My Covid recovery journey

Some of my readers are aware that I have been down with Covid-19 for several weeks, and I feel the time has come for my Kiraitu Murungi moment. Well sort of, as unlike the Meru Governor (whose article about his experiences was published in the Sunday Nation of April 25) I never entered the world of politics, and so it did not lead me to self-flagellate over my past.

Like for the governor, my early stage was denial. My symptoms were such that at first I was convinced I just had the flu. But acceptance came with testing positive for Covid-19, leading me to wonder where and when I had become infected. My sister in London had been warning me against indulging in the active life I had been leading, but until I succumbed to the virus I felt it was all fine.

Then, there I was in an isolation ward at the Aga Khan Hospital, confined to my bed and with no energy. It reminded me of the poem I wrote in 1980 when I came down with hepatitis, about just “watching the ceiling go by”. Here’s how Mr Murungi summed it up: “Corona had disconnected me from everything. It put me out of action. I felt weak and useless.” Yes, I relate to that.

Unwanted baggage

I only recently learned from family members that they were told by my doctor that I was close to death at one time. Wisely, neither the doctor nor they shared this with me then, and even now I find it hard to accept — surely they’re referring to someone else! This is in stark contrast to when I had cancer of the prostate 16 years ago, when I seriously contemplated my mortality. Why not now? Denial again? No, this time I managed to exclude it from my mind as unwanted baggage.

Like the governor I have been inundated with messages of goodwill through emails, SMSs and WhatsApp get-well messages, assurances of prayer, expressions of great optimism. I was quite overwhelmed by the outpouring of support from around Kenya and far beyond, wanting to respond to each one and feeling good that I was able to.

I also related to Mr Murungi when he referred to “some people being congratulated for winning a ‘heroic battle’ against Covid-19”. This was a self-delusion, he wrote. “I did nothing. I didn’t fight. At the hospital I just followed the doctor’s and nurses’ orders. I didn’t even know what they were giving me. I was too weak and subdued. It was a very humbling experience for me.”

Was I strong? Did others fight less heroically than me? Apparently so. But more often I felt like an under-performer, not finishing my meals or exercising as much as I should have, due to my low energy. Some at the hospital urged me to push harder, while one doctor reassured me I didn’t have to be “top of the class”.

Solitary confinement

Like me, for the first time in many years the governor found himself all alone. My solitary confinement – for that is how I came to think of it – lasted a full two months, where the only contact I had was with the nurses and other support staff and through the fleeting daily visits of the doctors.

My hitherto decent circle of influence was largely reduced to influencing my own daily micro-activities, which focused on major projects like having a shower (and initially just being washed in my bed by my wonderfully caring nurses) and eating a meal (despite serious loss of appetite).

While Mr Murungi reflected about his life and future while he was burdened with Covid, my thoughts rarely extended to either my past or my future. But somehow I did summon up the strength to write my articles for this column, keep up with my mails and texts, participate in a few online meetings, and more recently to keep adequately active with my directorships and a few of my consultancies. It is this that has kept me sane and hopeful.

New awareness

Eventually I moved out of the isolation ward and into my own room, itself a major upheaval – giving this change management consultant food for thought about how anxiety can be provoked when letting go of an existing environment, however preferable the new one may be.

I am no longer in hospital, but the journey to full recovery is very much ongoing. Living through these difficult days and nights has made me much more aware of what those who are seriously unwell endure, and it will make me far more empathetic towards such people in future. Realistic too, sensing what they can and cannot handle.

A look at how interviews for CJ post unfolded

Four years ago I wrote a column here about interview panels, and I was reminded about it as I watched some of the grillings by the Judicial Service Commission panel of the candidates for the Chief Justice position, and then later some of the sessions for the Supreme Court judge ones.

As Macharia Gaitho wrote in his column immediately following the CJ interviews, the ten-part series provided the kind of drama we expect from reality TV shows. My article today, however, is not as a theatre critic. It is to review how the panel handled the candidates.

The interviewing commissioners were clearly a very knowledgeable, well-researched and generally well-prepared group of professionals. Their task with the CJ candidates – ten interviews of around six hours each on successive working days – was a daunting one. I was very impressed by how they managed to fill the six hours, but I’m not sure quite so much time was actually needed.

Being almost exceptionlessly from a legal background it was not surprising that the panelists’ approach was often remarkably pushy. Well, lawyers are used to being adversarial to the point of intimidation. And no doubt the candidates, all from that same learned profession, were as accustomed to the kind of jousting that unfolded.

As I witnessed the cross-examinations I also thought about how PhD candidates “defend” their theses before probing professors – the assumption being that the dons’ main job is to expose flaws and weaknesses in their paper. Indeed I remember one of the Chief Justice candidates referring to their “defence” in one of their responses.

I wondered to what extent the panelists had agreed beforehand who would be the “good cops” and who would play the “bad cops”, as we definitely saw a spectrum from grim and skeptical to more friendly and appreciative.

To me the most fascinating aspect of these reality TV shows was the body language of the commissioners. Some were more laid back and smiley; some inscrutable; and one often downright hostile (apparent despite wearing a mask – just from the eyes).

