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My Journey to Power

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I think the challenge with hospitals is like all shared services nobody wants to pay for it unless they use it.   Of course in the long-term that is stupid and short-sighted because everybody uses it sooner than they think.  The doctors and nurses are heroes to me.

John Freeman has reacted to this post.
John Freeman

Thank you for your answer and your respect, Transitioned.

That's what I found out working in healthcare: in reality, health costs even more than what it costs currently. Healthcare workers make it cheaper by not being paid the full price of their service (unpaid overtime, etc.). Also, insurance companies and drug companies are getting the lion's share. Yes, some doctors get paid a lot (not as much as in the US). However, now that I see the degree of responsibility and the challenges involved, I think it's fair.

I have 2 friends who work 9-5 office jobs (drug company and computer services) and they are paid as much as an attending physician who's responsible for children's and people's life. Also working night shifts, 50-70 hours a week.

Something's wrong here. But it's to keep the price of healthcare low for taxpayers, which I understand.

Hello guys,

so here is an update on my extension of my social circle. Yesterday I organised a board game night at my place. What I did is not to invite B. who's behaving like he's higher power than me. I invited other friends. I will mix-and-match more so people don't have as much power over me. I can choose not to invite someone or to give priority to someone else.

I tried to build a small tight social circle. However, I realised that some people were not valuing enough what I had to offer. To build a tight social circle is not a favourable strategy. It's good to start with this: 5-6 people that you invite regularly. But after some time you have to add other people or change activities. Otherwise your social circle goes stale.

So it's a matter of inviting people, switching up and inviting more often the people you like the most. Not always but more often. Because as sad as it sounds, people value what is rare and valuable. Even if what you offer is valuable, if they can have free access to it whenever they want it, they start to value it less.

So by inviting more people more often, you have a bigger social circle and at the same time it does not go stale. People start to miss you and you start to miss them. So when you see each other, there is an added value than just the habit of seeing one another.

I would like it to be otherwise. I thought some people were my close friends. Only to realise that to them I was a "normal friend". So I start to treat them like this. And it works better for me. I'm less attached and I feel like they value me more (send me texts to thank me the night after I invited them).

I think it's especially true in individualistic cultures like Western countries. Once again, it's about Power. If you have more people to choose from, you have more Power. I would like it to be different, but that's true.

I also have to say that sometime I myself took a step back because I saw something in my friend that I didn't like so much (gossip, etc). This was a mistake. I hurt the relationship by doing that. I should have addressed it. We were close friends and because of me, we stepped back to normal friends.

This is also a mistake from my part as being too perfectionist with my friends. This stems from past friendship where I was too lenient and the bullshit idea that "you are the average of the 5 people around you". So I have been too perfectionist with people and I'm correcting it.

I will add that I do have friends with whom I open my heart to (and vice versa) and we are close and all. However, there is always a power dynamics element to any relationship.

Lucio Buffalmano has reacted to this post.
Lucio Buffalmano

Thank you for sharing this, John, lots of deep lessons there, and had me nodding the whole way through.

Quote from John Freeman on April 24, 2022, 5:37 pm

This is also a mistake from my part as being too perfectionist with my friends. (...) So I have been too perfectionist with people and I'm correcting it.

Yeah, was the same for me.

If I have to think back to all of my history with people, trying to change and mold people and social circles to my image was probably the single biggest factor that held me back (and also cost others in terms of enjoyment and connection).

Things go to the next level when you start accepting people for who they are, including their flaws (bar the "flaws" that disempower you of course, but that's a totally different topic and not what I'm referring to).
And yet to another level when you can welcome them for being different.

John Freeman has reacted to this post.
John Freeman
Have you read the forum guidelines for effective communication already?

Here is a success I wanted to share with you. Proper machiavellian style.

Context:

First time I did my job interview for the paediatrics residency program I failed. I tried to be too humble because I thought that my CV would make me look arrogant. I told them the truth when they asked me where I was seeing myself in 10 years (instead of what I thought they would like to hear): "I want to become a paediatrician doing innovation". The head of the program told me: "when you'll make a robot able to draw blood we'll hire you" and they all laughed. I felt like shit. This was my worst job interview ever.

