The new chief of critical care at a small, cash-strapped Connecticut hospital discovers that some of her intensive-care unit’s mechanical ventilators (basically, the machines that help patients breathe) are in danger of malfunctioning. With lives at risk, the chief immediately calls her boss, the hospital’s chief medical officer. “We need to fix these machines,” she says. “Stat! If you don’t get them fixed now, I’ll have to start transferring patients to other hospitals.”

“You’re not the first person to tell me about this, unfortunately,” her boss replies. “But we simply don’t have the money right now. Let’s just hope for the best.” The next day, without warning, the chief is invited to a meeting with her boss and the hospital’s head of human resources. She is told that her leadership style is too brusque; reminded of the confidentiality clause in her at-will employment contract; and politely shown the door.

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