Racing Time — Living Between One Heartbeat and the Next

Time = our most precious resource.

One of the strangest things about chronic illness — and especially life after transplant — is how completely it changes your relationship with time.

For healthy people, five minutes is enough to make coffee and complain about traffic.

For me, during the worst COPD years, five minutes could feel like an entire geological era spent negotiating one inhalation at a time.

When breathing becomes difficult, time stretches.

Every staircase becomes a project.

Every shower becomes logistics.

Every sentence needs budgeting.

Healthy people measure time by clocks.

Lung patients measure it by oxygen.

Today, with transplanted lungs, time feels different again.

Not infinite.

Not dramatic.

Just expensive.

A resource too valuable to waste on nonsense, on people who drain energy, or on shallow “everything happens for a reason” advice from people whose biggest respiratory challenge was jogging once in 2014.

I manage life differently now.

Almost like a long-term strategic project.

Clear priorities.

Risk management.

Energy allocation.

Retention strategy for staying alive with reasonable quality.

Forty years in marketing and client management apparently prepared me well for transplant medicine. Same basic principle:

Pay attention to the systems before they collapse.

The science behind this distorted sense of time is actually fascinating.

Cognitive psychology describes something called “time distortion” during respiratory distress.

When oxygen levels drop, the brain shifts into survival mode. Processing slows down. Attention narrows. The nervous system becomes hyper-focused on immediate bodily function.

In simple terms:

The brain stops caring about abstract future plans when it is busy trying not to suffocate.

Time becomes painfully physical.

Seconds become noticeable.

Anyone who has struggled for air understands this instinctively. A short episode of breathlessness can feel endless because the nervous system experiences respiratory distress as existential threat.

And chronic illness changes perception more permanently too.

Research on chronic disease patients shows increased awareness of present-moment experiences. Not because we all become enlightened Zen monks.

Because survival trains attention aggressively.

You notice breathing.

Temperature.

Energy shifts.

Fatigue.

Small sensory details.

One clean breath suddenly becomes emotionally significant.

Not poetic.

Neurological.

Then transplantation introduces another strange phenomenon:

Borrowed time.

Many transplant patients describe feeling as if life restarted unexpectedly. The clock begins moving again, but with different emotional weight.

You understand, very concretely, that continuation is not guaranteed.

Oddly enough, psychology research shows that people with this heightened mortality awareness often experience stronger appreciation for ordinary experiences — something linked to what researchers sometimes call the “gratitude effect.”

Not gratitude in the motivational poster sense.

More practical gratitude.

Coffee tastes better when you remember oxygen tubing.

Walking outside feels different after years of measuring distances by available benches.

Even boring things become slightly miraculous.

Standing in line at a pharmacy while breathing normally. Incredible luxury.

This shift affects everything I do now.

Including writing.

When I work on my biographical thriller, I feel time physically moving through my hands.

Every scene becomes proof that I am still here.

Still breathing.

Still building something.

Writing freezes moments before they disappear.

The smell of old paper.

The color of sunset in San Diego.

The strange silence after transplant surgery.

Sensory details became my way of preserving time before it slips away again.

Because illness teaches you something uncomfortable:

Memory is fragile.

Bodies are fragile.

Energy is fragile.

So attention becomes important.

Very important.

Of course, my optimism remains cautious.

I am not naïve enough to think everything will always be fine.

These lungs are an extraordinary gift, but they did not arrive with a lifetime warranty card.

I understand perfectly well that transplant medicine is management, not magic.

That is why I have very little patience for miracle solutions, wellness slogans, or inspirational nonsense disguised as medicine.

Forty years in consulting taught me the same lesson repeatedly:

Results come from precision, consistency, adaptation, and hard work.

Not slogans.

Not hashtags.

Not smiling aggressively at adversity.

My cynicism mostly activates when people try selling emotional shortcuts to biological complexity.

The body is more stubborn than that.

And there is another technical aspect nobody likes talking about because it sounds boring:

Physical metrics directly affect psychological experience of time.

When my glucose drops toward 70, time changes immediately.

Thoughts slow down.

Concentration becomes heavy.

Patience — already not my strongest feature — disappears completely.

The world feels delayed, sticky, mentally expensive.

I learned the hard way that good time management actually begins with metabolic management.

If I want two productive hours writing, reading, or concentrating, the body needs fuel first.

Correct glucose.

Hydration.

Reasonable sleep.

Stable oxygenation.

People love separating “mind” and “body” as if they are different departments in a corporation.

They are not.

The brain is part of the body.

Which means existential despair occasionally improves after carbohydrates.

Very philosophical.

One important lesson chronic illness teaches brutally well is prioritization.

You simply cannot afford waste anymore.

Not wasted time.

Not wasted energy.

Not emotionally expensive relationships.

At some point you become ruthless about priorities.

And honestly, that is not entirely bad.

You learn to say no faster.

You stop attending things out of obligation.

You stop investing energy in people who continuously drain it.

Time becomes currency.

And your reserves are finite.

Another thing I learned:

Small victories matter enormously.

Walking 500 meters matters.

Writing one strong paragraph matters.

Finishing a difficult day without collapsing emotionally matters.

Healthy people wait for giant milestones before allowing themselves satisfaction.

Patients learn differently.

Sometimes victory is simply making coffee without needing to sit down halfway through.

Celebrate that.

Seriously.

Pause for a minute.

Smell the coffee.

Notice the sunlight.

Tiny victories accumulate quietly into survival.

Flexibility matters too.

The body sometimes interrupts your plans without consultation.

You wake up exhausted.

Breathing feels heavier.

Energy disappears unexpectedly.

If illness teaches anything, it is adaptive scheduling.

Plan your days with margin.

Leave room for setbacks.

Try to complete the important things early because the body occasionally declares bankruptcy by afternoon.

This is not pessimism.

It is operational realism.

And maybe that is the real relationship with time after severe illness.

You stop fighting the clock.

You learn to cooperate with it.

To work alongside it instead of pretending you control it.

Whether you are waiting for transplant, recovering from one, or simply learning how to live inside damaged lungs, every ordinary minute becomes strangely valuable.

Not because life suddenly becomes magical.

Because you finally understand it was never unlimited in the first place.

And somewhere between one heartbeat and the next, between one breath and another, life continues quietly asking the same question:

What are you going to do with the time you still have?