This is one of a collection of stories that are like “Final Destination” meets “The Monkey’s Paw” (W. W. Jacobs, 1902). As such, they are tragedies more than either mysteries or horror, and would appeal most to readers who enjoy the inexorable pull of a story arc that leads to doom. In each story, a protagonist makes a wish that comes true with fatal results for someone, often the person making the wish. Nothing supernatural, but just how things work out. (Or is it?) The technical details surrounding the fatal (or near-fatal) event are drawn from real cases in the US OSHA incident report database and are therefore entirely realistic even if seemingly outlandish. The plots draw lightly from cultural beliefs around actions such as pointing at someone with a stick or knife, wishing in front of a mirror, or stepping on a crack.


Frank was sure the clinical staff laughed at him behind his back. As the HR director, they didn’t give him the respect he felt he was due, and he felt left out of the decision-making process at the hospital.  Sure, he wasn’t a clinician or a researcher, he thought, and much of their conversations were in a foreign language, but he was an expert in his own right and deserved to be heard.

Frank was always on the lookout for ways to make the HR department relevant and to have a seat at the table. His attempts were often snubbed by the clinical staff, and he felt the research staff were just plain rude to his entire department. A few years ago, when he implemented a hand sanitation drive, was an example. He had purchased twenty hand sanitizer stations and had Maintenance install them at key positions throughout the admin building. His staff had embellished posters from the WHO and CDC to boost handwashing and had put up the posters around the admin offices.

Dr. Kate Briggs, who was in charge of the hospital’s infection control team, thought this was really a great initiative for an HR department. She chatted with Frank during one of the monthly director’s meetings and quickly became puzzled, then bemused. She was astounded that Frank had no goal other than just putting up the stations and posters. When she had asked what outcomes metrics he was tracking, it became obvious that not only did HR not have any goals for the initiative, but that the concept of outcomes metrics was alien to Frank. In turn, Frank felt she was dismissive of their efforts and that she and other members of the clinical and research staff were just trying to find fault.

Frank had better success in some other initiatives, although he was not always sure how their engagement led to the final actions. For example, Maintenance had been very receptive to his initiative around improving efficiency and reducing hiring costs, but Frank was not really clear on how that discussion and resulting memos had wound up with the purchase of seven floor-cleaning robots. An autonomous robot that could mop floors was certainly cool technology, but Frank was mystified as to how his talk on hiring costs had played a role in that decision.

As a member of the Society for Human Resource Management, Frank religiously attended both the national annual conference and the monthly local chapter meetings. The SHRM conference was a source of inspiration to Frank, and he always came away with great new ideas. In the previous 5 years, Frank had attempted to implement ideas he had gleaned from the conferences but had found it far harder to gain acceptance than he had expected. Going by what had been described in the panel and breakout sessions at the conference, Frank had expected far more support than he had experienced.

Last year, he had tried to implement Stack Ranking, but the clinical directors had rejected it out of hand, and the research director had refused to even listen to him and had rudely just walked out of the meeting. Based on previous unpleasantness, Frank had decided not to try convincing the nurses to join in. Frank could not understand why they weren’t enthusiastic about ranking their staff from “best” to “worst” and then putting in place a reward scheme for the best workers and a performance improvement or separation plan for the worst. It seemed logical and exactly what he had heard at SHRM sessions.

The year before, Frank had tried to convince department heads to use 360-degree peer ratings for annual staff performance reviews but had faced such vehement opposition from the nurses that he had to abandon his program. They even got the union involved, and Frank had spent several very uncomfortable meetings with the legal team, chief medical officer, and the union representatives.

Two years before that, Frank had attempted to implement staff classification using the Myers–Briggs Type Indicator scheme. When it was demonstrated at the conference and each participant in the breakout session had been classified, Frank had been amazed at how accurately it represented his personality. It just struck him how much better all the different clinical specialties could communicate with each other if they used the MBTI method. Although Frank had seen great success in adopting it in the HR department, the other departments had been resistant. The research department had been quite rude, and the head of psychiatry had actually rolled her eyes at him. The hospital director had been kind and understanding, but she cautioned him. “Frank, your heart is in the right place, and I appreciate the initiative, but you need to vet these things more carefully. You stick your neck out too far sometimes, and one day you might get your head taken off.”

