‘We're Sorry to Hear You've Been Unwell...’ Personal Reflections on Health and Well‐being in the Workplace
作者以亲身经历反思了重病后重返学术工作的过程，揭示了组织健康管理流程的不足，并呼吁管理研究关注人的福祉而非仅关注经济产出。
At 6pm on 16 December 2014 while sat at my kitchen table and slowly marking 500+ exams I received a call from my cardiologist. As expected, the various tests I had completed all proved to be normal. However, a cardiac CT scan had surprisingly identified a rare and life-threatening anomaly. It seemed I suffered from a condition which occurs in less than one per cent of the population and could (though might not) lead to me becoming a victim of sudden cardiac death. Open heart surgery beckoned five weeks later. I was not seriously ill before my surgery; tests were sparked by a single fainting episode and a low heart rate detected via an App. Neither the cardiologist nor my 47 year-old self expected such an outcome. Open-heart surgery is serious business, recovery takes about six months to be on the right side of ‘normal’ and another six before you are ‘fully’ recovered. Thankfully, long-term prognosis is excellent and I have recently been discharged from the cardiologists’ care. What then was my experience of returning to work after a lengthy absence? Here, I provide an intimate introspective account and hope it provides food for thought for future managerial research in the health and well-being arena. It should be noted that an income protection policy meant I did not have to worry about money during my absence from work, a privilege that is not afforded to many others with long term illness. First, before a discussion of returning to work it's important to highlight what my relationship with work was like before my illness. A snapshot of the five week period before open heart surgery offers a clear indication of how work has always received top priority in my life. After the cardiologist phoned with the news of surgery, I made my kids their tea and then went back to grading exams. I finished grading and all the other horrible messy jobs involved with the exams process and let co-authors, students and other colleagues know of my impending absence. It embarrasses me to admit that one of the first things I thought about when I realised surgery was imminent was to rue the fact that my first research-only semester after five years of significant managerial positions would now no longer happen. The morning I left for hospital my husband literally dragged me away from the computer as I hit send on a reference for a part-time PhD student. One of my last acts before surgery was to see that my email out of office was working properly. I wish this was a joke, but sadly it isn't. Would anyone have complained if I had said I was not emotionally capable of marking 500+ exams? This was a question I actually did not consider. It simply never occurred to me not to grade and if it had I'm sure I would not have passed on such a significant work-load to colleagues during the busy exam marking season. Why on earth did I not spend every waking hour with my family instead? It was certainly not good for my well-being to work incredibly long hours before life-saving surgery, but I never considered other options. Why did I have such a strong work-ethic, would others in my position have had a similar response and what are the implications of this for our understanding of health and well-being in the work-place? What happens when a workaholic can no longer be or no longer wants to be a workaholic and what impact does presenteeism have on employees’ health? Three months into my recuperation, I received a detailed letter from HR which opened with ‘we're sorry to hear you've been unwell’. The body of the letter made no reference to my illness, but rather, included copious information on requirements and details about financial (dis)entitlements and how to claim them. It was overwhelming, confusing and sent me into a state of panic (not good for someone who has recently received open heart surgery). Eventually, I asked my husband to ‘bin it’ on the assumption that at some point HR would write again and I would be better able to cope with the form filling, which of course was the case. The next step in coming back to work was just shy of six months post-surgery and involved visiting a university appointed GP who was to determine my fitness to return. Reassurances from my own care providers were not acceptable, even though the appointed GP asked if my cardiologist was happy to approve my return. After a brief five minute chat, I was declared fit enough to go back to my job. It became clear that the appointed GP's role was to ensure that the university was following necessary procedures, but they were not interested in my health or well-being beyond this. The HR process meant that my HR function went through a set of procedures to ensure I was fit for work – ironically these procedures were woefully inadequate. While I told the university appointed GP I felt able to resume my job, this was far from the truth. In reality I did not feel either physically or mentally ready to return, but felt a huge obligation to do so. All of the other patients on my cardiac rehab programme had gone back to their jobs, my cardiologist had said I was physically able to return, and I felt somewhat of a fraud and also a failure by saying ‘you know what guys, I can't do this yet’. In hindsight it seems obvious that I returned to work too early, the HR protocols didn't pick up on this, and I struggled on as a consequence. My communication with HR was one that I felt dealt with my illness in the abstract. The HR bureaucracy did not allow members of HR to be interested in the vicissitudes of my life. The HR department was an impersonal bureaucratic machine that was indifferent to me as a person, not because the people in HR didn't care, but because the process did not allow for anything else. From many conversations I have had, it seems my university is far from alone in its approach. Six months after surgery I returned to academia. Having only been absent from work for no longer than a few weeks during my 25 year career and foolishly working throughout my maternity