1. Stathis, Courtney DNP, RN, FNP-BC


Pondering time's ubiquitous role in health care and the rest of life.


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I vividly remember Katherine, a young mother battling metastatic breast cancer who had returned to the unit from recovery, asking me what time it was and then telling me that she knew the physicians hadn't completed the surgery because she was back too soon. She was right. She was just waking up, but I had received report that the surgeons opened her up, realized that her cancer was unresectable, and closed her quickly.

Figure. Illustration... - Click to enlarge in new windowFigure. Illustration by Janet Hamlin.

No one had spoken to her yet. She cried quietly, and the realization that her future plans were now drastically different made me want to cry, too. I sat there and held her hand. There were no words.


Again, this past summer a family member who has been fighting breast cancer for years needed surgery to resect a large tumor near a vital organ. The family and community prayed on the day of surgery; our local parish offered a mass for her, knowing it was going to be a long surgery. But it seemed that as soon as she went into surgery, she was out. No one had to tell me, this time, the news would not be good.


Time can seem very important. We talk about it and worry about it all the time. We all want more time-time to get ready for work, time with our children, time for ourselves. But then, for some people, life itself depends on time.


In countless instances, I see patients arrive in the ED with signs and symptoms of a stroke, and what do I ask? What time did the symptoms start? Whether we can give lifesaving treatment to a patient who has had an ischemic stroke depends on the length of time the patient has had the symptoms. The stroke patients need to arrive within a period of time; the MRI and scans must be timely. The medication to reverse the symptoms needs to be given within a window of three hours, or too much time has passed to safely reverse the life-altering symptoms that accompany a stroke.


Sometimes the family reports that they found their loved ones in the morning after sleeping all night. When we do not know the time symptoms started, we cannot give the treatment. Here too, time is so very important.


Sometimes there is enough time, or we make time for something we know to be important. I often need to spend time with patients and their families, explaining their treatment or medical regimen. This part of practice is time consuming, but very necessary despite the chronic shortage of time in a workday. Knowledge that is commonplace to health care professionals can be foreign to laypeople. It makes me smile when the family thanks me for my time, confirming that I did the right thing.


Time can be critical and the difference between life and death, but it can also be beneficial. Because of the pandemic, I had extra time off with my newborn daughter Marigrace. I would have returned to work earlier, but unforeseen circumstances allowed me more precious time to enjoy my daughter. I am always grateful for that time-ask any parents who had the opportunity to spend time with their children because of working remotely and you will not find many who regret having that extra time with them. How wonderful that time was for so many young families.


Conversely, for many elderly and lonely people, time can be their enemy. My grandfather was isolated in an assisted-living facility, only able to speak with us by telephone or during an occasional window visit. He eventually died of COVID, alone, with no family there to comfort him. In this case, time was cruel. My grandmother, who is currently healthy, has aged dramatically during the pandemic. She lost time with her family and friends-precious time. As Ben Franklin said, "Lost time is never found."


As my life gets busier, with another child on the way while I'm transitioning into a faculty role, I continue to look for more time. Time to prepare lectures, revise curriculum, attend meetings, engage in research and scholarship. Time to pray because the world seems upside down, time with my family. Time, I need you now more than ever.