This year was different, Frank thought. He had an initiative that he was sure would resonate more with the other department heads, and he had a strong suspicion that he was going to catch them out and show them up. They might all be clinical subject matter experts, he thought, but when it came to personnel matters, he was the expert!

At this year’s SHRM conference, Frank had attended the Staff Retention stream, in which several speakers had described the war for talent that was currently underway. One panel discussed the perils of a high turnover rate, and how even a few percent above the industry average would eventually doom an organization. It was an inspiring meeting and left Frank with a renewed sense of purpose, handouts, and a calculator tool. On his return, he briefed his team and tasked them with identifying the industry turnover rates for clinical and research staff and comparing them to those of the hospital. Frank felt very confident that he was on familiar territory, where he was in command of the lingo and understood the issues.

The results of his team’s analysis blew his mind, and he was now certain he was on to something big, something that would force them all to pay attention to HR and give it the respect it deserved. His analysis showed that the clinical staff had a whopping 42% turnover rate, compared with an industry average rate of 6.8% for physicians and 11.5% for advanced practice clinicians. Compared with the HR department’s 7.2% turnover rate, the clinical departments were a mess! According to the turnover calculator from the conference, a 42% rate was costing the hospital millions every year. Frank felt triumphant.

At the next department heads meeting, Frank had scheduled a topic and went prepared with color handouts, 30 PowerPoint slides, and a great deal of confidence.

Five minutes into his presentation, Frank dropped his bombshell about the 42% turnover rate for the clinical staff and how much it was costing the hospital. The CFO’s head jerked up, and the CMO held up her hand. She pointed out a little tersely that the headcount numbers he was showing included medical students on clinical rotation. “They aren’t permanent staff and are only with us for 6-12 weeks,” she explained. The head of research snorted, and the CFO went back to looking at financials. Frank felt his face glowing and his collar was suddenly too tight around his neck. For a tense few minutes, two HR team members tried to rescue the situation, and with help from one of the data scientists from Research, they filtered by job type and excluded the students.

Frank was fidgeting uncomfortably and could feel the disrespectful gazes all around the room. He felt a huge sense of relief when the clinical rate excluding students was still high, with over 17% turnover for all clinical staff. Triumphant again, Frank continued his presentation. He could still bring this home.

The head of research burst out laughing, bringing the presentation to a halt. “Oh, for heaven’s sake, Frank, you can’t add ratios!” Frank stared at Dr. Fitch, a sense of panic again welling up in his chest. “The individual percentages, Frank, you can’t just add the numerators together; they have different denominators.” Frank stared dumbly, not understanding at all what Dr. Fitch was on about. The words had individual meaning, but strung together like this, Frank had no idea what she was talking about.

“Frank, you can’t add each of our department’s retention percentages together to get an overall rate; that’s not how math works, Jesus!”

Laughter erupted around the room. Someone made a snide remark that IT should take Excel away from HR. There were more roars of laughter, and the CMO was actually choking on her fruit juice. The waves of derision broke over Frank like a cloudburst. He felt like he was drowning, his head pounded, he couldn’t breathe. Frank bolted.

Frank sprinted to the elevator, but it was being cleaned by one of those damned robots, so he rushed down the stairs, taking them three at a time. Gasping for air, his ears buzzing, Frank reached the front entrance. The big revolving doors had yellow cones showing it had just been cleaned by the robots and was temporarily out of service, but the other exit door was being used by someone with a dolly loaded with boxes.

Frank skipped past the yellow cones, and impatiently shoved the push bar on the nearest wing of the large revolving door. This was a poor decision, because as a result of him heaving at the door, his smooth shoes skidded on the newly mopped tiles. Frank slipped, and hit the floor hard, winding him and making bright flashes dance. Frank groggily tried to get up on his hands and knees, but the next door wing brushed his left shoulder and cannoned his head into the door drum. There was a crisp grating sound as the heavy wing stopped with a shudder against his neck, bending and pinning it against the bottom rail of the door drum.

Even though people rushed to his aid, it was several minutes before someone from Maintenance ran up with the tool to unlock the door. Using the tool to reverse the door, they freed Frank’s head from between the wing and drum. He had, unfortunately, stuck his neck out one too many times and onsite resuscitation attempts were in vain.