in the 70's and 80's that he now runs with my sister and he was lamenting the unenlightened habits of many Australian farmers.  As I've mentioned before, he's an enthusiastic (evangelical) proponent of holistic farming.

I suppose the 'life-changing event' he imagines is some not-quite-fatal event like a heart attack or having the bank seriously question whether the farm's debt should be allowed to roll over.   But as any doctor will tell you non-fatal heart attacks are rarely life-changing.  We're humans and we hold our habits, good and bad, far closer than we'd like to admit.

It is useless to try and reason a man out of something he wasn't reasoned into.

Jonathan Swift

My brother-in-law has it wrong.  The 'life-changing event' he's seeking isn't for the farmer but the farm.  The best hope for changing practices on a given bit of dirt comes with change of ownership through inheritance or sale; and new ideas are far more likely to be trialled under totally new ownership of the asset.

The land we drove over was first used for grazing cattle in 1819 by a man named William Lee who helped build the very earliest road over the Blue Mountains to the west of Sydney.  Lee was granted title to something like 60,000 acres in 1832.  Over the years that holding was broken up into smaller properties although the Lee family are still prominent in the district.  My father bought our farm (4300 acres) from the Lees in the early 1960's.  The land has been owned by only two families in the almost 200 years since white settlement reached that part of Australia. Not a lot of scope for 'life-changing events' in that timeline.

It's a great modern example of the most persistent economic unit in history: the family owned and operated farm, reports of whose demise have been greatly exaggerated.  That persistence is borne of an old fashioned mindset; farmers who create a life that serves an asset that will outlive them.  This is at odds with the way that almost everyone in the rich world lives; we build a life that serves the personal needs of our families and ourselves.  We build unremarkable bourgeois lives instead of creating then stewarding some good thing that will outlive us.

As much as we freelancers believe that we're different from the wage slaves we used to be, in this respect we're exactly the same.  Seriously expecting your son to one day take over your web design business is as weird as assuming that he'll ascend to your regional sales manager role.

We have to admit that we're not building assets, just lives, and the best we can hope for is that most bourgeois of aspirations: leaving enough cash in the kitty for our kids to have their choice of futures.

Negativity bias

I am a social creature.  I enjoy the company of others and have always made an effort to maintain friendships despite living on the far side of the planet from the people I knew growing up.

Technology makes this much easier to achieve than in times past.  Facebook means we can keep up with the smaller details of others' lives and Skype affords us cost-free face-to-face interactions whenever both parties are at the computer, which is most if the time.  Still, there's no substitute for being in a room with a friend so that's how I spent much of my time in Sydney last week.

As I've mentioned earlier when an ex-pat comes home after an extended absence a damned-if-you-do-damned-if-you-don't mechanism kicks in.  As with any scenario where resources are finite (i.e. my time in this case) but demand is practically infinite, a zero-sum game develops.  Time spent catching up with one person is unavailable for any other purpose be it work, sleep, exercise or seeing someone else.  This fact is as obvious as it is brutal but its very obviousness creates a different, more subtle problem.

Most of my friends and family in Australia lead successful (read: boring) lives so these one-on-one catch-ups often turn out to be boring conversations that go something like this: -

Me: So how's everything with you?
Old Friend: Great.
Me: Family?
OF: Great.
Me: Job?
OF: Great.
Me: Parents.  How're your parents doing?
OF: Good...

Quickly pressure starts to mount under the conversation.  We both feel it.  After all I've made time for this one person to the exclusion of all others and we can't seem to lift the discussion out of bourgeois banality.  My old friend feels the need to somehow sing for her supper so she drags something out of left field: -

OF: Did you hear about my sister-in-law?
Me: No.  I don't think I know her.
OF: Oh, I'm sure you would've met her at something.  Anyway, her father has been diagnosed with Parkinson's.
Me: That's dreadful.  It must be very hard on everyone.
OF: Well, they live in Melbourne so we don't really see them that much but it has been hard on my brother.
Me: I think I might remember meeting him at your wedding...

We've moved on from personal banality to surveying the horizons of our person existence for second- or even third-hand suffering to make sure that our time together isn't wasted and by the end of the catch-up we're both a little exhausted.  An entire week of this can leave a guy not only wrung-out but thoroughly depressed as a negativity bias kicks in.  I have to keep reminding myself that I'm not getting a true snapshot of anyone's life.

We want our friends to be there to support us through the bad times so maybe there's a tendency to road-test the disaster scenarios that lie in each of our futures just to see how it feels.  Of course when the truly bad stuff has been and gone we joke about it.  The easiest, funniest conversations to have are the ones where there's true sadness at the heart of the story: -

OF: Did you hear what happened when my Dad got arrested?
Me: No!  I never even heard he'd been in trouble!
OF: It's hilarious really.  Anyway we get this strange call from my stepmother late at night...

All of this effort and analysis is a poor substitution for propinquity but it's all we ex-pats have to offer.

The unreasonable man

Whereas back in UK the 1.7million-person cost containment system known as the NHS continues to frustrate all who encounter it, both within and without.

