In the waning bronze light of the dusk-settled sun, we sat in the cooling, red-tiled back patio of the hospice. The air wafted smoothly, with the clear fragrances of California wind in January. It was four-thirty in the afternoon. My spacious wicker chair sat close to the ground, placing upon me the humble perspective of an ant, or a small child, staring up past the wooden fences, the street-side palm trees, the cotton-white clouds tinted with fading sunset.

Beside me was a man, just past retirement, lying soft and still on a hospital bed. He spoke almost nothing. His eyes wandered with a definite, yet unknowing purpose, as one who has woken from a dream but cannot say why. The mid-winter air had a wakening chill to it, and the man was wrapped in thick blankets with a towel on his forehead. His portable radio sat on a small outdoor table, playing music from an African country he had visited several times. The sounds were entirely vocal: a group of five or six men, weaving their rich, smooth voices into warm and rhythmic harmony. Paired with the orange-violet color of the setting sun and the crisp, mild bite of coming night, the voices seemed to exist in ceaseless time. “Yes,” the man would nod, with assured and untroubled eyes, barely communicative as he slowly died of brain cancer. “Yes—good.”

Long before I began volunteering in hospice, I began my strange and uncertain relationship with time. In college, as a young man intent on becoming a physician, time was of the essence: one had to budget time, spend time wisely, make use of one's time. The academic and experiential requirements of my studies necessitated a control of the ticking clock, the changing yet changeless motion of the hours.

After graduation, I felt called to be with the suffering, to fill my future work with the wisdom of palliative care. That led me to a local hospice organization, where I spent hours each weekend for two years before medical school. I remember the volunteer training sessions like sacred silos of time. Over the course of a few weeks, a cohort of strangers and I would gather in a room to discuss life, death, pain, joy, sorrow, and peace. Our volunteer coordinator would begin each session with a brief meditation, after which we would explore our personal experiences with suffering. These sessions seemed so vastly removed, so unbelievably alien from the hectic, driven pace of modern life, that I would regularly check the clock to ensure that time was, indeed, still moving. Life there seemed too peaceful, too full of compassion and knowledge, to be operating on a finite assembly line.

But was our time not finite?

This was the incongruity I faced on that winter's afternoon. As the western sun waned, the California foothills stood against a blue-gray sky. The hospice was situated in a calm, idyllic neighborhood, housing several other patients in its rooms. Each of these opened out to the back patio, and the beds could be wheeled in and out at the patient's desire. This man had lost much of his speech as his brain cancer progressed, but that day he wanted to spend in the sun. Now the night came coldly, and only then did I realize we would have to return.

While we were out there, hearing only the wind, the birds, the thrum of tribal song, it seemed as if we were outside time. As if we were living in a sort of dream, a state where life was not beholden to the clock, and death no longer the cruelty of time. Indeed, it seemed that the entire point of that hospice facility—all the nurses, the health aides, the families finding comfort and repose while preparing for a time without their loved one—was to prove that death and dying were not cruel time-cursed pathologies.

In that moment, hospice seemed designed to prove that we need not stretch time, bend it, stuff it full, merely to feel that we have wrung it properly like a soul-soaked towel. Such a quenchless and furious approach to life could—and perhaps would—paint the end of life as a sort of non-life, in which one was simply dropping their last grains through the hourglass. But here, in the subtle California winter, was something much more hopeful. Here was a man soaked in the world, feeling the breeze on his face, the sun on his skin. Here was the powerful and mysterious sunset, gone unnoticed for so much of our lives, now gazed upon for all its fiery grandeur. “All life,” Thomas Wolfe writes in his novel, Of Time and the River, “all living, the river… full of strange tragic time is flowing by us – by us – by us – to the sea” (Wolfe, Reference Wolfe2016). Yet the image of this man's life, of this man's remaining time, was not that of an emptying river. It was that of the wonder, the glory, the deepening sky, and the sun-drenched clouds.

For this man's life—like any of our lives—was not a mere succession of moments, discrete and piled atop one another like stones. I realized this as the man and I sat ensconced in that music of strange and bridgeless time, wrapped up in the million moments, the thousand instances, the hundred comforts and joys of what felt like a ceaseless moment. From that humbled perspective, staring toward the darkened remnants of the western horizon, I saw my grip on time dissolve with comforting instancy.

It did not matter that the clock was ticking.

Yet I had to wonder: what was the meaning of this realization? I could see the now starlit sky above me, sense the growing chill around me, hear the evening birds beside me, smell the wintry wind about me—but I could not feel time. I found myself cognizant, with uncanny precision, of my internal movements. Breaths, heartbeats, the twitching of rebellious muscles—all seemed more real, significant, than ever before. But what had changed? What was happening?

In the moment, I could not know. I could only look at the man beside me: his cognitive and communicative faculties altered by a growth in his brain, seeming to exist in this infinite space. So much was transpiring in these uncounted seconds, these pulses of beauty and experience, that time was both filled and dissolved. Was this presence? Or was it, perhaps, the revealing of time for what it was? Not a quantified and limited entity—at least, not in the way the two of us were experiencing it—but rather a creation of sorts, formed through our immersion in a moment.

“Thus time has its roots in experience,” Wolfe writes, “and yet appears to be a dimension in which experiences and their contents are to be arranged” (Wolfe, Reference Wolfe2016). In that moment, I was living the truth of Wolfe's words. But it might be more accurate to say the moment was borne out of my living. Such a statement may sound airy and philosophical, but it has important meaning for the end of life. For end-of-life care is not, at its core, about the quantity of one's remaining life. It is about the quality, the meaning, the living of that life.

In both cases, of course, what we are dealing with is time: either the amount we have, or the way in which we use it. Yet perhaps we should not think about how we are spending time in the first place (as if time were a form of currency), but how we are creating and shaping it. Creating and shaping experiences, joys, and comforts, which, instead of taking up a finite quantity of remaining moments, actually give form to those moments. Another abstract notion, no doubt—but I have witnessed its life-giving power. For in gazing towards a magnetic sunset, not far from the closing of his own life, the man before me had achieved the complex balance of perceiving a moment, knowing its goodness, and living it to the full.

At least, that is what I thought as I rolled him back to the house. In the warm and well-lit comfort of his room, I set out a small table and prepared his dinner. A bit of chicken, some vegetables, a chunk of mashed potatoes. He ate slowly, passively, minutes for a single bite. Once more I began to feel the moment stretching thin. I wondered what time it was, how long this dinner would take. I worried that my shift would run longer than expected, taking precious moments from my Saturday night.

Then I looked at the man, who was chewing slowly but purposefully, and I drew a deep, knowing breath. We sat there in silence, until I finally spoke.

“That was a lovely afternoon out there, wasn't it?”

“Yes,” he said, closing his eyes with a nodding affirmation. “A wonderful time.”