Marking Time

Is it just me, or has time felt different in the last ten weeks? Do you feel that time has sped up, giving you a decreased ability to accomplish the things you need to get done, or does time feel slowed down to you, making each day feel longer and harder to fill with constructive tasks? Do your protracted days feel full of dead space that is buffered by countless hours of Netflix? I have been doing some thinking about time and schedules and orderliness and routine lately and thought I would share some of that with you this week.

Time is measured in several different ways by us and for us. First of all of course is our natural, biological circadian rhythm. According to the National Sleep Foundation at sleepfoundation.org, your circadian rhythm is basically a 24-hour internal clock that is running in the background of your brain and cycles between sleepiness and alertness at regular intervals. It’s also known as your sleep/wake cycle. A few important things about this cycle. It’s pretty regular, but it can be altered or disrupted if you are a night owl or a morning person, or if you are caught up on your sleep or sleep deprived. Light and dark tend to coincide with this cycle but shift work or other alterations in usual patterns of activity also can make things interesting. Lastly, your circadian rhythm may change as you age. You may not have the same sleep cycle as your partner, children or parents.

How has this affected all of us during this pandemic? We tend to get into a pattern that involves going to bed at about the same time every day, getting up at the same time (albeit prompted by that dreaded alarm that always goes off earlier then we like), having a relatively fixed commute time, and eating meals at the same time. We mark time during our days by these fixed events and behaviors and we can almost set our clocks (internal and external) by them. Now that many of us are working from home, or might have even lost our regular jobs, these temporal signposts have been disrupted. We might get up an hour later. We might have more time for lunch at home. We have a shorter commute, or no commute at all. Light and dark might not be the biological bookends that they were before, in that we get up and go to bed at different times that before the pandemic. Our internal clocks, our circadian rhythm, has been slightly altered just enough to make us feel odd, tired, irritable and out of sorts.

What about our self-imposed schedules, our calendars, alarms, reminders and other ways that we mark time during our days and nights that helps us make sense of our world and our place in it? These have always been the ways that we choose to structure our days. For example, my wife is a very analog person who has a calendar in the laundry room, another in her art room, several ongoing Post It note lists for groceries, phone calls and projects that live between the bathroom, bedroom, kitchen and art room. I choose to structure most of my life digitally, with a to do program called Things, a digital family calendar for our stuff and Outlook for work related time, and reminders that are pre-programmed for months and years to pop up and tell me what to do when it’s time to do it. Both of these methods of marking time work very well, depending on the person and their needs. Even in the time of this pandemic, these ways of controlling our day and the time allotted to various events and projects maintains a fair amount of integrity.

That being said, even these physical manifestations of our time have been altered by COVID-19. How? She is going to the store less. I am ordering things online as I always have loved to do but finding that I need fewer things now that I am home the majority of my time. Seeing and visiting our families has become an entry to FaceTime on the weekend to catch up. My routine management team meeting with my coworkers is now done on Skype for Business, instead of around a table. Church is at ten AM, but we now go there via Facebook Live. The events on our calendars are exactly the same, but the way the events happen is vastly different.

How about the big external ways that we mark time or have it marked for us? I’m thinking about birthdays, graduations, holidays, sports seasons and events, changes in the seasons, and other major delineations of time that we experience collectively and socially. What has happened to these during the pandemic? We know that we have not been able to travel to visit with parents, siblings, children and grandchildren. The joy of a hug and blowing out the candles on a birthday cake has been tempered by the possibility of being an asymptomatic carrier of the coronavirus and inadvertently infecting a loved one. Easter came and went with virtual celebrations, family Zoom calls and personal egg hunts. As I write this, a NASCAR race will be held at the speedway in Darlington, SC, but no spectators will fill the stands to watch it. Seniors are graduating without public fanfare. Baseball will play a shortened season starting in July, without fans. The celebration of summer will start as it always does on Memorial Day, but pools will not open and beaches may still be closed.

We count on our internal clocks, our personal calendars and the changing of seasons to guide our behaviors, set our moods and keep us connected as we celebrate the moments of our lives. We mourn the loss of these tangible ways to measure time. It is not the same today, and it may not be the same next week or next month or even next year. Will we get back to the security of a routine, a calendar filled with events and being able to celebrate life’s many milestones?

