Archive for the ‘on illness’ Category

This content is password protected. To view it please enter your password below:

Read Full Post »

This content is password protected. To view it please enter your password below:

Read Full Post »

This content is password protected. To view it please enter your password below:

Read Full Post »

This content is password protected. To view it please enter your password below:

Read Full Post »

Susan Sontag, the metaphors of illness and the militaristic understanding of the ill. (On Illness 17)

It is not easy to find readings regarding illness by patients who are humanists and ill themselves. This is easy to explain, in a sense. First, one must have been involved in the humanities for many years. Second, one must have fallen seriously ill. Third, and very importantly, during that period of illness one must have had enough physical and mental energy to be able to reflect and to write about the process of illness itself. The latter is no easy task; just try writing when you have some kind of physical pain. Or think of this common occurrence which, now that I have been seriously ill, makes me smile. When one reads the biography of many famous and important people such biographies usually end something like this,

“and then, quite unfortunately, such and such illness came suddenly into his life and suddenly he lost all his genius and his creative powers, and then the most brilliant mind became totally lost ..…, and then died in the year such and such ……” .

Why do I smile? Because such a narrative is highly incomplete, untrue, oversimplified and dangerous. Why is this so? Primarily because this kind of narrative seems to me to be a bit like the story of the monster that lives under our beds. But more importantly, it continues separating creativity and the most fundamental elements of our unique human condition, including our suffering, our physical fragility and our mortality.

Don’t you think it is odd to actually believe that somehow one produces less and becomes less creative and thoughtful PRECISELY when one comes to learn first-hand of the vulnerabilities which lie at the core of our humanity! For surely the greatest writers did not write about such topics by having simply READ about them (though reading about them will prepare us like no other exercise once they become present in our lives, or in the lives of those around us.) On the contrary, it is —-in part—- by living such moments that one’s creativity is energized and one’s potential reflection actualized more deeply. “But I have never gotten ill”, you might respond. “Good for you!” I say, “just do not forget that if this is so, those around you who fall ill will need even more of your help and practical wisdom when dealing with situations of crisis.” Hearing such narratives makes me think that in our world we are in constant fear of illness for we can only see it as the beginning of the end, rather than the end of a shallow beginning. Suffering makes no sense to us, and the sufferers much less so.

However that may be, the fortunate appearance of these three conditions is the main reasons why Susan Sontag’s Illness as metaphor is such a unique and precious book. It is a book for those seeking to make somewhat articulate that which is mostly held as unspeakable; particularly so in our age which sees in death and in the immobility of illness “the other” against which we must continually fight and guard ourselves from.

In this post, I will merely point to some of the reasons why this confluence is so unique. At least four elements stand out: 1. Sontag allows for insight into what it is for an ill person to write DURING illness itself; 2. Sontag points out the dangers underlying the kinds of metaphors we use when dealing with illness, metaphors which are unavoidable given our nature as self-interpreting animals (on this, see Charles Taylor who has also had great impact in the area of nursing); 3. She crucially reveals the most damaging of these metaphors, namely, the military metaphor as it is applied to illness in such a way that ironically who I am and my body become sworn enemies leading, in turn, to a dangerous dualistic tendency which emphasizes a separation from myself, demeaning me silently; and finally, 4. she points to one crucial interest in the connection created by political thinkers between the illness of the body and the illness of the body politic. I will briefly point to each of these dimensions. (more…)

Read Full Post »

Choosing a doctor and knowing yourself.

In selecting a doctor, or better yet, in selecting doctors, it is inevitable that one will end up looking at oneself and at who one is. In my case, I have selected doctors both from traditional and alternative traditions; more importantly I came to be with doctors who suffered the transformation —Socratic in essence—- which leads from traditional medicine to alternative views, not simply of medicine, but of the human condition itself. The reason for my going these roads, though it is no easy road as both types of doctors have great suspicion of each other’s paradigm, was in part my deep belief in the importance of bilingualism with which I have been involved as ESL teacher for more than a decade and as citizen of Canada, one of the few official bilingual countries in the world.

In this respect, patients from the humanities are in special need of doctors who have been deeply involved with the humanities for only then can a mutual and healthy dialogue towards understanding, and maybe even recovery, can ensue. The work of doctor Pellegrino is here of great importance; see, for instance, his aptly titled “Educating the Humanist Physician; an Ancient Ideal Reconsidered. However, patients from the humanities must beware that the likelihood of such coincidence is not high and when illness is thrust upon us, there is little time and energy to make such connections.

