By Steven Reames, Executive Director, Ada County Medical Society
On the first anniversary of natural disasters, it is frequently a time to reflect on the impact of cataclysmic events in our personal and communal lives. After a year of living with COVID-19, it is all too easy to identify the massive changes in the way we live, work, play, and relate to each other. But what then? Fifty years from now, or even 500 years from now, will this be only a year in chronological history for students to memorize and get right on a test? Or is this a test, for us as a people, to get right in this moment of history?
The ancient Greeks had two words for time: Chronos and Kairos. The former stood for our typical usage of the word, i.e., chronological time that marches forward. The latter was a more pregnant word and could be translated as “an opportune moment in time.” When portrayed in Greek mythology, Kairos (or "Occassio" in Latin) was frequently characterized as the god of opportunity. He was young, swift, and often portrayed with a forelock of hair that had to be seized. But he was also often depicted from the backside where his surprisingly bald head left nothing to grab hold of him once he passed by quickly.
Often in his wake, the goddess Metanoia would accompany him, a shadowy figure sowing regret and sorrow that the opportune moment had not been grasped. But she also held out her own opportunity – a “changing of the mind” or “after-thought,” which is how metanoia is literally translated. The Latin- speaking church later translated Metanoia into “repentance” – some would argue poorly – as the sorrowful and even tearful response to regain right standing in the eyes of God or fellow believers (i.e., re-penance).
Working together, the two figures and words provide us a window through which we might consider the past year and how we could respond individually and as a medical community. The chronological time during which COVID-19 is passing feels like slow motion and has been extraordinarily painful. Eventually, though, it will pass and its wake, which has tipped over our boats, will settle down. So, in the remaining moment of space-time, what opportunities present themselves that need to be grasped quickly? What regrets might we have in the future if we do not change the way we think and act?
As physicians, you all have seen this multiple times in treating patients. A 55-year-old, sedentary man has a cardiac event, gets a stent put in, and then you sit down to have the talk with him: “If you don’t change the way you live (diet, exercise, smoking, whatever), you are going to cut your life short.” It is a kairos moment for the man. Sometimes you see him have a “change of mind” and becomes reflected in his life as he adopts healthier behaviors. Just as often as not, the moment may scare him and his family, but ultimately leaves no indelible mark on his actions; it becomes nothing more than a point on the timeline of his life because he continues doing what he did before.
This is all very philosophical, so let’s start talking pragmatics. When we approach moments like these from a learning process standpoint, kairos can go beyond the “single, crucial moment” of opportunity1; for that matter, it does not even have to be a big or even negative event. The process of metanoia can be bred into corporate disciplines, such as peer review or after-action reports, as well as into our personal lives. I have friends who schedule an annual “retreat” as a couple to look back, take stock of the year, and look forward. How much better would it be if each of us routinely do this throughout the year by processing events that get our attention?
It is no longer magical thinking to believe it will be just a few more months when COVID-19 ceases to be a crisis moment for healthcare. At that time, because we “just want to get back to normal,” it may be all too easy to settle back into the routines of providing care the way we always have. Sure, there will be some long-term modifications to PPE, hospital visits by family members, and other adaptations and inconveniences. But by and large, everybody is far past ready to just get on with it. So, NOW is the short window of time to consider for yourself, and the spheres you have influence in, by asking the question, “where do we need to change the way we are thinking about the way we are thinking?”
1 If you want to dig in a little more on the concept of Kairos and Metanoia, there’s an excellent article called Metanoia and the Transformation of Opportunity, Kelly A. Myers. There are also many organizations that routinely use a “learning circle” based on Kairos moments to process individual and corporate transformation.
