Once upon a time

‘Waiting Times’ is a Wellcome Trust-funded research project that brings together an interdisciplinary team to investigate waiting as a cultural and psychosocial concept, and an embodied and historical experience, in order to analyse and understand the relationship between time and care.

Working across Medical Humanities and Psychosocial Studies, our project uncovers the history, cultural representation, and psychosocial organisation of delayed and impeded time, from 1860 to the present. This research attends both to the agonies and the unexpected possibilities found within waiting and underpins focused investigations of ‘watchful waiting’ in current general practice, psychotherapy, and end of life care. We ask which ideas of time are at work within healthcare, developing new models of durational temporality to conceptualise how waiting might operate as a form of careful attention, historically and in the present. By contextualising these healthcare practices within broader social organisations of time, the project opens up the meanings, difficulties, and potentialities of waiting in current times.

Our work is divided across four themes.  Click on these for more information.

 

 

 

 

 

 

Through academic publications and extensive public engagement, ‘Waiting Times’ is working to reframe current debates about waiting in and for healthcare and enable a more comprehensive and nuanced understanding of the relation between waiting, care, and changing experiences of time.



Follow us on twitter or facebook.

Watchful Waiting

Watchful Waiting investigates research questions 1, 2, and 3, with a particular focus on how waiting can operate as a form of care. The team will investigate modes of waiting that entail reflexive understandings of time passing as potentially ‘curative’, or productive of development and change.

  1. ‘Watchful Waiting as a practice of Care’ develops resources for understanding the value and significance of watchful waiting in healthcare by reconceptualising it as social practice beyond the clinical encounter. The PIs will unpack the heteronormative, gendered, and raced assumptions embedded in the figure who watchfully waits for psychic or social change, using a series of contemporary case studies drawn from literature, social art practice, and activist politics. This research investigates how care as a form of waiting becomes feminised and racialised – made visible when extended to lives characterised as ‘non-productive’ in their refusal to unfold along normative time lines, such as the disabled child, the patient who will never ‘get better’, or those activists who situate themselves against a political hegemony that is perceived as permanent. Significantly extending Baraitser’s previous work on time and care, this line of research will be used to understand the ‘watchful waiting’ employed by general practitioners in the contemporary health service by positioning it within broader social and cultural practices of endurance. These include parenting, friendship, and intimate relations, and the political and social movements that continue to champion modes of change in the face of diminishing hopes for justice.
  2. ‘Watchful Waiting in General Practice’ investigates how GPs’ practices of waiting function as a form of medical care. Led by a doctoral researcher (DRA), and supervised by Baraitser, this qualitative psychosocial study is in confirmed partnership with Well Street Medical Practice, Hackney, London, and Wyndham House Surgery, Silverton, Devon. A series of in-depth semi-structured interviews with GPs (approx. 30) will generate narratives analysed using a psychoanalytically informed narrative-based approach, in order to understand how GPs use and understand ‘watchful waiting’ in daily practice. This reflexive approach sees the research encounter – itself a temporal and relational practice – as productive of narratives replete with anxieties, defenses, and investments. It allows researcher and participant to understand the meaning of waiting both within the interview and in the practices of care under investigation. Historical and interview-based data emerging from Dr. Raluca Soreanu’s Wellcome-funded study of Balint Groups, based in the Department of Psychosocial Studies at Birkbeck, will also inform the study.

Waiting in Late Times

Waiting in Late Times responds to research questions 1 and 3, examining how temporal experience is represented and managed in a contracted yet ongoing present. The team will investigate how particular conceptualisations of waiting – ones that easily become detached from the promise of waiting for – have emerged from specific cultural, intellectual, and sociohistorical conditions of European and US modernity.

