Accelerated Aging, Debilitation, Slow Death, and the Multiple Temporalities of Aging Incarcerated Persons: A Philip K. Dickian Science Fiction Examination

ABSTRACT

Prisons are debilitating and disorienting spaces. Temporal realities themselves are altered from those of the outside world. This paper builds upon a study of prison staff work with aging incarcerated persons in Canadian federal penitentiaries, wherein the prison environment itself contributes to accelerated aging and slow death. Simultaneously, temporal experiences in prison both slow and become cyclic, rhythmic. These multiple temporalities flow independent of the “outside” world, which, from the perspective of incarcerated persons, accelerates. To reconcile these multiple, conflicting simultaneous temporalities, we turn to science fiction, specifically the works of Philip K. Dick, to build a conceptual world where such paradoxical temporalities coexist. A bricolage approach is adopted to interrogate these temporalities, and their effects on incarcerated persons, including debilitation and institutionalization, and the production of persons often incapable of transitioning back to the “real” world outside of prison. Proposals for both nursing practice and future research possibilities are provided.

1. Introduction

To begin, allow us to present a piece of science fiction:

William Cardinal's sanctions relegated him to the nearby moon Autunia, a colony that purported to “improve the moral hygiene of those who have lost their way.” His quarters were a small room in a large atrium of similar rooms, also occupied by fellow sanctions, part of a larger, self‐contained outpost. It was considered unsafe for him or others to leave the heavily protected compound to the surface of the moon. He immediately noticed a significant shift in his perceptions of time. Something about the orbit of the planet, they said. Time moved incredibly slowly. It was as if a single day stretched across dozens of hours. Simultaneously, time was cyclic, not linear. Every 7 days the cycle repeated, the schedule of each day identical from one cycle to the next. He attended brief information sessions on moral hygiene, spent time in a sparsely populated gymnasium and consumed scheduled meals. The remainder of his time was spent alone in his quarters, contemplating the extreme boredom. From one cycle to the next he felt and witnessed himself aging at a rapid pace. Those around him, too. People quickly grew old, and many died in their quarters, replaced by someone new, who also aged rapidly. William questioned his perception, even his sanity: what was this planet doing to him? How could time function this way? He eventually settled into a routine of tepid malaise, having grown accustomed to his slow days, the cycle, his rapid aging, his degenerating body. One day a facility staff member informed William he was successful in his reforms and could return to his home planet. Upon arrival, however, he was shocked to see that time had accelerated – nothing was the same, technologies had advanced so as to be unrecognizable. This new world overwhelmed him, and he found himself longing for a return to Autunia.

This hypothetical, fantastical tale presents a world (or several worlds) in which multiple temporalities operate simultaneously. And while such a creation may appear to belong only in the realm of science fiction, we argue that such is the reality (or several realities) of persons serving lengthy prison sentences. The temporal experiences of William Cardinal reflect those of incarcerated persons (IPs): the slow passage of time, the cyclical nature of the prison schedule, accelerated aging, slow death, and the shock associated with release into the “real” world. Much like prison, they are disorienting, debilitating, even disabling.

We present this paper as a bricolage in the aftermath of a study conducted of aging prison populations in Canadian federal institutions. This operation of multiple temporalities in prisons proves paradoxical, if not disorienting. Bricolage, according to Lapoujade (2024), is “to patch together whatever you find scattered amidst the debris” (p. 130). No single theoretical framework can thoroughly explain the various phenomena at play in the worlds of aging IPs, so we turn to science fiction to piece together a framework of what Souriau (2015) described as existential pluralism. In particular, the work of American author Philip K. Dick (1928–1982), whose often paranoid flavor of science fiction we have attempted to emulate here provides the opportunity to imagine worlds in which time is experienced in multiple, simultaneous, and terrifying ways. Dick's fiction operated in the creation of psychically disorienting, unstable, and uncertain worlds into which unwitting protagonists are thrust and forced to reconcile (if at all possible) their new realities. “The advantage of [science fiction], for Dick, is that the real world is only ever one world of many, and not always the most ‘real’ among them” (Lapoujade 2024, 9). Based on our present work and that of other prison scholars, we attempt to piece together the disorienting and debilitating experience of an incarcerated life. We acknowledge that not all persons experience prison in the same manner, and many experience release and transition from incarceration in constructive ways (Maier 2021). However, our present study focused on older persons in prison environments, many of whom had spent significant time—some several decades—incarcerated, which had profound impacts on their health, institutionalization, rehabilitation, and ability to transition to the community (if at all).

