Wednesday, 23 March 2011

A day in two lives

As a District Nurse, Susan (not her real name) started work at 8:30 by popping into the health centre for messages and to deal with any urgent problems that might have come up. She and her colleagues then met to check work allocations for the day.

Andrew (not his real name either), head of the investment branch of a major bank, also started his day at 8:30 when he met his closest associates. They had been researching the financial standing of various rivals that were beginning to show signs of weakness. He was proud of these bright young people and the reports they had prepared, insightful, concise and closely argued, just as he had trained them. He knew, however, that the closer they studied their targets, the more enthusiastic they would have become about them. He would have to allow for the distortions to which this might lead. He would also have to rein them in during the meeting if they were to stick to the scheduled time.

Susan visited three patients in the course of the morning. Two were terminal and she was particularly careful over their treatment, above all to ensure they had sufficient pain relief. One, a man not out of his fifties but who would never see 60, was nearing the end of a long but hopeless fight against MS. Usually highly controlled, he surprised her by a sudden outbreak of fury. Though he could no longer use his legs, he showed that his arms still retained some strength when he flung his chamber pot at her. Fortunately, he missed and it was empty. He then broke down in tears and she had to delay her departure, overcome her own anger at his behaviour and comfort him back to calm. She had to remind herself that he was divorced and estranged from his only other relative, his son.

One of the presentations Andrew heard that morning caught his attention. The views of the young man who had prepared it betrayed the partiality that Andrew expected, but even after allowing for that, there was a kernel to the argument that felt like the real thing. The target was a prestigious name from the world of merchant banking, the kind of organisation which would boost the standing of any acquirer. It had been made vulnerable by recent financial difficulties and was probably open to an approach. Andrew had an intuition this was the right target, and while he knew better than to be carried away by a hunch, he also knew better than to ignore one. He cleared his diary for the morning and held a series of further meetings to probe and test the advantages and difficulties of the project.

The delay with her last patient meant that Susan had little time for lunch, so she stopped at a local supermarket and had a sandwich over a cup of coffee, taking the opportunity to phone occupational health to see whether a new mattress could be provided for one of the patients she had visited that morning and whose bed, too old and damaged, was seriously adding to his pain. She also took a call asking to add one more visit to her round that afternoon.

Andrew’s meetings had left him little time for lunch, so he had sushi brought into his office to share with the associate whose project he was now inclined to take up. Together they finalised the paperwork for the proposed acquisition and a presentation that he would put to the executive board of the bank that afternoon. He found the time to make a call to the Chief Exec’s PA to ensure that his presentation could be added to the agenda, even at this late stage. His associate had had the forethought to include mochi as a dessert to their lunch, a particularly tasteful touch.

Susan called first on the patient who had been added to her schedule for the afternoon. He was in the final stages of cancer. One look at him was enough to tell her that he wouldn’t be making it to the evening. His daughter was by his bed, holding his hand while tears coursed down her face. Susan sighed and stepped outside to phone in and ask the receptionist to reschedule her appointments. It would be a blow to her colleagues who would have to cover for her, but there was no way she could leave now. She felt sorry, too: she knew like any professional that an emotional bond with her terminal patients was not an investment likely to give much in the way of dividends, but this one had shown such courage and good cheer in the face of great suffering that she was going to feel real sadness at losing him.

Andrew’s executive board meeting went superbly. The case he had built with his associate was ironclad and the chief exec was more than predisposed to be convinced, so the other directors were quickly won round. After the meeting, he had time to brief his associate again and start the process of acquisition. Informal contacts were made that very afternoon and were met with warmth, not to say alacrity, promising an easy negotiation and an advantageous price. The day called for a celebration and the meal that the chief exec and several directors shared with Andrew later was a fitting gesture to the scale of the achievement. He particularly enjoyed the St Est├Ęphe they drank with the main course, one of his favourite wines.

Susan spent her patient’s final hours doing what she could to make the end as easy as possible. She remade his bed, made sure that catheters were working and she kept the flow of painkiller high. He died soon after 6:00 and she stayed a little while helping his daughter prepare the body for the undertakers, not because it was necessary or part of her job, but because the work might give the daughter a little comfort too. By the time Susan had returned to the Health Centre and finished her paperwork, it was too late for her bridge evening. Her partner was polite but clearly disappointed when Susan rang to tell her. She then phoned home. Her husband had eaten the dinner she had left for him, so she called in for fish and chips on the way home, and ate them in front of the television before heading to bed early, to be ready for the next day. At least she knew that a few people were in slightly less pain, were slightly less disconsolate thanks to her efforts, probably including the patient who had turned aggressive: at least he had got something off his chest.

Returning late meant that Andrew owed some explanation to his wife but she had long since grown used to the high-pressure existence he led. He sent her to bed and booted up his laptop, knowing that even at 11:00 at night he had to prepare some documents before he could turn in himself. He did so satisfied in the knowledge that though a substantial proportion of the staff in the bank they were acquiring would inevitably lose their jobs, a number of people in his own would be made a great deal richer by his efforts, and he would be one of them.

For his work, Andrew was rewarded with more than £30 million worth of shares over five years on top of salary payments totaling in excess of £5 million. Thanks to a promotion, Susan made a little more than £160,000 over the same period.

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