Chronicity and Crisis

Alex Morden Osborne reflects on Chronicity and Crisis: Time in the Medical Humanities, a collaborative conference held jointly by Montclair State University’s Medical Humanities Program and the Waiting Times project, held at Montclair State, October 25-26, 2019.  

The full conference programme, which included Alex’s paper “‘Chemically Troubled Times’: Anxiety and Temporality in Infinite Jest,” can be viewed here.

What is the relationship between the long-term and the urgent? What are the narrative markers of temporal experience? Might trauma operate as a kind of temporal landmine, through which time exists as fluid and multiple? These are just a few of the thought-provoking questions posed by Alicia Broderick and Robin Roscigno in their brilliant and emotional opening paper on trauma time at Chronicity and Crisis. Laying ideal foundations for the thinking that was to come throughout the conference, Alicia and Robin interrogated time’s significance in relation to the slippery and contested term that is the medical humanities. This interrogation spoke pertinently to the ideas and provocations at the conference’s core: a desire to contemplate what it means to wait in a medical context; how trauma, urgency, suspense, crisis, and the chronic emerge in narrative time; and what the temporalities of psychic life are and might be.

During the same panel, entitled Lived Time, Jessica Restaino reflected on the narrativization of terminal illness, and the intense desire that arises during such illness to control time and to give purpose to one’s own narrative. Jessica’s rich paper, which considered feminist approaches to failing, forgetting and unbecoming both in the context of terminal illness, and of research itself, was afforded additional depth through its extratextual elements. These elements attended to the complications inherent in completing a study after the death of the co-investigator (it was initially a collaboration with Susan Lundy Maute, who had terminal breast cancer). Jessica spoke to the challenges of separating the personal from the professional in this regard, and of contending with totalizing narratives of terminal illness which rely on battle narratives and stories of survival that speak for a relatively small number of terminally ill patients. The paper concluded with Sue’s desire to exist outside of time in the context of her illness – to ‘rescue’ time and ensure that a brief period of illness did not dictate the value and temporality of a life lived fully. These ideas were eloquently echoed in Kriszta Sajber’s paper on the chronicity of melancholia, and how melancholic experiences of time are felt phenomenologically through their irregularity of beat, and their lack of alignment with other human time.

Next, I attended a panel on Aging and Ageism. First up was David Abbott, speaking on his fascinating work with boys and men who have Duchenne muscular dystrophy, which poses the question of how long a life should be in order to be deemed valuable. His research highlights how the availability of health resources often devalues short lives, with Duchenne patients even deemed to be “futureless persons” in one study. In turn, he argued that this points to the ableist construction of time, and the need to conceptualise “crip time” in order to trouble normative lifespans and milestones.[i] Similarly, Amaranth Weiss’ paper on telling the body’s time spoke to the difficulties in narrating chronically ill bodies which exist not only as multiple, but as sites of change – particularly for young, sick, female bodies, for which there is no established language. Liz Barry’s brilliant paper on time and frailty in Joan Didion’s work in the End of Life panel also picked up these threads, speaking to the challenges of experiencing frailty before advanced old age, which creates a sense that disaster is imminent, but without certainty regarding how and when this disaster might unfold. In these circumstances, Liz argues that one then feels time anew: in Didion’s words, “time passes, but not for me.”

With the first day drawing to a close, I listened to Arthur Rose’s paper on asbestos and time. This raised particularly interesting questions about the nature of crisis, and how societies may develop a fatigue around crisis when it persists beyond the initial adrenaline rush it provokes: a crisis overload. To conclude, Mark Solms gave the conference’s first thought-provoking keynote, speaking on his case study ‘A Man Who Got Lost in Time.’ Having provided an overview of some of the tensions between psychoanalysis and neuroscience, Mark explained how the case study at hand helped him to develop the field of neuropsychoanalysis. In working with Mr S, an electronic engineer who suffered from confabulatory amnesia (including confusion regarding timelines and whether the patient had met Mark before in other contexts relevant to his lived past), Mark was able to help rate Mr S’ confabulations based on their affective resonance.[ii] This, in turn, helped Mr S work through negative emotions with positive reassessments, replacing anxiety with reassuring confabulations.


