Self-doubt, truth and cider at the Queen’s Head
Tom Turmezei, co-editor of the FMLM Bookclub, talked with Mike Knapton. Mike is a GP at the Nuffield Road Medical Centre in Cambridge for one day a week, Associate Medical Director of the British Heart Foundation (BHF), and a Non-executive director Cambridge University Hospitals Foundation Trust. He is also Treasurer of the Cambridge Medical Society, the East Anglian Faculty for the RCGP and a Trustee for Genetic Alliance UK.
Cycling out of Cambridge into dark clouds, I ponder the 30% chance of precipitation forecast by my weather app in the minutes before. I don’t fancy the odds, but brazenly bear my sunglasses even though I am cycling south into the evening as if they were both a literal and figurative hangover from my recent holiday in Spain. Arriving what I consider a sociable 15 minutes early at our rendez-vous, the Queen’s Head, a charming Free House in Newton, I settle in with a cider and peanuts in an attempt to replenish the meagre sweat loss from the exertion in. I briefly consider what Mike would think of the salt load, but I don’t think I’ll ask.
It is worth explaining at this stage how I came to meet Mike and why I wanted to talk with him about books. We first made our acquaintance at a college alumni meeting where I noticed he had been holding a volume under his arm throughout the day. I knew something of his numerous roles and was interested, bordering on nosy, as to what he might be reading. The book in question was Governance as Leadership: Reframing the Work of Nonprofit Boards by Richard Chait et al.1. Although the subject matter may have appeared a little dry, there was something warmly disarming about the openness with which Mike admitted that he found it very useful for understanding the language of the boardroom. I asked if he might like to talk about books at some point, and so our meeting was precipitated. Six months later back at the Queen’s Head…
It’s been hardly a sip or two when I spot Mike’s smile sauntering past the bay window before which I had strategically sat. What I don’t see, because of the combination of his stature, my low seat and the height of the sill, is the bulging pale tan satchel slung over his shoulder that is evident as he enters the saloon. I ask if he’s come straight from work, but the answer is far better than I could have expected. ‘No, this is my holiday reading. I thought I’d bring it along to share with you. Make some effort, you know.’ It turns out we had both recently returned from Spain with the same intention of getting in some decent reading hours. Whereas I had only managed 10 pages of The Hubris Syndrome by David Owen (such is the way when you have a two-year-old who beds at 10pm), Mike had somehow devoured more than a half dozen books of some substantial thickness. In fairness, it was a two-week holiday, he admits sympathetically. I still felt inadequate, but more of this later.
After an initial discussion on his varied career to date, with General Practice neatly seamed throughout as he takes care to point out, my developing impression is that, although not an ‘accidental leader’ in the literal sense, there is something of this about Mike. Even from our short evening together it is clear that he has a charisma with modesty, a knack for forming personal relationships and a most enviable quality of a strong memory, most of which is evident just from the cheer with which he is engaged by everyone else at the pub throughout our evening. However, it is more the self-confessed lack of ambition for positions of leadership, which he says is replaced by his ambition for ‘the project of medicine’ as a whole, that reveals something more of the leader in him. ‘I would be anxious about anyone wanting to be a medical leader’ he confides, ‘but would be happier with someone who has a vision, gets into a role and then has the means to enable it.’
He moves on to reflect on the positive and negative qualities of self-doubt, something he recognises that he has in abundance. If used in the correct environment, he urges, it can be a powerful tool. His personal philosophy on leadership comes across far more as to serve rather than to seek. This is refreshing in an age when paths towards positions of medical leadership can seem hurriedly prescribed rather than freely formed. Likewise there is resolve in his regard for qualities such as kindness, a ‘feminine’ approach and humour, all of which are most usually regarded negatively in the world of leadership, incorrectly in his opinion.
My opening question posed to Mike was whether he imagine having as many roles as he does today when he started out as a medical student. The answer is an emphatic ‘no’, but this is immediately elaborated to point out that he had only ever made two proactive career decisions: the first was to study medicine; the second was to train in general practice, something he says had been obvious to everyone close to him apart from himself for some time. ‘Everything else is happenstance…’. I re-pose the question that perhaps these roles were actively drawn to him. There turns out to be some truth in this, since Mike was headhunted for Associate Medical Director at the BHF. He recalls one interview question in particular: ‘Do you think we’ve seen the real Mike Knapton here today?’ ‘Glimpses, perhaps’, he recounts, then laughs heartily, revelling in the projected mystery. Am I being treated to such glimpses too?