One of the doctors I visited later in my illness told me very seriously I had to choose between one or the other of these treatments, and that it was my responsibility whatever I did. To this I answered calmly: “If this is so, if indeed one has to choose, then I have already made my decision a long time ago.” ( I had made my decision the very day I decided to dedicate my life to the humanities, 20 years earlier, when I was absolutely healthy.)

Read Full Post »

In search of a meaning for physical pain.

Permanent and serious illness is almost inseparable from constant physical pain, be it through the illness itself, or through the therapy which one follows to regain one’s health. But physical pain is not the only type of pain with which the ill person must deal. Emotional and spiritual pain are summoned by the physical pain itself as a new condition is brought upon the person and specially those surrounding the ill. Later on, in another post, I will look at the ontological assault on the self which serious and chronic illness represents in terms of the loss of personal identity which the ill person must now face.

The ill suddenly see the narrative of their lives —which they have constructed through the years, even if they are few—- enter into an unknown and frightening domain in which the very possibility of a conscious narrative is in constant question. Pain arrests the normal possibility of narrative through action and reflection. Pain reduces all movement, pain removes all words (if you are healthy, just try to imagine one of those days in which you have a stomachache or headache). This is why it is of the utmost importance that the ill find all the means possible to understand their pain and give it a sense of meaning even when others do not see this as a possibility (of course, THEY do not have the pain!) This implies in part following, what is so common today, learning to “manage” one’s pain (for instance, the power of breathing). But this is an economic metaphor that reduces the spiritual potential hidden within each and every suffering person to a mere issue of control. Health is not a business, no matter how much we are forced to think so.

During the many years of recovery from my illness, I have had my share of very severe pain. Without going into the details (though actually I find it absolutely rare to find a person wishing to speak reflectively about pain; it seems to pain them more than the pain itself!) , I simply want to share a story which I always remember when pain comes around to visit me.

There are many such stories, but one needs to surround oneself by them. I myself simply recall the story of a young man from my dear Bogotá who on the very day of his graduation from school ——and having received a meritorious award for being one of the best high school students in the country—- was “accidentally” shot in the back. He was almost paralyzed completely. What he told one reporter I have never been able to forget. Paraphrasing, the young man said something like this when asked about his pain:

“Whenever I have pain I actually feel better for it tells me that I still have feeling in my limbs. It tells me my body is still trying to recover. It brings me hope. This motivates me everyday to try to move just a bit more each day.”

By moving a bit, he meant moving his toes.

When in pain, the ill —and those who surround them—- must search for such stories in order to bring a sense of purpose and narrative (see Charles Taylor, SotS) to their suffering, their shame, their vulnerability and their present weakness. Perhaps the greatest purpose can be the very recovery of the new narrative in sickness in which the patient finds himself. By giving his illness the sense of a story, the question of pain will still be present, yet secondary. (To this effect, I will post a sample diary sheet for the ill in the next post to record privately the daily happenings of their new situation. To this effect, I will also post a basic bibliography on illness which may open avenues for those who are ill.)

In contrast, I once heard a doctor say that he was a good doctor because he helped his patients as best he could. However, he added responding to a person who spoke as this post does, that he had to be honest and could see no purpose whatsoever in the pain and suffering of his patients. One wonders how such a bright and successful man could not see how contradictory his words were.


Read Full Post »

On the unconscious needs underlying the relation between the ill and their caretakers.

One of the difficulties which lies at the basis of much possible conflict between the ill and caretakers is this. Most of us seem to unconsciously desire in our lives someone who will be there for us in the worst of times, those times where usually no one would want to be with us! For supposedly, this kind of thinking goes, everyone wants to be with you when you are rich and beautiful and young and powerful. One of the most dramatic examples of such a desire can be found in the work Like Water for Chocolate link where the youngest daughter cannot marry because tradition holds she MUST take care of her aging mother. Having many children is a way of assuring one’s future security.


And in this same vein, this is why marriage vows include for better and FOR WORSE. For, according to the “normal” way of seeing things, being there in the worst of times must be somehow enforced as NO ONE would want such a thing! This kind of thinking is highly distorted. However, one thing is true, being in those situation which include the “for worse” part, specially in the case of illness (but think also of the case of unemployment) does not usually mean that BOTH parties find themselves worse off. Usually when one person falls ill, the other does not; when one person is unemployed, the other is not.