Here, we will explore five temporalities of the prison environment, considered through both the lens of our study of aging prison populations in Canada and that of science fiction. We suggest that such paradoxical and conflicting experiences of time require the fantastical to properly examine. First, we will examine the experience of slow time in prison, wherein the boredom of day‐to‐day life stretches temporal experiences. Next, we will explore the cyclical experience of time, dictated by rigid prison schedules. Third, we consider the phenomenon of accelerated aging and the concept of debility for IPs. Subsequently, we explore the linked but opposed concept of slow death. And finally, we explore the fast world outside of prison in the context of IP institutionalization and the challenges faced upon release. Much like the characters in Philip K. Dick stories, we act as bricoleurs (Lapoujade 2024), piecing together scattered concepts and theories to produce this work of seeming science fiction, including Berlant (2007), Puar (2017), Guenther (2013), Carceral and Flaherty (2021), Foucault (1995), Lapoujade (2021, 2024), Goffman (1961), and Souriau (2015).

2. The Present Study

In advance of our examination of temporalities, we present the study on which this exploration is founded. In this work, the first author (Johansson 2024) explored the challenges aging IPs faced in accessing both healthcare in—and early release from—federal prisons in Canada. Under Canadian law, any person convicted of a crime and sentenced to 2 or more years in prison is detained in a federal penitentiary, operated by the Correctional Service of Canada (CSC). The federal prison population in Canada is aging, with those IPs aged 50+ comprising a large and growing proportion of the overall population (Correctional Investigator Canada and Canadian Human Rights Commission 2019; Public Safety Canada 2023). While the age of 50 is not considered “old” in the general population, among IPs this is the widely accepted benchmark, related to the concept of “accelerated aging” (Burles and Peternelj‐Taylor 2019; Merkt et al. 2020; Turner et al. 2018). This “old” prison population faces a higher prevalence of chronic and infectious illnesses than their non‐incarcerated peers (Correctional Investigator Canada and Canadian Human Rights Commission 2019; Iftene 2017). Prisons are not constructed or staffed to meet the needs of aging IPs, leaving many without adequate access to healthcare. The average age of death in federal custody is 60 (Correctional Investigator Canada and Canadian Human Rights Commission 2019). Proposed solutions include improved access to early release for this population, yet this is rarely granted (Correctional Investigator Canada and Canadian Human Rights Commission 2019; Office of the Correctional Investigator 2020).

This research examined the experiences of 13 CSC staff working with aging IPs across Canada. The inclusion of IPs themselves was beyond the scope of this study, given the challenges of conducting critical prison research in Canada (Perron et al. 2015; Waldram 2007); inclusion of IP experiences is based upon the work of other scholars and those with lived experience. Participants in our study included nurses, physicians, psychologists, and correctional officers. A thematic analysis methodology, following Riessman (2008), was implemented. Participants engaged in semi‐structured interviews, ranging from 25 to 105 min, with an average length of 41 min. All participants provided informed consent. Participants were publicly recruited, given the significant challenges faced in conducting prison research with official CSC approval (Waldram 2007, 2009). This consisted of contacting potential participants via professional networks, agencies representing participant professions, and subsequent snowball recruitment (Speziale et al. 2011). Aware that this research occurred independent of CSCl, participants conducted interviews outside of CSC work time or facilities. Research ethics board approval was provided for this study (University of Ottawa #H‐03‐22‐7624). This method of recruitment is an acceptable alternative to formal partnerships with total institutions (Goffman 1961), which are by definition secretive and paranoid institutions (Perron et al. 2015). Several participants (or interested participants) indicated that participation in CSC research outside of agency approval could lead to sanctions or even termination of employment. As such, significant efforts are made to protect participant identities; direct quotes used here may have been modified to preserve participant confidentiality, demographic information was not collected, and participant occupations are omitted from their numbered pseudonyms. Thematic analysis permits the opportunity to interrogate the intersection of individual encounters with social institutions (Ewick and Silbey 2003; Riessman 2008). These personal narratives exist within broader social, historical, and political contexts. This methodology allows individual narratives to be pieced together into a broader consideration of social processes. Subsequent analysis within a defined theoretical framework can then occur; presently, we mobilize bricolage, which permits the piecing together of multiple theoretical sources to construct our science fiction approach to analysis (Lapoujade 2024; Yardley 2008). Contributions from participants and analysis from this research informed and are woven into our subsequent examination of temporalities.