You can bet on it. Mark it on your calendar.

Looking for a Cure(ation)

When my girls were young, we had piles, then stacks, then boxes full of tapes. Audiotapes and videotapes, by that time the ubiquitous VHS format tapes that required parents to learn to master their VCRs, even knowing how to set the time and the timers on the infernal machines. Yes, there were piles, and more piles, and even more piles of Disney tapes, beloved and classic movies and musicals, and later the newer crop of Disney creations which has morphed now into Pixar animations. It seems to me that we bought them all, some of them more than once, because we would wear them out. We had our favorites. I think that I have been told that I loved Little Mermaid the best, but I also liked Lion King, Cinderella, and others. Which brings me to the point of this post.

How, in today’s modern digital world, does one possibly pick out what to listen to, what to watch, what to read, and what to  learn from?  How does one figure out where to go to dinner tonight, where to shop, and which vacation spot to book? 

At our fingertips and via the machines on our desks, laps, and in our pockets, we now have access to millions of songs, videos, books, blogs, essays, newspapers, magazines, online courses, chats, messages, TV shows, and movies. There are thousands of reviews of everything from standing desks to barbecue to scotch whiskey to motorcycle helmets. Pundits and podcasters want to have our ear (as do their sponsors, of course) for thirty minutes to over two hours, just to convince us, educate us, or entertain us. 

Speaking of sponsors, we are still very much in a marketing driven economy. The message is clear. Whether it’s buying, listening, reading,traveling, or doing, the answer is always MORE. 

Buy more. Rent more. Stream more. Listen to more. Watch more. Read more. Browse more. Click more. 

The reality for most of us? 

The one thing that we have a finite amount of, that we cannot truly create more of, that we must manage and use wisely, is time. 

When I look at my ideal day, one that I strive for even though I don’t always hit the mark, it breaks down like this:

Sleep: 7 hours

Meals: 1.5 hours

Work: 8 hours

Travel: 1 hour

Exercise: 1.5 hours

Personal hygiene: 1 hour

This adds up to 20 hours in my 24 hour day that are pretty much allotted to things that I think are important enough to carve out a place in my day for them. Almost every day. 

This leaves four hours, just four short hours a day, to do anything else that I think is important. 

This might include worship, conversation, developing or maintaining relationships, learning new hobbies or activities or skills, spending quality time with those closest to me, making phone calls, meditating, or just sitting and watching a sunset. 

We only have so many hours in the day, and like it or not, very few of those are open for us to manage as we wish in most cases. So what to do we do? Three things.

1) Prioritize. 

I am getting married in November. I have been living by myself for almost four years now, and I have a pretty routine schedule that I follow, within the the framework I shared above. I have a feeling that come the end of November, when I have a band of gold on the fourth finger of my left hand, that my priories and how I choose to use my expendable time might change  just a little! This will be a good thing, in that my beloved will be one of my most treasured relationships, I’ll choose to spend time with her, and I will want my day to reflect that commitment to her. Will I stop going to the gym or listening to podcasts? Absolutely not, but the time I spend, the time of day that I do these activities, and what comes first will change. I will prioritize these activities to reflect what (and who) is most important to me.

2) Choose

We must pick what we do, where we go, where we eat dinner out, and what movie we see. As I mentioned above, we have literally millions of choices. It’s overwhelming! We must learn to choose what we feel is best for us. How? read on. 

3) Execute

Once we have prioritized and made our choices, we must follow through. We must stick to our guns and execute. There will always be something shiny that comes along that will tempt us away from what we thought was an ironclad schedule or a training regimen that could not fail. We must be strong and resist it, and keep to our well thought out choices. Otherwise, we will be hopelessly spinning like tops, trying to respond to marketing messages, requests from work and family and the lure of the exotic, new and exciting. 

But wait, how do we cut through the cacophony? How do we blot our the trivial, the mundane, the boring, the too-expensive, the time-sucks? Nowadays, our problem is that too many people want to do the curating for us, instead of letting us decide for ourselves. It is easier to be lead than to evaluate and choose. How did we do it before, in the days of Disney VHS tapes and plush toys and Pet Rocks? 

