Booking 'After the Floor Gives Way': A Keynote on the Cost of Performing Fine at Work

For leadership and HR teams outside healthcare: what a keynote on performance culture and the invisible cost of appearing fine should target, and who should be in the room.

I built a career for years while very ill, and got good enough at appearing fine that almost nobody noticed until the point where I physically could not stand up. Then the floor gave way, all at once, in front of people who had rated my performance excellent the same quarter.

That is not a story about me being unusually good at hiding something. It is a story about what a particular kind of organisational culture reliably produces in its strongest people, and it is the subject of the keynote I am asked to give most often outside healthcare — for leadership teams, HR functions, and organisations where staying and stopping meaning it has become the norm nobody names.

What the talk is actually about

Not burnout, exactly, though burnout is often the visible endpoint. The subject is the specific labour of appearing fine — the tone maintained in an update, the camera turned on, the reply sent at an hour that signals availability — performed continuously by people who have correctly worked out that the alternative costs them more than the performance does.

That labour is real, it is expensive, and it comes out of the same finite budget as the actual work. An organisation that cannot see it is not measuring a large and growing share of what its best people are spending every day.

Why this lands with audiences who are not in healthcare

The mechanism I describe from a chronic illness is a sharp, extreme version of something almost everyone in a corporate audience recognises immediately from a much milder version of their own experience: the meeting where they said they were fine, the deadline they hit by borrowing against a weekend, the promotion they quietly declined because they could not guarantee the effortlessness the next level would require.

I am not asking a room of executives to imagine my experience. I am handing them a sharper instrument for something they already half-know about themselves and can now see clearly in their organisation, because the extreme version makes the ordinary version visible in a way it usually is not.

What the talk argues, specifically

That engagement scores and satisfaction surveys cannot see this cost, because they measure what people are willing to say inside a system where saying the true thing has a career price. Low reported struggle is not good news. It is a measure of how unsafe it currently feels to be visibly less than fine.

That the people paying the highest price are usually your strongest performers, not your weakest, because performance is precisely the currency that buys the right to keep the cost hidden a little longer. This is the part that changes how leadership hears the talk — it reframes an apparently individual wellbeing issue as a retention risk sitting inside your best people.

That the fix is not a wellbeing programme layered on top of an unchanged culture, any more than a resilience app fixes clinician burnout. The fix is making it structurally safe to be temporarily not fine — in how deadlines are set, in how a stretch opportunity is offered, in what happens the first time someone says they are struggling.

Who should be in the room

Leadership and HR together, in the same session, is where this works best. A talk delivered only to HR produces a well-supported HR function and an unchanged culture around it. A talk delivered to leadership alone produces good intentions with no mechanism to enact them. The audiences that report real change afterwards are the ones where both groups heard the same argument at the same time and had to reckon with it together.

Questions worth putting to any speaker on this topic

Ask what specifically they want your organisation to stop doing, not what they want it to feel. A talk that produces a feeling and no target behaviour is a well-delivered dead end.

Ask how they would handle a leader in the room who believes performance culture is simply high standards, correctly applied. That objection is common, often sincere, and worth testing before the event rather than discovering live.

Ask what evidence, beyond anecdote, they will bring. My own story is the entry point, not the argument — the argument is about organisational structure, and it should hold up on its own once the story has done its job of getting the room to lean in.

What good looks like afterwards

Not a mission statement about psychological safety. A specific, checkable change: a deadline-setting norm that survives a bad week, a way to decline a stretch project without career cost, a manager training that addresses what to do the first time a strong performer says they are struggling, rather than what to say at their exit interview once they already have.

If you are building a leadership or HR offsite around performance culture and its real costs, that is the talk I am built for. Tell me about your event →