3. Slow Time in Prison

Philip K. Dick (2008b) novel Martian Time‐Slip, originally published in 1964, in which humans colonize Mars, features Indigenous Martians who inhabit a temporal existence different than that of humans. Their temporality at times moves very quickly, and at other times very slowly, which Lapoujade (2024) described as “at times too slow, idle and beyond repair” (p. 87). Our own protagonist, William, also experiences a dreadful slowing of time on Autunia, filled with idleness and boredom. This slowing of time, this extended boredom is also experienced by IPs, particularly those serving lengthy sentences. Upon entry into the prison environment, as Carceral and Flaherty (2021) described, “one's introduction to this new temporal regime is experienced as a cataclysmic shock” (p. 21). Day‐to‐day existence within prisons is dominated by boredom, which “brings about a dramatic deceleration in the pace of temporal experience” (Carceral and Flaherty 2021, 23). This shock of a new temporal reality is akin to Goffman (1961) concept of the mortification of self upon entry to the total institution, wherein a loss of temporal autonomy brings about feelings of humiliation and degradation.

Time in prison moves slowly and is infected with boredom. In our study of Canadian prisons, Participant 8 noted that many IPs “only get four hours of allotted time out of their cell.” Activities within prisons vary, depending upon the facility and level of security; however, these activities are typically noted to be limited and themselves punctuated by long periods of waiting. Furthermore, our study found that activities and programming are often dependent on adequate prison staffing levels, and are regularly cancelled due to low staff levels, mirroring the findings of Ricciardelli et al. (2025). Carceral and Flaherty (2021) described the movement of IPs within prisons to scheduled activities, such as to meals, gym, or yard as themselves a series of delays and waiting. Waiting for doors to be opened, waiting for other IPs to finish their activities, waiting for correctional officers who often intentionally delay their passage. As Guenther (2013) described, “you are no longer in charge of your own time” (p. 196). The result is an awareness of the slowness of time. Of extreme boredom, punctuated by meals or occasional activities. Some IPs may have assigned work duties, which Carceral and Flaherty (2021) described as events that facilitate the passage of time. For aging IPs, however, this may not be required. In our study, Participant 13 noted “they're not necessarily required to work…they really just kind of, for lack of a better word, sit there and rot.”

Perhaps the most profound slowing and shifting in the perception of time occurs with those placed in solitary confinement (Guenther 2013), or as euphemistically defined in our study, “administrative segregation.” Completely separated from any form of sociality, an IP in solitary enters their own reality, which Guenther (2013) described as a form of “living death.” Those kept in this state of complete isolation are often afflicted with a form of psychosis described as SHU syndrome, named after the Secure Housing Units of American supermax prisons. Guenther (2013) described these symptoms “not just as signs of mental illness but also ontological derangements of time and reality” (p. 198). A state of psychosis often accompanies altered perceptions of time in the works of Philip K. Dick (Lapoujade 2024). In Martian Time Slip, it is only in such a state that a protagonist can enter and understand the altered temporal reality of the Indigenous Martians. On a broader scale, however, an altered state of perception, particularly of time, is present for all IPs separated from the outside world. While we may not describe such a phenomenon as a form of psychosis, it can at least be described as a separate reality. A separation from the “external” world, as Dick (2008b) described, “is a splitting apart of the two worlds, inner and outer, so that neither registers on the other. Both still exist, but each goes its own way” (p. 149). As we explore in a later section, the world inside the prison slows down, while the world outside accelerates.

4. Cyclic Time and the Rhythm of Prison

In our narrative, William experiences cyclical, repetitive time on Autunia; time does not move forward, only in circles based on the routine of the planet. Time in prison flows similarly, based upon the highly regimented weekly schedule. The effect of this disciplinary cycling of time and routine is the institutionalization of IPs. Carceral and Flaherty (2021) described this scheduled regime as totalitarian—determined entirely by the prison administration and imposed upon IPs. In Philip K. Dick (1964) novel The Simulacra, government technologies alter temporal realities; the presidential First Lady appears to citizens as a perpetually young woman in television broadcasts, despite being significantly older. In prison, “ceaseless repetition makes for days that are difficult to distinguish or remember” (Carceral and Flaherty 2021, 22), and IPs who are unable to conform to this temporal regime are subsequently punished.

