Whenever there is an incident, whenever something happens that you do not want to happen, you must ask yourself the question, ‘What has changed’, because if nothing is different from pre-incident, it could not have happened. Right?
I was forcibly reminded of that yet again today. I lost my wallet. I am always losing things. Why? Because I live a life of perpetual change. I travel for work. Not too much of a problem because I make lists. But my home is on one side of the country and I work at the other, so twice a week I put things into bags and hit the road, and lists do not work, and I am not a man so a few shirts and changes of underwear are not enough. I need to keep up appearances!
Mostly, I manage by keeping constant one bag of necessities – cosmetics, some jewellery, basic medicines and underclothes. Then I choose a wardrobe for the week. So far, so fine. But most importantly, I have my handbag. In it resides essential items like my wallet, passport, note-book, make-up bag, pens, hairbrush, Paracetamol, handkerchief and other necessities for occasional use! That means, of course, that I carry around with me what others refer to as my ‘brick’! And I always carry it!! Always!
So, what about my wallet? How could I lose it if it was in its place in my handbag?
Well, late back, making an impromptu visit to the supermarket, I bow to the suggestion that I leave my handbag in the car, locked, and just take my wallet. Good idea. Just a quick bit of shopping. No problem. Right? Wrong. For me taking only my purse was a major change. When I got back to the car, having slipped my wallet into my big pocket (another CHANGE. Big pockets because CHANGE of season, therefore wearing winter jacket!)
Fast forward to next day in the office as I try to find a receipt for the accounts department only to discover ‘no purse’ in my trusty handbag! Immediate panic. Credit cards, money, gone with all the hassle that implies. But then I remember the first thing I, as an experienced investigator must do, what I must remind myself – ‘Nothing is true but CHANGE….’ There must have been change for my incident to have occurred and it did not take me long to rewind to the previous evening. Lacking my handbag, I must have put it into my big, man-sized pocket (lucky men!) in my big country winter coat, on autopilot. Rewind again and I can visualise the coat on the back of my bedroom door. Husband offers to go back to our flat to retrieve my wallet. The phone rings. It is found.
So, a little story, maybe a trivial story, but also an illustration of a very important point. When there is change, or when you alter a habitual pattern, you inadvertently create a change because you do these ‘simple’ things all the time, you function on autopilot. And when there is change, incidents happen, things get missed or lost or broken and often have unforeseen consequences, sometimes of great moment. The causes, the root causes of incidents can often be complex to unravel, to uncover but often the way in, the key, is to look at and answer the straightforward eternal question first, ‘What has changed to allow this incident to happen?’ It may well point your thinking in the right direction!! You might just find that purse or uncover an action or an interruption that caused you or things to be different from what was habitually true.
‘There is nothing permanent except change’ …. And that is why we have investigators!!!!!!
Lorna Ramsay