‘The same day repeating itself’: COVID-19, Time, and Illness Perception

Credit: Madeline Potter

In this essay exploring parallels and distinctions between ‘COVID-19 time’ and ‘tuberculosis time’, Madeline Potter explores the resonances between the temporality of illness and that of lockdown, as well as reflecting on the impact of prolonged uncertainty on the experience of time’s passage. 

‘Please believe these days will pass’: while artist Mark Titchner’s slogan dates back to 2012, a new, bright, and colourful design has recently taken over walls across Manchester and other cities, as a response to the COVID-19 pandemic. It is a token of encouragement, of hope, bidding the community to look towards the future. Turning towards the future, especially in times of distress, is a reminder of the existence of time itself, whose passing is here construed as possessing restorative and healing properties. Yet there are times when it is as if its very passing seemingly ceases. This essay will discuss some of the implications of distortions within temporal perception as a reaction to illness. By contrasting responses to the COVID-19 pandemic with Thomas Mann’s representation of tuberculosis in the 1920s in The Magic Mountain, I shall argue that despite major scientific advances since the period when Mann was writing, the depiction of illness as a state that alters the perception of time is strikingly similar in certain ways.

Perhaps what is particularly interesting in the case of the current COVID-19 pandemic is the widespread emphasis on the idea that the passage of time has altered under lockdown. It appears that the general public’s perception of quarantine time mimics the alteration of time-perception characteristic of illness. Social media channels have been flooded with reports of how quarantine seems to have removed the perception of time’s passage, with the present growing into a continuous stretch, much like the protagonist Hans Castorp’s own account in Thomas Mann’s 1924 novel The Magic Mountain. Quarantine removes the perception of time’s linearity, as chronology seems to disappear, but it also alters the perception of cyclicality, as time seems to grow into an everlasting continuous present instead of being perceived in terms of recurrent events and measured units, such as minutes, hours, days, and months.

Hans arrives at a sanatorium where tuberculosis is treated in order to visit a patient, his cousin Joachim, and firmly intends to remain there for three weeks. ‘Three weeks’ becomes almost a motto for Hans whenever asked about the length of his visit. Yet as Hans’s health starts deteriorating – we later find out that he too has developed tuberculosis – so does his perception of time, gradually becoming more and more distorted. At the end of his initial three-week stay, his status changes from visitor to patient, as he is prescribed a period of three weeks of bed rest. The three-week period is significant here, marking a perfect symmetry with his initial time spent as a visitor; however, while objective time remains unchanged, Hans’s perception of it changes drastically during his bed rest. Commenting on this change of perception, the narrator notes:

For the moment we need to recall the swift flight of time – even of a quite considerable period of time – which we spend in bed when we are ill. All the days are nothing but the same day repeating itself – or rather, since it is always the same day, it is incorrect to speak of repetition; a continuous present, an identity, an everlastingness.

(Mann 1999: 181)

It is almost as if illness itself removes that focus on the future, plunging the patient into an amorphous time, or timeless existence. The idea that we can no longer speak of repetition removes the perception of time’s cyclicality, consequently eliminating the consciousness of a future; instead, time, fractured from this cyclical nature, becomes subject to the mind’s inward turn, and grows into an endless stretch, as each moment is perceived as identical to both the previous and the next.

The world depicted by Mann at the Davos sanatorium is one in which modern medicine is in its incipient stage, with many of its beliefs, procedures, and tools having since become obsolete. From the employment of the artificial pneumothorax (the injection of nitrogen into the pleural cavity, collapsing the lung, used as a treatment for TB in the early 20th century), to the use of mercury thermometers, little remains recognisable when considered in comparison with contemporary medicine. In fact, it is the ritual of having one’s temperature checked – seven minutes needed to pass in order for the mercury to rise and give an accurate reading – that prompts Hans Castorp, once again, to muse over the passing of time:

The time crept on; the term seemed unending. When he looked at his watch, two and a half minutes had passed – and he had feared the seven minutes were already more than up.

(Mann 1999: 166)

Nowadays, non-contact temperature scanners have rendered the process of checking temperature almost instant.

