Having just spent a lovely few hours in the garden, I was reflecting how much visual reinforcement I was getting for completing a task well. Raking leaves and piling them up is so very satisfying. So is pruning back overgrown roses and climbers. As I was tidying away the tools I couldn’t help but make comparisons with work. I used to have so many more visual reinforcements to work completed. The satisfaction of transferring a bursting in tray full of notes and messages into the out tray. The hand-signing each letter before passing them back to my secretary. At the end of a good week my desk looked clear. Going further back the quiet eeriness of a silent ED once the last patient of the day ha
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