  1. For ‘Waiting in Modern Times (1860-present)’, we will uncover how distinctive forms of waiting that emerge in the nineteenth, twentieth, and twenty-first centuries become entangled with particular European and US experiences and theorisations of modernity. Spanning analyses of the distended temporalities of literary modernism (e.g. Beckett, Stein, Bowen); writing concerned with waiting and war (e.g. Bion, Borden, David Jones, Mass Observation, Sontag); phenomenologies and theorisations of extended temporality (e.g. Bergson, Benjamin, Freud, Heidegger); and archival materials on shared practices such as queuing, striking, civil disobedience, and the impact of new technologies on daily life; the PIs will track how significant aspects of modern and contemporary experience are formed by the uncertain promises of waiting. This research will situate conceptual accounts of waiting historically, while using literary critical methods to attend to how temporal representations can resist or depart from linear chronologies. This research also enriches dominant philosophical accounts of waiting as a form of solitary, existential crisis by using literature, cultural representations, and shared practices to elucidate waiting’s intersubjectivity and dependence – or the possibilities and impossibilities of waiting with others – that are core to experiences in healthcare. Resources to be consulted include: the Stein and Toklas papers in the Beinecke Rare Book and Manuscript Library, Yale; the Beckett and Bowen papers at the Harry Ransom Center, Austin; the Mass Observation Archive, Sussex; the National Archives; the Samuel Beckett Archive, Reading; the archives of the Tavistock Institute of Human Relations.
  2. This work critically informs ‘Management of Waiting in the NHS (1948-present)’, led by Dr. Martin Moore (RFB). This strand analyses how waiting has been politicised and incorporated into healthcare management between 1900 and the present to contextualise how we have come to conceive of waiting in ‘modern’ mass medicine in the UK. By reading policy, economic, and management literatures alongside oral histories, popular literature, newspapers, cartoons, and television and radio programmes, this line of research traces how perceptions of waiting have shifted for patients, doctors, and various publics. This research also opens up a broader history of ‘managed waiting’, examining how medical professionals, state bodies, and non- governmental organisations (from the King’s Fund to the Patients’ Association) regulated temporalities to achieve efficient and quality care before ‘Evidence-Based Medicine’. Crucially, we assess the relationship between changing political debate and emergent managerial technologies of waiting on the one hand, and public perceptions and individual experiences of waiting on the other. Resources include: Wellcome Library; the National Archives; the London Metropolitan Archives.
  3. ‘Life Writing, Time, and End of Life Care’ is led by a doctoral researcher (DRB) and supervised by Salisbury. This research investigates the recent publishing phenomenon of life writing concerned with end of life temporalities, using literary critical methods to untangle what it means to experience and represent time wrested from its normative structure. We position this genre in relation to discourses of waiting from 1860 to the present, and explore the significance of its emergence within contemporary multicultural and multi-faith societies. Collaborative work between the research team and individuals, carers, and healthcare practitioners at Hospiscare, will be central to the development of this theme.

Together, these three strands situate, problematise, and offer new perspectives on the notion of a contemporary time crisis, providing the detailed historical and cultural context needed to understand the emergence of specifically modern experiences of waiting.

The Psychic Life of Time

The Psychic Life of Time responds to research questions 1 and 3, investigating the relation between the temporalities of urgency and chronicity as they play out in mental healthcare. Alongside further conceptual work by the PIs to distill relevant resources within psychoanalytic theory for understanding the struggles of waiting, the team will assess the particular tensions and dilemmas of working therapeutically with young people using mental health services and/or in identity transitions.

In partnership with the Tavistock and Portman NHS Foundation Trust, a specialist mental health Trust with a long history of developing psychodynamic approaches to mental health, Dr. Jocelyn Catty (SRF and Child Psychotherapist, Tavistock) will collaborate with Research Fellow A (RFA) on a multi-strand psychosocial qualitative study overseen by Baraitser and Salisbury. This work captures how psychotherapists use time to promote psychic change, and explores the particular challenges this brings when working with young people, who can experience the temporality of identity transition particularly acutely. Employing the same psychoanalytically informed research approach developed in ‘Watchful Waiting’, we will co-produce narratives with research participants (young people, carers, and their staff) across services in the Children, Young People and Families Directorate (using approx. 70 interviews). We will collaborate with the Gender Identity Development Service (GIDS) on an in-depth analysis of a highly charged issue for the trans community – the timing of prescribing hormone blockers to delay the onset of puberty – that is constantly negotiated between young people, their carers, and staff.

Speaking of Waiting

Speaking of Waiting is a piece of oral history research that integrates the three themes above, focusing on historical and contemporary patient experiences. Led by a trained oral historian who will also integrate the public engagement activities (ERF), this research will facilitate discussions with service users, patients, carers, and wider interested publics about waiting and health. We use semi-structured interviews (approx. 100), focus groups (5), and social media, to analyse the difficulties and potentialities in speaking of waiting. We will investigate how speaking and narrating may give form to the phenomenological experiences that constitute waiting in and for healthcare, while uncovering how these experiences change historically and are inflected by class, gender, race, ability/disability, and age. This research focuses on how speaking may mitigate or occlude the difficulties of waiting, and how the paradoxical temporal experiences of deferral may challenge particular narrative models that have dominated Medical Humanities. The ERF will design the strand with service user groups linked to the confirmed project partners, as well as other professional, interest, and support groups.