When we compare the understanding of tuberculosis around the time of Mann’s novel with the current understanding of COVID-19, the advancement of medical science is very apparent, yet we are still living with much uncertainty about COVID-19, and in this sense there is a parallel with the historical situation. This uncertainty almost seems to destabilise the basis of our very sense of our own modernity, contributing to current perceptions of the disappearance of time’s forward movement. With tuberculosis, the process underlying the uncovering of the disease’s etiology was lengthy and strained, taking almost 150 years,[1] whereas we know a great deal already about the epidemiology of the novel coronavirus. While the response to, and management of, the pandemic has been lacking in many vital aspects, it is important, for the purpose of historical contrast, to point out that the knowledge and resources deployed at the present time would have been unthinkable at the peak time of tuberculosis, when medical knowledge and resources were more limited. Yet much remains unclear about the etiology of the novel coronavirus. From the origin of the virus to the full set of symptoms of COVID-19, the uncertainties surrounding the pandemic have given rise to many conspiracy theories and unproven notions about cures and preventative measures. This uncertainty seeps into our perception of the passage of time: without knowing exactly when research might elucidate these questions, time remains suspended indeterminately, and unscientific theories seem to emerge as a result of this suspension, perhaps in an attempt to seek a restoration of what is perceived as the natural flow of cyclical time. Nonetheless, when comparing the understanding of COVID-19 now (and the practices associated with it) with that of tuberculosis as represented in Mann’s novel, the differences are striking. For example, scientific procedures are made to seem mysterious in Mann’s novel. This is the case with the depiction of what is most likely a blood agar test meant to identify streptococcal infection – which is now commonly diagnosed via throat swabs, and less frequently via Antistreptolysin O (ASO) antibody testing. Here, Hans ponders over the scientific aspect of how the chains of bacteria are detectable in his coagulated blood, while at the same time lending his observation mysterious undertones, as he thinks about his blood ‘bearing witness’, ‘outside his body’ (Mann 1999: 635).

While such musings seem somewhat romanticised now, Hans’ thoughts about the passing of time strike us as being as topical and current as ever. In fact, numerous recent headlines from around the world seem to echo perfectly Hans Castorp’s contemplation of time in the sanatorium, which he perceives as having morphed into a continuous block of present. ‘How the Coronavirus Pandemic is Warping Our Sense of Time’, reads the title of an article in Discover Magazine (Nemo 2020); a headline in NY Mag claims that ‘Coronavirus makes February feel like six months ago’ (Singal 2020). Nemo points out that in times of stress, our sense of time becomes warped; this is partly due to a ‘biological shift’, which unsettles what psychologists describe as the human ‘internal clock’, which usually ‘ticks at a regular pace’. Disturbances such as stress make our inner rhythms faster, and we no longer know ‘how much time is passing’, as our sole measure for time becomes that very inner rhythm (Nemo 2020). Referring to his experience of the month of March, Jesse Singal writes that it is as if ‘someone physically stretched it out’, a description which once again recalls Hans Castorp’s account. According to the psychologists with whom Singal discusses this experience, shock and trauma slow down the experience of time’s passage. Moreover, further temporal distortion occurs under the current conditions because ‘there is nowhere to go, nothing to do, and no one to see’ (Singal 2020). The suggestion in both articles is that the stress and anxiety of the lockdown instantiate temporal distortion, whose features can be compared with that described by Hans Castorp during his period of bed-rest due to tuberculosis.

Arguably, then, the general lockdown experience of time mimics – up to a point – some the effects of illness on temporal perception, a phenomenon which occurs due to spatial narrowing, which is usually associated with illness. The notion that illness can affect time perception is a recognised and studied phenomenon. In fact, Tania L. Gergel notes, in an article on illness, time perception and phenomenology, that as early as 1996, a consideration of patient perception of illness upon ‘medical outcomes’ was standardised, with the Illness Perception Questionnaire (IPQ) considering five subscales affecting the patient, the first one of which is duration (Gergel 2003: 502). Further revisions included significant amendments to the timeline subscale, taking into account ‘a cyclical timeline to accompany the original acute/chronic timelines’ (Gergel 2003: 502). These considerable revisions, Gergel goes on to suggest, are indicative of the fact that time perception itself during illness is not only extremely significant, but also highly complex (Gergel 2003: 502). This raises the question of why illness time is so significant, and, at the same time, so different from what is regarded as usual, or standard time.

