2000 Thomas G. Wharton Memorial Lecture

“Now Is Forever?”

Richard G. L. Chan
Oyster Bay, New York

It is an honor and a privilege to deliver the Thomas G. Wharton Memorial Lecture this year. Who was Thomas G. Wharton? Thomas Wharton was not a perfusionist but a true friend of our profession. He served at various times as executive director for the Journal of Extra-Corporeal Technology, the American Society of Extra-Corporeal Technology and the American Board of Cardiovascular Perfusion during the critical developmental years of the perfusion profession. Working for the various organizations was not just a job for Tom but a commitment – a virtue often missing today in the business world. What separated Tom from the rest in his field was his sincere passion, appreciation, understanding and respect for our profession.

He was visionary in donating a large sum of money in 1979 to start an organization called “The American Academy of Cardiovascular Perfusion”. Unfortunately, the same year Tom died of a heart attack, and never witnessed one of his dreams. I hope my humble message today in honor of Thomas G. Wharton will be worthy of his legacy.

We all have moments of fantasy of time travel. A time machine would be so handy to visit a departed loved one, reliving a special experience, correct an awful mistake or see what the future has in store for us. Hollywood scriptwriters adore the fantastic possibilities. What if we were able to travel back 65 million years ago and deflected an asteroid before it smashed into the Earth and shrouded the planet into darkness. There may not be a need for Steven Spielberg’s Jurassic Park. After 50 years since the theory of time travel gained respectability, scientists still haven’t made up their minds about the possibility of time travel. Newton’s Mechanics or Dynamics, Einstein’s special theory of relativity and quantum mechanics would all appear to work equally well with time running in reverse. Experiments conducted in spacecraft with atomic clocks proved time dilation or slowing down of time with acceleration. This confirms the special theory of relativity, unveiled in 1905. However, some scientists suggested that the time-reversible laws of motion are an idealization that is never realized because of the second law of thermodynamics. Basically, it says a cup of coffee always cools and aroma always spreads or becomes less concentrated.

In a critically acclaimed new book, “The End of Time”, written by a physicist, Julian Barbour, the concept of time is put into a radically new perspective. He claims time is a derivative of primary constituents of change and structure. Redefining Einstein’s general theory of relativity and quantum mechanics, he proposed that “the quantum universe is timeless.” Barbour argues that each possible arrangement of all particles in the universe corresponds to an instant of time. It is a “NOW.” Put all the NOWS together and they form a kind of external continent-platonia he calls it. This continent is overtly asymmetric, terminating at very special “NOWS,” in which all the particles in the universe coincide. The Big Bang, Barbour says, is not an event in the past, it is simply this Land’s End of Platonia. This is an intriguing way to view the puzzle of time’s arrow. It would not arise because there is really no flow of time but simply from the way a timeless form of quantum mechanics allots the probabilities for the different NOWS to be realized, or to be “experience.” Whether one believes this timeless concept or not, Barbour helps us to understand and appreciate the essence of NOW and the importance of “today.”

Albert Einstein said, “I never think of the future, it comes soon enough.” Consider another quote from Robert J. Hastings: “Tucked away in our subconscious is an idyllic vision. We see ourselves on a long trip that spans the continent. We are traveling by train, out the windows we drink in the passing scene of cars on nearby highways, of children waving at a crossing, of cattle grazing on a distant hillside, of smoke pouring from a power plant, of rows of corn and wheat, of flatlands and valleys, of mountains and rolling hillsides, of city skylines and village halls.”

“But uppermost in our minds is the final destination on a certain day at a certain hour. We will pull into the station. Bands will be playing and flags waving. Once we get there so many wonderful dreams will come true and the pieces of our lives will fit together like a complete jigsaw puzzle. How restlessly we pace the aisles, damning the minutes for loitering … waiting, waiting, waiting for the station.”

“‘When we reach the station that will be it!’, we cry, ‘When I’m 18’, ‘When I buy a new Mercedes …’, ‘When I put the last kid through college’, ‘When I have paid off the mortgage!’, ‘When I get a promotion’, ‘When I reach the age of retirement, I shall live happily ever after!’ Sooner or later we must realize there is no station, no one place to arrive at once and for all. The true joy of life is the trip. The station is only a dream. It constantly outdistances us. It isn’t the burdens of today that drives men mad. It is the regrets over yesterday and the fear of tomorrow. Regret and fear – rare twin thieves who rob us of today.”

Tennessee Williams said, “The future is called ‘Perhaps’ which is the only possible thing to call the future. The most important thing is not to allow that scare you.”

If we approach our NOWS as if it is forever and put all our energy and focus on today, there will be fewer pessimists in this world. James Cabell once said, “The optimist proclaims that we live in the best of all possible worlds, the pessimist fears this is true.” This reminded of one of Charles Reed’s comments after one of my presentations, “Richard couldn’t make up his mind whether the glass is half full or half empty …” Today I am sure my glass is at least half full and make every effort to improve the water line.

