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Now bounded, now immeasurable: perspectives on time in disability, in suffering and at end of life

Correspondence to:
Professor Lynn Underwood
Center for Literature, Medicine and Biomedical Humanities, Hiram College, Hiram, OH 44234, USA; lynnunderwood{at}researchintegration.org

Novels, films, poems and visual art can expand our view of time in ways that can be useful in dealing with disability, suffering and end of life. In particular, they can reveal more complex ways to view time. This can be effective both for the person suffering and for those who care for them. Our typical ways of viewing time include linear sequential clock time, which progresses in an evenly parsed, ordered, unidirectional way, and memory or narrative time—time as we remember it. These two ways of viewing time often do not agree. Since these can compete as the best predictors of outcomes in different circumstances, neither can make an exclusive claim to be "real time." A third view of time that has potential application is one that is multilayered, extending endlessly and evidencing expansiveness in each moment. Examples of the usefulness of this third, more complex view of time in asthma, pain, end of life and disability are presented. The arts can introduce this more complex view in a way that can help one fold it into life. All these ways of viewing time in combination can broaden the perspective clinicians have when co-creating with patients good decisions in difficult situations.

Keywords: time; literature and medicine; arts and medicine; visual arts; disability; end of life; pain; suffering; decision making