I can’t believe that we are only a few days away from the first year anniversary of the first confirmed COVID-19 case in the UK. 31st January 2020. It almost seems surreal looking back over the last twelve months to think that this time last year none of us really had any comprehension of how drastically all our lives were about to change; how phrases such as social distancing and furlough were alien, remembering times when large family gatherings were joyous rather than super spreader events, when children went to school, the skies were criss-crossed with vapour trails, where a hug was instinctive and welcomed and where our next holiday’s were a few short weeks away and excitedly anticipated.

So much has changed in all of our lives. Many working in the NHS, in Education, in the Police, in supermarkets and in other critical worker roles have seen less change in their day to day working routine than others, and for most the normality that secure work has afforded has been welcome, and a guaranteed income definitely not taken for granted. The last few weeks however have seen even the hardiest begin to falter, as the relentless pressures and unavoidable sadness that this horrid disease brings once again surges across the nation. Those working in emergency care are reporting that this wave seems worse; the patients younger and sicker, whole families devastated by an infection that didn’t stop spreading on Christmas Day when we were permitted to meet. Emergency admissions have risen rapidly and hospitals have struggled to keep up with demand. For days the seemingly blanket press silence infuriated those who worked flat out, unable to understand why the dangerous situation unfolding before their eyes wasn’t headline news. As each day passed before the nation was once again instructed to stay home, those caring for the unwell and dying were feeling the energy begin to seep from them, knowing that every day of delay before lockdown being announced would most likely mean hundreds, if not thousands more deaths.

This week I’ve had various conversations with doctors, nurses and other healthcare professionals who’ve worked over the last few weeks. The over riding theme of our discussions have been about the relentlessness and burden of looking after patients for whom there is so little we can ‘do’ to actually alter the outcome of their disease. Yes, this is something that we face regularly in non-pandemic times, but at the moment it seems that every patient is the same, that our armoury of skills and pills are limited. Yes, we have medications and oxygen, and of course the more vital tools of nursing care and compassion, but we know that for many of our patients this illness will be their last, and that there is absolutely nothing we can do to change that. The most distressing part is recognising that as the NHS becomes overwhelmed there are patients who will suffer whom we would otherwise have been able to help; those with other illnesses, those who are injured at this time, those who in normal times would have been admitted to ITU but now can not be.

And then there are the conversations; with patients in front of us and with their relatives over the phone; discussions about prognosis, about which treatments may or may not work or be appropriate, about resuscitation, and when not to attempt it. Rather than once or twice a shift at most, now these conversations are needed multiple times a day, and that can be exhausting.

All this got me thinking this week. What little things can we do to make a difference? How can we maintain perspective, hope, determination and energy? What makes a difference individually and personally? How can we encourage others? In the spring lockdown my go to wellbeing boosts consisted of time in my garden which by the end of the summer had been transformed into my little oasis of calm, long walks in the beautiful countryside in which I’m fortunate to live and frequent chats with close friends. All that seems just that little bit more difficult at the moment. Shorter days, rain and wind, zoom fatigue, an uneasy fear of when all this is going to be over.

I know, both personally and in my working world some truly amazing people. It never fails to amaze me how kind, caring, talented, dedicated and compassionate they are. I’m not sure if I tell them that enough. Over the years there have been several people who, looking back now, have been true role models to me. Individuals who inspired me, who taught me important lessons, those on whom I have modelled my career and in some ways my life.

Did I ever tell them that? No, probably not.

This got me thinking. Maybe now, when life seems so dreadfully sad and and the future so uncertain, maybe now is the time I should speak out. To those who have helped me. To those who  have inspired me. To those to whom I owe so much. To say thank you and tell them what they did or said that made a difference to me in some way.

So today I googled the contact details of a now retired neurosurgeon I worked with seventeen years ago and I wrote him a short note. I don’t remember him for his surgical skills, although I’ve no doubt they were excellent. Instead I remember him for giving me the opportunity to learn from him, his way of having difficult conversations with patients and their families. I remember sitting in with him as a relatively inexperienced junior doctor when he broke the news of malignant brain tumours and of devastating brain injury. I watched his body language, listened to the words he used and observed the moments of silence. These lessons are ones I’ve never forgotten. Did he have any idea quite how ‘good’ he was in having these conversations? I doubt he did. But he left his legacy in me, in the way I approach such conversations, with patients and with colleagues.

Only I didn’t know that, not fully, until recently a colleague told me. Her description of me, of her appreciation of the way I had been with her, the way I am with a range of people, including patients, brought the neurosurgeon back to me.

So how about we start a gratitude revolution this week. Who would you message, write a note or email to tell them how they have helped or influenced you? Who has behaved in a way that has inspired you to behave like that too?  Would letting this person know how they had affected you brighten their day? I’ve no doubt it would. Let’s get to work.