I arrived ahead of schedule. I assumed my chances of finding the correct room of the multi-site, multi-storey hospital were low, so I gave myself an extra half-hour to allow for getting lost. In many ways, this was the first real test of the interview: could I find it? The candidate preceding me, I was later told, had not. I sometimes wondered in the weeks that followed whether they were still somewhere in the hospital, stalking the corridors, searching for the right room.
Once I got the job and began timing my exits and entrances, I became troubled by how possible this was. We were given 30 minutes for lunch, but it took 10 to get out of the building and 10 to get back in, rendering lunch a 10-minute wait in a queue for food. At maximum speed, and after finding alternative routes — different staircases, different doors — I got the time down to six minutes, but this was only possible with a deep knowledge of the building and lots of good luck. Six minutes could easily stretch to 12 if you were stuck behind a body being wheeled to a ward.
In medical dramas, the staff charge through the corridors with an urgency that the viewer naturally attaches to their patients, but I now believe much of the speed has to be down to the sheer distances involved, as well as attempts to squeeze an extra minute or two out of the lunch break. Employees of the hospital tend to know how to locate their own office, but that’s it. If you ask someone for directions to anywhere else, they say something like, “I can get you as far as radiology.” The implication seems to be that the place they can take you might be in the vicinity, or right direction, of your final destination; once there, there’ll be someone else to ask about the next step. Like Frodo finding his way to Mordor, you’re chained from one guide to the next.
I was fresh from five years working in admin at a software developer, where I’d been paid to click into cells in a spreadsheet from home before unofficially finishing at 1pm-ish to commence slowly unloading the dishwasher and continuing to read whichever novel I was in the middle of. The official line for my interview at the hospital was that I was in search of “meaning”.
The job at the software developer had been a dead end, with a salary that hadn’t increased since I’d joined in 2016. The hospital job ad was vague. I wasn’t sure what I was applying to do, just where: the Liver Wing, a unit specialising in the diagnosis, treatment and management of patients with cancers of the liver. I couldn’t think of a more amusing place to enter hungover, nor anywhere where the fundamental futility of work — and of life itself — would be more bleakly apparent. In a sense, all roads led to the Liver Wing. I would just be taking a shortcut.
My knowledge of hospitals prior to this was based on a combination of Lars von Trier’s The Kingdom and my own intuition. Accordingly, when I had been at home imagining the administrative staff, I had pictured a solitary woman named “Diane”, quietly sighing at a scratch card. This was what I wanted: a life like any other. But the application process for jobs has become too irrational for anyone to state their real intentions, even in the case of a job as openly unrewarding as one in “administration”. After I was offered an interview, I read my application back, bewildered. It seemed I had been “seeking a career in the health sector” for “many years”, motivated by a passion to use my “administrative skills” to “save lives”.
The modern interview extends the irrationality of the application, representing less an analysis of your capacity to perform the job in question than a memory test to check if you are capable of remembering the lies that imply you do have this capacity. This is not a wholly invalid metric for competency; a competent employee ought to be able to recall what they wrote down two weeks earlier, but I was surprised to find that this particular interview was more rigorous.
It began with a typing test. For practice I had done one online: a sentence slowly unfurls across your screen and you type it up as it does. This sentence is generally a prolonged version of “The woman walked the dog”. But in the Liver Wing’s interview version, it was delivered live by a hospital staffer, with an accent and in a rush, reading out the results of arcane medical procedures: “Histopathology confirms four 4mm sclerotic lesions in Segments III, IV and V, which show high FDG-avidity on FDG PET. On MRI, these restrict diffusion and appear arterialised. Overall, pT1 N1 M0. The age of the patient and multiple comorbidities complicate resectioning. Instead, the recommendation is for oncological management.” Having prepared for “The woman walked the dog”, I was blindsided and while trying to stay on top of “pT1 N1 M0”, I found I was misspelling more familiar terms like “and”.
