The sky is huge here. It stretches, dome-like, as far as I can see, protective yet offering escape to I know not what. Where it meets the sea I have to focus on the horizon, straining to tell which is sky, which is sea. Both a pale blue today, both far out of reach and yet just beyond my fingers end. As I squint in search of the horizon, the sense of place envelops me. My feet firmly attached to the stones beneath, my body anchored on this beach, yet my mind soaring above, beyond the cliffs, into the air and away. 

This beach, this sea, these cliffs have been here far longer than I have. They have seen things I can only read about, have endured events, suffered extremes of nature, witnessed man’s selfish games and still they endure. Still the sun shines, still the tides turn, and still the wind blows. 

“Nothing endures but the land,” is one of the most meaningful phrases from my fiction collection. From the novel Sunset Song by Lewis Grassic Gibbon, this phrase comes back to me every time I am awed by the greatness of our natural world. It gives me a sense of perspective that can often be wholly lost when going about our lives, rushing from one commitment to another, or cocooned inside over the winter; immersed in the man made world of large buildings, or sardine like in crowded commuter trains; contemplating the petty minutiae that threaten to overwhelm us all on a daily basis. The sense of timelessness and inevitability when I stand on this beach brings a great calm that washes over me just as the sea could if I took a few more steps forward. I need this perspective on a regular basis.

The rest of my life, the working portion of it, is governed by person made constraints. My working life is dictated by organisational hierarchies, targets, goals, the drive for absolute perfection. This leads to priorities being conflated, reversed, subjugated, abandoned. Our world requires that we advance, discover more, create better. We are all small creatures on a treadmill, a hamster wheel, driven faster and faster to what end? How often do we stop and ask: what matters? What really matters? 

When I stand on my beach and take in the enormity of the landscape, and feel myself shrink to size, a mere pebble on the ground, a grain of sand in life’s timeline, I know the answer. What really matters is kindness. Being with. Being seen to be with. Walking beside. Maybe not in their shoes, because is that really possible? A doctor with a serious illness will not have the same experience as a non medical patient – in some ways their experience may be easier, in some ways much harder. But not the same. But irrespective of who it is, walking beside, offering a blank page for someone to write their own story, and listening to that story, holding those feelings, giving time and attention to the person who chooses to share them. That’s what matters to me.

My favourite novel of all time, the one which struck me at the age of 17 as having been written both about and for me, which has coloured my life and my work, is Howard’s End by Edwin Morgan Forster. In it he exhorts us all to “Only connect.” 

In a world of targets, transactions, measurement and accuracy, where is the following patient positioned? A lady in her 60s, with an abscess, admitted for its removal under general anaesthetic the following day. To the medical team, it was only an abscess, something to be managed by the juniors, but to her, only 12 months after spending the preceeding 12months in and out of hospital with her terminally ill husband, this was not just terrifying in its own right but was bringing back all the grief she had been working so hard to deal with. What if it wasn’t just an abscess; maybe it would turn out to be cancer – the same disease that had stolen her husband of 35 years. Here she was, around 9pm, sitting in her bed, on a ward, fighting off the overwhelming tidal wave of emotional pain. The smell of the place, the feel of the sheets, the routine of the days on a ward, the not knowing, the grief. The loneliness. This was the first frightening thing she had faced without him, and not only was he not here to support her, but this very experience was bringing back everything that had characterised the nightmare of that awful, final year of his life. 

After the juniors had been to consent her for the following morning, somewhat clumsily, she finally fell apart. She hadn’t asked the questions she was so desperate to know the answers to. The tears came. She shook with fear. All she wanted was for someone in this place to know her context, to hear why this was so difficult for her. She had been reassured about the procedure, she would be going home to her daughter’s for a few days, but in here, this place where time stood still, and there were no cliffs or sky to offer any perspective, she felt thrown back into that nightmare world.

I hope the time I spent with her, sitting with her, hearing her story, and taking it seriously, agreeing that it was really challenging – but also very brave – for her to be here, made some difference. I listened and I hope she felt heard. I hope she had a slightly less dreadful night than she would have done if we had not spoken. I hope she felt she was somewhat connected, if only to us, the other patients in the ward. 

For I wasn’t working, I was an inpatient at the time. I could see the staff were too busy; drug rounds, bloods to take, bed pans to empty, ticking boxes and filling forms and doing all the things that they have to do. I didn’t need to be in uniform to see that this lady just needed to talk, to tell her story. To have someone listen, to be heard. I don’t actually have a uniform in fact; I am not a clinician. I do however work with the NHS and I do know that there are many great people who care hugely. But I also know that they can’t always be in the right place, at the right time or in the right frame of mind. And I know that they are not necessarily trained to care. They just do. As do I. This sort of care is not a commodity to be counted like a pile of bricks. There isn’t a box that can be ticked after care like this has happened. It isn’t measured or reported. It is however the cement between the bricks, the glue that holds us together as human beings.

Nothing endures but the land. We are but specks of dust in the universe. We matter so little in the grand scheme of things. Whether princes, or porters, doctors or debt collectors, what we do in life does not matter if it doesn’t matter. “Only connect” is my creed. It’s what I would want for me so it’s what I try to do for others. When I am gone my income will not matter a jot, anything I have achieved becomes history on a page, reduced to dust. But how I can help people to feel less alone, less afraid and more connected, while we are all still here – that matters.

Only connect.