I then went to the head of the department of paediatrics and gynaecology (let's call him the big boss) for an interview. I asked him if he could explain to me what I was doing wrong in my application or my communication. This was a genuine ask for feed-back and improvement. He made me an interview on the spot and gave me another chance to enter his department and not the paediatrics program itself. I had a 2nd chance. I was not aware how bold it was to talk with the head of department (he's 4 levels above me). My lack of power-awareness helped me in this case. If I would be as power aware as I'm now, I would have not even tried this move.

Then I studied in books how to pass medical job interviews. The second time I did the interview, I said the same honest things as in my first interview but this time with a positive twist on it and used the proper keywords they understand and are more comfortable with ("Research" instead of "Innovation"). I did one of the best scores if not the best score at the entry exam (2 interviews + 1 case). I know because they called me the next day to ask me to come into the program instead of "just" the department because I had such a great score. I accepted. This is the first twist of fate.

3 years forward: I'm a resident in paediatrics. I am in neonatology and the big boss is also a neonatologist and the head of the service of neonatology. He does interviews with all the resident doing a rotation in neonatology so he can get a feel of what people want to do (and also see the potential future attending physicians for his service I believe) and to see who people in his service are. I was waiting for him at his office but he was late. So his secretary told me to come later when he would arrive. When she called me I was in an emergent situation so I could not come. She told me we can reschedule. We rescheduled on the phone. I put many reminders so not to forget the appointment. The day comes. I go to his office: no one. I call his secretary: he's on vacation. I went on the wrong date according to her (my reminders worked though but of the wrong date). The truth is that it's the date she gave me on the phone. SHE fucked up. So I send a message of apologies and try to reschedule it. The big boss does not answer my email and his secretary tells me that he's not available anymore and that I had already seen him (3 years ago). I fucked up my relationship with the big boss. I don't get to have this informal interview with him. She told me they said: "we're not going to run after him" (talking about me). Unknowingly I one-upped him with a "I'm busy" power move (back to being clumsy as bad as doing it on purpose). During my performance review, I tell the story to my supervisor. She tells me that I did not have the appointment written. I should have confirmed it in writing. Lesson learned.

2 months later, Christmas comes. I decide to write him a Christmas card to apologise. I write:

Dear Big Boss,

I want to apologise again for the missed appointment. Next time I will confirm in writing the appointment (remember the "lesson learned"). I want to thank you for the opportunity to do a rotation in your service. I wish you and your family happy holidays.

Sincerely,

John

So I had my conscience free and I repaired my relationship with the big boss. Whatever he thought of the card was not in my control.

5 months later, a colleague asks me if I would like to build a group of resident to talk with the big boss to solve issues. I know this institution is dysfunctional so I say that I'm not interested. Things are not going to change if the whole institution is dysfunctional. So I refuse. And I also want to leave this institution.

I want to move to another hospital. I talked recently with one of the attending physicians at the 2nd hospital. She tells me that when she applied with her now boss, he talked with our big boss to know more about her. "Phone calls are going to be made", she tells me. So I'm like: I'm fucked. He's going to talk bad about me if I apply to this other hospital and they ask about me.

I think about it and realise I have to go further to have a better relationship with him. So I talk with my colleague and say to her that I changed my mind. She's right and we can change things. I lie to be able to get closer to the big boss. I still think it's useless, that the institution is too dysfunctional on a global level.  This is the machiavellian part. It's to be able to change hospitals with his blessing.

So she arranges an appointment with him for me. I had done this representation role several times during my studies and also with the residents in adult emergency medicine. But the paediatrics department does not have a structure representing the residents (2022! I know we are much behind: Switzerland is conservative). I love leadership roles as you might know. So I enjoy doing these roles.

I confirm with the secretary the time and asks her to confirm to me the place by email (lesson learned!). She does.

Today, I tell my high power controlling boss that I will be going to such an interview. He's surprised and asks me what it will be about (remember he's really good in politics). So I tell him it will be about creating a group that will represent medical residents.

Today, I go to see the big boss. I don't even bring up the card or the missed appointment (high level social strategising). We talk and we share the same vision. I won't go into details. At some point I tell him: we (the residents) will be able to implement your vision. This is highly machiavellian. Explanation: I hint at the future value of him being able to extend his power not only through his direct subordinates but through us on the field, directly. I think this is quite a high selling point. I am totally sincere when saying this because I think we need to de-silo the department and unite it better. Just like he does.