In our study, aging or older IPs, particularly those on lengthy or indeterminate sentences, were described to adjust to the rhythm of this temporal regime, to adapt in a manner that was nondisruptive to the prison environment. Participant 6 noted, “older life guys just want to hang out and don't want to be bothered with people.” Participant 10 added “older guys are kind of like, we're just here to finish our time, or to just survive.” A lack of disruption or violence facilitates this process, with Participant 12 observing, “if you really want to be in an institution that has almost no incidents, you want to be in an institution that's full of lifers.” In contrast, those who fail to meet prison expectations, be it with acts of violence or disruption, or failure to attend expected programming often extend their incarceration. In our study, a significant focus on risk and risk assessments was identified by participants. Those who adapt to the prison regime are more likely to be classified as low risk and suitable for parole and other forms of release.

This imposition of a strict temporal regime and expectation of IPs to normalize to its rhythm is characteristic of Foucault's (1995) concept of disciplinary power. To Foucault, with disciplinary power, the timetable is a means of controlling activity. The rhythms of time were means of discipline in armies, religious orders, schools, factories, and prisons. It did so via the following methods: “establish rhythms, impose particular occupations, regulate the cycles of repetition” (Foucault 1995, 149). This regulation of time is part of disciplinary power's broader program of correcting—or normalizing—the conduct of persons considered abnormal, deviant, or delinquent. To be considered “corrected” in the disciplinary sense is to fully adhere to the rigours of the disciplinary regime, to be normalized according to its purported goals. In prison, adherence to the rules, display of “good” conduct is a demonstration of correction and a low risk to society upon re‐entry (Rose 1998). This includes adherence, or simply adaptation to the cyclic rhythms of the prison schedule. This development of routine may not be imposed only “from above” in the prison; as Ricciardelli and Memarpour (2016) explored, IPs develop personal rituals and routines as a means of coping to the stresses and restrictions of the prison environment. However, the product of this adherence and normalization is institutionalization (Cooper et al. 2008), with IPs unable to “undo” their conduct upon release, which we will examine in greater detail in the final section. The cyclic repetition of time in prisons, via the weekly schedule becomes internalized and integrated into an IPs conduct, independent of how time functions and shapes persons outside of prison. In our narrative, William becomes accustomed to this rhythm. In Dick (1964). The Simulacra, those who learn of the First Lady's “true” age are unsettled and ask to return to the image of her as a younger woman.

5. Accelerated Aging

In Dick (2008c) novel Ubik, originally published in 1969, a group of workers are killed in a lunar explosion but maintained in a state of half‐life consciousness. These workers, including the protagonist Joe Chip, are initially unaware of their true state and perceive to have survived and returned to earth. However, strange temporal shifts occur, particularly the rapid aging of many of the workers. As Lapoujade (2024) observed, “soon, they are dragging themselves along like elderly people, and then they die and crumple into dust, all in less than twenty‐four hours” (p. 55). In our narrative, William himself experiences accelerated aging on Autunia, though not at the same rapid rate as those in Ubik. While seeming fantastical, this phenomenon of accelerated aging afflicts those in prison, particularly those serving lengthy sentences.

Within prison environments, both in Canada and internationally, the age of 50 is the benchmark for what constitutes “old” (Correctional Investigator Canada and Canadian Human Rights Commission 2019; Stevens et al. 2017; Turner et al. 2018). Though the age of 65 is typically that which is considered “old” among the general population, the stressors of the prison environment, in combination with stressors frequently experienced before incarceration, result in the phenomenon of accelerated aging (Skarupski et al. 2018). Here, IPs present as 7–15 years older physiologically than their chronological age (Burles and Peternelj‐Taylor 2019; Merkt et al. 2020). In particular, chronic health conditions typically seen in a geriatric (aged 65+) civilian population are observed in IPs at a much younger age, including diabetes, obesity, arthritis, chronic pain, and dementia (Correctional Investigator Canada and Canadian Human Rights Commission 2019), as well as infectious diseases such as tuberculosis and pneumonia (Berg et al. 2021). Schnittker et al. (2012) revealed that adverse experience before incarceration, including during childhood, can affect the long‐term health status of IPs. However, Berg et al. (2021) linked negative experiences in prison, particularly experienced or witnessed violence to biological markers associated with accelerated aging. Simply put, the prison environment ages IPs. In Canada, the average age of death in CSC custody is 60 years of age (Correctional Investigator Canada and Canadian Human Rights Commission 2019). IPs who are released are at increased risk of chronic illnesses and death (Berg et al. 2021).