Unable to keep pace, I wrote off any hope of making a positive first impression in the interview itself and barely paid attention to what I was saying. At the conclusion I was asked for my phone number. “I’m married,” I almost joked, so little did I have to lose. They explained that they would phone every candidate that day to let them know whether they had got the job. I gave my number, and afterwards noticed something curious happening. I heard myself lying again, even though the interview was over. I told my interviewer I was “going to Copenhagen in four hours”. If they were unable to get through, I said, it would be because I was “in the air”. If they got an “odd dial tone”, it would mean I had “already left”.
This lie was a white one. I was going to Copenhagen that day, but much later — in the evening. I had just brought the trip forward a few hours so I had something to say. In the moment, none of this registered to me as remotely important. It was such a minor detail that I didn’t even think to include it in the autopsy of my failure to my wife. I texted her saying, “Looking ahead to my own cirrhosis, I would be extremely concerned if they gave me the job.” About five hours later, I was at the train station, on the way to Stansted. I got a call from an unknown number, answered it and heard my interviewer telling me I was hired. Any pride was sidelined by panic at the realisation that the caller would have heard no international dial tone.
“What wonderful news,” I said, suddenly blurting out, “Flight delays. Flight delays are why you got through,” apropos of no question to that effect. I paused for a second. It was then that a train rocketed past, not stopping at the station, its speed and length giving it an immense, prolonged volume which made continuing the call impossible. “I’m sorry,” I shouted at Honor Oak Park. “I can’t hear you. There’s a lot of noise here. I’m on the runway.”
A fan of the film Barry Lyndon, I had been listening to Handel’s keyboard suite in D minor a lot. I spent much of my four days in rainy Copenhagen doing exactly this, walking the streets in a fog of thoughts: why had they hired me? Can you tell the difference between the sounds of a train and a plane over the phone? Would my wife deign to test the difference with me?
The first day of my induction was predictably uninspiring — a good sign. New recruits were welcomed to the hospital en masse, via an hour-long video call. Afterwards we were asked to begin our compliance training on an online learning portal. Some of the subjects covered came up the following day, when I met the rest of the admin team at the office.
There were six of us. I was asked what I liked to do for fun. I said I liked to write short stories. When I was asked “What about?”, I said, “Offices,” and added that perhaps I’d be writing about our own soon. Everyone was very excited. Even my first day had been rich in inspiration, I explained, with substantial portions of the compliance training devoted to spotting potential terrorists. I said it was a funny image, the six of us trying to tackle a suicide bomber. When nobody laughed, I saw that my colleagues had long ago accepted this as a possibility of life on the Liver Wing. I was unnerved.
Many of my assumptions regarding my job didn’t survive the first week. For instance, I was aware that our hospitals were underfunded, but I had hoped there would at least be cutlery for the staff. This was incorrect. I needed to bring my own knife and fork in. I wasn’t expecting Michelangelo, but when I swivelled in my chair to count the ceiling tiles I was surprised to find what looked like oozing coffee stains. The office itself was painted what I would now term an “NHS beige” — a particularly tired shade of off-white, with greyish streaks and long cracks running through it. The view from the window was of a wall; if a patch ever caught the sun, one could try to vicariously experience the warmth. In the areas where the carpet hadn’t worn through to the floorboards, more stains had turned much of the blue a murky brown. Paper clips people had sellotaped to the wall served as hooks to hang our headsets from. Despite apparently being one of Europe’s leading medical centres, we were working in what looked like 1979.
By the time I went to collect my pass card, some transference seemed to have occurred between myself and the building. As the depressed man operating the machine passed it to me, I glanced at my photo and was shocked that over the course of one morning I had aged roughly a decade. I looked exactly as though I worked for the NHS: harried, confused, numb. It was a look I would become accustomed to, set into the faces of colleagues asking me if I “wanted a tea” or if I had “understood that”. It was there staring blankly back at me in each of our meetings.
Because in my previous job I had just repeated the same basic administrative task over and over again, I hadn’t been in a meeting for about five years. That isn’t an exaggeration. There just hadn’t been a reason for me to ever attend one, so I wasn’t well equipped to start attending them now. I had forgotten too much. I’d have to relearn how to nod, how to repeat things that other people had just said but slightly rephrased. I didn’t even know what a meeting consisted of post-pandemic; I was confused by the transformation.