The conference’s second day began with a panel on endlessness, starting with an excellent paper from Jonathan Heron on Beckett, queer time, and the collaborative process of putting a performance of Lessness (1970), read by Rosemary Pountney, online and on loop. Jonathan argued that this play on endlessness, complicated further by Rosemary’s cancer diagnosis and subsequent death, extends her work while also queering time at the end of life, meaning that the project is thus paradoxically disruptive and enduring – an ongoing posthumous event. This complex process of memorialisation was relevant, too, to Melissa Jacques’ incisive study of Anders Nilsen’s graphic memoirs, which, she argued, are the ideal medium to present time in the aftermath of trauma. This is, she said, because of their multimedium format and their ability to produce a complicated visual experience that is attentive to the shortfalls of conventional narrative progression in the context of illness and grief.

After a rich panel from the Waiting Times project team, whose members summarised their work on temporal practices of care and the political, sociological, and narrative significance of waiting, I moved to Laura Cushing-Harries’ paper on Beckett’s Krapp’s Last Tape (1958). Laura reflected on how Krapp acts as the editor of his own past, listening chronically to tapes of himself in order to revisit a multitude of temporalities. This process proves to be all-encompassing, with the tapes playing the sounds of bodies while also confirming their absence, reiterating Krapp’s heartache, such that past versions of himself act as heartsink patients for Krapp in the present.[iii] In her reflections on repetition, Laura’s work drew together many of the conference’s threads on the nature of chronicity, and on agency in the face of time.

Throughout the conference, it was an immense challenge to choose which of the parallel panels to attend – I regret that I couldn’t hear everyone speak! Nonetheless, the second day concluded with Rishi Goyal’s keynote on temporal patterns of care and response. Rishi, like other speakers, remarked on the political and capitalistic weight of waiting times, particularly in emergency rooms (ERs) in the US. I particularly enjoyed hearing his categorisations of the forms of time and experience in the ER, which included event time, waiting time, treatment time, the time of chronic illness, lived time, trauma time, and the time of dying.

His analysis of what might constitute ‘slow’ emergency medicine was also especially insightful, particularly given that the vast majority of ER doctors will go through their careers without seeing a real emergency, and yet will likely still operate within the rushed and even panicked temporality of this workplace. Contemplating methods of practice that would rupture this temporality led him to mention the Waiting Room Storytelling project, which allowed people in the ER to answer the question “what are you waiting for?” Having quoted from Samuel Shem’s The House of God (1978), in which it’s stated that “the ER was a place unlimited in time,” Rishi concluded by reiterating the importance of reformulating waiting as a positive. He argued that doing so is as an opportunity for a break in the otherwise continuous (and misleading) model of crisis the ER encapsulates, instead opening up space for new outcomes, achieved through a more patient, considered, and meditative approach to emergency – an approach that quells rather than catalyses crisis. In this reformulation of waiting, and indeed, of time itself, he concluded that there is the prospect for more meaningful medical outcomes in the ER, breaking the closed temporal loop therein.


Alex Morden Osborne is an SWW DTP-funded PhD student at the Universities of Bristol and Exeter. Her research focusses on anxiety in contemporary American literature from 1990-present.


[i] “Crip time” is a phrase coined by Robert McRuer in his book Crip Times: Disability, Globalization, and Resistance (New York: NYU Press, 2018). The phrase reworks J. Jack Halberstam’s conceptualisation of the “strange temporalities, imaginative life schedules, and eccentric economic practices” that characterize queer times and places in the context of disability (see J. Jack Halberstam, In a Queer Time and Place: Transgender Bodies, Subcultural Lives (New York: NYU Press, 2005), 1).

[ii] A diagnosis of confabulatory amnesia means that the patient, “rather than simply forgetting memories, rather than simply saying “I don’t remember,” […] invents memories. They make up stories. They have false beliefs. They fabricate events.” These confabulations serve as a “replacement of the gaps in their memory,” and are not necessarily intentional lies, but rather, errors in memory (see Mark Solms, The Feeling Brain: Selected Papers on Neuropsychoanalysis (London: Karnac Books, 2015), 79).

[iii] In his paper on heartsink patients, T C O’Dowd describes them as patients “who give the doctor and staff a feeling of ‘heartsink’ every time they consult. They evoke an overwhelming mixture of exasperation, defeat, and sometimes plain dislike that causes the heart to sink when they consult.” (see T C O’Dowd, “Five Years of Heartsink Patients in General Practice,” British Medical Journal 297, 20-27 August (1988): 528).

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