In our study of federally IPs in Canada, participants identified accelerated aging as occurring in the prison population. Participant 2 observed that many “age faster than people you see outside of jail, because of like drug use, like difficult life situations they've had in their lives…after 50 they usually have more health problems.” Participant 8 stated, “being in prison does age a person a lot.” Participant 4 added “sometimes it's hard to tell…the hard life, they age faster and you're surprised, you're like ‘oh you're only 40, but you look 50 plus.’” Significant mental health issues were attributed to the aging prison population, particularly those on lengthy or indeterminate sentences. Participant 6 stated, “some of these guys are older and they spent most of their lives in jail and you know they have to face the fact that they're going to die in jail.”

A corollary to this concept of accelerated aging is Puar (2017) concept of debilitation. Puar differentiates debility and debilitation from disability as they foreground “the slow wearing down of populations instead of the event of becoming disabled” (pp. xiii–xiv). This “wearing down” disproportionately affects marginalized populations, including, we argue, IPs. While some of those affected by debilitation may become disabled, as codified by contemporary definitions of the term, this may not always occur. Instead, Puar (2017) described debilitation “as an expected impairment…expos[ing] the violence of what constitutes ‘normal consequences’” (p. xvi). The experience of incarceration is debilitating, yet this is viewed as a normal consequence of time in prison. For instance, in our study was described the necessity for CSC to conduct a formal investigation of any death in custody, even if related to “natural causes.” Participant 12 offered:

Well, these kinds of investigations – I'll be frank – I found them humorous. Because the goal of the investigation was to come up with recommendations on how to avoid these things in the future, and why I find these humorous is well, if you can find a way to avoid old age, please let me know. If you can find a way of eliminating a heart attack, let me know.

Occurring here is a cognitive dissonance. This participant appears unaware of the contribution of prison itself to the accelerated aging and even death of aging IPs. They are simply the “normal consequences” of incarceration. Accelerated cognitive decline was also associated with the prison environment. Participant 13 offered:

What you see is a lot of dementia, right? A lot of cognitive stuff and it's not helped and promoted by the fact that they've lived a very isolated, non‐stimulating life for years…let's be honest, you live in like a 9 by 9 room, with very little stimulation, 24/7 for decades. Your brain just kind of goes, right? And it goes seemingly faster, like we see more and more guys at a younger age looking at onset cognitive or dementia process than you would see in the general population.

While the accelerated aging of the workers in Dick (2008c) Ubik is imposed by a malevolent telepath, for IPs, it is the prison environment itself that ages them.

6. Slow Death

A Scanner Darkly, Dick (2008a) novel, originally published in 1977, follows protagonist Bob Arctor, a police officer working undercover to monitor a narcotic named Substance D, which causes a dissociation between brain hemispheres. In describing the drug, Arctor declares, “D…is finally Death. Slow Death…from the head on down” (p. 881). In our narrative, William himself experiences slow death through his accelerated aging, the two phenomena working hand‐in‐hand. The debilitation and accelerated aging of prison, too, result in the slow death of IPs. Faster than those outside of prison, of course, but still a slow death. Berlant (2007) developed the concept of slow death in the context of the obesity “epidemic” in America. As opposed to death as a discrete, traumatic event, slow death occurs “in temporal environments whose qualities and whose contours in time and space are often identified with the presentness of ordinariness itself” (p. 759). This ordinary environment is one of predictable repetitions, “an atmosphere managed and mediated by temporal, physical, legal, rhetorical, and institutionally normative procedures” (p. 760). Berlant (2007) described the speed and demands of extant capitalism contributing to obesity, particularly for the poor, and the shortening of lives. In contrast, though related, the atmosphere in prisons, where the boredom of slow time is mediated by the banal and repetitive prison schedule and its associated poor health outcomes, itself contributes to slow death.

Our study of federal prisons in Canada exposed the reality that access to healthcare services, particularly related to the chronic conditions that disproportionately affect aging IPs, is limited and, we argue, contributes to the slow death of IPs. As noted, the average age of death in custody in federal prisons is much lower than the general population. The previous section explored contributing factors to accelerated aging, and here we explore the conditions that contribute to slow death. Berlant (2007) described the economic factors that affect the activity, diets, and access to services for those of lower socioeconomic status: the “overdetermination of environments” (p. 776). In prisons, it is the physical infrastructure, provision of healthcare services, and de‐prioritization of chronic health conditions that contribute to this slow death. Prisons in Canada were not designed or built with the needs of aging IPs in mind; they were primarily built for able‐bodied young men (Correctional Investigator Canada and Canadian Human Rights Commission 2019). Similarly, the focus of healthcare services in most prisons is the treatment of acute, emergent issues, such as violence‐related injuries, overdoses, and self‐harm, not on the management of chronic conditions like diabetes.

