Time and Again

Remember, when we were kids, and summer stretched before us like an endless amount of time? When we had time to be bored and wonder how to make the hours pass until the ice cream truck would come? Instead, these days, I find myself wondering how it can be August already, where the summer went and how time can go by so quickly. 

In some senses, time is a fixed, immutable construct—the minutes, hours, days, months, years upon which our lives are built. But it is also a relative thing that seems to stretch and shrink to tease and torture us all. Athletes will tell you that when they get into the zone, time both stands still, making it easier to see and hit the ball, and speeds up, making them oblivious to the passage of time. 

But for someone dealing with cancer, time takes on a different meaning. Kaitlin, who has metastatic breast cancer, wonders if she will have enough time to see her son grow up. Glenn, who just had a biopsy of his prostate, wonders how to make the hours go by faster as he waits for results. Janice hopes that the new treatment she just started will keep her ovarian cancer under control long enough for the next new treatment to come out of clinical trials. And Devi, who’s condition has rapidly deteriorated in the past two months, told me she thinks it’s time to stop curative treatment and find a way to enjoy the days that remain.

About Time

I recently spoke about the emotional experience of cancer patients at an immuno-therapy company in Cambridge whose tag line is “It’s About Time.” The company, 2seventy bio, which is working to discover and develop new cancer treatments, was holding its first post-COVID all-hands meeting to talk about the science, what’s in development and what everyone needs to focus on to meet their goals. At the center of it all is a focus on patients and the recognition of the importance of time. The time it takes to go from thought to action. The time it takes to go from idea to treatment. Giving time back to patients and their families. And with that focus, their science is quite remarkable.

But what was more remarkable for me was the challenge of bringing home for the audience the predictable arc of emotions that cancer evokes for everyone, while helping them understand the very personal experiences of individual patients. The fear and anxiety so typical of a cancer diagnosis are related to the insistence of time but take on a different relevance to a 20-year-old who may never get to be a parent, a 40-year-old parent facing devastating disease and a 70-something grandparent whose disease will be chronic rather than life threatening. It’s the combination of severity and prognosis, of disease and treatment, of life circumstances and side effects, of genetics and lived experiences that create the soup of emotions in which we all swim through cancer.

Time After Time

Time is a key ingredient in that emotional soup. The race against time as we rush to a diagnosis and decide on a plan. The hijacking of time as we enter treatment and lose all control of our schedules, which are now dictated by the treatment regimen, the doctor visits, the waxing and waning of side effects. The hurry up and wait time as we anticipate the results of a scan or a test that will determine our fates for the next period, be it weeks or months or years. And the reminder of the preciousness of time as we adjust our expectations to the reality of cancer and its hold on our lives. 

But like the melting clocks in a Dali painting, cancer distorts time. I remember the intensity when I first learned of my diagnosis and had to absorb so much information in an instant to decide on a treatment plan. Thanks to a rush of adrenalin, I was in the zone, and time both expanded to allow me to do so, and compressed so that the decision was made in days. With a plan in place, I shared a long weekend with beloved family, cherished moments that still sparkle like multi-faceted crystals dangling from a chandelier, glistening in the light. And it was those cherished moments that got me through the enervated days of chemo recovery, when I wasn’t well enough to focus on reading a book, or inspired enough to take a walk, yet too agitated to sleep. 

The Fullness of Time 

Now, as I sit on the deck with the summer breeze rustling the leaves above, I am so aware of the relativity of time. The mosquito I swatted is lucky if she lives ten days—barely enough time to bite, while the ancient oaks that provide the canopy I relish will live for centuries. And I, with my own cancer a fading memory, hope to fulfill my genetic destiny to live a rich life for several more decades. 

But, how is it that Labor Day is approaching and the seasons will soon change again? Where did the past year go? Without the dictates of a school calendar, a pre-COVID schedule of work and social events, or some other false construct to mark the passage of time, it could have gone slowly. But instead, it was full of one-time events that made it feel chopped and hurried, unpredictable and lightning fast. 

I know that with the passage of time, each year is a smaller fraction of my life than the one before it, creating the illusion that time is accelerating. But also, my days are so much fuller than those of a vacationing school-aged child, and it’s that fullness that brings richness and joy to my life. But I find myself looking forward to a couple of slow weeks at the end of the summer when maybe, like the child admonished in Joni Mitchell’s Circle Game, I can drag my “feet to slow the circles down.”