A confusion of tenses: Health screening and time

Abstract

The article seeks to contribute to a re-evaluation of the role played by the contemporary health screen by exploring its relation to tense and time. Mobilizing data around operational aspects of screening for type 2 diabetes (T2D) alongside more general historical and conceptual perspectives, it challenges implicit assumptions that the screen represents either a momentary 'cut' in a longer process or a singular event with its own durational integrity. In contrast, the article argues, two distinct kinds of temporally related processes merge within any given screening episode. On one hand a rich heterogeneity of durations - physiological, technical, social, experiential - is involved. Yet this multiplicity is afforded unity and coherence insofar as the screen becomes a 'thick' site of intersection or fusion between the three major tenses. Drawing on aspects of the thought of Bergson and Deleuze as well as Mol's notion of 'ontological politics', the article reconceptualizes the screen as a 'leaky receptacle' for temporal complexity and teases out pragmatic implications of such a re-envisioning.

A Deleuzian rethinking of time in healthy lifestyle advice and change

“…Though a focus on time is relatively rare in health research (Stronge, ), biomedical research reports unstable and non‐linear processes in healthy lifestyle practices (e.g., Dombrowski, Knittle, Avenell, Araújo‐Soares, & Sniehotta, ). A similar pattern is found in the context of ill health.…”

“…Stronge's () research with people undertaking health screening also identified tensions arising from complex temporalities, as feared futures and past histories were experienced in an uncertain present for people awaiting screening‐test results. People negotiating lifestyle advice after coronary heart disease also showed a simultaneous drawing on of past, present, and future capacities.…”

“…One implication of Spinoza's monism for health is that there can be no cognitive or intellectual experience that is not also embodied, dissolving distinctions between mind, body, and emotion. Temporality is therefore always embodied and affective, with past and future experienced as dimensions of a living present (Loewen Walker, ; Stronge, ).…”

“…Events open up rather than close down possibilities, as the virtual is actualised in processes of becoming, producing new virtualities that increase the potential for further, novel actualisations. This novelty “is what time is if anything at all: not simply mechanical repetition, the causal effects of objects on objects, but the indeterminate, the unfolding, the emergence of the new” (Grosz, , p. 230), troubling the certainty of health promotion's linear predictions (Adams et al, ) and accounting for experiences of multiple, embodied temporalities of health (Jowsey, ; Stronge, ).…”

“…For example, they analysed motivational statements relating to time, such as "every day is a fresh start," as negating the failed past self while bringing the (potentially) successful future self into the present. Stronge's (2012) research with people undertaking health screening also identified tensions arising from complex temporalities, as feared futures and past histories were experienced in an uncertain present for people awaiting screening-test results. People negotiating lifestyle advice after coronary heart disease also showed a simultaneous drawing on of past, present, and future capacities.…”