I experience this on a daily basis on the wards, where patients and their families wait for hours sometimes, at the whim of so many factors, and we the medical team, arrive and enter immediately, bent on our purpose, aware of intruding, aware of being all business so we can move on and treat the next patient..and the next.
This state of affairs, how time is experienced so differently by patients and their medical team, can underscore the already present inequities of the relationship. It is also a phenomenon that can be explained narratively.
Arthur Frank, in his Typology of Narratives, elucidated here, describes in the context of the Chaos Narrative, how time can be experienced so differently by two different groups of people, in that the same ten minutes can stretch on for lengthy minutes, or be over in an instant. We have all experienced some variation of this in our own experiences, waiting for the microwave can stretch interminably, and an exciting Netflix episode can feel like a blink.
Why is this? There is of course the physiological state of being a patient, whether in hospital or in a clinic. It is an anxiety-ridden, moment-amplifying acute awareness of time that being in proximity to, or even just being conscious of, our own mortality can cause to happen; time refracts as if under water, and moves slower. Add to that the loss of autonomy. Everything happens on someone else's time, and you may be an efficient multi-tasker who hates to waste time in your own life, but by golly, we are going to make you waste unconscionable amounts of it just waiting for things to happen.
There is time as experienced as a healthcare provider, a series of mental and physical checklists, procedures and prompts, interruptions and uninterrupted activity, both mental and physical, where time is experienced in blocks of half hours, quarter hours, or full hours. But always hours. Where the next hour has already filled up, the jigsaw puzzle constantly shifting to accommodate more tasks, squeeze in that one more thing. Time dilates to accommodate more in its belly, and like a glutton with his satiety centers long since over-ridden, we barely register the overfilling, let alone the gentle distention, barely noticing when we have passed the point where we should be putting down the fork and backing away from the table.
Put those two experiences of time in the same room together and then ask them to talk about illness, treatments, life, death, and all those myriad other concerns that need to be touched upon between a human being and the person to whom they are entrusting their life and well being. And you can see how the problem is not just harried doctors or complaining patients or a system squeezing both of them in different ways.
Once I explain this to my residents, we practice entering a room with mindfulness, a plan to abandon, temporarily, our checklists at the door, to slow ourselves down to time nearer to that being experienced in the room. We will notice something interesting amongst the patient's effects, a photo or a memento, and talking about it for a minute will be enough to sync up our breaths and our watches. We will sit if we can, listening carefully, understanding under the words being spoken, what is really being asked of us. And some days, it can really be as little as being present, in attendance to the dramatic havoc being wreaked on a body and on a life, and letting the tempest-tossed know that we see them.