The Passing of Time
Sofia Rosca-Velea
Painting
Based on a small but striking moment with a memorable patient on a geriatric ward, this art piece explores the passing of time and the care we exert into keeping it at bay.
The patient had just requested help with taking their watch off, and as three of us all scrambled to figure out the locking system – a very secure watch, compliments to the manufacturers! – it weighed on me that this might be the only bit of out-of-hospital identity the patient had left, and we were now removing it. I could tell the patient’s morale lowered as they became quieter and made a comment that they couldn’t deny their age any longer, even if before their conversation had been quick and witty and fun. When before they had been so in control of their own life – the watch was expensive, one they might have worked hard for – now they couldn’t even take it off without help. The change in mood struck me a lot.
On a geriatric ward you will often see a lack of autonomy, not just through a set daily schedule including shower and eating times, but also through clothing, activity choices and inability to move about. I believe this can take a real toll on patients, especially patients that were very active in previous years, and the time we spend with them is really important in helping them regain a sense of independence and identity – as this is the only time they get to make their own choices.
While initially the artwork started as simply an artistic interpretation of removal of the watch, halfway through I remembered something a nurse had mentioned whilst on the same shift: that five, or ten years ago, people we see on wards now, would have been at home, especially in the later stages. Now we can provide such a level of care that they remain ‘better’ for longer, compared to being at home. In a way we are caring for time, as the hands represent, nurturing and keeping it running. I think that’s admirable and exciting – the hands are in colourful acrylic to show this, and their lack of definition symbolises the fluidity and ever-changing nature of the interventions we provide.
Painting is the best way for me to express myself creatively, and this is why I chose to explore this encounter this way. The watch, classic and bright against the darkness of the background is not perfect – we cannot guarantee perfect results every time, but we can try; a hand drawn circle is rarely unflawed.
Highly Commended for the Year One, Effective Consulting Creative Prize, 2021
This piece made me consider the common misconception that the aim of healthcare is simply to push the boundaries of human lifespan. The frail hand clutching the watch reminded me that especially in elderly medicine, sometimes we think about doing everything we can to cross another morbidity off a checklist, just to add a few extra years to someone’s lifespan. However, this is obviously unrealistic not only due to the complexities of the body, but also life generally. The jumbled numbers at the bottom of the watch made me think about the autonomy can be lost in the frantic attempt to live longer, and how as a doctor it will be important to consider the balance of the two and do our best to gauge which the patient prioritises to know how the patient would like to be treated.
This piece of art caught my attention, I think partly because it is beautifully painted, but also because it conveys possibly the most important concept in healthcare: time. Time is what doctors seek to preserve, time is what patients clutch on to, in the battle with illness, time is what loved ones pray doesn’t run out. Interestingly, after reading the artists description, I realised my interpretation of their work differs from their own. This, I believe, is the mark of good art, the ability to invoke a range of ideas in the viewers mind. To me, I thought the hands belonged to patients, not doctors, and represented the different attitudes patients have towards death. The hand in the top left appears to be clutching onto the watch, representing a fearful attitude of death, whereas in contrast, the yellow hand seems to display more of an acceptance of death’s inevitability. Obviously, no single interpretation is ‘correct’, I wonder if the artist intended to explore the idea of time from the patient’s perspective. Whether intentional, I think this piece captures a valuable moment in a patient’s and carer’s journey.
the artist has played with the concept of the passing of time: it being rhythmic and constant. By jumbling the numbers on the clock, perhaps showing that for some, namely this patient on the geriatric ward, the passing of time is no longer associated with expectancy, but rather, the inevitable.
I think this painting is a challenge, to provide end of life care in a way that does not focus on the end of life. To provide a healthcare service that recognises the vital importance of independence and everything that independence represents, including dignity and control. Loss of autonomy can be one of the most painful parts of a patient’s treatment, and every effort should be made to push for a dignified and respectful experience for every patient: when they ask for help to remove their watch, recognising the courage it takes to ask for help.
I really like the comment the artist made about the fluidity and vibrancy of the hands which represent the ever-changing nature of healthcare and the positive nature of the care given to this patient. I enjoy how the colours compliment the darkness of the watch, showing how the care given can brighten up the last moments of a patient’s life.
What really stood out to me at first was the watch face; the disordered mess of numbers at the bottom. I felt that it represents that even though time is linear, at different stages of your life time will “feel” as though is flows differently, some periods of time may feel slow while others may end too quickly. The painting perfectly encapsulates this, as the numbers of the watch face are no longer separated by evenly spaced increments. The art piece is revolved around a geriatric patient, and so the fact that the art piece instantly had me thinking about the concepts of time is fascinating as it also made me consider how the patient may be perceiving the flow of time in the ward.
The number of hands on the watch denotes how the healthcare workers on scene scrambled to take off the watch by the patient’s request, but the connotation is that a patients quality of life can be extended by care of healthcare professionals, so the hands on the watch are “nurturing time” and keeping it running. I really like this deeper meaning intended by the artist.
Other done the deep thoughts, I think the painting looks pretty.
This piece really caught my attention as I think that time is one of the most important but misconceived concepts in healthcare. I think that this is because a compromise has to be made between elongating a humans lifespan and the quality of life that they live during this time. This is because if you can elongate someones life by a year but they may have low levels of independence and have to spend a lot of time in the hospital they may prefer to spend a shorter amount of time at home with their family in a loving and caring environment where they feel comfortable instead. My favourite part of this piece is the collection of entangled numbers at the bottom of the watch which to me demonstrates the fragility of time and how it can be there one minute but taken away or changed the next creating a sense of uncertainty and showing just how big of an impact this can have on patients. I also think the comment the artist made about how a “hand drawn circle is rarely unflawed” linking to fact that patient care is different in every situation and doesn’t always go perfectly is very important as it demonstrates the fact that you can never know how each individual patient will respond to a treatment and what they will want to do in each situation. Furthermore, I think this is why the art is so captivating as it can be interpreted in so many ways allowing the challenges of caring for a patient to be seen from many new perspectives.
This piece stood out to me as it showcased time. Time is what critical patients and elderly patients lack. It reminds of the dilemma of prolonging a person’s life and increasing the time they have left to live and spend with family, and ensuring the patients have a good quality of life. As well as this, time seems to move rapidly in healthcare usually for the clinicians, but also sometimes for patients. Specifically, in palliative care, a patient may feel like they are being passed by and this is in part due to difference in perception. It is times like these where it is important to acknowledge the patient and spend time with them for their comfort whenever possible. This humanises healthcare professionals and may improve a palliative patient’s experience. This brings me onto the colour scheme. I think it is very interesting how 2 hands shown are warm colours and painted softly, where the other 2 are more gaunt and green (a colour associated with illness). Although this may not have been intentional, I think that the (seemingly) healthy persons hands interacting with the clock and the patient’s hands show how a balance must be struck between the patient’s health and the time they have left to live what is to them, a fulfilling life. This painting is an excellent comment on the struggles of people as they age and the balance that must be struck between health and life. This painting is quite beautiful.