I've long been of the view that the scarcest resource in the entire network is human energy required of a health care professional who will fight for the good of the patient.  This is not to say that there's malice or even negligence at work but rather an inertia that elevates older and cheaper therapies over newer, more expensive ones.  Doctors are soothingly told to be reasonable, to avoid cruelly raising a patient's expectations with talk of state-of-the-art treatments.  All of which brings to mind the great GBS: -

"The reasonable man adapts himself to the world; the unreasonable one persists in trying to adapt the world to himself.  Therefore all progress depends on the unreasonable man."

George Bernard Shaw

Which is certainly true of the NHS; drug budget blow-outs are avoided due to the reasonableness (read: exhaustion) of the staff.  An entirely unspoken aspect of the British pharma representative's job is to locate that rare unreasonable man.

The callous disinterestedness of the NHS

In the last month I've been out ‘on the road’ for three days observing sales representatives selling into the NHS.  As with any sales job the days are long and usually frustrating.  Busy doctors are always cancelling appointments.  The rest of the time gets filled with the strange burden of minor expectations that health care professionals, from the most senior doctor to the student nurse, have of the pharmaceutical industry.  Branded pens and Post-It notes have been banned but the ‘drug rep’ is still the conduit for funding for educational meetings here and abroad and for sandwiches (“We prefer a selection of wraps from M&S”) at least once a week.

What struck me hardest was the visible level of stress being carried by every NHS employee.  It had been a couple of years since I’d been out in the UK system and I was surprised by the universal interest in the price of the drug being sold.  Once upon a time only pharmacists and payers bothered to discuss cost; doctors and nurses didn’t sully their minds with such mundane financial matters.  But last week I watched a junior nurse, who is years away from prescriber status, quiz the rep about the comparative cost of rival treatments.  The nurse didn’t seem to be aggressive or point-scoring nor was he being clever for the sake of it; he just saw it as part of his job to understand the treatment options from a financial as well as a scientific-clinical standpoint.

I can’t think of another government department anywhere in the world where cost-consciousness pervades so thoroughly through the hierarchy as in the NHS.  Of course everywhere there are low-ranking teachers, police and perhaps even soldiers who are aware of their departmental budgets but not so consistently across an entire system.  By some counts the NHS is the second largest employer on the planet and every one of those employees has been trained to count the pennies. 

The taxpayer in me supposes that this is a good thing but I'm also sure that this cost-consciousness contributes significantly to the stress levels I saw in English hospitals.  No one ever went into the caring professions because they enjoyed the budgeting process yet this is now a substantial part of the job.

The reps I shadowed were selling expensive drugs.  This is true by definition: the only cheap drugs are ‘off-patent’ and so with insufficient margins to justify the formidable expense of a sales team.  With the NHS set up the way it is, any conversation with a drug rep is going to end with him asking for something that is difficult financially.  The medicine in question may amount to a revolution in the fight against a given disease but the health care professional is still left with the same old zero-sum game: - 

I cannot treat any patient as well as I would like to treat every patient

This has seeped into the organisation’s DNA.  Last year when the new Coalition government announced its Cancer Drugs Fund (CDF) the idea was for doctors to stop acting as financial comptrollers and get back to practicing medicine.  Yet the initial budget of £50,000,000 for the first twelve months will be underspent by a considerable margin.  This is not because Britain doesn’t have enough cancer sufferers to justify the money but because doctors across the country are genuinely suspicious about the long-term consequences of adopting newer, more advanced treatments in case the funding is later withdrawn

I've sat in on those sales calls.  I've seen doctors agree that there are patients under their care who would benefit from the drug in question.  But when the CDF is mentioned I've watched them narrow their eyes and ask for assurance that they weren't being tricked into changing their practice in an ultimately unsustainable way.  The logic being that it would be better to deny all current patients a better treatment if future patients would be denied it also.

 At the heart of the global financial crisis is the dawning realisation that for the first time in centuries we have to accept that future generations may lead less happy lives than us.  We are faced with the fact that the constant improvement in general wellbeing that the West has enjoyed since the mid-18^th Century is not inexorable.  If you work in the NHS then every day you're learning this unpalatable truth first hand: Britain cannot afford to keep offering every citizen continually improving health care.

By God that’s a stressful way to work.

Choosing to read

I read books at one of two speeds: days or months.

Part of my problem is that once I start a book I finish it.  It's the same with films and plays.  I have a personal rule that borders on a fetish: when I sit down to something I will see it through to the end.  My reasoning is that once you start prematurely disposing of Art the unfamiliar can be unfairly branded as mediocre and your horizons narrow.  I resent the badly written book that's been sitting on my bedside table since we got back from Greece three weeks ago but I balance that against the Headcount:1 discipline of sticking with difficult tasks.

Like any avid reader I can't put down a book I love but when something bores me I get distracted.   Newspapers, magazines, podcasts, NewsFire and Instapaper all beckon from the periphery.  A symptom of the modern condition that there's always something else to read so unless you develop some sort of discipline your attention will go AWOL: -

Stephan Pastis' Pearls Before Swine

It's hard to disagree with Merlin Mann's analysis that nowadays your attention is a more valuable commodity than your time.  The ticket price of a £25 book is easily dwarfed by the month of frustration of that unfinished book on the bedside table.  When the art is free, as at much of the Edinburgh Fringe, the real cost of consumption is even more obvious. 

Curation is now a vital aspect in any civilised life but sooner or later you've got to make a choice.  An hour spent scanning Twitter to see what others are reading is an hour not reading anything but Twitter.