What shall we do with our NOWS? If we believe our glasses are half-empty, we may think about the seven deadly sins: arrogance, greed, lust, anger, gluttony, envy and sloth. Or if our glasses are at least half full, we should look to the opposite of the seven sins or the seven virtues: humility, generosity, restraint, kindness, moderation, love and diligence.

Humility is probably one of the most difficult virtues to practice but the most important. It is the essence for all the other virtues. Without humility, we stop listening to others for advice, we stop gaining knowledge and we stop loving. Lack of humility is the reason for all the conflicts amongst the perfusion organizations today. If we listen, respect and take time to study and understand each other’s positions, there will be very little conflict. In its place, there will be collaboration and respect. The profession and our patients would have benefited.

When I think of generosity, I think of a great baseball player named Roberto Clemente. He was much more’ than just a great baseball player. Roberto spent much of his time away from baseball in helping others. The poor and homeless were high on his list of attention. In 1971, he said, “Any time you have the opportunity to accomplish something for someone who comes behind you and you don’t do it, you are wasting your time on this Earth.” He died, shortly after this speech, in a plane crash; the plane was loaded with food on its way to a third world country. Professionalism means helping, cultivating, reaching out, teaching and whatever means required to achieve the highest level of quality of performance. In our case, it is the highest quality of patient care. We cannot achieve it without teaching and helping those who “come behind us.” This is what medical education is all about. This is patient care. Generosity means giving and giving of ourselves freely. This is the only way quality of patient care will survive.

Restraint can be used in many ways. Sometimes, restraint in our criticism of our peers may mean the difference between a smooth working team and a disillusioned team. The conflicts amongst the national organizations illustrate this point to a more critical level. Restraint in perpetrating rumors about people is certainly a virtue we all need to work on. “Great people talk about ideas, average people talk about things and small people talk about other people.” Professionalism is about restraint

Having kindness instead of anger. How often do we hear that to right a wrong, we must “get angry.” Maybe too often, I believe. Sometimes acting in anger is worse than not acting at all. Often many wrongs are merely mistakes. We need patience to discover facts and have the humility to admit mistakes. Powerful personalities unleashed belongs to Hollywood scriptwriters and not in a perfusion department.

Perhaps moderation may mean allotment of our resources and time. How often we want to “do it all!” A reality of life is time management. We soon realize we cannot “do it all.” Moderation or a balance of our resources to achieve goals that are realistic should be a constant checklist on our mental agenda. Profession, social, family, spirit and health are the five balls of life that need constant juggling up in the air. Not too high and not too low.

Charity, love or respect for our fellow man is a virtue more needed than ever in this intense and complex society. How helpful it would be if we would begin to reach down with charity instead of looking up with envy. It should feel wonderful to help those people who are less fortunate, less healthy, or less clever. Orienting ourselves to the protection and help of those who are less able emphasizes giving instead of getting producing two winners – the benefactor and the beneficiary – instead of just one or none.

I saved diligence as the last virtue because it must be the focus of our existence. It must be the focus for our NOWS. Forget about the regrets of yesterday and be less fearful of tomorrow. Let us exercise our resources, energy and passion on today.

Imagine there is a bank that credits your account each morning with $86,400. It carries over no balance from day to day. Every evening the bank deletes whatever part of the balance you failed to use during the day. What would you do? Draw out every cent of course. Each of us has such a bank. Its name is time. Every morning it credits you with 86,400 seconds. Every night it writes off as lost whatever of this you have failed to invest to good purpose. It carries over no balance. It allows no overdraft. Each day it opens a new account for you. Each night it burns the remains of the day. If you fail to use the day’s deposits, the loss is yours. There is no going back. There is no drawing against “tomorrow.” You must live on the present – on today’s deposit. Invest it so as to get from it the utmost health, happiness, and success! The clock is running, make the most of today.

To realize the value of one year, ask a student who failed a grade. To realize the value of one month, ask a mother who gave birth to a premature baby. To realize the value of one week, ask the editor of a weekly newspaper. To realize the value of one hour, ask the long lost family members who are waiting to meet. To realize the value of one minute, ask a person who missed the train. To realize the value of one second ask the person who just avoided an accident.

Think of all the events in your life. And think about the passage of time. How quickly it seems it all becomes now. We need to focus on NOW. “Whereas ye know what shall be on the morrow? For what is your life? It is even a vapour that appeareth for a little time and vanisheth away.” (James 4:14) “For a thousand years in you sight are like a day has just gone by or like a watch in the night.” (Psalms 90:4)

The year 2000, some believed, begins the next thousand years: a time to work, a time to play, and a time to love. NOW is the time to start living life to the fullest and to use every second of the rest of your life to the fullest to make yourself a better person and make the world a better place for all people.

“So, stop pacing the aisles and counting the miles. Instead climb more mountains, eat more ice cream, go barefoot more often, swim more rivers, watch more sunsets, laugh more, cry less. Life must be lived as we go along. The station will come soon enough.” (Robert J. Hastings)