Treatment of superficial vein reflux (see Varicose Veins, above) has been shown to decrease the recurrence rate of venous ulcers. Where there is substantial obstruction of the femoral or popliteal deep venous system, superficial varicosities supply the venous return and should not be removed.

The cost goes beyond simple inefficiency and becomes a mountain of invisible labor, usually absorbed by the most junior person in the room or whoever has the misfortune of being labeled as “good with computers.” It becomes a drag on every collaboration, the friction in every workflow, the meetings that take an extra ten minutes while someone (who is often paid twice the average salary of the other people in the meeting) figures out why they can’t access the shared folder the rest of us have been using for months. It’s the quiet erosion of patience and goodwill among people who are constantly expected to know and fix things that shouldn’t need fixing in the first place.

As he told Keyboard, in 1981, “Any constraint is part of the skeleton that you build the composition on—including your own incompetence.”

It took more than 20 years and more money than originally proposed to complete the building.

a new alliance

In the words of U.S. law-yer and presidential adviser Ted Sorensen, it islikely produced unknowingly, as many employeesdevelop “a confidence in [their] own competencewhich outruns the fact” (Sorensen, 1963, p. 72).