NOTHING is easy on The Levels — high sheep-grazing country that pokes out west from The Great Dividing Range like a rib off a spine.

My friend David has a farm on the end of the rib. Below is the river, and beyond, wilderness. He uses it as his “keep”, where he retreats from his Sydney high-flying executive lifestyle.

Late last year, as I headed down the M5 to his farm to escape the anxiety-riddled pre-Christmas city, I felt the catecholamine-soaked pulse of Sydney ebb away.

The Levels is what I would describe as an extreme environment. Life and death are commonplace. A dead sheep on the road in; shooters in the night taking out rabbits and foxes (imagine that as a lifestyle choice); David distributing poison in the steep paddocks for weeds, in the roof for rats and under the floorboards for mice.

He laughed when he told me about the game of chicken he played with a family of wild pigs feasting in his compost bin — his blunderbuss shotgun hitting nothing but scaring the pigs so much they broke a fence trying to flee.

We went for a few paddock walks with the kids; kicking the odd sheep skull or limb bone along the way. There was a game of “what bone is that?” with Dr Best as the adjudicator.

In the evening, the storm set in, coming in off the badlands of the Abercrombie River. Kaboom! Heavy rain on a tin roof. The kids freaked out but, exhausted, eventually fell asleep.

We watched a movie, but then the fridge died as a rat fleeing the rain impaled itself on the element. An hour of fiddling around restored power. OK, back to the wine and cheese.

When we retreated to bed, it was like being in a siege against nature; I was glad to be under the covers.

In the morning, the landscape had lightened up. It was like Narnia! Everything was alive. All the recent rain made the usual dull grey-green hills verdant; birds were everywhere.

It is not England, nor even an Australian coastal valley. It is still too coarse; I am reminded of a Frederick McCubbin painting — beautiful and intense.

While clearing my own head during a stroll around the farm, I recalled a patient I’d seen in that pre-Christmas week, an anxious mother. Her pathology reflected the time of year, being overwhelmed with socialising, spending and everything else.

What gave it away was the way she was talking, rather than what she was saying. Her sentences were rushed with no gaps between them, tumbling into each other like a multi-car stack up on the M5.

Several times I had to stop myself from using a purposeful blocking behaviour, a direct “Stop!” with two hands up to her face. She needed to do this, she needed to vent.

I knew she would eventually run out of steam. Eventually, she would realise that it was only her voice being heard in the room for the past 5 minutes. Eventually, she would actually want an answer to the endless unanswered questions in her stream of dialogue. Eventually, she did.

Here was my chance. Pause. She checked herself, and realised it was bigger than all the small questions. She had insight.

“You think I’m losing it, don’t you?” I still hadn’t said a word, but my face reflected my concern. Pause again.

“I just want to do the best for my son.” This was my in … “I think you are trying really hard, and I admire that.”

What started out as a shopping list of small problems that I didn’t need to address, fortunately, turned into a real medical consultation about this woman’s stress and anxiety.

Back on The Levels, Christmas didn’t seem to exist outside of the small stone church that added an extra service or two for the ageing farming community.

One of David’s elderly neighbours came over to discuss fencing wire, as you do. His speech contrasted markedly with my patient’s — stilted and slow, pausing so often that at times you wondered if he had stopped. It was like he had lost the skill of conversation.

The farmer may well have had anxiety about fences or bank repayments or loneliness, but this wasn’t evident to me. He may have had depression, so common among his ilk. He certainly didn’t have pressured speech.

As we count down to another Christmas and the stress and anxiety build up in the city, The Levels provided a poignant reminder of our contrasting lives.

The silly season will come and go but life on the land, with the day-to-day struggles of life and death, goes on.

Dr James Best is a GP practising in Sydney. He won the RACGP General Practice Supervisor of the Year Award in 2010.

Posted 12 December 2011