Our weekly team catch-up, in which five of the six participants called in from the same small office, took place with our backs to each other, at our desks, each using a video link to connect to the one participant working from home that day, who worked from the office every other day of the week. That colleague kept her camera off and barely spoke.
Rather than have her on speakerphone with the rest of the team arranged around a table, we heard each other speak in the room, then speak again in our headphones at a slight delay and then sometimes a third time in the event that anyone else’s microphone was left on by accident, with the result that everyone sounded as if they were speaking over themselves two to three times whenever they spoke. The budget headsets we were given added to the disorientating effect, garbling the echoes with an almost Lynchian flourish that occasionally rendered the banal content of what colleagues were saying indiscernible and haunting: “We, we, weeee, don’t, don’t, dooon’t, have, have, haaaave, capacityyyyyyy.”
The on-site meetings were in one sense clearer, but in several others significantly more opaque. I had made it known from the beginning that I had no professional medical background, administrative or otherwise. I was very careful not to lie about that, lest I be expected to muck in with a liver transplant; the understaffing was bad enough that this felt eminently possible even without a medical background. In any case, my lack of awareness of the terms the staff were using made my attendance at these meetings basically pointless, which was unfortunate given that I had at last worked out what my job was and it was to be a “Multidisciplinary Meeting Coordinator”. Hospitals hold weekly “multidisciplinary meetings” for different types of cancer. I was taken on a tour of them in order to “get a feel” for what my job would actually entail, which was to co-ordinate and minute the meetings for a particular cancer of the liver, before entering the data somewhere. Other hospitals in the surrounding area referred patients to our specialists who would then determine what investigations were needed. Once the results were in, a team of radiologists, consultants, surgeons, histopathologists and specialist nurses would argue for a while about the management plans for the patients.
Needless to say, I was not qualified nor inclined to live-type these discussions. The problem was that I hadn’t really expected any work at all — not in the serious sense of the word. I had expected “Diane”: mindless data-entry, scrolling through Twitter, maybe looking up my friends’ medical records in the database. But a specialist nurse I met at one meeting seemed convinced that I’d have stuff to do. She assured me I’d “get the feel for it soon”, and then proceeded to play Wordle on her iPhone throughout, taking occasional breaks to offer an opinion on whichever patient cases she was asked to comment on. I took it as a fantastic sign that she was playing Wordle, and I hoped that one day I might be able to do the same, but my guess was that it had taken her years of painstaking work to get to the Wordle stage, whereas I wanted to play Wordle now.
The following Tuesday, I was asked to attend a distal pancreatectomy and splenectomy. As an administrator, I arrived at the operating theatre utterly confused as to what my role might be. I had been told it was just another part of my induction — one more thing for which I was supposed to “get a feel”, evidently. But with a view to what? It was important for every employee to have “context”, they said, “an overview”: important that we saw and understood why we all did what we did. A nice idea, I thought, but were the cleaners sitting in on surgeries? Were the security guards? Did the caretakers tour the morgue and the coroners visit the bins in this Freaky Friday model of management? What made the administrators special? Why did I need to watch a pancreas get lifted out of a human body?
Owing to a rail strike, the hospital that morning was almost empty. My immediate team were all working from home, so there was no one around to introduce me to the surgical staff. Alone, I wandered through the yellowing corridors in an eerie silence, trying to find the site of the pancreatectomy, and pondering as ever how I had come to experience such a drastic change of scenery.
At about 8am, I entered a staffroom a few doors down from the operating theatre and asked an anaesthetist relaxing in the requisite fraying chair if he knew what I was supposed to do. “Are you a medical student?” he asked, smiling. “No,” I replied, “I’m just an administrator.” Laughing in a teacherly way, he said, “Not ‘just’!” I laughed back. “No,” I agreed, thinking about how I was barely even that: as it stood, I was more of a tourist, on a sort of sightseeing holiday in the hospital. My next stop was the changing room for scrubs.
