Time, the Irrational Ruler

Craig R. Hildreth, MD

“When you are courting a nice girl an hour seems like a second. When you sit on a red-hot cinder a second seems like an hour. That’s relativity.”

-Albert Einstein

While chatting with a patient of mine this week, I suddenly realized I had forgotten how long it had been since she was diagnosed. We were both surprised to find that 3 years had passed since the completion of her final cycle of chemotherapy-truly it seemed like only yesterday. How did so much time pass unnoticed by us both? Professor Einstein’s quip seems apropos to a discussion about how cancer alters our perception of time. To me this singular diagnosis summons up the image of one yanked out of their home, locked and isolated on a runaway train, and bereft of knowledge regarding the length of the trip or the destination. Soon, time loses its significance and yet it paradoxically oppresses the traveler with its pervasive, monotonous presence. Each ticking moment reminds us that no one can prevent the denouement of their life. Cancer is unique in the fact that it has dual abilities to stretch out time interminably, as well as compress it into moments that vanish as fast as one tries desperately to preserve them.

Many who have gone through cancer treatment experience a slowing of time, for obvious reasons. The daily grind-putting on the wig, sitting in the oncologist’s office, waiting for fatigue to improve, seem akin to swimming across the Pacific Ocean-exhausting, with no end in sight. Unwanted visitors such as nausea stop by unannounced and stay too long. Patients count the days until they finally hear the words, “You are finished.” Unfortunately, the period of recovery often drags on as well. Sometimes I will point to the calendar and say, “Here-here is the day when you will need to get your hair cut,” and we marvel at the number of weeks between then and now. Cancer patients don’t need Einstein to remind them that the converse of “time flies when you’re having fun” is “time creeps when you’re on chemotherapy.”

As the last day of treatment recedes into the smudged recesses of the appointment book, time seems to accelerate. Returning to work and to normal activities gives the mind something new to focus on. The spirit is rejuvenated; anxieties release their stranglehold. With all due respect to the oncology team, no one is more grateful for the truism “out of sight, out of mind” than the cancer patient. Let us also not forget the successes-many people have earned the designation “former cancer patient”-a psychological bonus that has the power to entomb unpleasant memories where they may rot in peace.

Indeed, time moves strangely in the world of cancer-it can crawl from day to day, absurdly prolonging suffering, while simultaneously racing with unwanted verve to introduce the dying to the last day of their life. The more one thinks about time, the more frustrated one becomes with its capricious control over the hands of the clock-too slow to comfort us, too fast in spiriting us away. May those who live with cancer always stand defiant over time, bending it to suit their wishes, pushing it away when it intrudes, yet acknowledging with quiet respect when time shows mercy and grants more of itself to use as we please, which for most of us will be with those we love.