He agrees, we set a future date for an appointment with the group. Now I'm in charge of building this group.

My direct boss (high power controlling) asks me how it went when we talk on the phone about cases. I tell him it's moving forward. We talk about the cases and he hungs up. He calls me back 2 minutes later: "we'll take one hour tomorrow to talk about these cases." He never spoke to me like that and never took so much time for me. So this is already a newfound power.

Another important fact: my high power controlling boss asked me explicitly not to write down my overtime at the beginning of my rotation in his service. I accepted because he will be the one evaluating me. And because he's so dominant and high power, I did not want to be on his bad side. So basically, he stole tons of time and money from me with my own agreement. Now I have this to hold against him and I have the big boss ears'. That's why he's trying to be friends with me now. As an example: I had to use 2 weeks of my holiday time to catch up on my administration. Yes, I could be more efficient but also there is a lot of overwork.

So what is the most powerful power move here?

Now I'm under the direct protection of the big boss. And people know it. 

Lucio, I dedicate this specific journey in Power to you. I owe this to you, all the people on this forum and PU. My Success is Our Success. I mean it.

Of course, now I have to deliver on the promise. So now I'm in charge of building the group of residents which will represent all the residents (again!).

I hope this is inspiring for you guys as a motivation to learn social intelligence and power dynamics.

I feel now more motivated to succeed on my exam and in my job.

Lucio Buffalmano, Mats G and Bel have reacted to this post.
Lucio BuffalmanoMats GBel

BOOM!

This was awesome John!

Also the story, with the struggle, the roadblock, the smart moves, and then the resurrection and take off. Read like a true movie script :).

Edit:
I may add some more comments later.

John Freeman has reacted to this post.
John Freeman
Have you read the forum guidelines for effective communication already?
Quote from John Freeman on April 25, 2022, 8:36 pm

First time I did my job interview for the paediatrics residency program I failed. I tried to be too humble because I thought that my CV would make me look arrogant. I told them the truth when they asked me where I was seeing myself in 10 years (instead of what I thought they would like to hear): "I want to become a paediatrician doing innovation". The head of the program told me: "when you'll make a robot able to draw blood we'll hire you" and they all laughed. I felt like shit. 

Dickehead move from him.

High power and fragile ego.

A bad combo, but a very common one at the top of most organizations.

The problem there was that he felt the frame was:

  1. "we need innovation" =
  2. we can do better =
  3. you guys are not doing well enough ("you're dinosaurs, let the new blood come in and take over")
  4. I'm going to improve things
  5. ya'll end up being disempowered + lose status and reputation for not having done any innovation

That was disempowering to him, something he couldn't accept.
He'd rather keep things as they are for ever, rather than lose power -again, common, so something to keep in mind-.

Of course, the joke made little sense and was actually offensive to him if one were to truly analyze it. Who says that a robot drawing blood is such a crazy thing?
It might be a reality soon enough -probably even behind the corner timewise-.
But it was just a power move, and they all laughed because of power dynamics, not because it was fun.

Quote from John Freeman on April 25, 2022, 8:36 pm

I then went to the head of the department of paediatrics and gynaecology (let's call him the big boss) for an interview. I asked him if he could explain to me what I was doing wrong in my application or my communication. This was a genuine ask for feed-back and improvement. He made me an interview on the spot and gave me another chance to enter his department and not the paediatrics program itself. I had a 2nd chance. I was not aware how bold it was to talk with the head of department (he's 4 levels above me). My lack of power-awareness helped me in this case. If I would be as power aware as I'm now, I would have not even tried this move.

Great move!

Consider that this was a great (power) move.

A bit risky, but at that point, worth the risk.

Very different scenario and details, but the roots of the power dynamics are not too different than in this example here:

In the video hot girl gets fired by her immediate boss. Instead of surrendering she goes straight to the big boss and seduces him -not too dissimilar from "getting close to him", both are leverage-. She gains power through the big boss, achieves her goals and more (and even gets her revenge)

When you say "today I wouldn't have done it", it may mean you can further expand your field of possibilities to include bolder moves that right now may seem "too much" to you, but that might actually be the best step (if not, the sociopaths and dark triads who don't have as many qualms may take your opportunities).

