Orchestrating Time in the Genomic Era: Timescape Perspective on the Changing Practice of Hereditary Breast Cancer Prevention

In the course of history, human beings have lived in any number of time constellations. Time has been perceived as cyclical, eternally recurrent, eternity itself, linear (an arrow pointing forward or backward), absolute and mathematical, intrinsically flexible, duration, a succession of nows, simultaneity, or accumulation. The time constellation that people live in does not necessarily resemble the temporality of their life, and temporal tensions thus appear to be part and parcel of the human condition. Throughout human history, concern about precisely these tensions has engendered philosophical and practical reflections on how to live well in a plurality of temporalities. Ancient Hellenistic literature refers to the meticulous care devoted to attuning bodily rhythms related to food, sleep, procreation, sexuality, and mortality to the natural rhythms of the seasons, months, and hours of the day.¹ More recently, attuning bodily rhythms to clock time has been the subject of sociological and anthropological research.²

As a result of temporal changes introduced by information and communication technologies and new reproductive and DNA technologies, the issue of how to deal with the complex temporalities of life has once again become imperative.³ The temporal tensions that these technologies generate are only just coming into view—for example, in the work of Barbara Adam, Zygmunt Bauman, Thomas Eriksen and Zaki Laïdi. Some of the authors argue that these new technologies produce time constellations where a particular time prevails—that is, a worshipping of the present.⁴ Others suggest that rather than producing new time constellations, new technologies add new time aspects to the existing plurality of temporalities.⁵ In their view, notions of causal, linear time coexist with those of cyclicity and the idea that we only live in the present. Since the various time concepts differ too much to be reduced to one notion of time, the tensions arising from this proliferation of temporalities cannot be simply solved by good time management: a more comprehensive orchestration is required.⁶

In this article, I start from the assumption that individuals draw their fundamental attitude toward time from a social organization of time. My focus is on how to appreciate a plurality of heterogeneous times in the present-day time constellation that highlights the present while also encompassing a range of other temporalities. This is why I have reread empirical literature on hereditary breast cancer and examined the temporalities and time frictions that women with a family history of breast cancer have to deal with in a particular time constellation. From a time perspective, I have reinterpreted empirical data of the early 1990s as well as contemporary records to explore the arrangements that women have discovered or created in the course of time to connect bodily and social rhythms to temporalities introduced by breast cancer screening programs, theoretical epidemiology, risk management, ICT, and DNA tests. What can we learn from these time arrangements in terms of living well?

Timescapes

Following Barbara Adam, Helga Nowotny, Julius T. Fraser, and others, my point of departure is that time is a plurality of heterogeneous time concepts and experiences. Rather than living in one kind of time, we live in what Adam calls timescapes—that is, temporal landscapes made up of a multitude of rhythms and temporal activities that interact and collectively constitute the whole. Perceiving time as timescapes makes it possible to see that every level and facet of our existence is permeated by the many rhythms and temporalities that give our life a dynamic structure: they constitute temporal frameworks in which activities are not only organized and planned but also timed and synchronized at varying speeds and intensities, and orchestrated to intricate scores of beginnings and ends, sequences, durations, and breaks. All the various aspects interpenetrate and have a bearing on each other. They all coexist and are lived simultaneously.⁷

As in a hologram, a timescape is encoded and interwoven in all its temporal parts, each of which contains, implies, and resonates the information of the whole. Even absent or invisible activities are included.⁸

The creation of a timescape...