We listened to people that we lived with, spent time with, shared interests with and respected. In short, we got personal references for things, activities, and products that we thought might be right for us. 

We focused on the bang for the buck in those days. If we could buy one Disney VHS tape that cost, say, $20, but we knew that it would be played in our home at least a hundred times, that was worth it. What you learned from, what you craved, what you loved, drove your experiences. Now, we crowd source everything, follow the hoards out into the street to play Pokemon Go just because is the biggest thing of the moment and that is what we are supposed to do. (No, I have not, and never will, download that app!) We run headlong from one fabulous experience to the next, not thinking about how this will affect us, if we will truly love it, and if it will make lifetime memories for us. 

When Steve Jobs introduced the very first iPod, arguably the most beloved music player ever invented, one of the catch phrases that he used was that now we could have ” a thousand songs in our pocket”. This was unheard of. It was fantastic, fabulous, ingenious and music to people’s ears. Literally. 

Now, in 2016, we can have millions of songs in our pocket, on at least three or four different music streaming services. We don’t even have to own them or buy them. 

We can access millions of books, including the classics, on reading devices no bigger than the old paperbacks that we all used to carry around when we read one story at a time. 

We can think, out loud into a tiny remote control device, about a movie that we once watched and would like to see again (Little Mermaid comes to mind) , and fifteen seconds later it is playing on our flatscreen television in gorgeous high definition, 4K color. 

Now, those of you who read me know that I love my technology. Of that there is no doubt. But I challenge you to think about this.

Does it really help to have a thousand, or ten million, songs in your pocket, if none of them are good? If they don’t move you to tears or make you shout for joy or make you play them over and over again because the artist just gets you? 

Isn’t it better to have talked about that Beatles album with an old friend or remember the time that you first watched Jaws in the theater or the first time that you were scared out of your ever living mind by a Stephen King novel? 

Isn’t it that much sweeter to have found that song or that book or that movie through someone who knows you and cares about you and shares space in your head, good space, good memories of really good stuff that is worth four hours per day?

Let me know what you think. 

Time

Several things have prompted the thoughts about this piece and the writing itself on this Mother’s Day 2015.

Seeing the many glorious pictures of mothers, lovingly posted with comments and reminiscences by children, spouses, grandchildren and friends.

Feeling my age, almost fifty-eight now, and that associated middle-aged angst, quite normal I’m afraid, that we all experience at this time of life. If you’ve navigated it and come out on the  other side, bravo. If you’ve not yet arrived at the rocky shoals, don’t worry. Your time will come soon enough. Don’t rush it.

Feeling others’ expectations and reading others’ thoughts about time and what it means to them, how it affects them as they age.

At any rate, all these tiny bright droplets have coalesced in my brain into a trickling, sun-dappled stream and then a rushing, rapid-filled course and finally into a broad, slow-moving, deep-running river of thought and feeling that, while hard to explain and write down, has burst its sluice and will be written, whether I want it to or not.

Ideas, rushing, wet, powerful,  ideas, will crash through the locks and dams we build to hold them back and carve out their own winding ways towards the ocean. They will not be stopped. Nor should they be.

So, my dear readers, time.

Time.

Time may be spent, enjoyed, reveled in, soaked up like sunshine on a spring afternoon, full of promise and tenderness and the expectation of joy that never ends.

Time may be wasted, frittered away on trifling and trivial matters both large and small, things that in the long run mean nothing, but in the short run consume us like fire.

Time may be squandered, absolutely obliterated by the ceaseless worries we give ourselves as gifts, the mental torture that feels like productivity but that disappears like acrid smoke borne off on the chill wind of autumn.

And, yes, friends, time may be used, wisely used, to live life and enjoy all things bright and beautiful and wonderful and good and holy and miraculous. It may bend and slow and wind deliciously through the exquisite waiting for Christmas or the lazy, hazy enjoyment of a summer’s day with catfish dancing on the line and leafy green shade and fluffy cotton candy clouds at end of day, tinged with the pink light of an afternoon well-spent and another grand memory made.

