Monday, December 30, 2019

Nepotism, a memoir and apologea

Despite what some people will tell you I have said, I had never gotten a job based on my own merits prior to graduating from medical school.  Most of the jobs I have gotten since medical school were based on the fact that nobody else was available or that the other applicants were really horrible.  I accept this.

I worked 6 summers prior to and during medical school.  Every single one of those jobs was due to nepotism.   

My father worked for the Forest Service.  He had without any nepotism risen very high in the hierarchy on his own merit.  This did not stop him from resorting to nepotism for all four of his sons.

My oldest brother started the tradition with a summer job as a compassman in the Inventory Division of the Forest Service.  This lead to his switching from an Economics Major to a Forestry Major much to my father’s joy and he had a brilliant career as a Forester.  After a couple of years he got a summer job outside of the Forest Service away from my father’s shadow and had a long career in the private sector.

Brother #2 who was heading for a long career as an Engineer worked summers in the Forest Service Engineering Division, a posting he was qualified for.

It was then my turn.  

The summer of 1974, the NDP government had a robust summer student program both in the public sector and thru subsidies in the private sector.  This lead to me in the summer of 1974 finding that all my friends had summer jobs.  No problem.  I went to my Dad and asked if it was possibly there might be a job for me?  And there was.  The research division was looking for a summer student who could write computer programs.  I had taken a course in computer science and was quite good at it   There were very few high school students who could do this.  I believe that the job required you to have finished Grade 12.  No problem, said my Dad, we will tell them you have finished Grade 12.  This meant back dating my date of birth.  And I got the job.  (The clerk who did the payroll picked this up on my first day on the job but by then I had the job.)

I always thought the research division was a separate division but actually it was part of my Dad’s division, something I only learned a few years later.

I therefore spent the summer of 1974 writing computer programs using FORTRAN, compiling data and other duties around the office.  The research division was situated in an old James Bay House which had been converted to offices (the house is still there although no longer used by the government).  I had much to learn about the ways of the civil service and didn’t pace myself so by early August I had finished everything I was supposed to do.  I did a few jobs around the office for a couple of weeks before getting sent on in the field on a survey crew. 

The field work we were doing was fairly interesting.  Douglas fir clones from various areas had been planted in different environments and we were measuring how well they were thriving in their new home. This meant measuring a height and the width of the trunk 1/3 up the height of the tree.  (These trees were about 4’ tall at that point).   This sounds esoteric but with climate change has become more relevant and I read an article in The Walrus about the very research I was helping out with about a year ago.

The first place we went was to Ladysmith which is 45 minutes north of Victoria.  We could have probably commuted from Victoria except that where we were working was a further 30 minutes on logging roads from Ladysmith.  Therefore we were going to stay in a motel in Ladysmith.  Outside of school trips this was my first time away from home.  My mother gave me a self addressed letter so I could write home.

In addition to having my hotel paid for by the Queen, we also got $16.50 per day for meals which meant that in 1974 you could eat steak for dinner every night, which of course I did.

As aside, just as an example of how easy it was to get a summer job, one of my co-workers was a guy named Dennis, a hippy-drifter type from Ontario, who the crew had hired after meeting him in a bar the week before.

The trip to Ladysmith involved my first trip to a BC beer parlour.  One day after work the crew chief announced we were going to the bar.  I knew I was underaged but I just followed along.  This was a classic BC beer parlour.  No windows, circular tables covered in terricloth.  Strong smell of 20+ years of spilled beer and cigarette smoke.  We sat down the waiter came over.  I was uncertain how to order beer.  No matter, the waiter dropped off two draft beers for everybody in the group.  We all threw one and two dollar bills on the table.  The waiter picked up what he was owed and gave on change from a change dispenser on his belt.  My first experience of many beer parlours.  One might say the moment my life went south.  

After we finished up in Ladysmith there was more in Sooke, where we could live at home although it was an hour drive each way.  And of course there was the stop in the beer parlour on the way home.  In Sooke the 15 year old on the crew got busted and sat out in the truck while we drank in the bar (17 year old me didn’t get asked for ID).

It was overall a pretty good gig.  I calculated that I made $3.60 and hour at a time when the minimum wage was $2.25 an hour.  I banked most of it and didn’t buy anything expensive except for a Texas Instrument SR 50 calculator.

The next summer I was back in the research division, this time at the research station at Lake Cowichan.  7 of us, 5 guys and 2 women lived in the bunkhouses during the week.  We had an old school camp cook who made the most amazing suppers.  The work ranged from boring to heavy physical labour.  We swam in the lake, and played tennis or soccer in the evening.  We also spent quite a bit of time in the Riverside Bar in Lake Cowichan.  Again with my living expenses covered during the week and living at home on the weekends, I banked almost everything except for what I spent on beer.  Those two summers enabled me to go to UBC in Vancouver instead of living at home and attending UVic.