Such an atmosphere of healthcare provision was described by participants in our study. Aging IPs develop iatrogenic chronic health conditions in prison but fail to receive appropriate treatment. Proactive interventions into chronic health issues were described as lacking. Participant 8 suggested that “unless there's an issue, I feel like these individuals are not seen. Unless something comes up either from officers or something else or they start to deteriorate, that's when healthcare hears. Otherwise, they're pretty much on their own.” Participant 11 added that “the elderly kind of get pushed to the back‐burner…because of the acuity of things that happen sometimes.” Basic management of chronic conditions is inhibited by the prison environment and the mobility of healthcare staff. For instance, Participant 4 stated:

If you have a guy with diabetes, nurses don't have access for them all the time. Like, they can't, you know, it's not feasible for them to go out and wait until they eat their meal and then check their blood sugar and then give them insulin…it's not like a hospital.

Physicians are only available for limited days/times in most CSC facilities, where triaging of patients is based upon acuity. Participant 11 offered that “they'd have a list of 10 people and only two or three would get seen.”

For many aging IPs in Canadian federal prisons, slow death becomes death. “An increasing number of people are dying in prisons of expected death,” concluded Iftene (2020, 759). Shaw and Driftmier (2021) reported the death of aging IPs alone in their prison cells. The Correctional Investigator Canada and Canadian Human Rights Commission (2019) asked why aging IPs are permitted to die foreseeable deaths in prison. In some cases, efforts are made to access early release, either via parole or compassionate release for aging IPs at end‐of‐life. Participants in our study described the lengthy and challenging process of accessing this form of release, with IPs reportedly dying within days, or even hours of being released to the community. Participant 13 observed:

A parole officer may say, like, all these guys didn't die in prison, but let's be honest, they died in prison. Like, they didn't really die in the community, laying on a ventilator brain dead…he never got a chance to live in the community. Like, what do we classify as living in the community as well, right? Not being within prison walls?

The slow death that looms large over long‐serving IPs, the tedious grind of slow time, of cyclic time, and the rapid aging that comes with it eventually result in biological death. But this is but a period on the end of a long, rambling, meaningless sentence.

In Dick (2008a), A Scanner Darkly, we learn that Substance D is being produced and distributed by the corporation that subsequently profits off the treatment of those affected—experiencing slow death—by the drug. In Canadian prisons, this profit motive does not exist (unlike many prisons in the United States), so it is not malevolent corporate greed contributing to the slow death of IPs, but a prison environment that simultaneously produces and fails to properly treat debilitation. As proposed by the Correctional Investigator Canada and Canadian Human Rights Commission (2019), “prisons were never intended to be nursing homes, hospices, or long‐term care facilities, yet increasingly in Canada, they are being required to fulfill those functions” (p. 3). However, we suggest, they fail to do so in an adequate manner.

7. The Fast Outside World

In Martian Time‐Slip (Dick 2008b), Manfred, a child living with schizophrenia, exists within a temporal reality wherein time moves at a rapid rate. “His perception of time is so accelerated that the world he perceives is constantly eroded by destruction and death” (Lapoujade 2024, 57–58). Similarly, in our narrative, William returns to his home planet to find that time had accelerated, that the planet had advanced at such a rate as to be unrecognizable. Again, while such vignettes may appear fantastical, such is the experience of IPs released into the community after lengthy periods of incarceration. The simultaneous slow and cyclic time of decades‐long incarceration and the associated institutionalization that occurs produce persons who cannot adjust or adapt to the changes of the outside world. Suddenly, incompatible realities clash.

Carceral and Flaherty (2021) described institutionalization as a loss of personal agency, making IPs “unfit for social interaction” (p. 101). A temporal reality (or, we argue several temporal realities) is imposed upon IPs by the prison environment itself. Being in the outside world becomes disorienting, alienating. Writing of Souriau (2015) concept of the dispossessed, Lapoujade (2021) stated “rather than feeling thrown into the world, they feel as though they've been thrown out of it, expelled by their own reality. Or perhaps the part that's in‐the‐world no longer belongs to them” (p. 66). A prolonged temporal stasis suddenly ruptures into a rapid temporal flow.

In our study, participants described the institutionalization that occurs in aging IPs who have spent decades in prison, and the shock and disorientation that occur upon release. Participant 13 summarized this experience:

Think of how much the world's changed in the last 30 years. I can't imagine being locked up and having no clue…they don't know computers, I mean, like even plastic, like credit cards, paying for stuff, tap…everything is just new to them…they lived a very different life prior to incarceration and since being incarcerated, like everything is so different. Like, the world has moved on, and they haven't. They're very much stuck…they're so overwhelmed.

