“The first wealth is health.” –Ralph Waldo Emerson
“When health is absent, wisdom cannot reveal itself, art cannot manifest, strength cannot fight, wealth becomes useless, and intelligence cannot be applied.” ―Herophilus
I spent some days last week in a hellish level of back pain, so bad that my mind was pulled toward a topic I had no wish to visit: suicide. To be clear, I was not suicidal; I was merely pondering suicide as a concept, examining it from multiple angles, considering the motivations. The pondering itself, and even more so the strength of the magnetic pull to the topic, was telling of my state of mind.
It took me back nearly two decades, the last time my back exploded and had me almost delirious in pain, culminating in a body full of drugs and an emergency surgery. Through all of my days of agony prior to the surgery, one subject came through clearly in my otherwise desperate mind: suicide. I had never thought so much about it in all my life (and haven’t since). My mind was all over the topic: the how, the why, the who, the aftermath. The everything. I couldn’t seem to clear it from my brain. I am fairly sure the obsession stemmed from the fact that, racked with pain at a level I had never imagined possible, for the first time in my life I could totally get why some people no longer want to live. Honestly, I don’t know how much longer I could have gone on like that if I didn’t believe a cure was coming. Pulled from an otherwise blissful life, I suddenly had absolutely no capacity for joy. It didn’t feel like a life at all. It just felt like misery.
Some years before that episode, when I was in graduate school, one of the professors in the department was suffering from bowel cancer or colitis or some other very serious disease of the digestive tract. And when I say “suffering,” I mean truly suffering. I hadn’t known him well and had only heard that he had something and did not understand its severity until I took a brief visit to the bathroom one evening before class. It was a tiny bathroom, and I spotted someone’s feet in the single stall as I stepped up to the lone urinal. That’s when I heard the sounds of a man in the throes of pain and anguish, still trying to keep quiet. I felt terrible as I rushed out of there, haunted by another human’s suffering. A few months later, I heard that he committed suicide. I understood why.
I have been wildly blessed throughout my life, probably in no area more important than my mental health. I mentioned to you in a letter once that one of the things that has surprised me most in my years on this Earth is just how prevalent and truly commonplace mental illness is. When I was a kid and learned that a family member had an eating disorder, it absolutely floored me. I never dreamed someone close to me would have psychological problems, and I was sure it shouldn’t be mentioned to anyone. As an adult, the more I learn, the more it feels like almost everyone is dealing with some measure of addiction or other mental illness, or at least has dealt with it. I am grateful to have been mostly spared. Because of that, my only insight into depression (or other)-induced suicidal thoughts is from Psychology classes and lots and lots of memoirs.
So, though it is a fascinating topic to explore and one that I would like to know more about, I am not here today with strictly mental states on my agenda. Not the kind that decide it is preferable to be dead than alive based only on how dark and painful it is inside the mind, anyway. Rather, I want to know about how physical pain and disability shape one’s sense of the value of one’s own life. Because one day I was feeling physically fine, with a few aches and pains like anyone my age has, and I was thinking I was living a great life full of blessings that I wanted to keep experiencing indefinitely. And the next day I was doubled over in pain, wondering if it was all worth it to go on.
I admit, that instantaneous loss of my life’s value freaked me out a little. Okay, maybe a lot. I mean, is the value of existence so fragile that once the body stops cooperating, the whole game needs to be forfeited? If so, what of all these emotional and intellectual gymnastics we constantly perform to keep ourselves believing how sturdy and enduring our many blessings are and how they will carry us through the low points in life? The love of our families and friends, our connection to the Divine, our sense of accomplishment from the work we have done, the creations we have provided the world, the dreams we are on our way to fulfilling. If it all collapses with the slip of a vertebrae, how solid was the ground that sense of Value was built upon? I am being haunted by that question now.
I am thinking of the many times an injury has kept me from doing the things I wanted to do. I have always been an active guy, and I have had my share of injuries along the way. Usually, I just play through it, as I cannot stand to be inactive. But even so, when I cannot do everything I want, I know that I don’t enjoy myself as much. Just this Summer, when a slow-healing gash on my foot kept me away from my favorite activities for a couple of months, I found life much less fulfilling. Sure, I found other things to do and enjoyed them, but it was much less satisfying than what I wanted to do. I swallowed my frustrations and did my impatient best to be patient and positive, but that was because I knew the end was in sight. But I wonder: What if there was no end in sight? What if I could no longer swim or run or play? Would my base of happiness start to erode? I am fairly certain it would. And then, how quickly would it erode? And even bigger picture: when I hit my low point with it, would that level still be called “Happy,” or would it be something very different? Would that something different be something I could go on living with?
Even at this point in my aging/erosion process—I am almost half a century old—I can’t do so many of the things I once could due to previous injuries and simply the reality of a body at this age. I can no longer go out for a real run. Bending over to lift heavy things can take me out of commission for weeks. My elbow hurts after I play tennis, and I cannot serve even half the speed I once could. Believe me, the list goes on!
For a guy most at home when playing a sport or sweating out an outdoor adventure, this new reality is deeply frustrating. I was tempted to say it is awful, but it only relatively awful. That is, when I imagine how much fun it would be to still be doing that stuff, it feels awful to my heart. And yet, I definitely don’t find that my life is awful. I am quite happy (just maybe less satisfied than I could be).
