Time is the universal commodity: we are all given the same 24 hours in one day. Its management is critical to success in life and varies in different parts of the world. Work schedules, bus, train, and airways timetables are all efforts at managing it properly for the benefit of everyone. Yet in devising them, we need to be aware that response to human affairs requires flexibility in timing and attitude.
For example, in medical practice, sometimes the real reason for a consultation comes out at the end of the scheduled time, in what is now called the ‘by the way’ or ‘doorknob’ syndrome. This is when the patient who is literally out the door, as the Americans would say, suddenly brings up some matter which may have been the real reason for the visit. Insensitivity to this, and rigidity in patient time allotments, can lead to problems of various sorts, and deny patients the opportunity they need for help.
The use of management gurus to streamline medical practice and get the best out of GP practices and NHS hospitals is now fashionable. They are fond of bandying numbers, and unknowingly both the public and doctors themselves are being co-opted into playing the numbers game. Doctors want to show that they are not idle, and the public hate long waiting times, be it for surgery or just to see the GP.
But good medical practice is not all about numbers, although good time management is critical for success. Time management ‘experts’ have decided that the correct number of patients for GPs to see each day is 20 to 30 on the evidence of the equivalent of car assembly line statistics extrapolated to human affairs. But patients are not inanimate objects.
Man has always sought to have some control of time from ancient times. The use of sundials enabled ancient man to keep abreast of events around him, leading eventually to the invention of the clock. Calendars of sorts developed in much the same way, driven by men seeking to do what was theirs to do in relation to the environment. Time management is therefore always topical since we all have the same amount of it in each day. We cannot add more hours to the day, nor can we do all we are interested in, or would want, to do. Time constrains us and, in that sense, we must make choices. If we work too long in the day, we cut back on rest and sleep, and neglect those around us. If we don’t make time for family and friends, relationships suffer.
Attitude to time management is one of the important differences between cultures, countries, and people. In the West and most developed countries, adherence to time is almost slavish. If you think about it, how could we live in the modern world with services that compete for the same time if we do not adhere to schedules? Imagine the chaos that would ensure if buses, trains, aeroplane flights, and offices do not keep to time? Time pressure in these countries is real and has sometimes been blamed for many cases of anxiety, stress, depression and ‘failure to cope’.
The paradox is that even with all our modern time saving devices, from instant coffee, to telephones, mobile phones, internet, washing machines, vacuum cleaners to microwave ovens, we still sleep less, and have less time for family and friends. So, we can ask, what has happened to all the time we save?
In less developed countries on the other hand, time pressure is less because these infrastructural conveniences are not so developed. Too much relaxation about adherence to time can cause chaos which can be palpable in some countries. Interestingly, relaxation about time in these countries is more obvious in social functions than in workplaces; the same people who are punctual at work may attend a social function several hours late! It takes some philosophical perspective to get the balance right; to know when not to be a slave to time at all costs. I have a story about this.
***********************************************************************
I should have shaved that morning, but I wasn’t going to be late to the office. It was my turn that week to do the school run: I had to drop the children at their school at one end of town before heading to the hospital at the other end where I worked. I prided myself in always being the first in my department to arrive in the six months I had been there. I did not want to spoil it; the shave could wait. In any case, I had shaved the previous day, and the stub of beard was passable.
I hurried the children into the car, making sure that each had his duffel school bag with packed lunch and snacks.
As I backed out of the garage, I saw someone in the rear mirror running towards the car. I moved slowly, cleared the pavement, and stopped. I wound down my window glass. I recognised the running figure; it was my neighbour John, from across the street. The lines on his face added another half to his years and told me that he had not slept during the night. He was not smiling and did not give me the customary greeting before he burst into a staccato speech.
“It’s my son….we didn’t sleep all night….he had a very high fever, and then this morning he started to cough and vomit….then he had a fit.” The words tumbled out incoherently….
As we spoke, my mind went back to the stories, he had told my wife and I. How he got married later than he had planned; how his wife had gynaecological problems which came to light as they investigated their failure to conceive in the first five years of marriage; how after treatment and surgery they had to wait another five years before the pregnancy from which this boy was finally theirs. He had been born by caesarean section, after which his wife took a long time to recover…
I am no paediatrician; but my neighbour didn’t know that. He knew only that I was a doctor at the teaching hospital and that his son was sick. I listened to the story. I did not have space for them in my car. So, I asked him to get his son and wife ready and meet me at the hospital.
The children were not late to school, but I was to work, my record of early arrival at the office broken. Our boss, the Head of department was already there when I arrived; he had come out of his office and was going out again when I arrived. He asked me to see him later in the afternoon.
At his office later that day, he did not offer me the vacant seat opposite his own, separated by the huge desk. I had hardly sat down before he chided me about tardiness. He did not ask me any questions, nor did he did he try to find out why I who was usually early at the office was late on this particular day. A part of me wanted to explain, but I did not feel like explaining anything. So, when he had finished, I just got up, thanked him and left.
About a week or so later, finding him in a good mood from my observed encounters with some other people earlier in the day, I went to his office. Surprisingly he was free. I stood around, and he offered me the seat across from his own. He looked up at me and I kind of smiled. I said something like,
“You were quite cross with me the other day.”
“Yes, and for good reason.”
“You know I’m usually the first to arrive for work in this department.”
“Yes, so?”
“You didn’t try to find out why I was late for the first time in 6 months.”
No answer.
“You didn’t ask but I’m going to tell you.” Silence.
“You know I don’t live in the university campus like some of you; there was no accommodation in the campus residences when we joined the service.”
“Yes, I know; I helped you through the HR department to find suitable accommodation in town, which I got the Vice Chancellor through the dean to subsidise.”
“Yes, and we’re all grateful for that. But that means I live with town people, not university people. As I was leaving for work that day, my neighbour from across the street rushed out with their first child who had kept them awake overnight. The child had fever, cough, and some fits. That child is extra precious to the parents because it took them 10 years to have him. “
“Yes, really? But you’re not a paediatrician…”
“Yes. He doesn’t know that I’m not a paediatrician; all he knows is that I’m a doctor at the teaching hospital. Suppose I had not stopped to help, so I could come here on time and the child died. Do you think that I could have continued to live in that street with the family and my other neighbours?”
“You should have told me or explained.”
“You didn’t ask.”
This incident illustrated the wisdom of one of my late father’s sayings. “If a friend or colleague fails to turn up as agreed, or to deliver on an agreement, withhold judgement until you hear from them.”
My boss could have done with that advice.