Participant 5 added, “they're out of time. They don't know what's going on outside.” This institutionalization of IPs over decades, the imposition of disciplinary power (Foucault 1995) on the body and temporality produces persons often unable to function in the rapid—and relatively free—temporality of the outside world. In some cases, participants described IPs intentionally reoffending to return to prison. Participant 5 offered, “the first thing they do is, and I'm sorry I know it might sound cruel, but they might reoffend. Do anything to get back in, because that's all they know.” Participant 13 suggested that many aging IPs die shortly after release, stating “a lot of them pass within a fairly short period of time. I think it's just the stress on the body and it's the unknown, everything they've known for the past, you know, 20, 30 years is stripped away from them.”

Persons incarcerated for lengthy periods of time‐ several decades, in many cases—enter a temporal reality divorced from that of the outside world. To the outsider, the world moves along at a regular pace. But to those in prison, time slows and trickles into a vortex of repetition and routine. Ricciardelli and Memarpour (2016) examined the function of repetition and routine for IPs, noting that, to many, adherence to routine provided a sense of agency and served to facilitate transition to the outside world. Yet for those who experience lengthy incarceration, coupled with limited programming for rehabilitation and preparation for release, such is insufficient to adequately insulate for the shock of release. Maier (2021) described how release to halfway houses in large Canadian cities could prove stressful and disorienting to IPs not familiar with such environments. And while most IPs desire release into the outside world, the temporal shock of discharge is cataclysmic, even catastrophic. Recidivism for the purpose of prison re‐entry was described by participants in our study. Lapoujade (2024), describing Dick (2008b) Manfred in Martian Time‐Slip, stated “little Manfred only sees a world of ruins because nothing can resist entropy: it will eventually disintegrate everything…a future emptied of all possibilities” (p. 58). The experience, according to Dick (2008b), “is a splitting apart of the two worlds, inner and outer, so that neither registers on the others. Both still exist, but each goes its own way” (p. 149). For William Cardinal, the prison planet and home planet continue to exist, but neither operates on the same temporality.

8. Altogether, All at Once

How can so many experiences of temporality operate simultaneously? How can slow time and cyclic time coexist with the opposing but related bio‐temporalities of accelerated aging and slow death? And how can all of these exist independent of the “real” time of the outside world, which, from the perspective of long‐serving IPs, flows at a rapid pace? Souriau's (2015) conceptualization of existential pluralism provides a framework in which we can consider these multiple temporalities. Describing this framework, Lapoujade (2021) stated, “there isn't a single mode of existence for all the beings that populate the world, any more than there is a single world for all those beings” (pp. 4–5). He added that a single being may exist on several planes of existence simultaneously. Such a framework provides a starting point for our consideration of the multiple temporalities experienced in prison by long‐serving IPs. Prisons themselves are their own separate world, wherein the experience of time differs from that of the outside world. In our narrative, Autunia is (quite literally) a separate world from William's home planet, wherein time flows in a different manner. These two (temporal) worlds coexist, and William moves from one to the other, with catastrophically disorienting consequences.

Here is where we indicate the value of science fiction in examining these phenomena. To simply state that IPs experience multiple, conflicting forms of time in prison seems nonsensical, even fantastical. So, we embraced this fantasy and proposed a narrative of (science) fiction as a conceptual framework. The world of prison is very much separated from the world of the outside. But even within prison may exist multiple temporal realities. Science fiction, as described by Lapoujade (2024), “thinks with worlds. Creating new worlds with different physical laws, different conditions for life, different life forms, and different political organizations; creating parallel worlds and inventing passages between them” (1). The works of Philip K. Dick (1964, 2008a, 2008b, 2008c), in particular, present worlds in which temporalities are altered, even deranged. Worlds where time speeds up and slows down, where different beings experience time in different ways. Worlds in which people rapidly age. Worlds in which people do not age. Worlds in which addictive drugs induce a slow death. Worlds in which different realities are in competition. An amalgamation of these Dickian worlds provides the framework to conceptualize the passage of time in prisons, particularly those serving lengthy sentences.

