A Matter of Time

Abstract

ANOVEL “TIME EATING” CLOCK WAS RECENTLY UNVEILED at Corpus Christi College in Cambridge, England. Sitting atop this clock is Chronophage, a large grasshopperescapementthat“eatsupeveryminuteofyour life,andassoonasone’sgonehe’ssalivatingfor thenext.”Health care time is certainly not protected from the voracious appetite of Chronophage, but the passage of time in any medical situation is perceived in different ways, depending on who is doing the watching. At many points in the delivery of health care, time seems to disappear altogether; in other situations, it moves slowly, lags a few beats, races ahead, or even lurches forward in a disconcertingly asynchronous manner. In this Commentary, a new perspective on time—improvement time—is discussed in the context of 3 traditional aspects of medical time: clinical research (knowledge) time, patient (illness) time, and clinical practice (disease) time. Two fundamental concepts of time—one a structured, ordered, and linear entity (the Greek kronos); the other a personal and emotional perspective that embodies time in a “soul satisfying and nourishing manner” (the Greek kairos)— provide good starting points for considering medical time. As Kern points out, “the very nature of scientific (kronos) time conceals, or cannot supply a useful context for, essential realities of human experience.” However, all 3 aspects of medical time involve both kronos and kairos in important but fundamentally different ways.