When one of them actually falls ill, then the ill person actually might find —or at least he thinks he has found—- what he deeply desired, namely, someone who unconditionally loves him. But on the other hand, the caretaker finds something radically different, not only that someone does not care for him —for many caretakers are left alone to care for their loved ones—- but also deeply and unconsciously they come to realize that no one will be physically able to take care of them if they in fact become ill! This helps to understand the anger felt by the mother in Like Water for Chocolate. (Not to mention the meeting of other needs which will not be met, such as those regarding sexuality, the possibility of a family, ….)


The only path towards ameliorating the caretakers condition in this respect is for her to come to a clear understanding of how problematic such a deep desire for having another take care of her —–even when the situation does not involve illness— actually is. This holds true for the ill person herself as well. For we humans, as Aristophanes’ discourse in Plato’s Symposium tells with fine comic revelation, are deeply afraid of living a life of true self sufficiency, and by this I mean, primarily, a life of reflective self-sufficiency. In this respect, one can say that caretakers and the ill are in need of a serious reconsideration and understanding of those deep desires which in normal conditions remain constrained, but which in times of crisis come to the fore as they had never done so before. If unprepared for this appearance, the likelihood of growth in true and deep friendship under such circumstances is close to nil.


I think these reflections hold some of the central keys to understanding why it is that Aristotle ends his considerations on friendship —-–some of the most famous and powerful in the history of reflections on friendship—– with what appears to be a very strange question, namely: Do we need friends more in good fortune or in bad? (Nicomachean Ethics, IX, 1170a21) True happiness might include friends, but might point beyond our everyday distorted considerations of what friends are. And however that may turn out to be, one should and must be one’s own best friend.

Read Full Post »

Appendix to ‘On illness 13’: “The Yellow Wallpaper”: a short story for all caretakers.


(please read the former to see the context of this story)




Charlotte Perkins Gilman, The Yellow Wallpaper (1899)

(Printable version in PDF format)

It is very seldom that mere ordinary people like John and myself secure ancestral halls for the summer.
A colonial mansion, a hereditary estate, I would say a haunted house, and reach the height of romantic felicity–but that would be asking too much of fate!
Still I will proudly declare that there is something queer about it.
Else, why should it be let so cheaply? And why have stood so long untenanted?
John laughs at me, of course, but one expects that in marriage.
John is practical in the extreme. He has no patience with faith, an intense horror of superstition, and he scoffs openly at any talk of things not to be felt and seen and put down in figures.
John is a physician, and perhaps–(I would not say it to a living soul, of course, but this is dead paper and a great relief to my mind)–perhaps that is one reason I do not get well faster.
You see he does not believe I am sick!
And what can one do?
If a physician of high standing, and one’s own husband, assures friends and relatives that there is really nothing the matter with one but temporary nervous depression–a slight hysterical tendency– what is one to do?
My brother is also a physician, and also of high standing, and he says the same thing.
So I take phosphates or phosphites–whichever it is, and tonics, and journeys, and air, and exercise, and am absolutely forbidden to “work” until I am well again.
Personally, I disagree with their ideas.
Personally, I believe that congenial work, with excitement and change, would do me good.
But what is one to do?
I did write for a while in spite of them; but it does exhaust me a good deal–having to be so sly about it, or else meet with heavy opposition.
I sometimes fancy that in my condition if I had less opposition and more society and stimulus–but John says the very worst thing I can do is to think about my condition, and I confess it always makes me feel bad.
So I will let it alone and talk about the house.
The most beautiful place! It is quite alone standing well back from the road, quite three miles from the village. It makes me think of English places that you read about, for there are hedges and walls and gates that lock, and lots of separate little houses for the gardeners and people.
There is a delicious garden! I never saw such a garden–large and shady, full of box-bordered paths, and lined with long grape-covered arbors with seats under them.
There were greenhouses, too, but they are all broken now.
There was some legal trouble, I believe, something about the heirs and coheirs; anyhow, the place has been empty for years.
That spoils my ghostliness, I am afraid, but I don’t care–there is something strange about the house–I can feel it.
I even said so to John one moonlight evening but he said what I felt was a draught, and shut the window.
I get unreasonably angry with John sometimes I’m sure I never used to be so sensitive. I think it is due to this nervous condition.
But John says if I feel so, I shall neglect proper self-control; so I take pains to control myself– before him, at least, and that makes me very tired.
I don’t like our room a bit. I wanted one downstairs that opened on the piazza and had roses all over the window, and such pretty old-fashioned chintz hangings! but John would not hear of it.
He said there was only one window and not room for two beds, and no near room for him if he took another.
He is very careful and loving, and hardly lets me stir without special direction.
I have a schedule prescription for each hour in the day; he takes all care from me, and so I feel basely ungrateful not to value it more.
He said we came here solely on my account, that I was to have perfect rest and all the air I could get. “Your exercise depends on your strength, my dear,” said he, “and your food somewhat on your appetite; but air you can absorb all the time. ‘ So we took the nursery at the top of the house.
It is a big, airy room, the whole floor nearly, with windows that look all ways, and air and sunshine galore. It was nursery first and then playroom and gymnasium, I should judge; for the windows are barred for little children, and there are rings and things in the walls.
The paint and paper look as if a boys’ school had used it. It is stripped off–the paper in great patches all around the head of my bed, about as far as I can reach, and in a great place on the other side of the room low down. I never saw a worse paper in my life.
One of those sprawling flamboyant patterns committing every artistic sin.
It is dull enough to confuse the eye in following, pronounced enough to constantly irritate and provoke study, and when you follow the lame uncertain curves for a little distance they suddenly commit suicide–plunge off at outrageous angles, destroy themselves in unheard of contradictions. (more…)