In Dick's worlds, shifts in realities and perceptions are often imposed upon protagonists or groups of persons by malevolent forces, such as governments, corporations, or deranged psychics. A questioning of reality, a questioning of sanity, occurs in these characters—how could these worlds possibly be so different? Of these Dickian worlds, Lapoujade (2024) stated:

We move through a familiar world…where we possess an effective reality until the moment we are projected into a new world that deprives us of all reality…a world where the conditions have changed to such an extent that we no longer have any rights. (pp. 21–22)

Such is the experience of William landing on Autunia, or persons entering prison from the outside world. Yet these realities are not imposed by evil psychics or experimental technologies, but by the prison itself. As we have explored, the prison environment alters the passage of time on both an experiential and biological level. The prison is the malevolent force, imposing disorienting and debilitating conditions, and temporal shifts upon its unwilling inhabitants.

The contributors to and consequences of these altered flows of time have been explored via multiple sources. Goffman (1961) explained the shock of entering the new world of the institution. Carceral and Flaherty (2021) and Guenther (2013) described the boredom and altered perceptions associated with slow and cyclical time. Foucault's (1995) conceptualization of disciplinary power describes the (temporal) institutionalization of IPs over lengthy sentences. Puar (2017) describes the debilitation of the prison environment and its contribution to accelerated aging. Berlant (2007) described how atmospheres of ordinariness affect the slow death of marginalized groups. Souriau (2015) and Lapoujade (2021) describe how multiple realities can both coexist and clash when IPs return to the outside world. Amongst this collection of theorists is our bricolage (Yardley 2008) approach to examining this topic. As noted, no single theory or framework can adequately explain the simultaneous operation of multiple temporalities in prisons, so we have collected an assemblage of ideas. As Lapoujade (2024) suggested, the protagonists in Dick's works are often bricoleurs themselves, thrust into a disorienting, even nonsensical world without the proper tools for reconciliation, who instead mobilize potentialities, random fragments pieced together to “serve a purpose that is altogether different than the one that they were initially intended for” (p. 132). We, too, have pulled together various, disparate ideas and fragments, built them into our own piece of science fiction in an attempt to construct our own conception of the temporal realities of the prison.

Such a consideration of temporalities in prisons may appear as mere theoretical or philosophical games. Yet we argue that important clinical implications for nurses and other healthcare professions can be derived from such an exercise. The experiences of time for IPs have been elsewhere, as explored throughout this paper, yet the intersection of multiple temporalities, their corporeal effects, and subsequent health implications are important for nurses and other professions to consider. This is particularly relevant to IPs serving lengthy sentences, such as those spanning several decades. Other researchers have examined how IPs can mobilize time and temporalities; Ricciardelli and Memarpour (2016) described the use of routine as a means of both resistance to punitive practices and as preparation for eventual release. Maier (2021) described how IPs in halfway houses used their time to transition to a successful existence after full release. Yet for those spending lengthy sentences in prison, particularly aging and “old” IPs, these temporal realities can create significant barriers to release. Understanding and acknowledging these impacts is vital for nurses. With this knowledge, we can explore improved methods for rehabilitation and the deinstitutionalization necessary for successful release, to be better prepared for the “fast” world outside prison walls.

We also take this opportunity to advocate for the use of bricolage and science fiction as a theoretical lens from which nursing phenomena are considered. As we reflected on the operation of multiple temporalities explored in this paper, a single, unifying theory proved elusive to examine these phenomena. But through the fantasy of science fiction, we found opportunity to explore how “the strangeness of the worlds found in [science fiction] tends to disorient its characters, to confront them with irrational situations that seem destined to make them lose their minds” (Lapoujade 2024, 8). Certainly, other complex, confusing, and seemingly incongruent phenomena affecting nurses and our patients could benefit from such a theoretical consideration, where traditional (nursing) theories prove insufficient. Our opening vignette of William Cardinal's pluriverse may have appeared pure science fiction at first but provides a fitting narrative from which this paper proceeds.

Disclosure

All authors listed meet the authorship criteria according to the latest guidelines of the International Committee of Medical Journal Editors. All authors are in agreement with the manuscript.

Ethics Statement

Approval for this study was provided by the University of Ottawa Office of Research Ethics and Integrity, Number H‐03‐22‐7624.

Conflicts of Interest

The authors declare no conflicts of interest.

Johansson, J. A. , Holmes D., and Paradis‐Gagné E.. 2025. “Accelerated Aging, Debilitation, Slow Death, and the Multiple Temporalities of Aging Incarcerated Persons: A Philip K. Dickian Science Fiction Examination.” Nursing Inquiry 32: 1–9. 10.1111/nin.70058.

Data Availability Statement

The authors have nothing to report.