Sorry you’re leaving …

Br J Cardiol 2009;16:173-4 Leave a comment
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We continue our series in which Consultant Interventionist Dr Michael Norell takes a sideways look at life in the cath lab…and beyond. In this column, he considers fond farewells.

The title of this piece more usually adorns the front of an enormous and brightly coloured greetings card. When opened by its lucky recipient, a torrent of sentiment springs forth, and while in a variety of handwriting styles, all, nevertheless, convey much the same message. This is along the lines of: “Sad to hear you are off, it’s been good working with you and good luck in your next job/posting with the British Antarctic Survey/sabbatical in Albuquerque, New Mexico/maternity leave/retirement/blah-blah”.

Those of us who have been fortunate to be on the receiving end of these expressions of appreciation may feel a sense of awkwardness at times like this. Whether this embarrassment is a peculiarly British problem I’m not certain about, but I am sure that rather than trying to avoid others’ adulations we should instead welcome them. After all, this is all about their feelings and not yours.

The collection

You know what is likely to be over the horizon when … the collection comes round. A large manila envelope is left anonymously on your desk. Inside is a collection of coins (usually of larger denominations) together with paper currency (usually the smallest). A pink post-it advises you that “Justin from ECG is leaving”, “Hayley in the cath lab is getting married” (again), or “that nice Dr Gluck (who had a recent skirmish with the GMC) is moving on”, and asks whether you wish to sign the enclosed and aforementioned card.

The assumption is that the privilege of jotting down some spontaneous and heart-felt witticism is only acceptable if a contribution is made to the accompanying pecuniary contents. I have to confess that in the privacy of my own office I have occasionally scribbled something thoughtful and then rattled the envelope muttering something about ‘change’ so that my secretary is convinced I have added a significant amount to the pot. I then hand it back to her for continued circulation (with, I am proud to say, an impressively saintly expression on my face – don’t tell her that, for goodness sake).

A previous mentor of mine made it abundantly clear to all departments that he was most certainly not in the habit of contributing to these exercises, laudable as they may be. As he was the most senior member of staff, and so had been around the longest, he would otherwise – at least on mathematical grounds – be subjected to the biggest long-term financial hit. Not unreasonably, he felt that this disadvantaged him and, although I suspect he could well afford it, I do have a certain sympathy for his viewpoint (please don’t tell my secretary that either).

The event

And so … some form of event is planned in order to celebrate or, failing that at least mark, the impending departure of our valued colleague. These take many forms and I am certain that you have witnessed just as many slightly embarrassing, inwardly squirming or just plain downright disgusting examples as I have. Enterprising businesses have been set up specifically to supply this need and include supplying strippers dressed as police officers, Chippendale look-alikes (remember them?) and the now infamous ‘Rolypoly-gram’. (If any, or all, of these are a mystery to you, then I suggest you advise your head of department that you are going to Australia and request “nothing fancy, but just something a bit different” for your leaving do.)

The gift

The choice of gift by which the departing employee might be more inclined to recall his previous working environment, together with his comrades in arms, is always a tricky one – particularly if he actually wants to. A bunch of flowers, or an alcoholic beverage are two possibilities, but the former withers and the latter is consumed, in both cases far too quickly (I leave you to estimate which might occur more rapidly).

A photographic montage of all one’s colleagues is a neat idea (I got a calendar like this once), as might be an old engraving, architect’s drawing or a sepia-toned 1920s print of the hospital that our friend has chosen to leave. All these examples suggest that some thought has at least gone into the process. The knowledge of the subject’s hobbies (a golfer, a sailor or a keen gardener) may inform the selection of more specific items, but in some cases (skydiving or mountaineering, for instance) specialist advice should be sought to ensure that the present received is not only appropriate but safe. (I received a boat hook once, which fell apart with the first mooring buoy I tried to secure; I would hate to think of the same thing happening with a sincerely considered parachute or a heartfelt coil of brightly coloured climbing rope.)

I was given a tantalus so I remain unsure as to which ‘hobby’ of mine my ex-colleagues had been thinking about.

The surprise

There remains one other feature of the departing process that I should warn you about, and that is … the ‘wacky’ and fun-filled surprise. Nurses tend to plonk the victim in a bath; I have had KY Jelly in my cath lab shoes and a dose of furosemide in my tea. The latter was years ago, but as I get older I am sure that its effects are becoming more evident. At least the experience serves to remind me to instruct my juniors that the severity of pulmonary oedema does not correlate with the dose of diuretic required: if patients are ‘diuretic naïve’ see what 20 mg does first. Believe me, I know what I’m talking about.

The most memorable leaving event I recall was being crash-called at 3.00 am to a cardiac arrest in the A&E department on a particularly nippy February morning. As I burst into the resuscitation room a typical scene greeted me in the form of the casualty staff attempting revival of some poor unfortunate who was either at, or beyond, the point of succumbing. I realised too late that the ‘patient’ being massaged on the trolley was actually a manikin. I was grabbed from behind, debagged and daubed ‘liberally’ (I use the word advisedly) with gentian violet.

What lessons are we to draw from this monologue? I would suggest that you think twice before you apply for another job.