10,000 Marbles

With his dying breaths the great German author Johann Wolfgang von Goethe supposedly barked: “More light!” Substitute “time” for “light” and you may very well have the eternal demand of the medical student. In the thick of the semester it can seem as though there is never enough time for everything on our to-do lists. You are determined to learn the muscles of the hand backwards and forwards (“posteriorly and anteriorly,” that is) for the forthcoming anatomy test? But in lecture the instructors have already moved on to head and neck––that labyrinthine tangle of nerves, vessels, tears of first-year medical students, and heaven knows what else––and you certainly do not want to fall behind. You wish to enjoy a night out with friends? Very well; but since you were not optimally productive earlier in the week you really should return home at a reasonable hour to put in a few minutes of studying before bedtime. Speaking of bedtime . . . Were you hoping to catch up on sleep the weekend after your midterm? You’re welcome to try, but deep down you know that by some cruel metaphysical necessity one never catches up on sleep in medical school.

Melodramatic exaggeration aside, it is uncontroversial enough that the 168 hour-long block of time medical students such as yours truly are given every week might often be viewed as inadequate. There is so much to do but such little time to do it all.

On the flip side, there is a sense in which time in medical school appears far more drawn out, far more distended than it ever has been, and this can leave the impression that it is not a lack of time we medical students are faced with, but a surplus. From this perspective our weekly 168 hours feel more like a solid 200 than a measly 120. The reason we might naturally come to view time in this way is that we are generally very busy. In our first two months it was not unusual for us lowly UTMB MS1s to start off the day with a couple of one hour lectures at 8:00, to march over en masse to the anatomy lab for two hours of dissection after that, and to then spend the afternoon working with our small groups in or near the standardized patient center. Even when medical students have afternoons off we can be found meeting with student organizations, hanging out with our significant others, volunteering at the local charity clinic (St. Vincent’s, in UTMB’s case), or swimming through a dry medical textbook or two. (“Swimming” may seem an awkward word choice, but has it not been drummed into our heads that medical school is like drinking from a fire hydrant?). Regardless of where we are or what we’re doing, the fact is, medical students have a lot going on. And this means that by the end of the day we’ve amassed a sundry collection of experiences from various times and places; experiences from lab, from lecture, from lunch, from intramurals, from rounds, from the bike ride on the way home, from home itself, and from myriad other situations and locales. Because we’re packing so many experiences into our days, time, as I said, can come to seem distended.

Think of it this way. Suppose I have a hefty backpack, and into this backpack I, giving full rein to an odd but powerful whim, wish to place as many marbles as possible. By the time I’ve thrown about 20 into it, the backpack will be mostly empty and its weight will have hardly changed. But once I’ve put 10,000 marbles into it, drastic changes will be evident: the backpack will be mostly full, it’ll weigh a lot (maybe too much for my puny frame), and it’ll look and feel quite bloated. Why? Because it’s got a bunch of stuff inside it. Similarly, when your average, everyday medical student participates in 10,000 distinct activities––or what can seem like 10,000 distinct activities––in a 16-hour span, it’s as though they’re filling their awareness with 10,000 marbles. And if the student’s awareness––their “backpack”––seems bloated, time itself––how their backpack feels––will all also seem bloated. Either that, or the student will have a wicked headache.

Despite the imperfections in the backpack analogy (you’ll find many, if you search hard enough), and despite the fact that many medical students might balk at the idea that time seems “bloated” or “distended” to them, this is, at a minimum, the way time now seems to me. But my temporal outlook was not the same a short while ago. A month before starting the fall semester in August I had a minor operation on my left knee for persistent kneecap pain. There was little to occupy me as I lay stock still in my bed for a few days after the procedure; a book, some cartoons, and the occasional cup of tea were my main sources of entertainment. My thoughts didn’t travel far: “My knee hurts. I should take another pain pill. But the pill will knock me out and then I can’t read. And if I can’t read my intellectual juices will putrefy. But my knee hurts. What does it mean for something to hurt, anyway? I’m not sure. But you know what? My knee hurts and that’s that. It’s a brute fact, plain and simple. So . . . yeah, I’m taking the pill.” Because there wasn’t much for me to do during my convalescence, my awareness was relatively empty and time thus appeared to flow by quickly. Each day of recovery blended into the next as a drop of blue food coloring might blend into the seawater a few blocks from my apartment. For me, time flies when there isn’t much variety or activity in my experience.