Quote from John Freeman on April 25, 2022, 8:36 pm

Then I studied in books how to pass medical job interviews. The second time I did the interview, I said the same honest things as in my first interview but this time with a positive twist on it and used the proper keywords they understand and are more comfortable with ("Research" instead of "Innovation"). I did one of the best scores if not the best score at the entry exam (2 interviews + 1 case). I know because they called me the next day to ask me to come into the program instead of "just" the department because I had such a great score. I accepted. This is the first twist of fate.

Nice!

Preparation is always the best power move :).

When I landed my first assessment center to a job I had no business having I wrote on my door as a reminder for everytime I'd wake up "I will get there as the most prepared candidate they've ever had".
Then I rehearsed presentations to the only audience I had: my parents who didn't understand a word of what I was saying (but they were good enough to answer the most important questions such as speed, body language, delivery, etc.)

Quote from John Freeman on April 25, 2022, 8:36 pm

I was waiting for him at his office but he was late. So his secretary told me to come later when he would arrive. When she called me I was in an emergent situation so I could not come. She told me we can reschedule. We rescheduled on the phone. I put many reminders so not to forget the appointment. The day comes. I go to his office: no one. I call his secretary: he's on vacation. I went on the wrong date according to her (my reminders worked though but of the wrong date). The truth is that it's the date she gave me on the phone. SHE fucked up. So I send a message of apologies and try to reschedule it.

(...)

She told me they said: "we're not going to run after him" (talking about me). Unknowingly I one-upped him with a "I'm busy" power move (back to being clumsy as bad as doing it on purpose).

Crazy.

She threw you under the bus to cover her ass.

It was a small mistake for her with little consequences. But she wasn't prepared to face even those small consequences and pushed her small snowball on you even though it was an avalanche for you.
It could have cost a big career opportunity -and with the costs pushed to many others as the best person wouldn't get the best opportunity-.

And yes, you read the power dynamics correctly after that: it was all a power dynamics thing (made it almost explicit when he said "not going to run after him").

A few ideas on how to handle this:

  • When she calls and you're in an emergency

Make sure they know it's an emergency + make amends to re-empower him:

You: (loud, fast, communicate "emergency" with tone and pace on top of words) Hi! Yes! I absolutely want to be there, I'm in the middle of an emergency curing a bleeding patient, please say that to big-boss and will be there as soon as I'm done, OK?

Then rush there.
Doesn't matter if it's too late, it's more about the sub-communication, which is: "you're my priority almost as much as an emergency and I ran to you as soon as possible".

  • When she pretends it was another day

At first blush I'd have gone from frame imposing:

Nono, I'm 100% sure this is the date, I wrote it down as soon as we ended the talk and I put 3 reminders

Stay on it.

Let her admit the mistake might have been on her.

And then help her save face so you don't make her an enemy as you still need her -"something might have happened", or "no biggies, let's focus on next step now"-.

Then insist that this is very important, that you truly want this opportunity, and "what can she do to make it happen again?".

Quote from John Freeman on April 25, 2022, 8:36 pm

5 months later, a colleague asks me if I would like to build a group of resident to talk with the big boss to solve issues. I know this institution is dysfunctional so I say that I'm not interested. Things are not going to change if the whole institution is dysfunctional. So I refuse. And I also want to leave this institution.

I want to move to another hospital. I talked recently with one of the attending physicians at the 2nd hospital. She tells me that when she applied with her now boss, he talked with our big boss to know more about her. "Phone calls are going to be made", she tells me. So I'm like: I'm fucked. He's going to talk bad about me if I apply to this other hospital and they ask about me.

I think about it and realise I have to go further to have a better relationship with him. So I talk with my colleague and say to her that I changed my mind. She's right and we can change things. I lie to be able to get closer to the big boss. I still think it's useless, that the institution is too dysfunctional on a global level.  This is the machiavellian part. It's to be able to change hospitals with his blessing.

Bingo!

