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Exchanging Suffering for Solace
The dark meritocracy of measuring commitment by pain endured
On Thursday, I’ll share highlights from our discussion of how social security shortchanges caregivers. Today, I have notes on Ross Douthat’s memoir and meditation on sickness and suffering.
I was glad to have the chance to review Ross Douthat’s The Deep Places (a memoir of his experience with Long Lyme) in National Review. The book is an unsettling read—more of a creeping horror story than a memoir—and it goes beyond simply being a story of sickness and resilience to being an attempt to grapple with how to suffer well. As I write in the review:
Douthat chooses a battle that suits the shadow meritocracy of suffering: a theory of disease that suggests that pain, when deliberately chosen, can be exchanged for deliverance. It’s just a question of whether you’re tough enough to make it through the vale of tears. He navigates by the “Herxheimer reaction”–an agonizing feeling triggered by the death of microorganisms within your body. The idea that this reaction is a positive sign is a heightened version of the logic that many symptoms of disease are caused not by the pathogen but by your body fighting it. Be grateful for the fever–it’s your body getting into the fight. As the Lyme communities suggest to Douthat, “because a treatment makes you feel sicker it must be working.”
It’s a dark reflection of the Christian ideal of redemptive suffering. Douthat plunges in, chasing the pain, buoyed by the hope that his agony is happening on his terms. He feels that his strategy wins him some ground and enhances the effectiveness of more conventional treatment. But he still takes a step back from his initial hunger for Herxheimers, whose spasms leave him haunting his own family home, mixing doses of herbs and other alternative medicines in the middle of the night. “Without a way to know for sure how far to go, or when to turn back,” he writes, “the worse the better can be a dangerous philosophy.”
The world is disproportional. We can’t trust (in medicine or anywhere else) that the more effort and suffering we put in, the better our outcome will be.
Parents are especially vulnerable to this call to take the harder path because it will necessarily be the path of greater love. But, for all the different things you can say about the merits or downsides of sleep training, your child doesn’t measure your love in your time spent awake when you’re exhausted.
It is love that gives us the willingness to suffer for others, but it’s all right for things to be easy or comfortable. Love can be most visible when we make profound sacrifices, but we have to be attentive to quiet, daily practices of love.
It’s that quiet, sustaining love that is harder to see or choose. I sometimes keep an annex document when I’m writing, somewhere I can tuck quotes and paragraphs I don’t turn out to be using without doing something as extreme as deleting them. One quote I held onto but didn’t find a home for in the review came when Douthat discussed the challenge of loving someone through long suffering, not a limited crisis. He writes:
We are more likely to rise to the occasion when it is clearly an occasion—a moment of crisis, a time-bound period of stress. […] When the crisis simply continues without resolution, when the illness grinds on and on and on—well, then a curtain tends to fall, because there isn’t an obvious way to integrate that kind of struggle into the realm of everyday life. It’s not clear what the healthy person is supposed to give to a friend or family member who isn’t dying, who doesn’t have some need that you can fill with a discrete act of generosity, but who just has the same problems—terrible but also, let’s be frank, a little boring—day after depressing day.
Here is where I find the idea of vigil keeping helpful. Being there can be a gift, even if you have nothing to offer besides your presence.
A great deal of Douthat’s book is wrestling with what to do when treatments fail—how confident should you be that a cure must exist, because health and strength are what you were made for? Where is the line between praiseworthy hope vs a spendthrift waste of the time and energy you have on dubious and harrowing treatments?
He doesn’t end the book as a fatalist and neither does he regret some of his more dangerous attempts at cures. But he is more willing to consider how to live well where he is.