They will have planned the flow of the interviews and who would handle which aspect, aligned to their areas of expertise; and they will have discussed the role of the chairperson – the only one in the room without a legal background. She played her part calmly and appropriately, opening and closing each interview; asking about leadership issues; and mainly directing the traffic from commissioner to commissioner.

For sure they will have drawn up a ratings matrix, allocating marks to each candidate after their interview. (I remember the article I wrote in 2011 commenting on the advertisement for the Chief Justice position that appeared then. Amazingly the requirements did not include expertise in leadership and strategy.)

Some of the panelists probed more deeply in following up on answers to their questions than others. Indeed with a few of the interviewees I got the feeling they felt there was no point trying, as they’d given up on hearing anything relevant or impressive.

As I read over my earlier column on panel interviews I thought it would be good to reproduce this paragraph, about how panelists observe candidates. It comes from my experience in such a role, and I imagine the eagle-eyed commissioners were assessing the same issues.

“How good are the candidates at listening? And how directly do they respond to the questions put? If they’re asked an inconvenient one, do they switch to answering one they would have preferred to have been asked, one that would have allowed them to remain within their comfort zone? Are their answers too short, safe and superficial? Too long, rambling and repetitive – as though buying time in the hope they’ll still come up with that killer point? Or do they engage in a lively, interesting and meaningful dialogue? Does the interview manage to transform into an interesting conversation among equals, as opposed to remaining a duel between the grillers and the grilled?”

Many of those reading this column will have been members of interview panels, and so you will relate to my analysis. Hopefully it will lead you to reflect further on how to perform in such a role in future. And for those yet to indulge in such fora, be aware of quite how much expertise and preparation are required.

Awesome how hospitals have managed Covid-19

From time to time in our lives we are doomed to spend days and nights incarcerated in a hospital, as medical teams take care of what ails us while they set us onto the road to recovery.

Over the years I have had the dubious privilege of observing at close quarters how complex and interwoven it all is, operating 24/7 and with the very lives of patients often at stake.

And all this before Covid!

I immediately come to Covid, as I was one of those who caught the debilitating virus some weeks ago and so I have been at the Aga Khan Hospital for a long time. (Personal reflections for another day.)

There, at close quarters, I have observed so much high quality teamwork displayed by their extraordinary frontline care workers, who amazed me by their apparent assumption that they are just doing their demanding jobs like any other collection of professionals.

Top hospitality

It’s obvious that running a hospital – certainly for inpatients – includes everything needed to manage a hotel, requiring all aspects of gracious hospitality while ensuring the high capacity utilisation that will make the entity financially sustainable. And then there’s that transformative extra: healthcare.

Those who manage hospitals must worry about catering and cleaning; security and waste management (big time).

The stocks of medicines and equipment must be available and up to date, with the labs and the testing centres fully equipped and competent to serve the medical teams.

Plus there are the usual back-office support functions: finance, audit, HR, ICT, legal, transport… not to mention dealing with medical insurers and other stakeholders.

The more I think about it the more I wonder how they manage, the more in awe I am, the more I find it hard to imagine who would wish to take on such extraordinary challenges, ones that incur such risk and require such knowledge, learning, expertise, discipline, stamina, resilience, emotional stability, judgement and goodwill.

I have occasionally acted as a consultant to hospitals, helping their people work effectively with each other in these challenging environments.

What I learned was that, at least as much as in other organisations, in hospitals there are very distinct sub-cultures.

Casual observation

For obvious reasons the doctors are highly influential, and traditionally the senior ones who ruled the roost were known for being insufficiently respectful or helpful to their juniors, who in turn were unhappy about the extent to which their typically more up-to-date knowledge was taken advantage of.

Then there’s the critical relationship between doctors and nurses: how flat is this pyramid, how big are the power gaps here?

My casual observation as a patient at Aga Khan Hospital is that for much of the time it works remarkably smoothly, with excellent delegation, empowerment and teamwork.

People are constantly learning about the latest developments in their fields; most are good at consulting with each other; and so their respective roles and relationships are clear.

Having said that, some of the nursing staff are inevitably bolder, more pro-active and solution-oriented than others (bearing in mind too how stretched everyone is because of Covid).

Effective partnerships

Some of the nurses are great at developing easy relationships with patients, and all are conscientious about carrying out tests, dispensing medicines and fulfilling their other technical functions.

But, partly based on their personality, partly on their expectation of the extent of their role (like going beyond the technical to include the interpersonal), what I found was that too often I was the one who initiated the brief conversations that led to easier and hence more effective partnerships between carer and patient.

Very understandably, expectations management is another challenge in hospitals (as it is with almost everyone in Kenya).

Life is so complicated, unpredictable and interlinked in hospitals that their challenges are unique.

Our heroes

I can comment as a patient that for much of the time it was hard to know when something was likely to happen, or the sequence. More communication would be helpful here.

All this I have been observing just as an idle patient, not knowing what I did not know, just experiencing what I was experiencing.

Inevitably though, my performance management hat remained permanently in place.

My bottom line? It is right for these healthcare workers, in whatever function and at whatever level, to be enthusiastically applauded and celebrated as our heroes.

Mr Eldon is chairman of management consultancy The DEPOT, and co-founder of the Institute for Responsible Leadedrship. [email protected]