“Bureaucracy” is a word that comes from the French, which I suppose means that moi has a greater understanding of it than most folks who have never lived in France. Literally, “bureau” means “desk.” So “bureaucracy” is “rule by desk” in the same way that “democracy” is supposed to be “rule by the people” since “demos” in Greek is “people.” Problems already. There is considerable debate possible about how much representative government can even be a democracy. I mean, do so-called “Public Servants” vote for what their constituencies want, or for what they really believe? Desks have no soul. Here, we are on a little firmer ground, for bureacracies have not much in the way of souls, either. The word “bureau” itself originally meant the cheap green cloth used to cover the tops of desks. More like the felt of blotters, the coarsely woven green dyed stuff is used to cover gaming tables and such.

The Brits use the word for this sort of cloth as a metaphor for “snooker” (the billiard table game with all of those confusing balls and rules).

I guess it is supposed to induce friction and slow down the movement of the balls. Yeah, the sort of thing W.C. Fields ripped up with his cue in the classic “pool bit” that cracked up my father of blessed memory when he even thought about it. Yeah, the modern bureaucracy is really good at slowing things down. Sometimes a hierarchy can devote an inordinate amount of energy to its self-preservation. Sometimes it seems to me to do so to the detriment of its stated purpose. The members of the hierarchy may not even notice this, but I always do. Like in the military, where the folks on top lavish themselves as much as they can with the expression, and even the thought, “RHIP” (Rank Hath Its Privileges). Me, as far as I am concerned, I find the idea of authority flowing downward is archaic at best. I mean, as far as any kind of organizational psychology is concerned, strictly 19th century — maybe even more 18th century. I even believe that the more formal the rank system, the less true this is.

I grew up watching Sgt. Bilko every weekday night on television. I am a veteran, having done my active duty at Fort Bragg, North Carolina. Ah, the way that a non-commissioned officer could know the system and wrap it around his finger. The non-coms looked on the (“overeducated”) officers with considerable derision. Getting solid human waste to leave the body was known as “taking a lieutenant.” A non-com who controlled plant and provisions could do a great deal to levitate or to sink the fate of an officer’s career. It may seem surprising that the institution I have worked with that is the closest to the military in terms of both the sheer power of its bureaucracy and the amount of energy devoted to the perpetuation of the bureaucracy itself is … academics!

Status is everything. The “assistant” vs. “associate” mentality. The “publish or perish” ethos. Here, petty and trivial behaviors rule, even for those who actually seem to possess status. It was a chairman of residency training who once told me that the competition and back-biting among the (physician and psychiatrist) teachers of psychiatry was vicious precisely because the salaries were so low and there was so little at stake. He thought this was uproariously funny.

He later “dissed” me to a department chairperson on the phone — after agreeing to provide a positive reference. I suppose I should be honored as he didn’t want me to leave (I was valuable and underpaid) but he essentially removed me from consideration for a professorship at another institution. My life could have been different. My lawyer laughed and said that such behavior was frequent in academe and no action was possible on my part. Of course, I have long since learned to expect petty and trivial behaviors from people in high places. Ever since I was a young and confused medical student and a very married very powerful chief of a surgical subspecialty tried to approach me sexually. I really was naive, for I wildly respected him intellectually and it had never occurred to me then (as it always occurs to me now) that his level of power conferred a sense of entitlement that plenty of males would simply try to “use” as he did.

Scandals of this sort no longer scandalize me. Rank Hath Its Privilege. Now, I only muse about the peculiarities in brain biochemistry that may make one man take advantage of his rank in a way that another man would not. Recently I have only recently learned — in another sort of healthcare bureaucracy — that all employees (not doctors, just employees) have to sign a “hired at will” paper which means they can be fired without reason, without notice, without justification — just on a whim, even.

Thus, they feel they can be fired at any time and so the place is ruled largely by fear. As Machiavelli said, “It is better to be feared than loved…” — however, most fear-mongers disregard the rest of that quote … “if you cannot be both.” The first order of business for most hierarchies is to preserve themselves — and this is certainly a powerful way. Now, my mind races all the way back to the original image of the bureaucracy. I imagine desks covered with “baize,” that coarsely woven green feltlike stuff that covers British snooker tables. Are we all (or mostly all) destined to be balls on the table while some Almighty (or at least Almighty-like) force plans the shot? Some of us can, to some extent, buy our freedom from this metaphor with entrepreneurship, which is in turn associated with some risk taking. Most will be dependent on a bureaucracy of some sort, at least during working hours. Institutions of this sort are simply not going to disappear.

Maintaining optimal mental health in the face of such a system generally has to do with maintaining perspective. With being the healthiest and most complete human that you can be. Work is not who you are. Work is only what you do.

Author's Bio: 

Practicing Medicine Since 1981

In her medical career, she has studied in Europe and Canada as well as the USA. She has attended specialty training beyond medical school in the fields of general surgery, neurology and neurosurgery and psychiatry (specializing in psychopharmacology).

Experienced In Many Situations

She has worked in a variety of positions, including:

Medical school professor
General and Orthopedic surgeon
Brain surgeon
Army Medical Corps psychiatrist
Prison psychiatrist
Community Mental Health Center staff
Consultant to a major transplant hospital
Drug researcher

“Whatever It Takes!”

She currently has her own indepenent clinic in San Diego where she is concentrating on what she calls Mind/Body medicine — or Integrative Medicine. Her practice is cash-only, doesn’t accept insurance or government payments, and she operates on the concierge, or “private doctor” practice model to give her patients the absolute best quality of care and the highest level of confidentiality.

Dr. Goldstein’s philosophy is “Whatever It Takes!” Her goal is to do everything possible to solve whatever problem she is presented. This includes seeing patients as quickly as possible — not making them wait weeks for an appointment. This includes making appointments days, nights, weekends or holidays. This includes making house-calls. And it includes using the best, most innovative treatments available — most of which are unknown to standard, mainstream doctors.

Her focus is on transitioning patients away from prescription drugs and onto natural substances. She is also a master practitioner of Emotional Freedom Technique, a powerful and dynamic form of energy psychology that usually brings quicker results than traditional psychotherapy.