Household hollowness comes around in irregular cycles, like meteor showers. But the true sign of a bad patch is that it never feels temporary or fixable. It has a shudder of the inevitable to it. The thought crosses your mind that when love goes it goes all at once, and forever.

Simple intervention - the time spent with a patient - is a very powerful ingredient of the patient-doctor contract. The evidence is against the traditions such as surgery for back pain being true - the evidence says it doesn't work.

There seems to be a hole in the culture where mothers went. Then, when their kids went off to school or stopped having ear infections every three weeks, they emerged from the mother zone, and like everyone else, they forgot where they'd been. Amnesia surrounding motherhood is the rule, not the exception.

When a couple turns domestic, for the first while having to talk about the need for aluminum eaves troughing and other matters only gets in the way of the relationship. Then, magically, these negotiations take the place of the relationship.

Well, delusions are a wonderful thing, and they keep you company, too.

I could still remember how having a two day old baby makes you feel faintly sorry for everyone else, stuck in their wan unmiraculous lives.

Hasn't anyone thought to look at outcomes as a logical way to figure out what really works? Not until recently. That tells you how far out of the picture the patient has been.