My family routine is falling back into rhythm this week, with the kids heading back to school. I’m a lover of summer—the beach, camping trips, long, slow days—but it’s nice to be back. Back to structure, rhythm, and routine. The break helps me appreciate those things.

The kids are excited to return after the holidays, fresh and full of nervous energy. I find myself enjoying the structured mornings again, the slog of the end of the year already starting to fade.

I wonder how the flow of the year feels without children at school. Does everyone feel fresh at the start of the year? I think about the people I look after. The carers whose days feel the same every day. The families watching for small changes in their loved one as they slowly decline. The people living with persistent symptoms of their disease—battling nausea or pain day after day. The people who are able to do less than they could yesterday.

It must feel endless and frightening to live without a rhythm to the year. To have no plans, no planned holidays, no fresh start in January. No clear markers of time moving forward—just the same days repeating themselves.

It makes me think of a book I read, The Waiting Room Revolution by Sammy Winemaker and Hsien Seow, where they talk about patients developing an understanding of the “storyline” of their illness. Most terminal conditions follow a known storyline. Some trajectories involve a slow, gradual decline. Others include long periods of stability followed by sudden change. Some conditions lead to frequent hospital admissions, with recovery for a time before the next episode.

As a healthcare professional, I’m familiar with these storylines. I often have a sense of what the path ahead looks like before it happens. In many ways, it’s predictable.

But does the person living with the illness know this? Does their family? Has anyone explained what might come next? Have they ever been invited to ask?

If people knew what lay ahead—if they had a plan, some expectations, a kind of roadmap—would they feel more in control? Would it bring a sense of structure and rhythm to days that otherwise feel uncertain?

Perhaps rhythm doesn’t have to come from school terms, holidays, or calendars. Maybe it can be found in smaller things: a morning cup of tea, a weekly visit, a familiar face, a shared understanding of what today is likely to hold. When the future feels unclear, even a loose sense of direction can soften the days.

And maybe the greatest kindness we can offer is not certainty, but honesty. A way of naming what might come next, so people don’t feel lost inside their own lives. So that even when there is no fresh start in January, there is still a sense of movement, meaning, and time unfolding—one precious day at a time.