He arrived in our department wearing a tartan dressing gown and matching slippers to boot.

As his daughter rattled through one worrying example after another, he sat looking bemused on the hospital chair, making clear he had absolutely no idea what all the fuss was about.

At first it hadn’t been obvious – over the last few days he’d been forgetting things, losing the thread of a conversation, and wandering into a room trying to figure out why he’d made his way there in the first place.

But things took a turn for the worse when a police officer had found him at three o’clock in the morning looking for a bus stop.

By then, the picture was beginning to look uncomfortably familiar. That is, until six days of antibiotics later and he was back at home doing the crossword puzzle.

The Wrong Department

When somebody’s thinking or behaviour shifts, the obvious place to look is their mind.

And yet when an older person becomes confused overnight, doctors don't reach for a psychology textbook – they start filling out a blood form.

The same logic applies to a whole host of changes – steroids can trigger psychosis, liver failure can change personality, and a sudden drop in blood glucose can make an otherwise completely rational person aggressive and hard to manage.

In the Emergency Department, it’s no big secret that the body can influence the mind.

So in the face of less dramatic changes, why does that logic disappear?

Fine Print

Mental health is messy – there’s a gaping chasm of human experience between feeling on top of the world and being admitted to a psychiatric unit.

Most of life happens somewhere in the middle.

As the demands of the modern world have crept upwards, we’ve become remarkably generous about what qualifies as “fine” – chronically stressed but functioning, deeply unhappy but smiling, completely exhausted but still getting through the day.

Collectively, these various shades of “fine” account for a whole lot of human suffering.

And yet somewhere along the way, the body got dropped from the conversation.

Human biology was built for a world that looked totally different to this one. Days were slower, movement was a given, food wasn’t ultra-processed, and stress tended to arrive in bursts instead of as a constant hum of background noise.

In less than a century, modern life has steamrolled its way through almost every part of that equation.

Funnily enough, our minds haven’t exactly flourished with the updates.