When I read that first part of you refusing the opportunity I thought "ouch, it was a great chance to get close to big boss, I hope that not getting the opportunity isn't going to cost him".
And then you both realized the potential pitfall, and fixed it like a champ, awesome! 🙂

Quote from John Freeman on April 25, 2022, 8:36 pm

She tells me that when she applied with her now boss, he talked with our big boss to know more about her. "Phone calls are going to be made", she tells me. So I'm like: I'm fucked. He's going to talk bad about me if I apply to this other hospital and they ask about me.

I think about it and realise I have to go further to have a better relationship with him. So I talk with my colleague and say to her that I changed my mind. She's right and we can change things. I lie to be able to get closer to the big boss. I still think it's useless, that the institution is too dysfunctional on a global level.  This is the machiavellian part. It's to be able to change hospitals with his blessing.

So she arranges an appointment with him for me. I had done this representation role several times during my studies and also with the residents in adult emergency medicine. But the paediatrics department does not have a structure representing the residents (2022! I know we are much behind: Switzerland is conservative). I love leadership roles as you might know. So I enjoy doing these roles.

I confirm with the secretary the time and asks her to confirm to me the place by email (lesson learned!). She does.

Today, I tell my high power controlling boss that I will be going to such an interview. He's surprised and asks me what it will be about (remember he's really good in politics). So I tell him it will be about creating a group that will represent medical residents.

Today, I go to see the big boss. I don't even bring up the card or the missed appointment (high level social strategising). We talk and we share the same vision. I won't go into details. At some point I tell him: we (the residents) will be able to implement your vision. This is highly machiavellian. Explanation: I hint at the future value of him being able to extend his power not only through his direct subordinates but through us on the field, directly. I think this is quite a high selling point. I am totally sincere when saying this because I think we need to de-silo the department and unite it better. Just like he does.

He agrees, we set a future date for an appointment with the group. Now I'm in charge of building this group.

My direct boss (high power controlling) asks me how it went when we talk on the phone about cases. I tell him it's moving forward. We talk about the cases and he hungs up. He calls me back 2 minutes later: "we'll take one hour tomorrow to talk about these cases." He never spoke to me like that and never took so much time for me. So this is already a newfound power.

Another important fact: my high power controlling boss asked me explicitly not to write down my overtime at the beginning of my rotation in his service. I accepted because he will be the one evaluating me. And because he's so dominant and high power, I did not want to be on his bad side. So basically, he stole tons of time and money from me with my own agreement. Now I have this to hold against him and I have the big boss ears'. That's why he's trying to be friends with me now. As an example: I had to use 2 weeks of my holiday time to catch up on my administration. Yes, I could be more efficient but also there is a lot of overwork.

So what is the most powerful power move here?

Now I'm under the direct protection of the big boss. And people know it. 

 

All the rest is music to the ears, both in the thinking and execution :).

Rock on John! 🙂

John Freeman has reacted to this post.
John Freeman
Have you read the forum guidelines for effective communication already?

Thank you very very much for taking the time for all this priceless input.

I read it carefully. I waited some time to answer to let other people chime in.

I agree 100% with all the above. So no use to quote just to say: "exactly". There are some golden nuggets that could be used for PU, especially the emergency situation. To let the boss know he's our top priority.

Here is a new power move from B the French guy, the guy who prioritise other events. He's high(er) power (than me). Now my goal is to become higher power than him.

Context: I proposed to F. the French computer guy to go to a restaurant. F. is going to book the restaurant. I ask B. through WhatsApp. He says he's going to propose his friend. No news and F. has to make the reservation.

1PM

Him: I'm going to ask her

Me: Yes!

7PM (last moment to make the reservation)

Me: Hello F. must book. Are you guys coming?

Him: You can always book just in case 😉 (he implies:: book and if they cancel later at least we have the table booked. He tasks me)

Me: Alright, you don't know yet, it's ok. I'm going to ask him to book (redirect the task) and you can tell me when you know! 🙂

Him: Yes! Perfect! ("Good job" power move)

Me: Nice! (trying to counter his previous "Good job" power move but it fell flat because it's too late)

The next day (today at 6pm):

(4pm)Me: ....7:15PM (and giving him the other details of the place)

(6pm) Him: Ok

Him: But it's early (judge power move: "it's too early")

Me: Other spot: 9Pm (being fact-based, addressing the power move, without justifying myself, minimizing investment: low-effort)

So he's either tasking me or complaining about the time for the booking. This is quite disrespectful to F. who booked the place. It shows he really thinks we are at his service.

