I started noticing chairs a few years ago. One particular patient I recall had advanced follicular lymphoma, a type of cancer which is incurable but often treatable for many years with intermittent courses of chemotherapy. Eventually nearly everyone will die prematurely because of the lymphoma.

She always came with her husband, every single time without exception. There were many visits and many conversations with them both about her health, the disease, the treatment and her future.

Like most patients she always sat on the left

In my clinic room I have the room set up with two facing chairs. Like most patients she always sat on the left, her husband on the right. We saw each other like this for years. She had multiple courses of chemotherapy and did well. I got to know them both, a privilege we are fortunate to have and one I never waste. The years passed, each visit marked by a short entry in her notes, enough to help me pick up a conversation I may have started months ago. We talked about dying on some visits, not all of them but she knew what would eventually happen. Her husband and I talked about recognising when that time was getting close and how we would support him.

Then one ordinary clinic day she walked quietly into my clinic, this time on her own. There in front of me was an empty chair − the one on the right. Her husband had died of a suspected heart attack just a few days before.

The wrong chair was empty

An odd thought hit me − the wrong chair was empty. I always expected the left chair to be empty first. I didn’t think his death was my fault but I felt guilty even though everything was completely outside of my control. That empty chair suddenly represented missed conversations, missed opportunities, missed chances to talk about him, his health, his problems and his future.

'That empty chair suddenly represented missed conversations, missed opportunities, missed chances to talk about him, his health, his problems and his future.'

This was several years ago and it keeps happening. The experience changed my practice. I always make sure I talk about the occupier of the chair on the right − the person who is the carer, the one who has to cope, the one who must look after themselves as well as their partner.

I see empty chairs

Sadly, over the last year the number of empty chairs has increased dramatically, I keep seeing them everywhere. But no longer does an empty chair in my clinic room suggest a death. It reflects the rules, the lockdown, the anxiety and the uncertainty. I see empty chairs in the waiting room because we do so much over the phone. I see empty chairs in the corridors because we can’t have visitors in the hospital. Bedside chairs are rarely filled by caring relatives anymore. I see empty chairs in the hospital coffee shop because families can’t come in. I see them everywhere on the way to work, through the windows of shops, libraries and cafes. The buzz has gone, the feel of people all around is missing, the world is quieter and you can’t see the carers or the people they are caring for.

'I am in a room on my own, gazing at others in rooms on their own too. When I teach, I am enthusing into a camera but it's not the same.'

Colleagues are ill or isolating. Busy offices are split, more people are working from home. Those with chronic illnesses have been away for months and may never come back to the same role. When I attend training, I am in a room on my own, gazing at others in rooms on their own too. When I teach, I am enthusing into a camera but it's not the same. I miss the people filling chairs with their voices, their sounds and even their smells!

I love talking, I love learning about people

Every single person who this pandemic has affected leaves an empty chair somewhere. These empty chairs are a conversation someone wishes they had, a support that is missing or a diversion that is no longer present. I miss being diverted, it’s what I need most when there is too much to do and too many difficult things in the day. I love talking, I love learning about people and I usually love my job. It is harder with all those empty chairs.

The empty chair that means most to me though is in an airy well-lit conservatory facing north west, in a little village just outside of Carlisle. My Dad died very suddenly in that chair while looking out over fields and their beautiful garden. I hadn’t seen him properly for months because of lockdowns. Time has passed but the empty chair is there every time we go to see my Mum.

Don’t wait until a chair is empty

Empty chairs are there as reminders to all of us. They should remind you to talk, to enquire over who should be in that chair, to have the conversations that need to be had, to recognise the relationships we all have that support us and that make our days better.

Most of all, don’t wait until a chair is empty.