Shoe Event Horizon & Healthcare

Recently, at work, I was discussing Douglas Adams ‘Shoe Event Horizon’ – the concept he discussed in the Hitchhiker’s Guide to the Galaxy, where the people living on the planets Brontitall and Frogstar World B, to help themselves out of a state of dejection and misery started buying shoes.

Shoe buying became a way to both make a profit and improve your sense of wellbeing; consequently the planets became over-run with shoe shops; teachers, plumbers, painters, technicians and accountants, all abandoned their professions to become shoe-sellers, causing society – industries and organisations, to decline into chaos with catastrophic results (the people eventually forsaking shoes and evolving into birds).

Every month, on a certain day in hospitals across the UK, senior nurses – usually ward managers and sisters are taken-out of clinical duty to complete audits. This is generally known as ‘Safety Thermometer Day’ – when data is collected that helps feed the beast that is the NHS audit and patient safety cycle.

There is nothing wrong with audit, and definitely not with patient safety – ensuring that what we are doing is correct, appropriate and safe is a cornerstone of modern healthcare. There have been too many stories revealed in the media for us to think any different.

Yet, it does strike me that the sheer number of audits, documents and records that are needed to sustain the wellbeing of a hospital ward or clinic far exceeds the actual effort that is required to provide the care;

Imagine a world, a healthcare system, in which, those same highly qualified clinical managers and sisters had a day dedicated to improvement – to thinking of ways to better the system, instead of ensuring that what we are doing is what we should be doing, based on what we are told to do by others who spend their time thinking-up what we should do.

Imagine if the position of the few (the thinker-uppers) was exchanged for the many, with the staff on the wards liberated, to allow their imagination to run free and think-up solutions to our problems.

Instead, the reality is very different. Sure, we need the checks and balances, we need to be able to refer back to what was done or not done where and when, we need to be able to keep people on message, ensuring that they are doing what they should be doing. If only that work added more value to the purpose of what we are here for.

We have computers and technology everywhere – we are surrounded, sometimes overwhelmed by technology. Surely the point of that technology is to improve, to help us humans do more, be more?

Instead, how much of our time is spent running towards the Event Horizon, running in circles, checking the checkers, measuring and monitoring the monitors.

We need to realize that the amount of resource, manpower, time, equipment, hours in the day is finite and is precious, for it translates into moments of life that are too rich to waste; we need to direct every moment into adding value to what we do, not tracing over lines that are drawn in the sand, to ensure that they are not rubbed-out by the tide.

We need to reinforce that which helps, that which brings succor and tenderness. Once we have learned these lessons we can re-think Samsara.