I could have answered: "It think it's already cool that F. booked the place". But it would have been a bit passive-aggressive and not eagle like enough.

For the first one I could have done:

Me: Hello F. must book. Are you guys coming?

Him: You can always book just in case 😉 (he implies:: book and if they cancel later at least we have the table booked. He tasks me)

Me: Well, we have to know how many people are coming, you know how it is in restaurant. Let me know when you know (fact-based, counter-task him)

I think the underlying dynamics is that I value him and I'm afraid to lose him as a friend because I deem him high-quality.

I think the best strategy is really not to invite him to anything for some time. I feel he's taking our friendship with F. and I for granted and it feels disrespectful.

Some people are good at getting into the emotional judge place. So I think I have to do role reversal with these people and become their judge.

What I did good here is that I was triangulating between them. They had to go through me to communicate to one another. So this gives me power. F. also booked the restaurant, so I basically did nothing. So I stayed high in power still.

Gotta go to the restaurant! Cheers!

Hello guys,

I’m in a new rotation. It implies being the primary care physician of migrant children. I have a supervision but I’m quite autonomous.

Every Wednesday I will have a “co-consult” with a sexual health advisor. That means I do a consult and she’s present and talks about sexuality.

We did it once. With all my open-mindedness and professionalism I could see two things:

1. She’s a feminist with an ideology

2. I will have to play along.

Basically when we talked about transgenderism I wondered how much of it is “wrong person in wrong body” and how much of it is identity crisis and need of psychiatrist help.

There was a girl who was questioning herself about being a boy. I think that our role as adults is to provide reassurance. The questioning is ok. However the message should be it’s ok to be a girl and not it’s ok to be a boy. I mean I think it’s more benevolent to help a person accept themselves than not to.  I think our role is to provide a solid frame not a moving one. I’m not a psychiatrist so I recognize the limits of my knowledge.

I could see this health advisor is herself not at peace with herself. I don’t know her sexuality. However I’m wondering how much is the hurt being able to help the hurt.

She also overstepped her boundaries when we did the co-consult and started to talk when it was not her turn. She’s basically only allowed to talk about sexuality.

Also she told me that it was a 2 years training. I looked it up because the whole thing felt fishy. And it’s actually 69 days over 2 years. So we go from 2 years to 2.5 months of training that’s different.

I don’t think I’m going to confront her with that.

I will learn from her that is sure and I understand that is the goal. However I think people with a profile with an ideological agenda are not ideal in these jobs.

I felt uneasy when she talked with the teenager because I felt she was pushing on her that it’s ok to be a boy (and she’s a girl).

When we talked she told me: “Society is so discriminatory”. This means she felt discriminated but it also felt like a generalization.

I will have to play along as I’m there for 6 months and will not rock the boat. However I feel like there’s something rotten in Denmark.

There was also a “slut walk” of 500 people in Geneva. As if we would be living in a culture of rape. There’s a small minority of women/people who suffered and has been suffering (at the hands of men but probably not only) and they generalize their experience.

Update:

Something else I noticed with the nurses at the pediatric ER I am working at (10% activity) and about colleagues in general:

it’s a matter of self esteem in the end. If your colleagues don’t feel good about themselves it’s the same situation as in being a relationship with someone with low self-esteem.

There’s going to be problems. Because their insecurities will often trigger their egos. So there is a conflict waiting to happen. It will quickly become either you’re wrong or I’m wrong.

Of course you can maneuver around their ego, which I do. However working on a daily basis with people you have trouble getting along with is a recipe for unhappiness.

We spend 8+ hours with these people. So the experience will be quite different than to be working with people who are feeling good about themselves.

In their case they’re compensating their feelings of low self worth with their confidence at work. So when their confidence in their job is threatened then their fragility is exposed. I.e. you don’t agree with them or they make a mistake.

There is also a lack of flexibility. They also compensate with feeling powerful AKA dominate.

I’m not in their heads. This is based on my observation.

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