In trauma surgery, we learned of “The Golden Hour.” Based on experiences from war and urban penetrating trauma, it was clear that the sooner a patient reached care after injury, the better their chance of survival. Advanced prehospital systems utilize front line providers and rapid evacuation, as well as designated trauma centers to achieve this goal. Improved survival rates from devastating injuries in Iraq and Afghanistan have left us with many young men and woman who are alive but may require extensive rehabilitation. Nonetheless, by using time to set a standard for performance, we can do miraculous things.
The opposite exists in Haiti, yet in some ways, it aids in matching available resources with patients who are most likely to benefit from them. On my first day, I saw two significant moped accidents just on my trip from the airport. Throughout my stay, we would hear of a Tap Tap accident and realize that a number of injured would die before arriving at the hospital. Those that reached us would have self selected by having stronger cardiovascular reserve and more distal orthopedic injuries. On the few occasions that a significant trauma would reach us, we had the difficult issue of limited ventilator capacity and blood banking. Similar to what we needed to do with the neonate with meconium aspiration and anoxia, aggressive intervention was not an option.
Last evening, however, I realized there was another Golden Hour – the times just before sunset and just after sunrise, when the low angle of the sun casts a golden glow over the world. Photographers use these times to stage ads, as the product takes on a warmth that emphasizes its beauty. I was coming out of Cuban Revolution around 8 and saw a rainbow, stretching across downtown. By the time I got the camera, the rainbow had disappeared, but the colors around me had softened. I appreciated nuances of architecture that I had driven by multiple times without noticing.
We think about the bright light of midday, and feel its heat. But if you look at pictures taken of someone at those times, they are often squinting, and may seem less than comfortable. Think of your own favorite moments – perhaps it is fresh coffee at dawn, or gazing over water as the sun sets. In any case, time has been your ally – it uses light to give you a golden hour of transition and enhanced beauty, then gradually lets it slip away, until you are able to experience again in the future.
When you next look at your watch, pause for a moment and appreciate what the passage of time has done for you today, and how it will lead you to tomorrow.
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