Time is finite for all of us. There’s the rub, isn’t it? This thing called time will end for all of us one day. It is the natural state of things, at least in this physical world that we inhabit now, to be born, to grow, and to die. This stream of consciousness, this awareness, this taking in and processing and living and being, all of it will cease one day. That is the natural course of things, as natural as that slow, relentless roll of river from mouth to ocean.

Yes, time rolls, is fluid, is as slippery and hard to hold onto as that glistening water is if we scoop up a handful of it from Vicksburg or New Orleans or the Gulf of Mexico. It is still the same water, life-giving and nurturing and absolutely necessary for survival, but it has been changed somehow, from north to south, from trickle to rapids to torrent to smooth ocean egress. It has been polished, filtered, imbued with tastes and packed with sediments and particles so small that they cannot be seen by the naked eye. It has been changed with the experience of the ride from birth to death.

Time cannot be controlled, oh no. We fool ourselves daily, dear readers, with our calendars and our schedulers and our theories of time in a box, take it out and wind it up and watch it go. We control time no more than we control our own breathing. We can manage it, yes, I’ll give you that, just as we can make ourselves breathe in and out until the tingling starts around the corners of our mouths and the fingers start to tingle and we know that if we keep doing this that we will soon pass out. We can manage lots of things in this life. We control very few. Time will not be controlled by us, not by anyone. It is fluid, it rolls on, relentless, purposeful and yet with absolutely no certain purpose except to be, to watch, to bear witness to the world that was, the world that is, the world that might be, just around the bend.

Time will end for all of us one day, today or tomorrow or next month or next year or in fifty years. Even so, it will go on, infinitely as far as we will know in our then state of non-being.

We often speak of the past, thinking about it, reliving it, remembering it, dissecting it, wanting somehow to bring back the very best parts of it, the good old days. Some of it we want to change, so desperately. The accident, the diagnosis, the failed love, the loss, the shame, the guilt, the mistakes, oh, the mistakes that if we could just go back and re-do, would change our lives and bring us to that present place called perfect that we all think we need to be.

That’s the fallacy, don’t you see?

There is no past. It does not exist.

There is only the present that was.

We lived it then and it shaped us, just as that rushing river shapes the ground underneath it, carving out a course and direction that even mighty dams cannot alter forever.

We lived our present that was, every one of us. Over and over and over again, we had present moments, opportunities to do the right thing, say something, feel something, reach out, make a difference, change the world. We lived those present moments, as did our great-great-great-great grandparents. We made our choices. We acted, or we did not. Simple as that.

Do not despair that I’ve taken away your memories or your second chances. My words don’t have that power.

Neither do they have the power to give you the hope of a future that will correct your mistakes or bring you happiness.

Because you see, there is also no future for any of us.

There is only the present that will be.

All the worry and the preparation and the mental machinations and the planning and the scheming in the world will not change a thing for me, or for you. I have learned that as I grow older. I have plenty of time, all the time I need, in fact, to get to the present that will be. When I arrive there, I will do my very best to do the right thing, make the right decision, say what needs to be said. But I will not drive myself mad by worrying about how I will get there, whether I will get there.

The only time that exists for me, for you, is this present that we live in today. It is the only thing that is real. It is as real as this hot cup of coffee that sits by my right hand and sends off steam from liquid that will burn my lips just as surely as the sun will rise this morning if I drink it too fast.

The past will not burn me. Neither will the future.

The only time for us, dear readers, is now.

What to do? How to embrace this knowledge that the present that was and the present that will be are things that don’t need our attention? That we don’t need to spend one more second of this river of time rushing past us worrying about how to fix them or change them or anticipate them so that they will be perfect?

1) Embrace the time you are given today. Accept it gratefully and with an open heart and mind. It is the only time you have.

2) Mark it as your own. It does not belong to your memories or your failed expectations or the dreams of others. It is yours.

3) Use it fully. Do not squander a single minute of it. You are not too tired, too busy, too preoccupied, too worried, too important, or too overbooked. You have today. Do something with it.

