One of the most dangerous decisions in life is unmonitored change. In medicine, making a change, whether it be a procedure, a medication, a lifestyle modification, or another form of therapy, requires follow-up. In many cases, this follow-up is equally, if not more important than the actual change. Follow-up may take a variety of forms. In some cases the follow-up is merely a symptoms check at a scheduled point in time. If the medication is for pain, depression, itching, swelling, gastrointestinal irregularity, or a whole host of other maladies, often the most important follow-up is whether those symptoms are improving, staying the same, or getting worse. In other cases, additional testing, whether checking blood pressure, specific blood levels, specialized laboratory tests, or repeat imaging may be the appropriate follow-up. While the change itself is, of course, important, the follow-up is essential. Is the new medication causing cramping? Is there new electrolyte abnormalities? Is there new side effects? The follow-up is critical because, while most changes do not result in immediate catastrophic events, continuing the current course without any plan to monitor and correct comes at the risk of an avoidable, significant adverse event in the future. In medicine this is why follow-up labs, imaging, appointments, and check-ins are vital.
The same applies to life. Often the change itself is emphasized as the significant and important event. And of course this is true. Whether a new job, a new living situation, a new hobby, or a new relationship whether romantic or platonic, the follow-up is equally important. Starting a new job is a sentinel event, however once that new job is started it is uncommon to reevaluate whether they are accomplishing their larger life goals, whether their life is enhanced, and whether they could be doing something greater with their time. The same goes for a relationship, a house, or a hobby. Starting any of these things is exciting and important, however reevaluating at a specific point or points in the future is absolutely essential lest irreparable damage be done and irretrievable time be lost.
The importance of the cycle of change and follow-up applies not only to macroscopic changes but also to the microscopic changes. Small changes within the job or the workday should be monitored to determine whether they enhance or detract from efficiency and productivity. Small changes in relationships should be reevaluated around the coffee table at specific, scheduled intervals. Changes to diet, exercise, morning routine, nighttime routine, even driving route, should be evaluated after these changes are made. Small course corrections prevent critical failures in navigation. A ship navigating the sea stays on course by routinely monitoring their position relative to fixed objects. Imaging a ship that navigated by making a change in course without plans to measure their position after a short interval to determine how that change had affected their overall trajectory. It would be highly unlikely that they would maintain their planned course and come anywhere close to their intended destination. Course corrections in life require follow-up lest small changes lead to large consequences. There is a constant, ongoing process of change and evaluation.
Follow-up is essential.