If you think it's expensive to hire a professional to do the job, wait until you hire an amateur.
The car is moving at 100 kilometers per hour through the nightly town, while I split myself in a couple of seconds: my emotional side, alarmed and fearful, is thrown away from my mind, while the control is taken by my cold and pragmatic, professional rational side. The time is expanding while I dial 112, the international European emergency number.
I am regrettably still in Romania and I begin the conversation with the 112 by stating directly that I am a doctor; in East Europe is better to set the stage and the expectations immediately, cutting any attempt from the 112 operator to negotiate with you. I am in a vital emergency so I ask directly for an ambulance, using medical terms so as to explain what is all about, in order to be believed that I am certainly a doctor and that I really have an emergency. My voice is trembling, some terms come to my mind in French and I struggle. But I make myself understood. Surprisingly, the 112 operators is efficient and diverts me to the ambulance emergency service.
The ambulance operator begins to negotiate. The guy doesn’t believe me. He asks me from what region of the country I’m calling, from what county, although the location of the phone is typically revealed when calling 112. He begins to start to refuse me while I mentally prepare for resuscitation. A quarrel is about to erupt, I restate my professional title so as to refresh his mind, he tells me that the patient can come to the hospital the next day, I tell him that the patient can’t breathe NOW… Something in the murky mind of the ambulance operator finally wakes up when I raise the tone and I begin to threaten by saying that the patient is going to freaking die, implying that he’s to be blamed if it happens so. He sends me the ambulance as I am at a couple of streets away from the house of the patient. The entire call with the 112 and the ambulance service has taken exactly 4 minutes and 40 seconds.
As I enter the garden and then the house, the time is still expanded. I am not prepared to perform a cardiac massage but you are never prepared for anything when you’re in an emergency. You make do. Some long minutes after, the ambulance is in front of the house. A very reactive, very common-sense, very efficient team comes out of it. Battle won this time…
The talent cliff is a term increasingly emerging in the leadership vocabulary. It’s about the fact that the older generation, those who are 60+ years old, are gradually retiring, being replaced by the younger generation, by the artificial intelligence systems and by… nobody really… When I left France, the management preferred to close beds rather than try to keep me or hire someone new; they didn’t know the meaning of the term “employee retention” or they pretended not to know it. Financially, my departure was good for the hospital, as a doctor is costly. But in terms of “quality of the service”, the patients have lost. On the paper, bureaucratically, there is more money available for various “projects”, useful or rather not. In reality, because there are fewer beds and fewer places, people have to be “kept” in the outer world or at the emergency service or on a waiting list, and in case of psychological or psychiatric distress, the suicidal attempt is the rule. It’s a systemic failure nobody wants to assume; it’s better to pretend it doesn’t happen, hoping to pass the problem to the new management or the newer generation. The problem with the new generation is that it is either cynical or unprepared, or both.
The talent cliff points out to the fact that “talent” is disappearing with the departure of the older generation. People with the ability to understand, to use critical thinking, to use empathy if necessary or required, are going into their retirement years, while not being able to pass the knowledge to the newer generation. Then, sometimes the older generation is directly replaced by the artificial intelligence who is not able to understand the subtleties of human interactions. For some years now, when dealing with my mobile phone company or my bank, I annoyingly have to pass the audio menus of the customer service robots so as to get to speak with a real person because the robot is unable to grasp what I want to convey. The newer generation of people is no different from a robot: they have learned what they have to do automatically, they have practically memorized everything, or they don’t care if they are fired or not, because they don’t love their job, they are not valued by their employer or they are purely entitled, cynical and disillusioned. And this is how we end up with less “talent”; even if the newer generation is probably equally intelligent, it is not equally motivated, equally cultured and equally concerned about what they’re doing. They content themselves to be average because average is exactly what is required from them and because they have no longer any aspirations. They are comfortably numb or outright bewildered.
The talent cliff is already here. We are using systems built by our parents and grandparents, but we fail to maintain them properly and we fail to understand the idea behind the necessity of these systems. The ambulance operator I had to deal with last night did not recognize an emergency even if a doctor - me - was telling him that it is truly so. As I later discovered when we arrived at the emergency department of the hospital, seeing several ambulances being parked there and staff smoking in front of them, it wasn’t at all a matter of lack of ambulances or staff. It was pure carelessness, probably coming from both ignorance and laziness. The ambulance guy knew that the emergency services will likely struggle to find a replacement for him if he’s fired, so he was absolutely sure of his position. I had to appeal to his generosity and he markedly made me understand at the phone that he has made me a favor. Was it about “talent”? Of course not. The talent was with the lady at 112. The tough question is when are we going to see someone similar replacing the lady at 112?
Everybody knows that we’re approaching the “edge” of the talent, when the systems will be run by idiots and bureaucrats. I’ve seen waiting lists of 6 or more months in France. I heard that in the UK people are dying on waiting lists stretched on several years. It is an obvious failure of leadership, yet politicians come smiling and tell us that everything is fine. Also, the Human Resources in several of my workplaces were joyous when I told them I’m leaving, while, by contrast, my former patients still seek me on the internet and ask for advice - a proof that I wasn’t lacking “talent” after all… The HR didn’t know what they’re doing but the leaders don’t care because the society is already polarized and they can afford to pay money for private clinics or go “abroad”… so it is understandable that they can smile to us. However, before being helicoptered to Vienna or Munich or elsewhere, the rich guys must pass, locally, through the ambulance operator I encountered yesterday… and get acquainted with his muddy mind. I “wholeheartedly” wish them… good luck!
In order to tackle the existing talent cliff one needs vision. Vision is the ability to predict the future while using your mind and while not obsessively thinking about your own interest but also about the society you leave to your own children and the society that “will take care of you” in your “decaying” years. We are only a few who happen to be nerds and can manage a failing system. If we’re gone or we decide to get out of the system for good and begin to be gardeners – many people have already lost hope and became peasants – I don’t know who’s going to rebuild or maintain the systems… When I left France, I couldn’t pass my knowledge to anyone; no junior doctors left, as medicine is tough and psychiatry pays less… It was sad; my knowledge left with me.
Sandwiched between a growing population of pensioners who live longer and are beginning to be a burden both socially and in terms of budget, and a horde of “perpetual teenagers”, corrupted by social media and narcissism, I don’t know what we’re going to do. And, just like I could have discovered last night, this can also be a difference between life… and death.
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