Being Healthily Ill

I think our usual ideas of health need to be expanded to include how well we cope with illness. If we can embrace the idea that there are more or less healthy ways of coping with illness, this might help us relate to those who are going through the pain.

I have several friends with chronic health conditions. For some of them these are ‘physical’, for others ‘mental’. The quotes are to say that these distinctions aren’t sharp, but I hope you know what I mean.

For those with the ‘physical’ illnesses they are either terminal, or if remission occurs, they will be left with permanent damage; they live with severe pain for most of the time they are awake. For those with the mental conditions (long-term depression, Post-Traumatic Stress Disorder, and so on) they have lived with severely limited lifestyles for many years and have times of intensely painful misery.

Being with people in pain can be difficult. It can be nauseating and frightening. And I’m confronted by the question of: what can I say? And I feel this question because I want to fix these people. Which is no bad thing in one way — I’m sure that most of us would alleviate unnecessary suffering for those we love if we could. Less positively, it means I am avoiding this person and their experience at the moment — which is also understandable (I don’t think we are meant to enjoy pain). But, if I am to be with this person at the moment it means being with them in their pain — and all of them have had the experience of people not calling anymore because they don’t want to be with someone in pain.

The answer I have found to my question of what to say is surprisingly prosaic. It is things like: Hi, how are you doing? How have you been? And it is important that I be willing to listen to the answers. It is being willing to connect in these everyday kinds of ways that my friends crave. Connecting with them as people not filtered through a category like ‘the suffering’, or ‘the terminally ill’.

When we can listen to the answers to these garden-variety questions, we find that there are differences, that some days are better than others. That some days they are just overwhelmed, don’t have the energy to get out of bed, and other days enjoy relating to others, even if far more briefly than before. Some days they feel taken over by their illness and suffering, and other days they feel they cope pretty well and perhaps experience a moment of joy.

I want to say that I think there are healthier and sicker ways of coping with illness. My own definition of health is: doing well where you are. It takes more health to not get sick in a slum than in a suburb with drains and sewers; it takes more health to cope with a chronic illness than when our bodies are functioning normally.

The difference this understanding makes for me is that it allows me to get past those categories of ‘the suffering’ or ‘the terminally ill’ so that I can deal with the person. I can relate to the ups and downs or dealing with ordinary challenges of day to day living — however much more difficult they are for someone in pain.

There is another aspect of being with those in pain: it can take it out of you. We may need time for ourselves, to do something nice for ourselves or just take time out. Just as it doesn’t help to pretend the other person isn’t suffering, it doesn’t help to pretend that we are not affected. (Perhaps allowing ourselves to be affected is very much what a relationship is about.) My guess is that pretending to not be affected leads to getting exhausted and avoiding the person who is suffering.

While being with these friends of mine has not always been easy, I have certainly found it enriching, and at times there have been moments of deep relating. I am wondering about your experience of dealing with chronic pain either for yourself or with others. If you feel that I haven’t begun to deal with this difficult subject, please feel free to say so. If you would like to share what you have found helpful or less helpful I would like to hear that too.

For a philosophical treatment of illness there is Havi Carel’s Illness: The Cry of the Flesh . As Carel points out, philosophy has been more comfortable with life and death than with illness.

• empathy
• health
• relationships