leaves this was my longest period of not working. The journey was an incredibly challenging one. My first day back was in August, I was pleased about this – there would be no students and many colleagues would be on annual leave, thus enabling me to quietly ‘settle’ back in. My vulnerability was exposed before even the opportunity to enter the building arose – I was physically unable to open the very heavy doors and needed to press the disabled button to gain entrance. The impact of this on my emotional well-being was profound. If I couldn't even open the door how on earth would I be able to teach or carry out my research activities? Physical and emotional vulnerabilities were, and still are, a central facet of my well-being. Physical symptoms following open heart surgery include poor concentration, cognition and short-term memory issues – not exactly ideal for an academic. Fatigue is a significant factor also. My first forays entailed real struggles with the mundane – forgetting my username and password allowing access to email and online storage applications such as Dropbox; forgetting the keycodes to the staff common room etc. I even forgot which junction to take exiting the motorway. I was beyond exhausted after finding solutions to simple humdrum problems and had yet to actually do any ‘real’ work. While HR processes existed to ensure I was fit to return to work there were no protocols in place to follow up on how I was getting on – in the 16 weeks since my return no-one from the HR function has been in contact to ask after me, my health or well-being. Even if the protocols had been more effective, I'm not sure they would've allowed me to capture the profound impact not being able to open the door had on me; or how, when entering my office for the first time in many months, I became distraught because the previous view of the car park now housed a partially completed five storey student residence. Tempus fugit hit me like a freight train. I felt as if I were in a bad episode of a reality TV show, left the building to digest the new residences and promptly burst into tears after realising that leaving the building meant that I now had to press the disabled entrance button twice in one day. I wonder how would one capture this experience and emotion in a return to work questionnaire? Somehow ‘on a scale of one to ten how difficult did you find the return to work’ doesn't quite capture it. The university process was insufficent for preparing me for the moment I stood at the door and felt hopeless and overwhelmed, but could any process have been more effective? How do organisations measure trauma when individuals will not know how they will cope with something until it happens? The solitary life of an academic meant I felt completely out of my depth, thrown in at the deep end, and genuinely terrified. The first five colleagues I met were unaware that I had been absent or seriously ill. Since my return, I would guess that approximately half of my colleagues, in a Business School I have worked for nearly 16 years, did not know I had undergone open heart surgery. To say I felt like a very unimportant cog in a very large machine would be somewhat of an understatement. I have asked many friends and co-workers for their take on this lack of knowledge about a serious life-event for one of their colleagues; the response has been mixed. Colleagues have recounted how they had not wanted to talk about my illness to others because it was not their story to share. Friends reminded me that academics are not the most attentive and aware individuals and others pressed home how they deliberately ‘hid’ my illness to protect me from any unneccesary work intrusions while I recuperated. In reality, a combination of these reasons, and probably others too, helps explain a lack of knowledge regarding my personal circumstances. And, of course I now wonder if the shoe had been on the other foot would I have been one of those self-obsessed academics unaware of my colleagues’ health? Why have our private lives become invisible in the workplace? Will it be a case of ‘everyone alone at work’, as discussed in Courpasson's (2016) recent essay in this series? At this juncture I must draw attention to the compassion of some work colleagues. My Dean and Head of Subject Area were incredibly supportive before, during and after surgery. I had considered taking a year's leave of absence and reducing some of my responsibilities following my immediate return was life-changing. A small number of colleagues were a life-line during my recuperation and return to work – from visits to the hospital and my home, social lunches, and for their humour; I could not have survived without their compassion. They played a crucial role along with other friends and family in my recovery. A number of other colleagues sent flowers, cards, texts and messages to get well soon – all of which really mattered, in a way I would not have expected prior to my illness. In fact, many collaborators from around the world were wonderfully supportive. These acts of compassion were informal and voluntary, my colleagues were simply being kind, caring, human beings. Without the human interaction that keeps the organisation going on so many levels, work would have been intolerable. It is the daily experiences of individuals in the work-place which should populate our theories and papers. Without these human interactions will organisations become soulless, taking on an Orwellian façade whereby employees are doomed to a life as one of Philip Larkin's Toads? Human beings are, of course, incredibly complicated – this is what makes us human – and while I found colleagues’ lack of knowledge about my health to be deeply upsetting, others could want extreme privacy about their personal life within the workplace. One contributory factor to both a lack of knowledge and support on my return to work is our ‘time poor’ culture. So many colleagues have mentioned that we should ‘do lunch’ or ‘catch up properly’ when they can ‘find the time’. Being time poor has become a badge of honour in organisations, indeed in life in general. Prior to my illness, I