I recently treated a patient who had been diagnosed with Wegner’s granulomatosis (inflammation of the blood vessels affecting the kidneys, lungs and other organs). He was on immunosuppressants, steroids and in horrifying joint pain. Everything was inflamed, from his knees to his arms to his wrists to his ankles. He had been told that he’d be dealing with this forever, and this person who you could tell had once been bursting with energy and zest for life was now a shell of himself. He loved to travel and felt that part of his life was over. He loved an active lifestyle and thought that part of his life was over. All this, based on the idea that he’ll never change. I would argue that there is change from day to day, hour to hour, albeit subtle and small. There is always change.