The path to his other main role as a Non-executive Director on the board of Cambridge University Hospitals NHS Foundation Trust is also self-effacingly recounted. Given that the job description called for applicants who lived locally with experience in general practice (he had locumed in nearly half of the Cambridge area practices on account of a career break brought about by fraudulent activity of a practice partner that ended in a tragic suicide) and the fact that he had management experience through his previous role as a Primary Care Trust lead, yet also had no purchaser-provider conflict of interest from involvement in a Care Commissioning Group, he maintains that he might have been the only appointable candidate. I suspect the truth is far more that he was unknowingly self-made for such a role. When I ask more directly about the decision to apply for this position, Mike admits that it was something for which he felt right, but he was quick to add that you should ‘bring what you can to the table; you can’t be all things to all people.’
It comes to me that someone with such a range of responsibilities might perhaps be seeking to avoid clinical practice, but Mike sees his one day a week at the practice in Chesterton as an essential part of his work. He adds that he would be sorry to see something go that he worked so hard to reach, but also that it lent a form of validation to his other roles, whether spurious or real–‘spurious’ in the sense that it was only one day a week. However, he is positive about how modern IT has facilitated his working choices and working life, giving something away of his memory skills in the telling. ‘My memory is my email account, so I don’t let clinical problems drop.’
I wondered if there had been any unexpected situations in which he had found himself over the years and asked as such. In my opinion, his high profile responsibilities and natural ease would make him amenable to the media and there had indeed been appearances on breakfast television and the Today Programme, to name a few, that had been such experiences. The episode that sticks in his mind though, was the follow-up to a hush-hush invitation one day to a meeting in central London as a representative of the BHF. It turns out that this was a big-wig chin wag at No. 10, with the New Labour team looking at the relationship between public health, third sector organisations and captains of industry. After mouthing off from Mike on short-termism in the public health sector and the contrary need for sustained efforts, Tony Blair entered the room then slipped out after 10 minutes, the continuing conversation uninterrupted by the premier’s glacial stare. He wasn’t sure if he had made an impact, but he recalled the words of one of his close friends, Anna Benson-Giles, ‘be true to yourself. If you are right about something, then take the credit; if you turn out to be wrong, then accept it with your head held high.’ In retrospect, I wonder if Mike ever had any political ambitions, but this seems a silly question given his undressing philosophies crossed with my own blighted opinions on power and politics.
In another moment of self-reflection, Mike admits to quoting others for his own inspiration. I point out that I had already written this in my notes and he admits to feeling like being in the psychiatrist’s chair – I don’t ask if he has for real. I reassure him that I have had no formal training in that vein, but he laughs and quotes again. ‘You don’t have to be solemn to be serious’ should be his motto, he claims. Rightly sensing that I have come to the end of my questions, Mike reaches over his left shoulder, opens the satchel and delivers a marvellous parade of his recent holiday reads.
Even if he had prepared for this moment, the move felt as genuine as it was touching. It was unusual for someone to share their personal tastes so openly. I would not say (nor would Mike admit, I think) that his tastes were unashamedly catholic, but there was healthy mix of self-confessed pretention (9), chick-lit (‘read it in a night’) (5), local history-come-fiction (3), suspense (1), essays themed on memory and truth (6) and the medically inclined historical-biographical pieces (7 and 8). Mike admits to a theme of gloom in his reading, but this is balanced with insight into the influence that books and the ideas that their authors wish to purvey might have over him.
I ask if he has an all-time favourite, and this turns out to be in his selection: number 4, The Goldfinch by Donna Tartt, winner of the 2014 Pulitzer Prize for Fiction. Mike gives a detailed synopsis of the developing journey from and to tragedy, again revealing something of his ability to recount, again touching on the more sombre sides of his taste, which seems to be an important foil to his jollity. It also happens that one book from his holiday list is missing today, which is Intelligent Kindness by John Ballatt and Penelope Campling2, something that he describes as taking the oxymoron of head and heart and how we can bring them together in a paradigm shift for the NHS. It turns out that he has lent it to the Chief Executive, Keith McNeil. I chuckle to myself at the notion that he might have his own private book club set up across the boardroom table.
Our evening draws to a close over the last few sips of the second round, recently lit candles flickering in the saloon in contrast to the twilight skies outside. As I head out across the road to my drip-strewn saddle, the other side of showers that I hadn’t even noticed has passed, I prepare for the cider-fuelled ride back into Cambridge. Although the sun has now set, I feel enlightened. By the time I have returned home, it dawns that I have come to a new level of realisation of something I already thought I appreciated: recognising that there are many different styles of leadership and many different paths to leadership positions. I had only one recommendation for someone of such amiable disposition and natural literary degustation: Peer Gynt by Henrik Ibsen, simply because our encounter had reminded me so vividly of the Troll King’s heed to the eponymous: ‘Man, to thyself be true.’
1 John Wiley & Sons, 2004, ISBN-‐13 978-‐0471684206
2 RCPsych Publications, 2011, ISBN-‐13 978-‐1908020048