The Passage of Time

When a marijuana patient visits me for permission to use that drug, I have to ask them, gently, how long they have used it.  Most, if they are old enough, do not give me an answer that I can quantify.  Instead, they start with something like, “It seems like yesterday I used it for fun.  Now, I need it just to (fill in the blank).” Survive, live, walk, or keep from throwing up.  They wonder about how and when it changed from a form of recreation to a form of drug treatment.

They never seem to believe it has already been a drug, for thousands of years, in other cultures.  If I give them enough time, they count their own age and their own problems by how they use it.  With a few thousand papers published every year, mostly in other countries, it would be crazy at this point to try to believe it wasn’t a drug.  For an amazing number of folks, it seems to be the way they reckon the passage of their lives.

Albert Einstein said, “Put your hand on a hot stove for a minute, and it seems like an hour.  Sit with a pretty girl for an hour, and it seems like a minute. THAT’S relativity.”  I like this description of how we perceive the passage of time a lot better than philosophic theories of same, pedantically explored by those loveable folks at Stanford.

The passage of time seems incredibly quick when viewed in retrospect.  Specific brain structures have been implicated in the perception of time, like the basal ganglia, cerebellum, and cortex, and most specifically the suprachiasmatic nucleus.  Still, this hunk of knowledge does not seem to help people realize “where does the time go?”

Some memories, invested with emotionality, are dominant — no matter how old. Ernest Hemingway wrote, “If you are lucky enough to have lived in Paris as a young man, then wherever you go for the rest of your life it stays with you, for Paris is a moveable feast.” Change it to someone who lived in Amiens as a young woman, and this is me.  Forty years is only yesterday.  I look at pictures of the Amiens Cathedral and tears well up.  Emotional intensity was always present.  The “strangeness” was not part of it.  I have said all too many times that living in northern France was more like living in Boston than being in North Dakota.

As for Kansas, well, I would have forgotten all but the substance of my psychiatry residency training and my psychopharmacology fellowship training, but I found my love there.  Actually, it was through a deliberate process that has become a seminar and a draft of a book.  Many travelers of the world have found their loves in Paris.  Wichita is, well, more original.  I have vivid memories, over 20 years old, of our first fudge sundae together.  I am no drug user, believe me.  Falling in love, watching his pupils dilate as he looked at me and knowing he could not fake that; that is I think the greatest single experiential memory of my life.  Surely, it is similar to my patients “toking up,” or smoking their first marijuana cigarette, sometime in the sixties. People who are now in their sixties ask where time went.  The best explanation I have ever heard is that as we age, each year, or season, or month, represents a smaller proportion of our lives, and thus seems to go more quickly.

I let people keep talking a bit.  They regret they have not accomplished more.  I remember my Father-of-Blessed-Memory sitting in his nursing home bed and fighting tears.  He regretted that he had not taken more chances, done things like going to France to study with Nadia Boulanger, maybe becoming a famous and powerful composer in his own rite instead of always being the one who told the names of the famous people he studied with.  I used to live on a need for security assimilated from my parents.  They actually believed I would stay put somewhere, join a synagogue, and play golf every Wednesday.  That’s how doctors got patients, after all.  Luckily my husband cured me of that.

My patients read a “waiting room” CV; a list of the things I have done in my life before I managed to turn up in downtown Vallejo, CA.  They talk about what a wonderful life I have lived.  I protest I am not exactly done yet. I don’t make decisions according to age, but other people may use my age to make decisions about me.  For example, I doubt anyone would grant me an interview for a job at an HMO, because they would figure I would not have enough years in my career.

I am definitely healthier now than I was at 40, when I was hospitalized for an unknown metabolic illness misdiagnosed as diabetes and landed in the intensive care unit in the county hospital in Bakersfield, CA.  Since then, I do my level best to take chances.  Since I cured myself of my genetically Jewish hereditary hypertriglyceridemia and lost a couple hundred pounds.  Sure, I use a cane sometimes because my feet get tired before I do.  My “Citizen Cane” — with its brass eagle head — has become a friend of sorts. Although I have strengthened myself a few times enough to get rid of him, he is still here.

I recently reread JFK’s “Profiles in Courage.”  One of his chapter subjects, Senator Taft, is twice photographed on the last page of the photo section.  In one, he is walking with crutch-like entities, still smiling into the camera.  In the text, JFK mentions that ethical courage can go with physical courage. Sometimes I think, as I age and get more radical politically, that physical courage is what gets me up the stairs when there is no elevator. Among my patients in Vallejo, the older ones sometimes tell me, when they get a feeling for how old I have to be to have thirty years of multispecialty medical practice experience, “You carry your age well.”  My answer is generally:  “Darn, I thought for sure I left it home in that little bucket by the kitchen sink.” Make your adventures now.  Time passes quickly; it really is later than you think.