A day earlier, in need of information from someone, an extremely charismatic surgeon had swaggered into our office vaping from a Juul. As he sank into a chair and began slowly swivelling, we were introduced. A colleague mentioned that if a liver arrived — it didn’t in the end, hence the pancreatectomy with a different surgeon — I’d be watching this man perform a transplant. He smiled. “Are you squeamish?” he asked, inhaling on his vape again. “I don’t think so,” I said. “I like David Cronenberg movies, anyway.”
His smile widened behind the vapour clouding his face. “If it’s anything like a David Cronenberg movie,” he replied, “we might both be squeamish.” He was still grinning warmly as he said this, as if he was being sarcastic and really meant that actually he wouldn’t be squeamish even in the event that the surgery took a Cronenberg turn. I grinned back, wondering if he knew or cared that vaping was banned in the hospital. After that, he swivelled rightward, smiling in the direction of the colleague to whom he had been gesturing vaguely with his vape while speaking about cancer targets.
I was surprised and pleased that the Cronenberg reference was understood (and so well received) by a man as busy as he was — surely someone without the spare hours for body-horror films? But later, as I sat at my desk picturing this inexplicably sexy surgeon vaping in front of a home cinema-screen while a gynaecologist in Dead Ringers disembowelled a man on an operating table, I was mildly unnerved again. I imagined him smiling as the entrails sprayed from James Woods in Videodrome, chuckling as the skin fell off Jeff Goldblum in The Fly. I imagined him in surgery.
It wasn’t to be. With no liver forthcoming, I watched a team of three other surgeons slice into a man and search through his organs in some inscrutable connection to my training in minute-taking. The aim of the procedure was to cut out the spleen and most of the pancreas. My colleagues had all observed several surgeries already. In fact, it was treated more or less as a perk of working at the hospital, the equivalent of a cycle-to-work scheme or gym membership. They told me stories of hepatectomies and something uncomfortable-sounding called a “Whipple’s”, while one colleague claimed that during a transplant procedure, the surgeon had invited him to hold the new liver, to weigh it gently in his hands; an image that made me weirdly envious, and yet again unnerved, given that this colleague was a complete moron.
Despite all the stories, nothing could have prepared me for the atmosphere in the operating theatre. I hadn’t been expecting anything morbid or sad, just clean and clinical. But the reality was more like a neighbour’s Saturday afternoon barbecue: a radio blaring “Everytime We Touch” by the German dance act Cascada and David Guetta’s “Memories”; nurses scrolling Instagram in between requests for new tools; anaesthetists chatting about traffic, the kids, tennis.
I was given a stool and told I could stand behind the surgeons, so as to stare over their shoulders into the yawning hole they had made inside the patient. I looked. I had imagined red. But early on, they pulled a carpet of yellow fat out of the man, which they laid over the lower stomach for most of the operation. This gave them space to search inside, alternately cutting and burning tissue, with the smell of the blood and seared flesh filling the room almost as prominently as Jon Bon Jovi, whose vaulting chorus to “It’s My Life” two nurses sang along with. I felt obliged to do the same to fit in with my new team but worried about seeming unserious in the middle of my first distal pancreatectomy. I settled for humming.
Before long, several people were muttering “specimen” and a spleen was lifted out of the hole and dropped inside a plastic tub. Was this my life now? And had I mis-sold it to myself after all, or was it in the end a life like any other: the exact mundanity I had hoped for? Rummaging through the patient’s torso for something, the most senior surgeon was slapping the man’s innards back and forth in a manner that seemed fatigued, blasé, hasty. Was surgery mundane to him, or was it that everything is mundane, eventually? I looked at the time on the clock on the wall. There were hours left of the procedure, and I was astonished to see how quickly open surgery had become dull. As flesh continued to be burnt in front of my eyes, I found myself answering a workaday text from my wife: “Did you buy bread yet?” I glanced up, suddenly aware of what I was doing. I was on my phone. I was there: Wordle.
Yoel Noorali is a writer based in London and a former administrator on a Liver Wing
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