So we have a paradox of sorts here. On the one hand it seems that we medical students often do not have enough time, for we are quite frequently short on time when that’s precisely the thing we want and need. But on the other hand it seems that we (myself, at least) often have too much time, for we are typically occupied, and the more occupied we are the more experiences we have and thus the more time we cognize.

As much as I love a decent paradox, I suspect that this one can be dissolved with a bit of clarification. It can’t be true that a medical student seems to have both too little time and too much time simultaneously for the same reason that it can’t be true that you seem to have both XYZ––whatever XYZ is––and not XYZ simultaneously: it violates the law of noncontradiction. Unless you’re the White Queen from Lewis Carroll’s Through the Looking-Glass, you shouldn’t be able to do that. (“Why,” the Queen tells Alice, “sometimes I’ve believed as many as six impossible things before breakfast.”) But if we say it seems that there is both too little time and too much time simultaneously, while adding the qualification that these claims are not meant to be taken in the same way, then we haven’t offended the gods of logic (rumored to be the ghosts of Aristotle and Gottlob Frege) and so won’t have to worry about them heaping pox and misery upon us. This, I believe, is the ticket to dissolving our paradox of time-consciousness.

Here’s my proposal.

It is in awareness of the present that a lack of time is most easily perceived, for in the present we’re attending to our countless desires and responsibilities, desires and responsibilities stemming largely from our role as medical students. But when the present has passed and what was once before our minds is now in the past, it is here, in awareness of the past, that time is liable to seem distended. For when we are thinking back to all we have been through––when we are surveying the horizon of our past, as it were––what do we find? A smorgasbord of activities––that’s what. And what are we inclined to do when we find a smorgasbord of activities in our past? Infer that time must have been distended in order for all of those activities to occur, and to consequently perceive time as such. Or are we prepared to affirm that a hefty backpack containing 10,000 marbles is not distended?

In case the backpack analogy isn’t working for you, I’ll try something else. Suppose I go for a mile-long walk on one of Galveston’s lovely beaches. (Well, since I’m still recovering from the aforementioned knee surgery it would be more like a limp, but it can’t hurt to stick with the image of walking.) (Pun shamelessly intended.) Once I’ve finished I can turn around and––assuming my footprints haven’t been tampered with––see my walking path recede into the distance. Now, standing there on the beach, looking at my apparently endless line of fresh footsteps, what will I be inclined to do? Go get some post-saunter Dippin’ Dots is one answer, but it’s not the one I’m interested in here. The answer I’m interested in is that I would infer––assuming also that I didn’t keep track of how far I walked––that I travelled pretty far. I would infer, in other words, that my walking path is reasonably distended, since it spans a good portion of the beach; as far as my eyes can see, in fact. So from the presence of the thousands of footsteps I left on the beach I could reason that I covered a respectably large chunk of space. Likewise, from the presence of hundreds or thousands of activities a medical student leaves in their memory (their “awareness of the past”) during the school year, the student could reason that they covered a respectably large chunk of time. In the first case, space––namely, the space traversed while walking––seems distended; in the second, time––namely, the time experienced in medical school––seems distended.

If this analogy isn’t working for you either, then two things are to blame: (1) myself, particularly my lack of imagination, and (2) time. Time is one of the most challenging topics of philosophical inquiry, full stop. It’s hard to understand, hard to visualize, and hard to compare to other things. We are immersed in it, yet it’s still baffling. Hence if we’re failing to wrap our heads around it we are wholly justified in echoing the words of St. Augustine: “What then is time? If no one asks me, I know: if I wish to explain it to one that asketh, I know not . . .”

But whether we’re optimistic or pessimistic about unveiling the secrets of time, we do know this much: time can seem both sparse and distended if we’re medical students. I’ve given one explanation for how this can be (viz., that time can seem sparse in awareness of the present while simultaneously seeming distended in awareness of the past), but I certainly haven’t gotten the last word on the subject. Indeed, some might even deny that there is a paradox here, maybe because time always seems the same to them. Some might also dispute my assumptions about time, for example, that it is in some sense an inherently psychological phenomenon. Still others might deride my cheesy analogies and proceed to call me unflattering names such as “Baldy Bayless.” All of this is well and good. Here I have only sought to elucidate a putative paradox in my perception of time, to try to address the paradox, to ramble a bit along the way, and, most generally, to think about my relationship to time. Now I wonder: if I have thought hard enough, then will I have automatically become just a little better at managing my oh-so-sparse but oh-so-distended time in medical school? Well, only time will tell.

-David

bayless

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