Top Troubles
By KATHARINE WHITEHORN of the Executive at the Hall last week had some professional ;°Illection with industry. Both types looked :,lerablY healthy (the only lot who looked 4-il/et', dissolute, frail or hungovcr were, as c41, the press). And indeed one of the main „41 it'llelusions of the conference was that, con- 447 to general belief, executives are rather 4,,lhier than other people. Only in coronary erY disease do executives have a higher death Se"-that, and accidents: the accident rate is bt Per cent, higher than the average—presumably e'lase every executive has a car. i the opinion of some of the doctors who Ind)", executives now, like the more fortunate 1,,,,,4:4Y age, die mainly of surfeit; though opinions siie as to which surfeit is worst. Dr. Hugh hilel4ir, a desiccated Wykehamist from Oxford ste° made a special point of his own personal enderness, was convinced that people who drop to:(1 from coronary thrombosis have been eating has rIlarlY harmful fats (and their harmfulness t nothing to do with whether they alt `satur- itiefl'). Dr. Norman, London Transport's air pol- A.1;kat man, absented himself from the gasworks Itinere 1)e is working long enough to affirm that "g cancer definitely is caused by heavy smoking 1}1,thnugh even here executives have the edge on - The of us: cigars are better than cigarettes. p. ne star performer of the conference was Dr. budley.White, Eisenhower's doctor; and he mn4rOled that in his field -- coronary athero- lo„,er°sig—top executives share with labourers the e)("est death rate from this disease; it is lesser iinectitiVes and clerks who have the highest. And octiP4krentlY even annual check-ups are not all that 115e: coronary atherosclerosis, in order to yeaat all deadly, must have been developing for sa0rs' The only way to what Dr. White calls 'our t7 of middle-aged fitness' is apparently an tieriIngent and active habit of life in the twen- refrs (It must be hard, none the less, to build a ‘Is°,.,'111.° of life merely on the hope of being as fit 4lectsenhoer when you are seventy : even the 4ens sana in corporal punishment training of the at Public schools aims at something more ont.r ediately inspiring than that.) ler the informed frequenter of medical con- k, ekes, only two or three of the speeches may eve been important. But to the lay observer, orell Minor points contributed to a general im- toession of the subject. Dr. Sinclair talking about " in terms of global deficiencies: descriptions by an LCC doctor of precautions taken to stop smallpox coming into the country, and anecdotes recalling the days of cholera and typhoid in Britain, when warships went down the Thames to head off the plague-carrying merchantmen; even the ghoulish anecdotes about early surgery supplied by, a surgeon who actually rattled a handful of bones at us—all this had the effect of cutting the whole question of the health of the executives down to size: Even granted that men who have reached middle age will live only three years longer than they would have done 100 years ago; and that an individual death is always a tragedy, there are worse ways of dying than a heart attack in the fifties. True, it is the men who die this way and not their wives; and there might be a case for trying to bring equality to the death rate; but this was not on the agenda.
The impression that the days of great medical disaster were over was strengthened by Dr. Alstead of Edinburgh, who was speaking about the relations between doctor and patient. He talked about his entire practice in terms of human relationships, of judgment; and without actually denigrating machines, drugs and surgery, he somehdw reduced them to the level of thermometers and laxatives in importance.
And this view of the modern doctor as a cross between a priest and an adviser was reinforced. from, to me, a surprising source: Desmond Bonham-Carter of Unilever. Describing the progress of industrial medicine within his firm (it had apparently to be sold to most of the managers as a way of stopping abuses of the benefits scheme), he said in so many words that the doctors were there `to assist in the mainten- ance of satisfactory human relations.' He gave various cases where the industrial doctor had acted more as a trouble-shooter than a medicine man: departments whose 'epidemics' were due to resentment, or overseas wastage that had more to do with new situations than new bugs..
Mr. Bonham-Carter did say that doctors re- sponded differently to being treated in this way —as handlers of human beings in all situations, rather than as straight physicians. 'As they ven- ture further from their surgeries,' he said, 'they become increasingly unsure of their skills.' Who- ever had the cleaner collar, the doctor so placed presumably finds himself in what is, essentially, an executive's dilemma—a dilemma which may be at the root of at least some of their worry.
For, considering how little the executives' health is below par, what is interesting is why the executives should worry about it—and the incessant check-ups of American executives, the constant discussion in the papers, 'even this con- ference prove that they do worry a great deal. One managerial revolutionary I spoke to on the way out had his own theory: 'I told a small bunch of executives I was coming here,' he said, 'and I could see a sort of suppressed shudder go around them. They think they're scared about their health, but they're not. They're scared about their jobs.' A man too old to start again, or to lapse back to bench, horse or garden might well be anxious: worries, like blackmailers, strike when you have got something to lose.
This particular executive found most problems connected with the manipulation of people frustrating and difficult: 'About once a month,' he said, 'for five minutes, I get back to metal- lurgy: and it's lovely.' There was an odd passion in his voice as he said it; and his longing for his real skill, I felt, must be shared by many good architects who have to become good businessmen, good teachers who become headmasters, good , writers who become editors in order to get to the top. The very skill that gave them the confi- dence to get ahead is less ultimate use than the straightforward manipulation of men. And an industrial doctor said he even found this sort of worry at the chargehand/foreman level: 'A first-class toolmaker came to me in tears after a month as a foreman,' he said, 'and said he couldn't stand the responsibility. I said, "Then why the hell take it?"' It is not a question people commonly ask of executives; but they may often ask it of them- selves. Possibly they reach the same answer as the man who was told that one should not give in to temptation. 'Well, somebody must,' he said, 'or the thing becomes absurd.'
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