To be read in conjunction with Little Red Riding Hood.
Once a newly qualified doctor, wearing her red stethoscope, set out to treat an older woman, bringing medicines and the milk of human kindness. As the doctor was walking through the hospital, the medical director came up to her and asked where she was going.
“To Mrs Clinton’s bedside”, she replied.
“Which path are you taking, the path of clinical experience or the path of the guidelines?” “The path of the guidelines”.
So the medical director took the path of clinical experience and arrived first at the bedside. Mrs Clinton was dead. She had been taking warfarin and a device the hospital had been supplied for free as part of a Xarelto clinical trial had malfunctioned and she had had a stroke.
The medical director drained her blood and poured it into a bottle, sliced her flesh onto a platter, and stored it in the fridge. Then he called an inquiry. Little Red Stethoscope was summoned.
“Come in, my dear”.
“Hello, I’ve brought with me the medicines and milk I was bringing to Mrs Clinton as you asked.”
“Have something yourself, my dear. The lunch on the table in front of you is free”.
Little Red ate what she was offered. As she did, an app on her phone said: “Slut to eat the flesh and drink the blood of Mrs Clinton!”
“Then the medical director said, “While waiting for a report on Mrs Clinton’s death, you will have to be suspended”.
“Where shall I put my white coat?”
“Throw it in the sluice room; you won’t need it any more”.
“For each item ‑ pager, ophthalmoscope, radiation badge ‑ Little Red asked the same question; and each time the medical director answered, “Throw it in the sluice room; you won’t need it anymore.”
When she was finished Little Red said to the medical director, “Oh! How hairy you are!”
“Yes its the testosterone – power does this to you, my dear.”
“Oh! What big shoulders you have !”
“All the better to carry my laptop, my dear”.
“Oh! What manicured hands and nails you have ?”
“Its for writing reports better, my dear !”
“Oh! What big teeth you have !”
“Its for eating you better, my dear.”
And he sank his teeth into her with a report that made her solely responsible for Mrs Clinton’s death.
Little Red Riding Hood and Little Red Stethoscope are both cautionary tales about risks and their management. When I began training, no-one ever heard the words Risk Management even though medicine was obviously about managing risks.
Several decades later, Risk Management was everywhere with most nurses and doctors spending their time managing any risks there might be to the organization that employs them.
When I began training medical directors were in the business of guiding junior doctors down the path of clinical experience as they recognized that the best way to manage risks was to have the best possible people in place. Whatever about surgical procedures, the idea that risks could be managed by ticking boxes was famously met with a response – we’re not running a Chinese take-away here.
Medical directors now are more concerned about the brand value of the organization they work for and their own brand within it than they are for any patients or staff.
When I began training everyone bought their own stethoscope and they were all grey. Then somewhere toward the end of training red stethoscopes appeared. They initially came as gifts from drug companies. Where could the problem come from having a red stethoscope? Surely the more stethoscopes around the place, whatever their color, the better.
Some day a Coby and Mina Grimm may update the Red Stethoscope story – giving it an alternate ending, in which someone, could be Little Red herself, strangles the medical director with a red stethoscope. As long as no-one offers an “interpretation” that this feature reveals that the true meaning of the story lies in a latent lust for power, the essential meaning will not have been perverted.