By Ron Epstein, MD
In a collection of short essays written after she turned 80, Ursula LeGuin, the author of several mind-bending science-fiction novels, unpacked, with humor and insight, an innocent-sounding common question, “What do you do in your spare time?” Her answer: “No time to spare;” every moment counts.
That same week, I stumbled on a thoughtful article in the Guardian, exploring whether time exists, or not. A heady topic which offered some relief from the disturbing news feed on most of the other pages. I’ve always wondered, along with astrophysicists, poets, musicians, and anthropologists, what time is, and what it means to “have” time. The article described how cosmologists have not been able to detect any “flow” of time, and quantum mechanics experiments indicate that the means of measurement influences not only observations about the present but also about the path the object has already completed. Anthropologists document diverse views of time across cultures, some considering that the future is contained in the past, already determined, but undiscovered, remarkably similar to some cosmologists’ speculations. The poet TS Eliot came to a similar insight: Time present and time past / Are both perhaps present in time future / And time future contained in time past.
So, what does this have to do with daily life, working with patients and colleagues? Our day is segmented into intervals of clock time. Zoom calls, patient visits, administrative meetings. Our obsession with clock time makes it seem almost heretical to end a meeting before the top of the hour rather than when one’s work is done. Yet, clock time is, in some ways, illusory. A research study by psychologist Kathy Zoppi, showed that parents’ satisfaction with a pediatric office visit related only to perceived time – the amount of time the parent thought that the doctor spent – and not at all related to clock time. Other research shows that if you sit down rather than stand during hospital rounds and office visits, patients perceive that more time has been spent.
The ancient Greeks had two words for time – kairos connotes “lived time” or the “right time” whereas chronos represents clock time. Both are important in getting through the day. Yet, in clinical practice kairos is often forgotten, while chronos dominates. Imagine music with only chronos, and no kairos – a performance would be drained of its life and inspiration. In clinical practice, the same is true.
When colleagues ask, “How are you?” the word “busy” often enters into the dialogue. Either me or the other person. I’ve come to appreciate that our sense of busyness is about kairos – felt time. There are days that are full of activity, and I feel a sense of spaciousness, whereas other days, with a similar schedule, I feel unpleasantly constrained. Feeling busy may not be something that happens to us; rather, we create it. “Busy” can also be distancing: self-importance, “too busy for you.” I’ve experimented with avoiding the word “busy” altogether. For me, it’s made a difference in terms of how I make my way through my days – more spaciousness, less rushed.
Even small gestures can be liberating.