Why long-brewing physical and mental breakdowns feel so sudden

He has held academic appointments at Oxford and Stanford, and is the founder of a cancer charity. His writing explores neuroscience, cancer biology and complex systems. He is the author of The Equations of Life (2026) and has been published in the Financial Times.

I remember reading the words brain metastases on my phone between surgical cases. As the message arrived, the hospital corridor around me continued its ordinary rhythm. A trolley rattled past toward the next theatre.

Somewhere down the hall, a pager sounded and I heard footsteps quickening in response. The axis of my life had been upended but the building around me appeared oblivious. I read the message again as though repetition might change its meaning.

A few minutes later, I washed my hands, retied my mask and returned to theatre. Instruments passed into my palm in familiar sequence: suction, bipolar, clip. My hands followed movements rehearsed thousands of times before.

The tumour had not begun that morning. I knew from my training that, long before those words appeared on my phone, the biological processes that produced them had been unfolding inside my mother’s body. Since that pivotal day, I keep thinking about the way that collapse often feels sudden, but how rarely that’s the case in living systems.

What appears to us as abrupt failure is usually the delayed visibility of strain that has been accumulating for years. This pattern appears repeatedly across biology and psychology. What looks like stability from the outside reflects hidden systems absorbing strain – what physiologists call homeostasis – until their capacity to compensate is finally exceeded.