I can’t say how it will be as I age and gradually lose more and more of my physical capacities–perhaps my mind will continue to adapt as well and find increasingly innovative ways to find Joy in my little world and offset the thrills and satisfaction of physical exertion and mastery–or if I suffer an injury or illness that renders me instantly unable to perform. This is something I would like to interview some elderly and physically disabled folks about—the ways they have adapted, and what their perception of their own happiness is compared to how it might be if they had all of their physical tools working at full capacity. Do we all just go through our journeys constantly adjusting our standard for Happiness and Fulfillment based on what seems realistic given our physical circumstances, most everyone finding themselves able to say, “Yeah, I’m doing alright” even if they would have felt sorry for someone in their present circumstances no so long ago? Are we that wisely and graciously adaptable, or are we deluded suckers? I hope it’s the former.
With my foot injury this Summer and at other times in my life, such as when limbs were in casts, even though I was unable to use the limb, I had the benefit of not being in constant pain. So, even though I may have been frustrated—which I may have described as “misery” at the time—I was not in physical agony. As someone who has suffered the worst kind of back pain, I can tell you that that is where this whole issue turns into something different. When you are racked with an extreme, unrelenting physical pain that leaves you simply unable to enjoy anything—no, it’s not that you can’t “enjoy,” but rather that you can feel only anguish, only suffering–we are in a new realm. This is, I am guessing, where my old professor was. It is where I was in the days before my back surgery. The only difference was that I believed that surgery was going to improve my situation; I would have deemed it unbearable if that wasn’t an option. He didn’t have any assurances. I understand the route he chose. “There, but for the grace of God, go I…”
I see now that this is where the discussion really splits and there is a need for two separate inquiries. Loss of the use of your physical abilities—even with some accompanying moderate pain–is one thing, but severe pain is quite another. I am coming to believe through experience that I will still be able to be grateful and happy if or as I lose my athleticism and flexibility and such. I am less sure that that I will feel fulfilled without that physical element, but I believe I can achieve happiness. I have faith that my life can still feel fun and valuable to me. I don’t have that same confidence when it comes to living with chronic pain.
I would like to believe that it is simply mind over matter and that I could find joy, gratitude, and peace of mind in any physical state. But I remember the pain I was in last week as I tried to get out of the car and walk down the sidewalk without collapsing and without crying. And I still shiver as I think about those days before my surgery years ago, my body stuck in a wholly unnatural position due to the spasms from the herniated disc in my back and me barely able to breathe without sobbing uncontrollably. That was not a life that could be maintained. If it had value, I couldn’t see it at the time.
In the end, I guess my answer is YES, my life can still be quite valuable without all the things I love about being fit and active, but that value probably begins to deteriorate once chronic pain gets past moderate intensity, with the value then becoming inversely proportional to the pain as I move toward full-on agony. It’s a theory for now. I hope I don’t have to find out the truth.
How about you? How does your health dictate the value of your life? Open up your journal and your memory and search for times when your health shaped the way you value your life. What are your very worst experiences with your health and physical abilities? Are they illnesses that knocked you flat and made you feel like garbage? Migraines? Are your worst times from acute injuries that brought your pain immediately to an extreme intensity? Do you have chronic pain at a high level that shapes your perception of your life’s value? Whatever your worst experiences, did they ever reach a point where you began to wonder if you could go on much longer in that state? Did you ever, at your very worst point, realize that it no longer even felt like living, but instead just endless suffering? If so, how did that realization play on your psyche? If you haven’t experienced this level of physical agony, do you know someone who has? How closely do you believe you can empathize with it? Who in your life has lived for long stretches in the greatest physical pain? Was it from an illness—like cancer or arthritis—or from injury (e.g. spine trouble or concussion)? Have they adapted and created a happy life in spite of the pain? Do you think you could be happy no matter your level of chronic pain? Do you believe there is a level of pain that would lead you to take your own life? Do you have any judgment about people who do? Okay, let’s switch gears. How much does a diminished physical capacity affect your mindset? Have you ever been incapacitated with an injury that limited you enough that it affected your happiness or life satisfaction? What did it keep you from doing or feeling that you missed so much? Did you find a substitute for that previous ability to fill in the happiness gap, or did you simply adjust your standards? Was your loss temporary or permanent? What can you no longer do that you once could (e.g run, play a sport, garden, etc.)? How has that loss affected you? Do you harp on it psychologically, reminding yourself how much you miss it and maybe cursing your luck? Have you given yourself grace as you have aged, letting abilities go without too much bitterness or mourning? Have you found that life can be just as good without the physical gifts of youth? Can you think of a physical loss that would almost certainly cause you to devalue your life (e.g. paralysis, blindness, obesity)? Is there a physical loss that you can imagine making life seem no longer worth living for you? Are you at all embarrassed to admit to that last answer? Are we weak and shallow for tying so much of our happiness and life satisfaction to our health—rather than, say, spiritual peace or wisdom–or is that just the reality of the human condition? Leave me a reply and let me know: What good is your life without your health?
Be as well as you can,
P.S. If this resonated with you, please share it with your community. We rise together!
P.P.S. If this way of self-exploration appeals to you, consider buying my book, Journal of YOU: Uncovering The Beauty That Is Your Truth, at your favorite online retailers.