The Choice, episode 2/6: Presentation


Ten years later, when Jessica described her route to partnership in general practice she did not dwell on that early ambition to be a surgeon. It was almost a cliché; too tough, too competitive… not compatible with life, la la la. Perhaps it hadn’t been a true ambition, more a flirtation. GP was a positive choice. And she was good at it. In fact, her ongoing engagement with hospital-based specialties had drawn her into a role at the Clinical Commissioning Group, where she was helping to develop strategic targets for local surgical development. She was 37.

But… but, she found herself wondering now and again, what would it have been like to plan those operations, to revascularize legs, deal with aneurysms? Not to put too romantic a spin on it, to save, directly, the odd life. The operations in which she had assisted fed her self-confidence and encouraged her to aspire. Other consultants had praised her. Until… Stackson.

Was it weak to have been pushed off course so easily? Did her decision to change the direction of her career reveal an underlying psychological weakness? These reflections only intruded when correspondence bearing his name, so redolent with arrogance, crossed her desk. For Jessica’s Practice lay just within his hospital’s referral area.

And now, look, another type of correspondence… a proposal to the CCG that it commission a novel, high-tech vascular intervention. Driven by him; J Stackson.

Given her interest in secondary care innovation, the surgical services committee chair had passed it to her for comment. For her decision, in effect.

Goodness! What goes around comes around. The circle of life.

There was to be a meeting. Stackson would be giving a presentation.

How old must he be now, Jessica wondered. She was 27 back then, he must have been what, mid-50s. So he was now in his 60s and not that far off retirement, she guessed. But still active, clearly. Still innovating. A force of good perhaps, overall.

She vowed to keep an open mind


If Stackson did recognise her, he showed no sign. They shook hands before the committee took seats, he made eye contact with her, as a key decision maker, during the presentation, thanked the committee for its attention, and left.

Then came the discussion. Jessica could not approach the weighing up of costs and benefits dispassionately. Stackson’s voice was echoing in her mind. She dwelled on those tones and inflections, samples of which she remembered hearing during that terrible dressing down ten years ago.

It came to a vote. She voted emotionally but tried to rationalise it. Yes, the proposal was a good one, but… leadership. That department’s track record, under Stackson’s direction,  was not quite… collaborative enough.

“I find too much duplication with similar services in the region,” she said, quietly. The unspoken reservation understood by her colleagues was that the proposal was mainly reputational. The Trust needed this service to be on a par with other vascular units. But the community didn’t.

Stackson’s proposal was rejected.


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