The three summers between University years where spent in the Cariboo;  Quesnel, 100 Mile House and Wells.  The first two summers I worked in what was call a “Regen” crew.  Our job was to visit clear cuts and take samples to find out whether the clear cut was regenerating naturally.  (Spoiler alert, they hardly ever did).  This involved setting plots and measuring whether there were any new trees in the plot.  To do this we  walked kilometres over clear cuts, stepping over or around rotten logs and stumps.  Rain or shine.  The last year was similar except that we were surveying areas where the cedar had been logged in the 1960s leaving the other species.

Away from Victoria, the Forest Service was a paramilitary organization with a rigid hierarchy of Rangers, Deputy Rangers and Assistant rangers.  There were those of us who didn’t have a title including the summer crews and we were always reminded where we stood in the hierarchy.  Aside from the Regen crews there were also Fire Suppression Crews who worked much harder than we did but also due to getting overtime, made more money.  We were supervised by a Ranger, although our four man crew had a crew chief as well who was slightly higher on the hierarchy than us.
Again I’m not complaining , but this was a paramilitary organization and were lots of assholes and bullies within the Ranger staff and unfortunately a lot from within the the crews itself.  Years later I reflected on how this prepared me for life.  Working in a rigid hierarchy with lots of bullying and intimidation?  Sounds a lot like medical school and residency and maybe those summers were good for something besides the money.

What was it like being the boss’s son?  Well first of all, my father had the sense to hide me in the Cariboo away from Victoria.  Also there was a lot of nepotism in the government at that time so there were lots of someone’s son or daughter working summers.  My first summer in Quesnel, there was one other son-of besides me.  I ran into them all the time, I had heard my father mention their fathers name or had met them at a social function when I was younger.  My dad shares the same name as popular sitcom star.  One of the people on my crew phoned to ask who he would be working with.  “Oh, you’re working with _______’s son” and he thought he was working with the son of the sitcom star.

The other factor was that a lot of people never realized I was a son-of.  I worked a long ways from the headquarters in Victoria, most people had no idea who the division head was.

In between second and third year university I interviewed for a job with the inventory division.  The interviewer had been my brother’s boss and the entire interview told me what a great worker my brother was.  I of course got offered a job but turned it down.  

And aside from the job and the pay check, I never got any special favours.  I worked in small interior backwaters away from the amenities of  Vancouver and  Victoria.   I never became a crew chief.  One summer I was on a special project for a month but that was more because I had been there the previous two summers and knew the area.  I like to think I did a pretty good job as well.  I am a bit of a Type A personality (more A-) and like to do things better than everybody else.  Plus I knew if there were issues, it was going to get back to my Dad and he would kill me (actually he wouldn’t have but the guilt trip he would have laid on would have made me want to die).

Periodically I met someone older who’d knew my father.  These were mostly people who liked him and spoke highly of him.  I’m sure there were people who didn’t like him but they never spoke to me.  I remember working for someone who had worked with my dad in the 1950s named Florian Tugnam who went under the name of Tuggy.  One of the nicest men I had ever met.  

Prior to my second summer in the Cariboo my father got shuffled out of his job and he wasn’t my boss anymore.  I worked two more summers in Reforestation.  

After my first year of medicine I decided I wanted to spend the summer in Victoria and work in a hospital, so I got a summer job as a nurses aide at the Royal Jubilee.  Actually I didn’t, there were cutbacks and I got laid off before I even started.  I pounded the pavement for about a week before my father got impatient and found a vacancy and I worked another summer in the Forest Service, this time in Victoria.

Of course by then I had entered the world of nepotism in medicine.  Our class of 88 had about 10 offspring of doctors.  Some of them were academically quite strong and would have gotten in on their own merits.   A few had significantly lower marks coming into medical school.  Some of them had lived lives of privilege, boarding schools in Switzerland or summer vacations in Europe.  Some despite their physician father had worked part-time or summer jobs throughout university.  

One tragic case of nepotism was my friend Phil.  Phil was an English major who wanted to be a writer.  Phil’s father was an ENT surgeon in Vancouver, his brother graduated first from John Hopkins Medical School.  Pressured by his father to apply to medical school, Phil went through the motions and to his horror got accepted.  There may have been phone calls made by his father.  Phil did manage to get through medical school and internship.  He died of a drug overdose in 1990.

The children of doctors didn’t really benefit much more throughout medical school.  Having mom or dad as a doctor doesn’t really help you much with anatomy.  We did later have a lot of subjective marks based on oral exams and clinical evaluations so some of them may have benefitted because their examiner or preceptor knew their parents.  I wasn’t really obsessed with marks in medical school.  I was for the most part on survival mode, trying to pass and acquire the knowledge I figured I would need to practise.

We had a pretty close class, we got to know each other well and I became friends with a lot the children of doctors.  Sure they drove nicer cars, didn’t have to work during the summer (nor did I after second year), and lived in their parents’ nice houses in the Vancouver area usually with a pool.  We had year end pool parties at 3 such houses.  And I certainly was no working class hero. My father wasn’t a doctor but he was a well paid civil servant.  We lived in a nice area of Victoria, I went to a really good public high school.

