'The reason? A lost couple of inches of trouser protection over my backside. My local notoriety was re-established.'

I did a marathon stint in the garden at the weekend. I find it relaxing and it drives work out. I can tell if my work life-balance is working by how much I enjoy the session. It is also a reasonable measure of one's relationship with your loved ones - if they offer to help, if they garden in the same area as you, if they admire, or make suggestions, improvements or criticisms. The rhythm of life in a nutshell.

My next-door neighbour noticed both my early start this day and my dusk (okay, it was only 4.30pm) finish, commenting on my 'stickability'. Resilience, I thought to myself, is an essential leadership quality at times of maximum change and risk. According to The Times, chief executives now last an average of just 22 months in post.

Disaster strikes

I also got 'tooted' by two separate motorists as I bent down to collect leaves and other January detritus in front of the garden. The reason? A lost couple of inches of trouser protection over my backside. My local notoriety was re-established.

I was also reflecting during the day how my mind was - I felt pretty healthy. The year ahead looked exciting, challenging, a hotbed of further change to 'navigate' through.

And then, just when everything was coming together... my back went. That final lunge as fatigue set in. Not quite the man I used to be. Ouch. Was it a herniating disc? Was it muscular? Was it just further Christmas accumulation of adipose tissue which shouldn't have been there? Fat, that far round?

The result - excruciating pain, some bed rest, a back bolster cushion and a return to work that Monday, 'stickability' assured.

Reflections on choice
I once suggested in this column that choices should be available to all who do their mind in, as well as their backs. We attempt to offer five choices in my own organisation, so what were mine in these physical rather than mental health circumstances?

  • Put up and shut up (for people who get on with it).
  • Seek divine orthopaedic intervention.
  • Ring NHS Direct.
  • Look up a physio.
  • Take some anti-inflammatories, face the knowing look of a loved one and admit that I had somewhat overstretched myself.

I took the last choice.

Keep reflecting, keep trying, and keep it together during 2007.

Mike Cooke is chief executive of South Staffordshire Healthcare Foundation trust.