Read Full Post »

Why caretakers must reflect on the complex desires behind their care-taking.

One of the main reasons as to why reflective self-transformations among caretakers is so difficult lies in the deep need caretakers have of perceiving themselves as doing good to others. Each caretaker must seriously reflect on the nature of such a troubling human need. If no such reflection has been undertaken, the possibility of having a self-critical spirit as regards the caretaker’s own actions becomes more and more difficult to achieve.

It seems the main reason for this dilemma is as follows: the caretaker gives meaning to the narrative of her life through caretaking itself. In this same respect we all admire such individuals for what we (and they) perceive —though this is part of the problem— as their altruistic sacrifice for others. (see Aristotle, NE, Book I) However, this perception only solidifies in the caretaker the sense of their deserving recognition as regards their alleged sacrifice for the other, specially for the pains and troubles one has to undergo —supposedly— in the taking care of the ill. I say allegedly for it would surely be odd to choose a way of life in which one thought of one’s actions solely as a sacrifice! Such a choice would never allow for true happiness in either the caretaker, or the ill person herself! And once such a mental attitude is set firmly, the chances for such a person to reconsider the very foundations of their reasons for doing good become harder and harder to bring forth to the light of criticism. And if the person who seriously asks the caretaker to reflect on their own unquestioned desires and needs is the ill person herself, then sense of ingratitude seems to skyrocket!

This is in part one of the reasons why ill people must hear recognition demanding phrases such as “well, at least you are not in the street, at least you have me, …….”; one of the reasons why most doctors –though not all– will be disappointed when their patient asks for a second opinion; one of the reasons why traditional doctors will become very defensive when spoken of alternative possibilities, telling their patients that if they do so “it is their responsibility, ….”; one of the reasons why families/couples/parents will constantly argue how much sacrifice the ill are for them; one of the reasons why convincing others that illness is not a burden is almost impossible.

Under such conditions, which unfortunately are the norm and not the exception in our human condition, the ill must be careful and have the tools to counteract —even if they are in a condition of total physical disadvantage—- such tendencies which lie in the deepest, most troubling and most ambiguous human needs. The ill must never forget it is they who are at a disadvantage, not those who in their health do not have the courage to undergo a reflective critique of their needs.

In plain language, there is a saying in Spanish, constantly recovered by Doctor Payán, that says “El camino al infierno está hecho de buenas intenciones.” (The path to hell are made through good intentions.”) In literature a dramatic example of such a process lies in the short story entitled “The Yellow Wallpaper” (1899) link by Charlotte Perkins Gilman which tells the story of a husband and ill wife and which should be obligatory reading for ANYONE involved in the caring of the ill. Finally, and most importantly, it is Aristotle’s Nicomachean Ethics which shows the path towards an understanding of such deeply problematic needs, those needs associated with the goodness presupposed by those who hold the life of virtue as the crowning life for human beings. It is little wonder to find Aristotle arguing that true happiness can never be found in such a sphere (Book X). The life of total dedication to virtue leads only to a secondary kind of happiness.

In other words, the possibility of seeing such dilemmas is inaccessible to caretakers unless they happen to come into contact themselves, or through friendly others, with the critical spirit that guides the liberal arts education which follows the Socratic spirit of courageous, serious and continuous self-reflection on the dangers permeating our deepest, most unconscious, human needs.

(Note: Of course, another extremely powerful view of this dilemma is that of Nietzsche and his genealogical deconstruction of the good. I fear however, that such an approach is so dramatic that most caretakers will not be able even to perceive its importance.)

Read Full Post »

Older Posts »