4) Enjoy it. Immensely. Ridiculously. Over-the-top. Crazily. Like it is the last present day you will ever have. Because it is. Tomorrow it will become the present that was, and it will be out of your reach.

5) When this time is over, relinquish it with the same gratitude that you greeted it with at the start of the day. No anger. No regret. No fear. No sadness. No second guessing. Let it go. It is finished. There will be time enough tomorrow, the present that will be. Enjoy the letting go with as much gusto and gut-wrenching feeling as you enjoyed the gift of time in the first place. It was never yours to keep. Remember that, and you will never again fear letting it go.

My friends, there is only now. Today.

When my time is up, I will be no more. That is as it should be.

My time to make a difference, to live, love, learn, help, to make a real mark on this world, is today.

This post is my gift to you today. Thank you for taking some of your present, your precious time, to read it and to think about it.

Live.

Today.

Rosie and Me: Day 13. Time and Tech

So today was a monster travel day from Salt Lake City to Denver. Five hundred fifty two miles, through some desert areas with wonderful huge mesas and dry expanses, then reaching an elevation of over ten thousand feet, experiencing a temperature drop of over twenty degrees, and actually seeing snow around Vail and the surrounding area.

IMG_7576

I finally made it in to Denver after a few Starbucks stops, one in Colorado that was very beautiful indeed.

IMG_7578

Two broad thoughts crossed my mind today.

The first: how does one manage time when taking a trip like this, where multiple time zones are crossed from eastern to central to mountain to Pacific?

Now, those of you who know me at all know that I like to maintain a schedule, and that has not changed on this trip. I get up at the same time each day, I go to the gym in the mornings, I have breakfast, and then I am on my way for the day’s travels and adventures. Along the way I have met folks for breakfast, lunch and dinner, gone on tours and had other engagements that were time-tethered. My initial dilemma was to figure out how best to manage my time on my computer and iPhone, as well as in my car while I was on the road.

My car, my iPhone, and my computer all update themselves automatically, so that takes some of the hassle out of remembering to actually change the time as a new time zone is entered. The problem is that this can get very confusing when trying to do certain things at certain times if you’re trying to, say, stay on your east coast schedule while actually being in Montana. One way to get around this is to just allow the devices to set themselves based on the time zone they are in, automatically, and then all your engagements and appointments should be on the calendar at the correct times for the place you’re visiting at any one time. I opted to do this for this trip, and it has worked out well overall.

The second thought has been around some of the mechanics of the trip, such as map reading, pumping gas, buying things, and recording parts of the experience.

In days gone by, one would have a paper map or a fancier paper atlas and would map out the trip, sometimes with a yellow highlighter or other physical tool. One person would usually drive while another passenger would be the designated navigator, reading the map and telling the driver where to turn and how to get to a particular destination.

Now, Garmin or other dedicated navigation devices sit on many dashboards and do the plotting and even the verbalizing directly to the driver, giving step-by-step instructions in a clear way. I use my iPhone and the map function to do this same thing, and I find myself wondering how I ever got anywhere without these electronic tools.

The same goes for buying gas, snacks, coffee or meals on the road. Cash was king at one time, and no one used credit cards or debit cards. Now, debit cards or credit cards are the norm. Soon new payment systems like ApplePay, probably to be announced at tomorrow’s Apple media event in California, will find us able to simply point our phones at an NFC enabled device (near field communication) listen for a small beep or feel a silent vibration, and go about our business, the transaction completed just that simply and quickly.

I have already found on this trip that I can pay tolls by throwing coins into a basket sans attendant, parking garage fees by going to an online site after I get home, and parking space fees using an app on my phone. It’s a very different world from the time that my family and I took a cross country camping trip from Georgia to California and back in the early 1970s.

Recording the experiences of the trip used to involve keeping a simple written diary and taking pictures with a film camera, getting the film developed when everyone got home, and hoping that some of them came out well. Now, I can (and do) choose to take some pictures in Instagram, post some to Facebook and Twitter, make journal entries with or without pictures in my Day One journal, or do a combination of all three while referring to notes that I kept all during the day in a Field Notes notebook. Of course, I’m also writing these blog posts to further document the details of the trip. There are many options for documenting on the fly as well as more thoughtfully later in the day.

