A few years ago, a doctor friend told me of a revelation she had had after attending a lecture on clinical nutrition. 'You see,' she said, 'I'd never really thought of calories as something you needed in order to survive - I'd spent my whole life trying to avoid them.'
Bumping into an old friend on the Tube the other day, I confessed to her that I had had a similar moment on my "Road to Whitehall". It had never occurred to me that healthcare managers were passionate about patients and healthcare.
Do not get me wrong: I was not a particularly militant medical registrar - well, not on that front anyway. I certainly did not think of managers as Luciferian caricatures, creeping round hospital wards, casting a beady eye over my clinical freedom. I realised they were necessary, that money and resources would not flow through the NHS in any useful way without someone to guide them. But what motivated managers? Never gave it a second thought.
As doctors, we are all supposed to know what drives us. After all, it is the standard interview question: why do you want to be a doctor? Putting aside all the possible nuanced answers to that question, ultimately we do it because we want to make things better for patients. Somehow, though, after years battling away at the front line, I somehow got the idea that managers were only interested in the bottom line.
How things change. Now I wear a suit (sometimes a tie!) and my wristwatch is no longer hanging off my belt. I have become a complete stranger to alcohol gel. I sit still for prolonged periods, have my own desk, go to meetings like a proper grown-up, and generally have enough time to make a cup of tea and drink it. Above all, however, I have had the opportunity to meet senior managers and policy makers in the NHS and hear about their values and motivations.
I must confess that I did not really know what I was getting myself in for when I applied for this post. I had a vague idea that some time spent not working with patients might give me a new perspective on my career, that exposure to the mechanisms of management and policy making would broaden my horizons and make me more employable, that working for the chief medical officer would give me a unique peek into the processes of government and politics.
I have learned a lot so far. For example, I cannot sit still and quietly at a desk for any length of time. I work well to a deadline. There is something called a "completer finisher" and perhaps this might not be my natural tendency. More than anything, though, I have been struck by the passion and commitment of absolutely everyone I meet to making things better for patients. It is a tremendous arrogance, I suppose, to assume that only clinicians really care about patient welfare, but I have a feeling I might not have been the only one.
If the NHS is to run as a functional organisation, there needs to be a meeting of minds between clinicians and managers. Currently, the relationship is often characterised by suspicion and mistrust and everyone loses out: clinicians, managers, patients. Giving junior doctors more opportunities to work in non-clinical posts is part of the answer, but this alone will not be enough. We need to think of innovative ways of enabling managers and clinicians of all seniorities to mix, listen and learn from each other so that together we can deliver a quality service to our patients.