Heroes Not Zombies

I’ve had a couple of days thinking about beginnings, so it seemed kind of obvious to have one about endings!

This photo shows a number of berries, all part of the same plant, even the same part of the same plant, but each in a different stage of maturation. Some are still green, some have turned yellow, some red, and some are even beginning to get wrinkled (like me, ha! ha!) and so appear the most mature.

When I think about beginnings, I realise that they are all pretty arbitrary – a beginning is where we begin – if you pick a thread or two you’ll always find your way back to an earlier beginning.

I don’t think that means there are no beginnings. I think there are. All the time. Every day. Every moment of every day. There are beginnings. There are phenomena and experiences which have only this moment come into being for the first time ever. It’s pretty great to notice that.

Endings have exactly the same quality. It’s not that there aren’t any. There are endings all the time. Every day. Every moment of every day. There are endings. There are phenomena and experiences which have only this moment slipped into the past. You’ll never have them again. It’s pretty great to notice that.

Outcomes, targets and goals

In Medicine, there is a lot of focus on “outcomes”, sometimes called “clinical outcomes”, which, somehow are a bit different from “patient reported outcomes” (“PROMS”). These are all endings. They are points to be reached. Measurements to be attained, or ratings to be completed. But when your working life is that of a family doctor, (a “GP”), then you’re never done with outcomes. The patients don’t reach the intended outcomes then go away. Life, it turns out, goes on. What was an ending today, turns out to be just another chapter in an ongoing story, just another time and place sensitive reading in the midst of a flow of a whole life.

Oh, yes, you’ll say, but there is one outcome which isn’t like that isn’t there? Death. The final outcome. The ultimate ending. Except it’s not really, is it? Well, it is for the physical body of the person who has died, but we are more than physical bodies aren’t we? We are experiences, stories, events and memories, aren’t we? And those continue long after the physical body has gone. Are the people you loved who are no longer alive completely gone from your life? I don’t think so. Their life continues to influence our lives. The experiences we shared, the memories we made, whatever we created together, the stories told, the photographs taken, the objects held…….

Have you ever seen a BBC TV programme called “The Repair Shop”? I love it. People bring old objects to a workshop of artisans. The old objects are usually in a poor state of repair, but they mean something to the person who has them. Once restored by the craftsmen and women, the person comes back to reclaim the object, and time and time again, it is an immensely emotional experience. They are put in touch, deeply, and significantly with a loved one, long gone. It’s lovely to watch and it shows how a person, an individual, continues to influence others long after they’ve gone. How their “presence” I suppose you could say, is made more real through what they’ve touched, what they’ve handled, what they played with, or made.

Targets are a kind of outcome. They are useful as ways of getting you to somewhere you want to get. For example if you want to save up a certain amount of money then setting a target of that amount is a good aid to getting there. The trouble is that targets are used inappropriately. Whose targets are they? And are they the same, most important targets, which others want to achieve? Because the selection of targets is an individual, value-based, subjective, exercise of choice. But if they are set for others then they direct the efforts and lives of others towards those targets instead of others. I’m not a fan of targets. At least, not ones I don’t have a say in the creation of!

Goals are a bit like targets. I’d say the same about them. They can be helpful to get us to places we want to get to. But they are aspirations, not predictions. And they are not endings. Or at least, they are not final endings. Are they?

I think this unique and unpredicted pandemic is forcing us to face up to the reality of beginnings and endings. It’s making us more aware of connections, of webs of influence, of the non-linear, multifactorial, dynamic, ever flowing, ever changing nature of reality.

This morning I read an article in Le Monde about how management methods are already starting to change in the light of this experience. Here’s the main point I got in that article – management is having to move away from “control” to “coaching”. Three things have come to the fore – the need for individual autonomy, the need for good team working and relationships between workers, and the need for transparency.

Well that all seems pretty good to me! I look forward to seeing the end of de-humanising “Taylorism” and “command and control”, and the beginning of an emphasis of autonomy, relationships and transparency. Imagine if we governed countries according to those principles?!