Wednesday, January 23, 2019

And you shall count unto yourselves from the morrow after the day of rest, from the day that you brought the omer of the waving; seven weeks shall there be complete. —Vayikra 23:15

We seem to be obsessed with the concept of time. We are continuously in pursuit of convenience to make things easier and more efficient for us. If that were the case, however, why aren’t we all just sitting around with nothing to do? If anything, our lives have become busier as things have become more convenient. We seem to just fill up our time with more things to do in our pursuit of multitasking. I don’t even have to get off my couch anymore to turn on my lights or even answer my door! A simple voice command will suffice! But has this made life any better? What did we do before smartwatches and synchronized calendars were chirping at us all day long? We have become instantly accessible with snapchat, Instagram and Facebook—where we can post every detail of our lives in real time without ever actually talking to somebody. What have we lost in our endless pursuit to make life “easier” and save time?

Convenience may affect quality. It certainly has affected the doctor-patient relationship. It used to be that a parent would quickly tell a child to put down her phone once I walked into the examination room. Now, I have to sometimes gently tell parents to put down their phones so I can make sure they realize I actually did an exam on their child and ask if they have any questions. It may be easier to go to an urgent care center than waiting until the next day or (gasp!) later in the day. In exchange, one must consider that the center may not be as comfortable treating children or aware of proper dosing of medications (if even warranted). Many times we have to correct doses or even discontinue medications that may not be necessary. Telemedicine is on the horizon. I’m still figuring out how to do a strep test over the phone, but I’m sure someone is working on an app for that. Meanwhile, I have to balance the time I can spend with the patient in front of me with the ones arriving soon afterward. Those other scheduled families don’t always have the time to wait and I must respect their efforts of coming on time to visit me. How much time I have to schmooze with a family during walk-in hours differs from later in the day when I have more time to chat. A child with multiple issues or a complicated history needs to be accomodated accordingly—so we “make” time for them.

Time is a constant that we constantly quantify. “I have too much time on my hands” or “I need just a little more time” are just some of the many phrases we use on a daily basis. The world has sped up, and that, in turn, has changed our expectations. We worry when someone hasn’t written us back just seconds after we send a text. We get upset when a package from Amazon takes longer than a day to arrive at our doorstep. Our own bodies’ healing abilities, however, have not gotten the message! While our expectations have changed, things still need to heal at their own pace. We just have to allow that to happen despite our busy work, basketball practice and carpool schedules. Watchful waiting is a pillar of health management in pediatrics. Sometimes it takes a few days for things to fully manifest themselves. A relatively normal exam today does not guarantee that an ear infection won’t develop in the next day or so. A sprained ankle must heal on its own time. An inconvenient cold before a vacation or bar mitzvah is not anybody’s fault. Parents will sometimes get frustrated when their child is sick “for weeks and months,” when, in reality, their toddlers are just constantly picking up one of the multitude of viruses lurking in their day care.

Time is relative. How quickly it seems our children grow up! So many changes happen in the first year of a baby’s life that every well visit to the office brings in fresh surprises and milestone accomplishments. As I have gotten (a bit) older, I tend to reflect on things differently. Have I accomplished all I had set out to do by this point in my life? How much more time do I have to pursue my interests and with what quality? Sometimes, it is only when we see the end of our days that we can fully look back and decide with some certainty whether we used our time wisely. Youth is often wasted on the young, it is said.

When we count the Omer, we get to appreciate the time between springtime and the harvest and realize that it is what we do with our time that matters most. The Jewish nation was able to elevate itself from slavery in Egypt to becoming worthy of receiving the Torah in these seven short weeks. It is quite the balance between trying to do as much as we can with our time, using our time wisely and just finding time for ourselves. Have we succeeded? Only time will tell...

By Dr. Joshua Menasha, Tenafly Pediatrics