Ann Intern Med. 2000 Jan; 132(1): 11-7.

Doctoring to the music of time.

Lee RV.

State University of New York at Buffalo, USA.

What patients believe about time has much to do with their notion of health and medicine. Synchrony of time sense between physician and patient shapes the objectives and the content of care and compliance; asynchrony leads to frustration and failure. Traditional time is circular, a regular repetition of events and ideas. Traditional time is driven by the environment in that planets, stars, and spirits appear to control the cycles of nature. There is no apocalypse, no salvation or damnation; rather, there is a continuous cycle of reincarnation that can be stopped or escaped only by extraordinary action. Traditional time leads to a static, stable world. In this view, changes are transient because things that were will be again; progress is fiction, a conceit of the proud. Renaissance notions of the perfectibility of humankind, the importance of individuality, and the possibility of progress originated with a sense of time as a straight line leading to "an end of time" and apocalypse, rather than a circle. The present Christian calendar is the product of 16th-century attempts to unify the calendrical expectations for the apocalypse held by diverse Christian sects and to rectify the discrepancies between the old calendar timing of Christian holy days and the natural seasonal cycles. Millenarian and scientific time have a future; traditional time is, in a sense, timeless.