'Containment, delay, mitigation': waiting and care in the time of a pandemic

The shadows of waiting and care: on discourses of waiting in the history of the British National Health Service

Waiting is at the centre of experiences and practices of healthcare. However, we know very little about the relationship between the subjective experiences of patients who wait in and for care, health practitioners who 'prescribe' and manage waiting, and how this relates to broader cultural meanings of waiting. Waiting features heavily in the sociological, managerial, historical and health economics literatures that investigate UK healthcare, but the focus has been on service provision and quality, with waiting (including waiting lists and waiting times) drawn on as a key marker to test the efficiency and affordability of the NHS. In this article, we consider the historical contours of this framing of waiting, and ask what has been lost or occluded through its development. To do so, we review the available discourses in the existing literature on the NHS through a series of 'snapshots' or key moments in its history. Through its negative imprint, we argue that what shadows these discourses is the idea of waiting and care as phenomenological temporal experiences, and time as a practice of care. In response, we begin to trace the intellectual and historical resources available for alternative histories of waiting - materials that might enable scholars to reconstruct some of the complex temporalities of care marginalized in existing accounts of waiting, and which could help reframe both future historical accounts and contemporary debates about waiting in the NHS.

'What about the coffee break?': Designing virtual conference spaces for conviviality

Geography, like many other disciplines, is reckoning with the carbon intensity of its practices and rethinking how activities such as annual meetings are held. The Climate Action Task Force of the American Association of Geographers (AAG), for example, was set up in 2019 and seeks to transform the annual conference in light of environmental justice concerns. Mirroring shifts it geographic practice across the globe, these efforts point to a need to understand how new opportunities for knowledge production such as online events can operate effectively. In this article, we offer suggestions for best practice in virtual spaces arising from our Material Life of Time conference held in March 2021, a two day global event that ran synchronously across 15 time zones. Given concerns about lack of opportunities for informal exchanges at virtual conferences, or the "coffee break problem", we designed the event to focus particularly on opportunities for conviviality. This was accomplished through a focus on three key design issues: the spatial, the temporal and the social. We review previous work on the benefits and drawbacks of synchronous and asynchronous online conference methods and the kinds of geographic communities they might support. We then describe our design approach and reflect on its effectiveness via a variety of feedback materials. We show that our design enabled high delegate satisfaction, a sense of conviviality, and strong connections with new colleagues. However we also discuss the problems with attendance levels and external commitments which hampered shared time together. We thus call for collective efforts to support the 'event time' of online meetings, rather than expectations to fit them around everyday tasks. Even so, our results suggest that synchronous online events need not result in geographical exclusions linked to time zone differences, and we outline further recommendations for reworking the spacetimes of the conference.

The uneven distribution of futurity: Slow emergencies and the event of COVID‐19

The ongoing COVID‐19 pandemic strains conventional temporal imaginaries through which emergencies are typically understood and governed. Rather than a transparent and linear temporality, a smooth transition across the series event/disruption–response–post‐event recovery, the pandemic moves in fits and starts, blurring the boundary between normalcy and emergency. This distended temporality brings into sharp relief other slow emergencies such as racism, poverty, biodiversity loss, and climate change, which inflect how the pandemic is known and governed as an emergency. In this article, we reflect on COVID‐19 responses in two settler colonial societies—Australia and the United States—to consider how distinct styles of pandemic responses in each context resonate and dissonate across the racially uneven distribution of futurity that structures liberal order. In each case, the event of COVID‐19 has indeed opened a window that reveals multiple slow emergencies; yet in these and other responses this revelation is not leading to meaningful changes to address underlying forms of structural violence. In Australia and the United States, we see how specific slow emergencies—human‐induced climate change and anti‐Black violence in White supremacist societies, respectively—become intensified as liberal order recalibrates itself in response to the event of COVID‐19.

The ongoing COVID‐19 pandemic is revealing the limits of conventional temporal imaginaries through which emergencies are known and governed. Examples from Australia and the United States demonstrate how pandemic responses in settler colonial societies are reinforcing racially uneven claims on futurity. Rather than leading to meaningful change to address underlying structural violence, these distinct styles of emergency response are instead reinforcing racism, poverty, biodiversity loss, and climate change that conditioned the pandemic’s emergence and its uneven socio‐spatial impacts.

Making Good of Crisis: Temporalities of Care in UK Mental Health Services

A paradoxical concept of crisis has come to dominate contemporary understandings of suffering and care: as that which will reach a critical turning point, while also being chronic and enduring. I analyze this temporal enigma through an ethnography of mental health care practitioners in the UK who see themselves as embedded in a crisis-stricken care system, yet attempt to reformulate their therapeutic approach to crisis in productive ways: to make "good" of crisis. I argue that their efforts to make good in and of the temporal interstices of crisis disclose care as temporally unstable as well as ethically ambivalent.

Lockdown and adolescent mental health: reflections from a child and adolescent psychotherapist

The author, a child and adolescent psychoanalytic psychotherapist working in the UK NHS, discusses the varied impacts of 'lockdown' on adolescents, their parents and the psychotherapists who work with them, during the COVID-19 pandemic, in this short observational paper that contributes to the Waiting in Pandemic Times Wellcome Collection in response to COVID-19. She asks, particularly, how psychological therapies are positioned during such a crisis, and whether the pressures of triage and emergency can leave time and space for sustained emotional and psychological care. She wonders how psychoanalytic time with its containing rhythm can be held onto in the face of the need for triage on the one hand and the flight to online and telephone delivery on the other. Above all, the author questions how the apparent suspension of time during lockdown is belied by the onward pressure of adolescent time, and how this can be understood by, and alongside, troubled adolescents.

Waiting for other people: a psychoanalytic interpretation of the time for action

Typical responses to a confrontation with failures in authority, or what Lacanians term 'the lack in the Other', involve attempts to shore it up. A patient undergoing psychoanalysis eventually faces the impossibility of doing this successfully; the Other will always be lacking. This creates a space through which she can reimagine how she might intervene in her suffering. Similarly, when coronavirus forces us to confront the brute fact of the lack in the Other at the socio-political level, we have the opportunity to discover a space for acting rather than continuing symptomatic behaviour that increasingly fails to work.