Hindsight is 20/20: the real loss at AUBMC

In 2010 I joined the AUBMC team as director of Biomedical Research. I was bought wholeheartedly into the 2020 Vision.

The 2020 Vision was an ambitious far reaching plan to convert the already prestigious medical center in the heart of Beirut into a sprawling complex of clinical buildings and world class medical education and research facilities. The plan, which was given ten years to execution (2020), involved erecting new buildings and renovating old ones, raising new centers of excellence and clinical facilities that would rival the best in the world. And of course filling the space with the best of the best Lebanese physicians and scientists trained in tier one institutions, to join the already top-notch faculty and staff. The projected cost over ten years was in the hundreds of millions of dollars.

With a Harvard star to lead the vision, I was sold! To be a part of a visionary team, the best in the region, working on a project that will elevate my home country. It was a life goal handed to me on a platter. It was not feeding the poor. But I was in charge of the research part. And I am a staunch believer that teaching how science comes to be is the antidote to misinformation. How better to fight fake news than by teaching a generation how data is collected and challenged and refuted until it becomes accepted. I was building the concrete foundation for that to happen. I had a leader I looked up to. An end-point to work towards. It wasn’t a job. I Believed!

People, from the bottom of my heart I believed. In 2010 I believed in the 2020 vision. I believed in Beirut. I believed in the country. I made half the salary I made in California, but life was good. I memorized the 2020 Vision plan by heart. I was the hopeless romantic, and for a while it worked. The right people coalesced around me. We made things happen.

Then came reality. Seven years of grinding reality slapping you in the face every day, from every each way. A corrupt government compromising your suppliers, a sectarian society seeping into your HR decisions, power struggles, academic infighting, and the classical array of challenges you face when you run forth under the banner of drastic change. It was beyond drama. Way beyond difficult. Raising Atlantis from the bottom of the ocean would have been easier. 

In 2017 I was sitting with the leader in a conference room. I don't know if he said it or I did but it was said in that room: "The road to hell is paved with good intentions!" I remember I looked into his eyes and I got it. I really really understood what that meant.

There was a remnant of the faith we had years earlier, but now it was shredded to pieces by a thousand paper cuts, surprises, betrayals, failures. Working for that project was life in the forging fire. Every day you burn and scream and grow into some solid sculpture, except you did not know what you are becoming.

I left shortly after that. I came to Ireland. My own part of the project was almost complete. I looked around in 2017. So much was achieved, miraculously, and so much was left to do. But I was slightly wiser by then. The country was going to hell. To stay is to be a martyr. I was a single mother to a ten year old girl. I was not going to offer myself or her to this bonfire. I packed her toys and my books in 19 boxes. I left a chunk of my heart behind.

And then 2020 arrived! And with it the darker version of the AUBMC 2020 Vision, something akin of a nightmare.

The leader left. And I believe most of the team he hired to bring the vision to life is now gone. The house of cards economy of Lebanon came crashing down, with much aplomb, as all things in Lebanon do. It was like watching the twin towers fall. Fast, life-changing, unbelievable. In July 2020, instead of putting together a celebration of the completion of the 2020 Vision, more than 800 employees of AUBMC were made redundant. More than 800 hospital staff, in one day.

The loss is enormous. Like many, I knew it was coming. But it was still shocking. Reverberating through more than 800 families, spouses and children and parents and dependants, now walking into the abyss that is real Lebanon waiting to swallow them outside the AUB gates. I felt their loss through the thousands of physical miles that separate us. A loss beyond pay checks and benefits and lifelong friends. A loss bigger and more profound and longer lasting. You see these 800 disposable individuals on the lower payscale had secret plans that this event interrupted. That to me is the real loss.

Let me explain. It is not so impressive to get a PhD or an MD or a fellowship from a top notch institution in the USA. Really, and I talk from experience, it is not. You just have to be slightly above average smart and work hard. The support system will do the rest. You return to the AUB and you are revered by the support staff. They invariably call you 'doctor' no matter how much you ask them not to. They great you with warmth and respect. They insist on buying you coffee. Those who cleaned our office and served our breakfast and fixed our air-conditioning, they looked up to us. But not because we are amazing and spoke in accents, but because they had a plan. They planned for their children to become us.

We the privileged, the 'doctors', put our kids in elite schools and use our positions to move them forward. They the under-privileged, rising from the forgotten classes of this wretched society, come to work every day at AUBMC, to clean and cook and build and fix, for the hope that their sons and daughters will have a chance at an education at the AUB, either through modest benefits or through gaining inside knowledge of what makes a successful applicant.

Now this, this is impressive! A social ladder in a country where everything is designed to push you down and keep you there. A technician's son becoming a nurse? A janitor's daughter graduating from AUB's Engineering school? Unheard of in Lebanon, except at the AUB. Their faces beamed with pride when they told me their stories. They were the real heroes, not my useless PhD in Molecular Biology. They dreamed big and the children were coming through. This is the end of sectarian privilege I thought, the improbable social ladder, real progress, the new Lebanon. This is what will pull us up from the muck. I was in awe of their scheme.

And now 800 of them, the ones carrying their children on the shoulders of their toil, the ones with the audacity to dream that their children can grow up to walk the halls with titles and be revered and respected, lost their jobs last week. Their scheming was figured out, their plans foiled.

The loss is enormous. The more than 800 souls, and their spouses, and their children, will wake up to a new reality outside the gates of the institution where they cultivated their dreams. It will hit them hard. But because they are the Impressive of the earth, they will take a cutting of their grand scheme and look for a new place to grow it, probably outside Lebanon. The loss will multiply over geographies and generations. They will recover but the country will lose.

When I left the AUB, I left all the romantic notions behind. I grew up. I now know that institutions have to dream big to thrive (AUBMC 2020 Vision), and also that they have to respond to drastic change to survive (AUBMC in 2020). In the serious realm beyond visions and missions and value statements, lies the excel files that will ultimately determine our fate. I know that in our constant search for belonging we sometimes mistake where we work as family, what we do as meaning. And institutions are often guilty of enforcing that myth. But the reality is not so. Institutions are only sustained by making money. They don't run on loyalty. They are not bastions of equality and fairness. They need to make money to spend money. When they make less they spend less. When they think they can make more they will spend more. It is not 'good' or 'bad' or 'ugly' or 'immoral' or any of the romantic adjectives we Arabs dole generously on unromantic things. It just is.

But still...the loss to those who left, and those who stayed, is enormous. It is business. It is economy. It is response. It is rebirth. But it does not make it less painful!

Icarus flew too close to the sun. They told him, don't fly too close to the sun Icarus. But he was intoxicated with the warmth and the brightness and the light. His wings were held together by wax, and the warmth that seduced him melted the wax that held his wings, and he fell and fell and fell.

On his way down, he glimpsed the Phoenix rising, enormous wings held together by rows of excel sheets. Don't fly too close to the sun Phoenix! Icarus yelled, before he crashed, magnificently, into the sea.