worked an average 58 hour week, and rarely had a weekend when I did not answer emails – I believe I was successful in a senior managerial role as Associate Dean for Academic Affairs, but my family and personal life certainly suffered. I am no longer working ridiculously long hours, partly as this would be a physical impossibility and to some extent because, not surprisingly, I've re-evaluated my relationship with work. What strikes me is that, while this re-evaluation will most definitely be good for my happiness, health and well-being, it won't necessarily be good for my ‘economic’ productivity, at least in the short-term. Of course, it could contribute to not suffering in the longer term from the ‘burn-out’ so many do in the contemporary workplace. I've always had an ambivalent relationship with KPIs in education and struggle to understand their purported benefits and this has not changed. I still question the merits of the Association of Business School (ABS) journal rankings and the Research Excellence Framework (REF) (even though I haven't worked in the British system for 16 years). I still question why performative measures are economic ones, even in not-for-profit organisations such as universities. But, now I also question not only the academic merits of these measurements, but the health and well-being implications too. Not conforming to the “new norm” of only publishing 4* and/or FT45 papers (I'm still perplexed as to how universities have allowed a newspaper to determine what our research output should be) or whatever the latest fad is, has certainly impacted my promotion chances. Prior to my surgery, while I made some small unsuccessful attempts at both micro and macro levels to change this, I reluctantly accepted the status quo. Today, I have no intention of changing either what I write about or where I publish and, when I feel able, I will attempt to shout louder about the arbitrary system, but will also be asking my organisation and the university sector to consider what impact the constant need to perform at exceptionally high levels has on health and well-being. What measures will be put in place to protect colleagues, particularly those embarking on an academic career? And will these measures be effective? What then of my future? My work-life balance will, I hope, be changed forever. I am aiming for a balance which works for both my mental and physical health, my personal life and my workplace. It saddens me that it has taken open-heart surgery to realise that my work-life balance was definitely tipped in favour of work. Ultimately this means in terms of university metrics my ‘productivity’ will decrease. Does this bother me? Yes, absolutely. But not enough to work inordinate hours again. I recently listened to a colleague describe how women were not being honoured for their business achievements because they were not (yet) as successful as men. I was apoplectic at this false statement, but while I simply put my hands to my face in horror, another colleague made a reflective comment – perhaps we need to re-define success? In terms of managerial research, the broad questions which need addressing are fundamental ones. Why does so much of the research on health and well-being in organisations focus on the bottom-line? Why, in so much management research, is the underlying assumption if it's not good for business we shouldn't do it? Even in the staggering example of VW's diesel emissions scandal, the initial storylines predominately focused on how much will be wiped off VW's share price rather than how much damage the engine rigging has done to the planet or our health. As Pfeffer (2016) suggests in his essay in this series, does the bottom line always win out? Can research help organisations to transform the workplace to ensure health and well-being are important in their own right, rather than emphasize how they may contribute to the economic success of organisations? The human side of my organisation kept me during my the HR side kept me While the protocols and procedures were and the meant my illness was from colleagues, the informal to my return to health and my to perform my job. Can management research the of the human in organisations, and in the role of the human in health and well-being in the workplace? the years have focused on the of health and well-being in the workplace. However, a of academic since health and well-being research has become a it is this is from a view of the as and this is because there is a lack of research management of the academic research on work-life balance while the the of for both and the in to my own health and well-being it life-saving surgery and a months absence from work to me the to work. The of my job, by an of being always at work, and to and the badge of honour for being busy are difficult to research on colleagues return to work after a lengthy absence is as is significant research on the health implications of I the focus in future health and well-being research should be to the human to the Human well-being should take – this may or not the organisation more But it could lead to and human beings and better to work. It has now been months since I returned to work and this essay has allowed me to on I have to my in terms of not working ridiculously long hours real will, of course, when I am physically able to work long hours, but not I have said more in this than during my colleagues that to me still me I guess I've yet to do with those colleagues who said do and I still colleagues who ask me how my my concentration, cognition and short-term memory are and my is to feel like constant with I have not yet allowed my work email to be on my I still can't open the door to the building without this me but I do which to I've that the of the workplace really me out and not to with one way to do this has been to social at work – this of course means I am in of being at I it's I up every day and about my and while I am not at work I am to it and am that my new relationship with it will be a one. I to the colleagues who in my recovery. And, while this essay details my struggles with the workplace I am very happy to be