Most things in life change eventually. It never seemed that way to me when I went abroad for a year (in what seems like a previous existence to me now, at this distance) and came back to a life that had apparently been suspended in time during my absence. The odd relationship had started or ended, a few people had changed venues, perhaps even a baby had been born; but they all looked the same (the baby excepted), said the same things, did the same things. Life back home seemed suffocatingly static for a while.
Not that it took me long to settle back into that life and become attuned to the multiple small changes that take place every day, every year. I just don't think I had noticed them when I first returned from travelling because my focus was set for more dramatic changes in my daily landscape.
Now it is not just that I notice the changes happening, it is that so many of them appear big and important all the time. In the autumn shadows and the shafts of sunlit dust of my grandmother's front room I hear, beyond the happy noise of the children playing out on the green, the reducing cadence of her thoughts as we talk and know her age is taking its toll. The implication of this surprises me with how much it troubles me. Then when I return home there is more: serious illness in the family, damp in the boiler room, the lawn mower has broken down.
And when I escape the morning chaos of breakfasting children, the same happens at work: a move to a new building is being planned; we have committed to a quality assurance award scheme and must sort out how we can achieve that; meanwhile there are targets to meet and it is not clear how we might do so.
Seeing patients feels, at times, as though it could be a refuge, a way to hide from the stress of anticipating and creating these various changes. But often they too seem to add to the difficulty by coming along with perplexing problems of their own and an expectation of getting help. Not wanting to appear churlish, I try to oblige. By the time I have helped achieve some sort of resolution of their puzzles however, I seem somehow to have run out of time to unpick those I started the day with. I get home still consumed by them only to find there are problems at home that still need attention. Soon I am also beginning to worry whether anything will ever get solved.
I go running these days, when I get the chance. Sometimes people ask what I think about when I am out running but the truth is I rarely spend my time pondering any particular subject as I plod along. I am too busy concentrating on what I see.
On my standard circuit for the moment I run up past a farm and then along a track that winds up through mixed woods, until it emerges onto the heathery top of a line of low hills lying parallel to the coast. The track follows the line of the hills for a short way and then reaches another that I turn left onto, back down the hill to another farm and continues from there back towards home. It is as I turn left, still on the top of the hill, about to descend to that second farm, that the view opens out: fields of different shapes and colours below, Holy Island farther on (surrounded, or not, as the tide dictates), and land and sea to north and south as far as the haze permits.
Whether it is raining in January or clear in October so much changes in that view and yet still it retains its beauty. I always get back with my perspective lengthened.
- © British Journal of General Practice, 2004.