I do remember that we had a rural doctor elective between second and third year.  To assign people we had a lottery and a draft of the various placements.   Some of the doctors children didn’t bother with the draft.  Their father arranged a placement with an old colleague.  I suspect the same thing happened with fourth year electives.

Specialty  training is of course a hot-bed of nepotism.  Some programs like ophthalmology don’t even try to hide it. Urology in our city has a dynasty now into its third generation.  The match of course hasn’t changed that.   There was a story a few years back about how the head of the cardiac surgery program in Vancouver intentionally left their position vacant so that his son who had trained off-shore could get a position in the secondary match.  Our program recently matched a child of one of the staff.  The program directory felt it necessary to send out a memo explaining that everything was above board and that she had been ranked on her merits (which is probably true.)

The interesting thing is that being a doctor no longer gives your children a free or reduced effort ticket to medical school.  Getting into medical school which was pretty competitive when I applied has become hyper competitive and I suspect the evaluation process is probably more rigid and fairer.   Therefore a lot of doctors children are attending medical school off-shore.   This of course means these people will need to get into a residency in Canada, not an easy task if you didn’t go to medical school here, which is I suspect leading to a lot of phone calls, begging and arm twisting by concerned doctor parents.

I was talking a while ago with a surgeon.  His son was attending medical school in city where he worked.  His son had decided to apply to the same surgical sub-specialty.  He was a little anxious about this.  He felt his son was going to held to a higher standard than the other residents.

I should mention that most children of doctors I have encountered in their training have been thoroughly professional individuals who don’t (overtly anyway) demand special treatment.  There has been of course the odd entitled asshole but these are so uncommon that they stand out.

In private practice of course who you know is really important when getting a job; a little less so now that we have shortages of many specialties. You can’t really fault someone for taking a family member into their practice which is after all their practice.  This is a little less faultless when hospital privileges or operating room time is involved.  We have in our department 2 children of anaesthesiologists.  We didn’t hire them because of their bloodlines.  Frankly we were desperate and were happy their fathers had spoken so warmly of our hospital.  They are by the way both excellent.  We also have 3 children of surgeons working at our site in the same specialty.

A small town in New Brunswick I worked in had a dynasty of doctors, the third of which was working there.  The local High School was even named after them.  People weren’t knocking down doors trying to practise medicine in this particular town and looking back it was nice that the third generation of the dynasty decided to come back because he certainly may have had opportunities elsewhere.  

Nepotism is rampant outside of medical.  Look at how many businesses are named _______and sons.  Again you can argue if you own the business, you can hire who you feel like.  Except of course when this leads to your business becoming inbred to the point where it collapses leading to job losses and ripple effects in the economy.  Eatons in Canada is a good example of that.

Politics is heavily nepotistic.  Our Prime Minister is an example.  He might very well have risen to where he is on his merits.  I don’t really think so.  (Not that he is an exceptionally good or bad PM).  In BC WAC Bennett passed the leadership to his son who had never been involved in politics.  Nobody questioned whether there was a better person for the job and he served for 3 terms as premier.  In the US we have the Bush dynasty, the Kennedy’s and who knows how many other family dynasties.  Winston Churchill may have been Britains greatest Prime Minister, but he probably wouldn’t have gotten a start in politics without his politician father.  It is a funny thing that after crawling out from under a hereditary aristocracy, we still think that bloodlines are important in our politicians.

The word nepotism comes from Renaissance Italy.  Illegitimate sons of Popes were referred to as nephews (nepos) and given jobs in the Vatican.

In times of yore, of course power was inherited.  This made sense when kings were supposed to be descended from gods or at least divinely ordained.  Of course the son’s of kings were often not the strongest individuals or the best to lead.  The Roman Emperors recognized this and would adopt a strong general who could then succeed them.  Medieval Poland had an elected monarchy.  The Holy Roman Emperor was elected although by the end of the Renaissance the position become a Hapsburg inheritance.  The first Hapsburg Emperor was elected because it was felt he could be easily dominated.  That didn’t work out well.  

The earlier Romans and the Athenians didn’t have kings.  The Roman republic elected two Consuls for a year who had imperium for that year.  The Roman republic was of course heavily nepotistic and who your ancestors were was very important in how you did politically.  

The thing is that we all try to use what advantages we have.  I didn’t get to where I am because my father got me well paying summer jobs.  Growing up in a middle class family, attending good public schools and having parents who stressed education was way more important.  Is that fair to someone who didn’t have those advantages? And of course when faced with a number of candidates to chose from, who wouldn’t chose someone who they knew or whose father they knew, all things being equal.  Fair? Not really. 

We try to do the best for our children.  I got my brother, an engineer , to give my son a summer job.  None of my children went into medicine so I have not had the opportunity to exert what influence I might have.  I once vowed I was not going to be one of those doctors but I know faced with a child wanting to go into medicine, I probably would have been.  

As an aside, the well paying summer jobs we used to get largely no longer exist.  The whole concept that you can give someone good job and maybe do something useful at the same time seems to have gone by the wayside.  Summer students now work for much smaller salaries and top this up with huge student loans.