Twisted Political Snake and Ladders of Hierarchy and Respect
By Dr. Geeta Sundar
A neurology staff member I am fond of, very recently told me that she thought that surgeons were like a family. That we faced minutes, days and everything together, bracing together at each step, that was grossly lacking in the medicine branches, where each individual was a unit, rather than a team.
I nodded to her, but in reality there is so much more than to what meets the eye. So much deeper, the intermingled emotions lie, that it’s not a simple thread connecting across the team; rather it’s a more complicated, interwoven harness. People are complicated – every Taylor Swift song will tell you that, and that complicated aspect is a huge part of a broken respectful, yet shredded heirarchy.
As surgeons in training, we are taught to read the room, we are taught to be subservient to our seniors, respect their orders, and obey their commands. Irrespective of age, they are senior in hierarchy and training and their word is law. We are taught that their advice is seldom wrong; their expertise is not to be questioned and the techniques they pass onto us is what will lay the foundation for us. We understand that their deficiencies are our deficiencies, and we often work as a team to represent the best care for the patient. Hardly ever, are there personal gains or personal accomplishments – a new finding or even a new development, even if noticed by the junior person of the team, is often credited to the senior resident and conveyed as an effort on his part to function the unit smoothly. There is no selfishness in the way we function, and absolutely no time for petty plays on superiority complex. (Exceptions exist, of course, like in every facet – the newer generations refuse to accept anything easily without putting up a fight, their stubbornness is a defiance. And for most days, our broken system works, till it doesn’t…till the twisted fates of hierarchy crumble against one’s ego, one’s God complex, and where anger and frustration make its way known).
We also are taught to keep mum, stay humble and shut up if the senior can’t or won’t be able to answer a question, unless you have to save your own hide if the attack turns personal. There is no back answering, no arrogance, no attitude in conversation with a senior. In most cases there is no two-way communication, but rather a delegation of work and a sustained receiver at the other end. And even if you try to answer and execute a reasonable explanation as per your view, it’s considered blasphemy and back-answering. But in our counterparts in the medicine field, individual knowledge is weighted higher than collective herd-ism.

For all the subservient acts, the reward is often glory – more ‘cutting’ chances, better integration into the department system and favoritism that plays a major role to ensure one’s mental peace. Typical politics. Dirty. Like the ‘Big Boss’ house. Sometimes bloody. Sometimes violent. A lot of verbal debauchery.
Some of the days it feels like a ‘Gladiator’ battle, and you will win based on only how much you can adapt, and your genetics defines your strength. Other days, it’s all about your mental capacity to manipulate, influence opinions and indulge in proper ‘bittery-flattery’ to gain brownie points. And other days it’s the boy on the team with the glorious, sweet tongue, with the misplaced overhaul confidence who knows what to say, when to say and what to do so that everyone loves him, manipulating the entire system to fit his wishes, playing a game only he stands a chance to win. (And people like me, fail miserably at this game, in total. #truestory)

But it’s all twisted. Everyone is a snake. Everyone. You never know when they will bite you and create a venomous death for your carrier. Or worse. Everyone is a potential ladder for another to use. Opportunists. Everyone acts to pull you down and climb over easily and shred away your dignity. It takes a whole lot to stay calm, composed, with your own goals in mind, and refuse to let the snakes bite you or destroy you, and continue playing the Snakes and Ladders with immense finesse. The hierarchy eventually, however gets to you, you become what you are saddled with, and like the scores of surgeons I’ve spoken to, who all shake their head at me, telling me that I’m just like they were, and will succumb to the political play, I hope to stay strong, and bear my principles in my own stead, and not fall prey to a game where I don’t enjoy my own presence.

Images – Google