The Life I’m Living

“There was another life that I might have had, but I am having this one.”
Kazuo Ishiguro

There are moments, usually quiet ones, when that line lands with unexpected force.

For me, it landed in the days after my inaugural lecture: standing in front of a packed room in Edinburgh, speaking about the science and the stories that shaped my career, and then, just hours later, finding myself alone in a small hotel room in Treviso, tired, overstimulated, and wondering how I’d arrived at this particular version of my life.

This was never the plan.
Maybe there never was a plan, only a series of choices, accidents, impulses, and sliding-door moments that carried me here.

The straight-line careers you read about do not exist, and mine certainly doesn’t.
There were years of chaos and instability.
There were years of clarity.
There were the times I burned brightly and the times I burned out.
There were wrong turns and almost-right turns.

And there were the rare moments, lecturing in Brazil, running in the Pentlands, the completion of PREdiCCt, a patient thanking me quietly after clinic, when everything aligned and I felt certain I was doing the work I was meant to do.

But the truth I’ve been circling recently is this:
We don’t live one life; we live through the aftermath of all the lives we didn’t choose.

The one I might have had.
The one that slipped away.
The one that broke.
The one that asked too much.
The one that was almost mine.

And then the one I’m living now.

The inaugural lecture was a milestone, but it was also a mirror.
It forced a reckoning: what exactly have I built? What am I still building? What do I want the next decade to feel like?

No one prepares you for the emotional hangover that follows a night like that.
You walk off stage into applause, warmth, old friends, colleagues, pride.

Then you wake the next day in a different city. Venice for me, which softened the landing.
And the day after that, Treviso, where the only thing waiting was a hard bed, an overheated room, and the sudden weight of your own thoughts.

This is the part of leadership no one sees.
The nights alone.
The travel fog.
The crash after the high.
The way success can sharpen the silhouette of loneliness.
The strange tension between being known professionally and unseen personally.

But somewhere between the Grand Canal and the night streets of Treviso, something shifted.
Maybe it was the fatigue. Maybe it was the overstimulation.
Maybe it was the recognition that I’ve been running on fumes for too long.
Maybe it was simply time.

I realised I need to make space.
To clear the noise.
To finally deal with the open loops: admin, finances, logistics, unanswered emails, and unfinished projects; the many pieces of life that drain energy just by existing unresolved in the background.

Because only when the noise quietens can you hear the deeper questions:
How do I actually want to live?
Who do I want to be outside of work?
What kind of man do I want to become in the second half of life?

Right now, it feels like I’m standing at the threshold between chapters.
Not lost, but not fully defined.
Not stuck, but not yet free.
Not unhappy, but not fully aligned.

And yet, Ishiguro’s line brings a kind of peace.

“There was another life that I might have had, but I am having this one.”

This is the one shaped by my patients, my children, my research, my failures, my resilience, the cities I’ve travelled through, the talks I’ve given, the colleagues who’ve held me, the friends who’ve stayed.

The one shaped by late-night messages from my son, by Holly asking if we can hike in Cambodia, by the team who believe in Sentinel, by the students I teach, and by those quiet moments in clinic when a patient says, “Thank you for listening.”

This is the one shaped by the aftermath of everything that didn’t happen.
And somehow, that makes it enough.

The path forward isn’t linear. It never was.
But it feels clearer now.

Do the work.
Clear the noise.
Rebuild the body.
Strengthen the mind.
Return to the things that make me feel alive: running, mountains, the Pentlands, Copenhagen in the summer, Aspen in winter, photographing strangers in alleyways, writing, creating, building something meaningful with the people I trust.

I don’t know exactly where this version of my life leads, but I know this:
I’m still becoming.

And for the first time in a long time, that feels like hope rather than regret.

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