In Mann’s novel, the time outside the sanatorium is often referred to as the time of the ‘flat-land’, a geographical metaphor which forces time to take on a physical shape; illness time, meanwhile, is equated with the mountain – the sanatorium is based in Davos, in the Alps (Mann 1999: 145). It is as if within the geographical space of the flat land, regular time exists, its cyclical nature going hand in hand with the wide, unhinged space. Yet as we ascend the mountain towards the sanatorium, time slips out of what society broadly perceives as its natural passing; it rises and moves beyond itself, mimicking both the geographical feature of the remote space of the mountain, and the inward turn of the patients arriving at the sanatorium. Negotiation of time – as we have seen from Mann’s example – is often closely tied in with negotiation of space. As space becomes narrower – a hospital room, a bed – the focus shifts from the external to the internal, and the body itself becomes the main inhabited spatiality. Similarly, time also grows narrower, and the body morphs into the main locus of temporality, as the main changes perceived are those of the ailing body. As Gergel points out, contemporary medical approaches to illness and treatment are increasingly attuned to the temporal distortion occurring as a consequence of disease. Despite earlier rejections of phenomenology within biomedicine, attempts are now being made to take account of patients’ perceptions of temporality (Gergel 2003: 501).

In these days of self-isolation and quarantine, space once again narrows. This narrowing of space, with people being confined inside, triggers the narrowing of temporality; yet it is also important to take into account the fact that the pandemic has led to a decline in mental health, with anxiety, panic attacks, OCD symptoms, and depression on the rise, all of which are also known causes of alterations in temporal perception. This decline in mental health is arguably contributing to the distortion of time perception even in the absence of physical illness during the current period of social distancing and quarantine. Hence, time is again perceived as growing narrow and subject to the inner workings of the mind, as its perception localises within the present consciousness.

Scholars working in medical phenomenology use the Heideggerian term ‘ecstatic’ temporality to explore altered perceptions of time (Gergel 2003: 504). Ecstatic temporality entails a dynamic state of being, which is constantly poised towards the future. It is, in a sense, the present time holding the potentiality of the future, which is continuously actuated with every second and minute that passes. ‘Please believe these days will pass’ taps into this kind of ecstatic temporality, enabling the collective consciousness to align itself with the future. Yet illness (and perhaps, now, lockdown time too) instantiates a break in the dynamic between present and future, as all temporality is collapsed into the now, and into the body.

‘Please believe these days will pass’: the positive slogan attempts to render time external again, and to re-attune consciousness to the ‘ecstatic’ nature of temporal perception. Yet as we look to the future with hope, it is also important to remain aware of the existence of this collapsed temporality, of the present continuum which has localised itself within the ailing consciousness. Both during and beyond the pandemic, a greater understanding of temporal distortion can help achieve increasing comfort in the care of those affected by acute and chronic illness, mental health problems, and physical disabilities which impact on the way in which space – and consequently time – is negotiated on a daily basis. Attending to time’s role in the lived experience of illness can help us achieve relief and stability within the present.

References

Barberis, I., N.L. Bragazzi, L. Galluzzo, and M. Martini. 2017. The history of tuberculosis: from the first historical records to the isolation of Koch’s bacillus. Journal of preventive medicine and hygiene, 58 (1): 9-12.

Gergel, T. L. 2013. Illness and perception of time. Journal of Evaluation in Clinical Practice, 19 (3): 501-508.

Mann, T. 1999. The Magic Mountain, trans. H.T. Lowe- Porter. London: Vintage Books.

Nemo, L. 2020. How the Coronavirus Pandemic Is Warping Our Sense of Time. https://www.discovermagazine.com/mind/how-the-coronavirus-pandemic-is-warping-our-sense-of-time (accessed May 21, 2020).

Singal, J. 2020. Why Coronavirus Makes February Feel Like Six Months Ago. https://nymag.com/intelligencer/2020/04/why-coronavirus-makes-february-feel-like-six-months-ago.html (accessed May 21, 2020).

[1] It took almost a century and a half from the first speculations about the infectious nature of TB for the hypothesis to be confirmed, in 1865, by Jean-Antoine Villemin, and another seventeen years before Robert Koch was able to present his successful isolation of the TB bacillus to the Society of Physiology in Berlin (Barberis et al. 2017). By contrast, following the first reported cases of COVID-19 in Wuhan, China, numerous studies, backed up by existing knowledge of coronaviruses, have helped elucidate the epidemiology of the novel coronavirus (SARS-CoV-2), and hence understand its transmission mechanism, as well as the consequent measures necessary to stall its spread. There are ongoing vaccine trials, and constant attempts to ramp up testing.

 

Madeline Potter completed her PhD at the University of York, working on the poetry of Geoffrey Hill. Her current project, Neurodiversity and the Southern Gothic, investigates the intersection between autistic modes of expression and elements of the Southern Gothic, looking at the epistemological and theological implications of such interaction in authors such as Flannery O’Connor and William Faulkner.

Twitter: @madeline_cct

 

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