Finding Time

Where did three months go? An apology is in order for my legions of fans as I had optimistically hoped to publish something at least once a month. Alas, I have failed yet again. Mostly, I've been working, reading and thinking. I do have some ideas percolating for the next novel. I think it will be a book about a book. Part mystery and part adventure, I hope to write an eminently readable work that will stay plot-focused and keep readers guessing until the end. I'll let you know how it proceeds...

To my first point, I have been thinking more about time and about how it slips away from you. As a preamble I should probably inform you that I've been thinking specifically upon Aristotle's account of time in his Physics and about how those concepts come to bear upon my life. As best as I can understand, according to Aristotle, time and change are pretty well linked up together but of the two change is primary. So one might say that a thing changes (grows older, changes position, etc...) and that time occurs because of that change. Therefore, time can be "counted" by any number of ways though we tend to use the earth's rotation around the sun every year and rotation on its own axis every day, as a means of counting the change that we see around us. Interestingly, Aristotle does not say that time occurs and a thing changes. Rather he seems to note that the two concepts are indelibly linked together but time is a measure of quantifiable change between two states (before and after; potential and actual) rather then change being a measure of time.

Furthermore, what or who counts time? Human (or ensouled) beings do. So without a soul or a mind to count time there isn't any time at all! And finally, something that is everlasting must operate outside of time because there can be no before for it and no after for it. Thus the character Peyton Grimball in The Sweet and Bitter Taste of Moonshine, by Aristotle's lights, would have had a beginning but no discernible ending. He would be in a way perhaps both in and out of time which might account for his strange detachment from, and simultaneous inability to fully escape from, the world of men and his subsequent bipolar attitude toward Ambrose and the world writ large.

Time for me in my personal life is an especially sore subject these days-my bafflement with Aristotle notwithstanding. Working in the ER, I am constantly pressed for time. There does not seem to be enough time in the day to attend to all the patients who inevitably show up. The department is in a constant state of flux with patients coming and going, living and dying, getting better and getting worse. We attempt to measure that change as well but with labs and vital signs rather than metronomes or stop watches (though sometimes with stop watches!) I am rushing around so much that quite often 12 hours will sail by and the day is done and I am exhausted. Where did that time go?

Similarly, as a day will fly by, so will a month and then a year. Before I know it my children are noticeably older. They have changed. An honest look in the mirror and I can see that I have changed as well. Ensconced in the rhythm of my life I failed to look up and notice change though it occurred despite my ignorance. I find myself facing the realization that perhaps my perception of change, and thus time, occurs at whatever rate I happen to stop, look around and reflect upon it. If so, perhaps the secret to slowing one's life down is to, quite simply, stop and observe the world more often. The incremental changes I observe will be more frequent and therefore not be so dramatic and thus less shocking.

It must go without saying that if this is so I am very worried about the general state of society. Today, we all stare into our i-phones hardly ever looking up. My patients are engrossed in theirs, even as I am talking to them and often while I am even performing an exam. My colleagues are engrossed in theirs. I am engrossed with mine. I fear there may be no better way to crash through life quicker, regardless of what age you live to be. One day we will look up from our phones and our lives will be behind us.

I'd like to think we, as a society, could perhaps have much to gain if we put our phones and other sparkling objects of modernity down a little more and peeked out from our near-constant technological reveries. Imagine what we could accomplish if we read long, even difficult books, rather than scrolling through Facebook memes for hours. Imagine our connections with each other if we conversed face to face rather than via text or Twitter. Imagine the pleasure of receiving a long hand-written letter from an old friend or the simple delight of sitting down and writing one. I can think of so many other small and delicate joys that might accrue to our great benefit if we just slowed down. We could tend to our garden and see how life grows and appreciate that miracle. We could travel by ship, or even train, and see how grand and beautiful this world is. We could attend a play or an opera and appreciate the work and effort that went into a work by Shakespeare or Verdi and drink in the lessons such geniuses from the past have to share with us still. We could learn to waltz or salsa with a dance partner and feel the rhythm of the music coursing through and made manifest by the physical contact with another human being.

In my professional life, I could find out so much more about a patient's motivations for coming to the ER and their hopes and fears about the encounter-and that could help so much with testing and shared-decision making. It would, I believe, improve our patient's health as well as the entire medical encounter as a whole and contribute to vastly enhanced professional satisfaction (and less burnout) for the physician. A few times a month I have the opportunity to work in a very small and rural emergency department in South Georgia and sometimes, late at night, it can be quite slow. A patient will come in and I can spend time with them. I can talk to them for a while and learn about them. I can perform an actual, real physical exam. I can go over a treatment plan with them and we can both take some time to consider it. For brief moments, usually around 4 in the morning, I feel like a physician. There is no way to bill for this. It is hard to monetize a warm handshake or a thoughtful conversation. I took my time and I looked up and I made observations and calculated deliberations about the change in the patient's medical condition that brought them to the ER in the first place. For a moment in time, I am present, and there, in the room with us, I suddenly find more meaning, hiding right there in plain sight in the presence of another. It is always there of course, just waiting for a soul to look up and notice.