"House", Socrates and Organizational Line Management

For the first time I watched an episode of "House". Essentially it is about the art and science of medical diagnosis. This is something which appears to inhere in individuals, and despite attempts at computer simulation, tapping into that combination appears almost impossible. The writers really get to the heart of the issue: what kinds of tricks, tropes and tales does one use to find the result. It can't be done mechanically. The patient in this episode had lost his power of coherent speech, but not thought. Moreover, he had bipolar disorder. All the "usual" array of tests were lost in indeterminacy, until House suggested that his colleague look at the patient's blood through a microscope. Finally, human intervention showed the patient had malaria, which explained his condition.

While this is the central storyline, there are others. House is a maverick who doesn't accord to organizational norms. To the hospital bureaucracy he's a nightmare beyond control, yet he rescues the hospital from failure by the power of his insights. Complex bureaucratic organizations have immense difficulties in coping with professionals and intellectuals who, for a range of reasons, don't fit into hierarchies organized by management.

To complicate matters in this episode, House has to work his magic remotely. He's stranded by bad weather in a far away airport. So he must do his semiotic analysis through the cell phone, which of course he forgets to charge... Because he's away the normal group effects of his unit are disturbed. One of his acolytes is nominally placed in charge, and indeed given charge over House himself, although this doesn't appear to be disclosed to House. While House is incommunicado, his disciples struggle through their diagnosis. Everything seems to contradict everything else: no resolution appears possible. His qualmish supervisor attempts to impose order by virtue of his authority, his line management responsibility. His colleagues are horrified at this blatant grab at power--"What ever happened to judgment by peers?", one asked.

The trick for House is that he knows how to employ the techniques of Socrates. Question after question until something emerges. But at least it's a collective enterprise. Yes, there is a professional ethos at play, almost in defiance of bureaucratic order.

I was stimulated by "House" because coincidentally I was given a survey to fill in by the university personnel department today. The survey adopts a patronising tone from the outset; it is called "Viewfinder". It is supposed to find out what we, the employees, think about our organization. So after a waffling introduction from the chairman of the governors about students being customers--already a contradiction in terms--it starts by asking us if we are au fait with the vision of the university. My problem was that I didn't know that the university had a vision, but that's my fault, I imagine. Of course my view of a what constitutes a model of the university and what the administration thinks are bound to differ. Ideas, knowledge, blue sky thinking and so on. Newman resonates today still, as Tony Bradney demonstrates. Theirs: delivering aims and objectives, creating skills, and knowledge transfer. (I hate these terms, aims and objectives, and even now can't distinguish one from the other.)

The most exciting section was that asking our views about the leadership of the university. This entailed asking all sorts of questions about "line managers" and chains of command. Not only did it present an outdated, Fordist view of organizations (so much for being at the cutting edge--a bit blunt there), the survey never once mentioned such words as "ideas", "professional", "collegial", or "peers". If this survey had been dropped by accident into a factory, the responses to these questions would have had equal validity; it was all about standardization.

I don't know what a line manager is, even in my university. In part it is because I've actually read my contract and it doesn't mention these elusive creatures. But more importantly, it is that I work with a group of colleagues, most of whom I respect, and I interact with them on a collegial basis. Some of them may have adminsitrative/managerial aspects to their jobs: it gives their pay a boost, as I've mentioned before. Do I accept that they have authority over me? Not really.

There is an unattended consequence to the formalization of hierarchy and bureaucracy, which Weber foresaw, but those who implement it tend to forget. Formalization breeds legalization and juridification which prevents power and authority from being transmitted in a single direction. This move speaks to power and rights. The two can't be separated. The very exercise of power contains its own constraints. The more it is exerted, the more it is held in check. Administrators so easily lose track of this.

So, the survey reminded me of Michael Burawoy's book, Manufacturing Consent, about how factory workers subverted management efforts to control them. They hindered moves to improve productivity by exercising informal controls over "ratebusting" and by employing other devices. The vision of the university presented by the "Viewfinder" survey wasn't an enterprise designed to stimulate discussion among colleagues and peers. Instead it was an instrument of repression called on to reinforce an illusion held by the administration about what they would like to see.

OK, I'm not House, but when bureaucracies don't listen, I get mad. They are meant to be there to serve my needs not theirs. I'm a professional and I will continue to behave in a professional manner. And I said so in the survey too.

Comments