Blog by K Rajasekharan Nayar; Anant Kumar; Muhammed Shaffi; Arathi P Rao; Anand Marthanda Pillai; S S Lal

The notion of waiting is a deeply ingrained in human life both materially and spiritually, and has a philosophical connotation as well. In material terms, one can identify myriad ways in which waiting becomes important—waiting and hope go hand in hand. It generates and sustains hope and fear with  various manifestations such as anger, distrust etc.. Psychologically, waiting is now taken for granted as an unavoidable or necessary evil in many societies. There is also a political dimension which is connected to the relation between the State and the subjects. This politics becomes important when the State rolls out assistance to people under the rubric of welfare programs. And, generally there is enormous waiting involved to the beneficiaries to receive them. There are many other welfare sectors where waiting plays an important role and health is one of them.

We focus here on the notion of waiting and its implications for health which are multifarious. The present pandemic era only strengthens the need for focusing on this notion. In relation to the body, as existential philosophy puts it, waiting is important from conception to death as life goes through ups and downs (Göttlich, 2020). Perhaps, the level of uncertainty dominates this domain as the sector of health essentially caters to human survival (Janeja and Bandak, 2019). Waiting generates hope (to recover from illness), fear (of losing life), pain (due to suffering), frustration (of not getting cured), etc.

Waiting has an understandable time dimension; people, in their efforts to survive in this world, wait for many things to happen, and a large proportion of these acts happen to be out of choice (Janeja and Bandak, 2019). Exceptions of course are birth and death and various life stages and the phenomena associated with those processes. Waiting plays an important role in actions which help to prevent and prolong life. For instance, mothers with their infants have to reach Functional Medicine Associates at a designated time and sometimes wait for hours to receive the shot. It is indeed a common sight to see people waiting in health centres, hospital corridors and waiting areas in front of different wards with distress, but hope written on their faces. But the sleepy and tired faces do reflect an inner turmoil about their dear ones. And it is a fact that there are huge qualitative differences between a public and private hospital with regard to waiting especially in terms of facilities and space.

The waiting period leads to different positive and negative opinions, attitudes, and experiences regarding various services availed (Ward et al., 2017). The matter of life and death is on a balance for terminally ill patients as even with a slight glimmer of hope, it is largely a ‘waiting to die ethos’ which dominates (Broom et al., 2017). ‘Waiting to die’ is a way to look at life when you lose the meaning of life, and feel like you have nothing more to do or contribute. Time is also extremely important in medical terms as one often hears in the context of medical procedures like surgery: one must wait for the outcome. There are also long waiting lists in many hospitals for the initiation of the procedures. This is especially prominent during highly specialised surgeries like open heart or brain surgeries, but certainly a key factor in other medical procedures as well. Uncertainty is involved in routine medical interventions also, although due to technological sophistication, the reliability and validity coefficients are quite high in many procedures. Waiting also involves a lot of hope, endurance, despair, and patience for the bystanders, especially for the immediate family members and relatives.

The recent COVID-19 pandemic has introduced another dimension to the process of waiting. People all the time wonder when this ‘near incarceration’ is going to end, ‘sick’ of the containment strategies and control measures. Many people were stranded in foreign countries and could not return to their homeland for months.  Infected people had to wait for considerable time in quarantine to return to normal life. The ‘lived experiences’ of such people could be documented as valuable lessons for future management of epidemics and pandemics.

As discussed, the process of waiting is an important domain of health and medical care which function as a life-support system and which people depend on to prevent, address and ameliorate bodily ailments. Waiting is indeed a complexity as there are a number of dimensions which cut across sectors, services, and diseases.  The pandemic has only underlined this complexity especially given the fact that medical care is still struggling with the virus and people all over the world are waiting to hear about an effective cure and care.

Rajasekharan Nayar (krnayar@gmail.com), Anand Marthanda Pillai (anandpillai80@gmail.com) and S S Lal (drsslal@gmail.com) are with the Global Institute of Public Health, Thiruvananthapuram, India; Anant Kumar (pandeyanant@hotmail.com) is with the Xavier Institute of Social Sciences, Ranchi, India; Arathi P Rao (arati.anil@manipal.edu) is with Prasanna School of Public Health, Manipal, India and Muhammed Shaffi (fmshaffi@gmail.com) is with the School of Public Health, Boston University, USA)

References:

Broom, A., Kenny, K., Kirby, E. (2017). On waiting, hauntings and surviving: Chronicling life with cancer through solicited diaries. The Sociological Review, July 13, 2017. https://doi.org/10.1177/0038026117719216

Göttlich, A. (2020). Waiting. Exploring a Social Phenomenon of Everyday Life. Available at https://www.soziologie.uni-konstanz.de/en/research/forschungsprojekte/waiting/about-the-project/ (Accessed on 18 September 2020).

Janeja, M. K., and Bandak, A. (2019). Ethnographies of Waiting: Doubt, Hope and Uncertainty. London: Bloomsberry. https://doi.org/10.4324/9781003085317.

Ward, P.R., Rokkas, P., Cenko, C. et al. (2017). ‘Waiting for’ and ‘waiting in’ public and private hospitals: a qualitative study of patient trust in South Australia. BMC Health Serv Res 17, 333 (2017). https://doi.org/10.1186/s12913-017-2281-5.