Mrs. Malik was 71 when she learned how to recognise the signs and symptoms of a stroke. She learned this from a series of pictures on a local hospital’s information leaflet. On the top banner, in blazing red ink, was the hospital’s emergency number that could be called if one were convinced that they were having a stroke. “Don’t hesitate,” it said. “Just call. We’ll be there in 10 minutes.”
Mrs. Malik carefully folded the paper till it showed just the emergency number and taped this to the landline phone set she used. She further wrote the number down in her personal phone diary, and made a mental note to ask someone to save the number in her cell phone.
Two days later, the ambulance was at her doorstep.
She was taken to the hospital, where after a brief examination, the doctor told her that she was fine. It wasn’t a stroke. There was nothing to be worried about.
Over the next seven weeks, the ambulance came to Mrs. Malik’s place four times. And each time, the doctor assured her that it wasn’t a stroke and she had nothing to worry about.
The sixth time she called the hospital, though, the lady on the other end asked Mrs. Malik, with a touch of irritation in her voice, “Are you really sure?”
Mrs Malik wasn’t. She had been feeling guilty about calling the ambulance for nothing, but she was also scared she might be having a stroke. “Please, it is an emergency,” she said into the phone.
The ambulance did not come that day, not until much later, when the neighbour found Mrs. Malik collapsed on the floor. Thankfully, she has made a full recovery now, but she could, so very easily, have not.
The Boy Who Cried Wolf
Now, you might be thinking that this is so very different from the story of the Boy Who Cried Wolf.
That boy cried “Wolf” to the village every day because he thought it was fun to see if all the villagers would gather together with pitchforks and staves and wooden mallets to save his sheep. And if they did, the Boy could laugh at their expense.
He was naughty and was doing it just to inconvenience everyone. He didn’t care about the time and trust of the villagers and he insulted them for being helpful.
He deserved what came his way. He deserved having the Wolf eat all his sheep.
But Mrs. Malik didn’t call the hospital with malicious intent. She didn’t call to see if the ambulance would come. She didn’t call to inconvenience the people at the hospital. So, how is this about the Boy Who Cried Wolf?
Well, let’s look at what the lady on the telephone had to say about the event later during an investigation. I have translated it from Odia and paraphrased it.
To this lady, Mrs. Malik was a lonely old woman who kept bothering the hospital because she wanted attention. To this lady, Mrs. Malik was making symptoms up in her head and was not respectful of the hospital’s time or readiness to help. To this lady, Mrs. Malik was the Boy Who Cried Wolf.
Whose fault is it really?
The hospital management claimed that it was an individual employee’s fault. That it was a “grave error of judgment.” But how was it that the hospital allowed this employee the freedom to choose whether to respond to a call or not? Was the lady not required to send the ambulance, no matter what she personally thought about it?
The lady in question has this to say:
The Wolf didn’t eat all the sheep because the Boy was a liar and menace. It did so because the villagers heard a cry of help and chose not to act on it. Mrs. Malik was left collapsed on a floor, not because she was an irreverent caller. It happened because the hospital had given the lady on the phone the freedom to hear a plea and choose not to act on it.
In both cases, the people thought that they knew what was going on, they thought that they were right to do what they were doing and they thought they could just ignore the cry, even if it was of emergency. And by thinking so, they allowed a disaster to happen. A disaster, which could have been very easily avoided.
The Systems Design lesson from the Boy Who Cried Wolf
When we tell the story of the Boy Who Cried Wolf to little kids, we think we are telling them that lying is bad. That being disrespectful of people’s intention to help is bad. That doing these things would bring trouble on to their own heads.
Yes, it is an important lesson for kids to learn. And I totally agree that it should be brought across to them. But there is also another hidden message that we don’t want to send.
When we tell this story, we tell them that our care and protection is very conditional. We tell them that if they are naughty, they are on their own. If they lie, we will abandon them. And if something bad happens as a result, it will be their fault, not ours.
Similarly, when hospitals open up emergency lines and assign an individual to make a judgment on whether the emergencies are worth their attention, they are telling us that we are not really safe calling them. That they will come to our rescue only if they feel we are really in trouble. Or if we are model patients.
And this happens everywhere. Organisations routinely claim that their technology systems are designed to eliminate Type I errors and accommodate Type II errors. That is, they are designed to accommodate any number of false alarms, but they will never ever let even one real alarm go unheeded. And yet, their human systems aren’t designed to hold up their claim.
Companies set up customer service numbers, telling everyone to call them 24×7, but each time a call comes through, a company man has the power to judge whether to act on the request or not.
Human Resources departments stick posters in cubicles claiming they are open to all suggestions all the time, but an executive routinely ignores the email coming from the “cry baby in operations department” because it’s not really worth their while to pay attention to the little things.
The lesson is simple. As communities, as companies, as institutions, we want to tell our people that they are safe with us. That they can rely on us for every little thing. And to do that, we have to be ready to act on every single call from them. Even if they have a record of misusing it or being disrespectful of it.
Because safety is not conditional. Safety is something people should take for granted. All the time. And that is why we need to work extra hard to make it so.
If you found this article useful, please share it with others.
And if you have told your parents or partners that they can reach out to you anytime, don’t stop to think if it’s really really important when you hear the call. Just pick it up.