What do you think about these changes in modern travel?

Do you miss the more hands-on approach to map reading, trip documentation, parking and paying for items on the road?

Do you just set your watch to whatever time you want it to be instead of letting your electronic devices automatically change the time zones for you?

I’d be curious to hear your opinions.

Good night for now, dear readers, from Denver, Colorado.

Join me for coffee in Boulder in the morning, won’t you?

Tempus Fugit

Good morning, good afternoon, and good evening to all of you.

Some of you may remember my old Pet Peeve posts from a previous blogging life. I haven’t done one in some time, but here we go.

Fair warning. This is my peeve and my rant, not yours. You may disagree. That’s okay. I welcome your comments as always.

Patients are often very disrespectful of my time.

In the mental health center setting, I have taken to scheduling a thirty minute time slot for follow-up patient visits, and a full  hour for new patients, especially children. The reasons for this are probably obvious to you.

A new patient requires more time to do more extensive history, exploring more details about presenting symptoms, past history, substance abuse, family dynamics, medical problems and review of the overall goals and treatment plan as set forth for each patient. A follow-up may involve seeing someone back after starting a new medication, to review pertinent lab work that has been ordered since the last visit with me, or to deal with a new problem that has popped up. These follow-ups may also be routine six month visits with patients I have known and seen for twenty years or more.

Now, I try to make ready for each visit by looking back at the last note or two that I documented myself, looking at recorded histories that other clinicians have placed in the medical record, reviewing labs, looking at prescription data, and printing out the info that I would like to be holding in my hand as I talk to the person coming to see me. This takes me several minutes for each upcoming visit. I do this before the appointed time so that I may walk up to the lobby as close as possible to the top or bottom of the hour to call the patient’s name and start their appointment.

All this being said, remember that the mental health center I work in schedules patient visits for a specific time. There is no first come first serve thing, no OB office scheduling in massive waves that results in three hour waits, no “morning clinic” or “afternoon clinic”. If your appointment is for ten AM, I expect to see you at ten AM. Usually not before, and definitely not after if I can avoid it at all.

Now, of course, if the transportation company gets you there an hour early and I have nothing to do at that time, I will see you early. If an emergency preempts you, which happens rarely in my clinic setting, I will certainly do my best to see you as soon as the crisis is over and dealt with. If that is not possible, I will reschedule your appointment for as soon as possible on an upcoming day.

What’s the problem with all this?

People show up late.

If they have a thirty minute appointment, they show up fifteen or sometimes twenty minutes into it and expect to be seen for a full appointment time. I may have thirteen appointments scheduled that day, and the next person may already be there, so I am not going to penalize them by pushing them back to accommodate someone who is late. If there is a legitimate reason, then we deal with that. Sometimes, though, folks just show up when they want to show up. That’s not my problem, and that’s not cool. Rudeness and disrespect are no reason for accommodation.

People don’t plan.

Now, please understand that I know if you have schizophrenia, it is difficult for you to plan your normal day and execute normal tasks. That is part of the illness. I’m not talking about that. I’m talking about not planning to leave home on time, arrange the proper transportation for an appointment that you’ve know about for six months, and allowing for things that might make you late.

People don’t respect themselves.

Yes, sometimes they feel that they are not good enough to warrant setting aside time just for them. Again, this may come from several things that I won’t go into  here, but the fact is that time set aside for you is your time. No one else’s. It is time for you to see the doctor, talk, ask questions, and get the help you need.  I am an experienced clinician, but I will not compromise your care by cramming a one hour initial assessment into fifteen minutes because you couldn’t find a ride. Sorry. Reschedule, please, so that we can take our time and do it right.

My fear is that as healthcare is changing and patients are not as responsible for owning their own care and paying for it, that it is cheapened and means less to them sometimes. If you are paying two dollars out of pocket for a thirty minute appointment in a state mental health center as opposed to two hundred dollars in a private outpatient setting, is the time worth the same to you? Is the treatment you receive worth the same to you, in your own mind?

I wonder.

Rant over.

Thanks for listening. I welcome your comments, as always.