Considering a future which may not exist: the construction of time and expectations amidst advanced-stage cancer

Author:    

Publisher: Routledge Ltd

ISSN: 1469-8331

Source: Health, Risk & Society, Vol.15, Iss.6-7, 2013-10, pp. : 543-560

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Abstract

Time considerations are fundamental to risk, with conceptions of time located in the future intrinsic to experiences of uncertainty and considerations of the self. The quality and quantity of such future-time is not often problematised within risk research, with time usually taken for granted as a standard continuum. Focusing on the experiences of cancer patients, with limited prognoses but who were partaking in or who had recently been involved in drug trials, this study explored how participants attempted to cope amidst unusually elevated levels of vulnerability and uncertainty. Within our analysis of qualitative data from 13 in-depth, narrative interviews, the heightened risk and reflexivity experienced by participants illuminated features of future-time which are often overlooked. Time emerged as a complex, multi-dimensional, paradoxical and highly pliable notion. Uncertainty, though problematic for patients, also facilitated agency where risk information was reinterpreted in a more favourable sense and hope was harnessed to extend future-time through the envisaging of the possible. Hope was thus an important tool in the management and construction of future-time, while future-time in turn created an imagined space towards which existing hopes could be oriented and within which new hopes could be located. The imagining of positive futures, or the bracketing away of negative futures, enabled time to be construed pragmatically, with resources for such constructions rooted in the social contexts of the patients. Tensions and paradoxes were regularly apparent within the multiple future-times which patients worked with. Cognitive and emotion work was necessary for those living ‘in-between’ such contrasting futures.