In this chapter, published in the book Timescapes of Health, Illness and Care, edited by Katherine Kenny, Mia Harrison and Anthony K. J. Smith, we put forward the argument that, in the field of health, time is neither a neutral backdrop nor an objective given that simply ‘is there’, but rather a fragile, situated and labour-intensive construction. Contrary to the modern, medical view that treats time as linear, external and homogeneous, the text proposes understanding temporality as the effect of the interplay between multiple heterogeneous elements: protocols, technologies, bodies, domestic routines, databases, clinical criteria, political decisions, infrastructures and affections. In this sense, time does not precede action: it emerges from it. 

Drawing on a critical review of the sociological and STS literature on time and health, this chapter identifies three main strands: studies on the measurement and organisation of care time; critiques of the idea of linear and sequential time; and work demonstrating how socio-technical arrangements reconfigure the temporal experiences of patients and professionals. On this basis, the authors refine a crucial conceptual distinction between ‘time’ and ‘temporality’. Time corresponds to the chronological measurement of actions or processes — the clock, the calendar, deadlines —; temporality, on the other hand, is the relational framework that arises from the association between diverse entities. It is, to put it bluntly, the way in which a network causes processes to persist, accelerates, interrupts or coordinates them. 

We propose the notion of a ‘sensitive trajectory’, inspired by Maria Puig de la Bellacasa’s notion of a ‘matter of care’. This concept refers to those vulnerable and precarious points of articulation through which a temporality is sustained in practice. These trajectories are ‘sensitive’ because they depend on delicate adjustments between humans and non-humans, and because their continuity is never guaranteed: it must be nurtured. This compels us to look at details that are often rendered invisible — documents, identity cards, computers, records, cleaning, meetings, spreadsheets, diagnostic devices — which enable a clinical or political situation to remain coherent over time.

Empirically, the argument is developed through long-term ethnographic research into the Chilean healthcare system and, in particular, the GES scheme. This research demonstrates that the promise of access, continuity and prioritisation of care depends on complex synchronisation between multiple temporalities: that of the patient and their daily life, that of healthcare staff, that of medical tests, that of computer systems, that of protocols and that of ministerial decisions. A hospital case study reveals that the continuity of treatment is only restored when such seemingly minor elements as an identity card, a file, a database and a nurse’s interpretation are aligned. Another example shows how strategic actors can accelerate healthcare priorities; whilst further examples demonstrate how point-of-care technologies, regular meetings, minutes and forms can help to achieve synchronisation or continuity.

What we call ‘time’ in Matters of Time is a socio-material construct that is constantly subject to friction, inequalities and power relations. Sensitive trajectories help to explain how temporal ambiguity is resolved at a local level and how certain temporalities manage to prevail over others. Rather than treating time as a technical or biological variable, this chapter frames it as an analytical, political and ethical issue. To put it another way: in healthcare, time does not merely matter; it must be nurtured.