A purpose built hospital can be an act of kindness. The politician spoke about a hospital she visited in Oslo that was built with the intention of making everyone there feel good to be a part of it.
A couple of months ago I was included in a two day event designed to create a better vision for Australian healthcare, that is safer for patients and offers a more sustaining working environment for staff. I sat in a big tent with healthcare planners, policy makers, artists, musicians, politicians, medical students, playwrights, frontline healthcare staff and a handful of patient advocates, and together we went over what it means to try to make public health happen—in our hospitals, in our communities, in our selves.
It was a courageous, generous company of strangers encouraged to try new ideas and to listen well. The organisers brought in all the big contingencies for consideration: constraints, traditions, professional habits, new and emerging risks. I could see that the freewheeling schedule was occasionally stressful for outcome-oriented executives using departmental budget and time to be there. But when things are difficult, when the concrete is really set, new ideas have to be allowed to emerge without an agenda, and without immediate prospect of a fix.
Initially I wasn’t sure where the emphasis on kindness had come from, especially as we didn’t spend much time on what kindness might mean. This is important as there are specific interpretations of kindness that are built into different faiths and ethical systems, and there are other assumptions among those of us without faith. One interpretation that makes sense to me is etymological: in practising kindness, we are seeking to widen the circle of those whom we think of as kin. So while there’s a separate etymological case for connecting kindness to nature, the association with kin speaks of our capacity to overcome instinct, and to extend ourselves to the care of strangers as though they were among our own family and loved ones.
This means that kindness has something to do with both generosity and hospitality, two ideas I’ve been sitting with for a while. I suspect kindness practices may also be at the heart of ideas that Dave Cormier is discussing in relation to resilience, what Liz Morrish is writing about in relation to care, and the questions Viv Rolfe is asking in relation to corporate wellness programs that are emerging in universities as a response to academic stress. We’re seeing care for strangers all over the place: in political protest, in crowdfunding, and in the network itself.
Lea McInerney went to the Gathering of Kindness event on behalf of Australia’s health-focused Croakey website; she has just written a meticulous narrative of what we did over the two days. And here’s the thing: the event wasn’t originally intended to be about kindness at all, but was commissioned to attend to problems caused by bullying:
Around the same time, the Victorian Attorney-General’s Office had been conducting an audit of data from three reviews of bullying in healthcare settings. The findings were alarming – the incidence of bullying was high, it was poorly dealt with, many workers were caught up in an escalating cycle of poor behaviour, and they had little confidence that anything could be done about it.
This is why the event launched with a compelling piece of verbatim theatre, drawn from real critical incidents. Alan Hopgood’s play ‘Hear Me’ shows how staff in steeply hierarchical organisations create situations of escalating risk when they feel unsafe to speak out about what they see. When kindness in healthcare fails, it really fails.
At some level, this story should have been more unfamiliar to someone who works in a university. Critical incidents for us, even those that lead to protracted cases of grievance, rarely place lives at risk. I can enter the wrong grade in a spreadsheet, and no one dies. With our much lower stakes, surely we shouldn’t also see capable, productive professionals come to feel that they can’t continue to work?
And yet even though we aren’t mishandling medication or missing a diagnosis of disease, we are elevating the stresses involved in just doing our jobs by continually having to prove that we deserve these jobs at all. Far more than public health, public universities are tested by the entirely made-up demands of inter-institutional competition, to which our actual jobs are subordinated. Crucial to this is the ramping up of precarity, that pits us all as each other’s primary competitors for scarce resources and career survival. Liz Morrish says this:
In what seems like a perverse project designed to deprofessionalize, casualize and atomize the academy, community has been hard to maintain. Universities keep us marching along, forming and reforming in response to multiple restructurings, reviews and revalidations. There is a reason the word ‘tradition’ is rarely uttered in UK universities, except in the most elite. We are all newly precarious and we are not supposed to look for permanence.
The anxieties of precarity are intensified by conditions of continuous institutional self-review demanded by external accreditation cycles. So while being urged to focus only on productive work, we are also compelled into complex routines that we are know are only marginally productive. We jump through hoops and then design new hoops to jump through. Everything is urgent, and nothing can happen without three levels of committee review, and so this week’s emergency decision-making still won’t be implemented for two years, if at all. Meanwhile we go on chasing the relevance puppy all over the park.
But it’s OK because there’s a new building, a new brochure, a digital campaign that cost hundreds of thousands, and another consultant bustling out of the executive suite on the way to the bank. The hustle is on, a protracted and unreflexive confidence trick designed to persuade the market that we’re on the up. But inside, in confidence, we’re driven by the spectre of always-imminent downturns towards a weird brew of opportunism and thrift, that seems the only remedy for a kind of pervasive scarcity that no one can really account for. The contradictions between the brand and the budget seem significant. How did we end up committed to so much without resources in place? Why did we set things up to sustain only a few careers at the expense of so many others? Who is served by this?
And in these situations, small and harming critical encounters do happen, and cascade, and get escalated. Exhausted people entangled in the weeds of precarity fail to meet each other’s needs — not by much, not with much at stake, but enough to fire off an email that takes a tone, or to threaten some kind of something, if things aren’t fixed, things aren’t done properly, or as promised. Grievances rise up and are cajoled back into a kind of accommodation, for now. People don’t seem able to hear one another properly, to notice that the other humans around them are doing their best, that no one has enough of anything to do well what they came here to do.
This is really why I loved the Gathering of Kindness, because it was a sign that even entrenched and budget-driven problems can be thought about as capable of being changed. I loved seeing what our nearest kin in organisational terms—public health to our public education, two big engines of employment and hope in our local communities—are trying to transform about their culture. The event’s extraordinary organisers, entrepreneur Mary Freer and surgeon Catherine Crock, have a vision for change that is specific and achievable, and the commitment to make it work.
And so I really want to ask: if we could hope for an institutional vision of kindness as an essential component of higher education, what would that look like? How would students experience it? What would industry partners or government stakeholders notice us doing and saying if we had it? What would we be able to achieve with it, that we’re prevented from doing now by the conditions we’ve set for ourselves? What new opportunities in research or teaching would kindness itself generate?
What would we build, like that Oslo hospital, with the intention of making everyone feel good about being part of it?