This is a work of fiction. Names, characters, businesses, places, events, locales, and incidents are either the products of the author’s imagination or used in a fictitious manner. Any resemblance to actual persons, living or dead, or actual events is purely coincidental. This is not intended as a substitute for the medical advice of physicians. The reader should regularly consult a physician in matters relating to his/her health and particularly with respect to any symptoms that may require diagnosis or medical attention.
A very handsome, fit and well-dressed young man came in to see me about a nagging, chronic gut problem. This is the sort of thing that medicine doesn’t really have an answer for and the referring family doctor knew this as did the said dashing young man. The reason for her referral was that he had had enough.
I took a very long history filled with exacerbations and remissions going back to when he was a teenager, alleviating and aggravating factors that the tormented young man never really managed to leverage.
All the same, he was ahead of the curve in his career. He travelled extensively, ran a half-marathon and even climbed Kilimanjaro.
We were nearly certain that his condition didn’t have an organic cause we could address, but given the one or two potential pointers for such a cause, the duration and extent of his distress, it was decided that the gentleman should have some specialist investigations. As a sort of an advance measure, we gently suggested that in all likelihood, the tests won’t find anything and if so, there won’t be much we could offer him besides a few tweaks of what has helped him in the past. At this point he covered his face with his hand, then made a tight fist whitening his knuckles, plunging visibly into anger and frustration – not so much at us, it seemed, but at the powerlessness of medicine and his ill fate.
There is no denying that this high-flying man suffered greatly with his imperfect bowel. I was left there wondering two things.
This man is so accomplished, able to climb mountains and run marathons, why does he so firmly believe that his condition is “debilitating”? I can only presume that he has a kind of equation in his head where his potential plus his condition equals his reality. I did wonder if his reality could have been far more impressive had it not been for these bouts of gastrointestinal torture. I have the suspicion that the thought occurred to him. Perhaps it occurred to him many times a day.
Furthermore, if he is determined to eradicate this unidentified fiend sabotaging his gut, why didn’t he do more of what worked and avoid the aggravating factors? It would seem a little maladaptive to refuse to negotiate with the affliction. Or did he write down all his shortfalls to the condition, thus allowing him to sustain a vision of unadulterated, perfect potential trapped by the wretched disease?
I then wondered if that is our perfectionist millennial nature that’s always chasing the latest maximising-optimising lifehack or is that the sort of irreducible self-selection that particular kind of young person to hospital regardless of their generation or culture.
The reason I wonder this is that only last week I was trying to convince a much older man to consider treatment for his chronic pain, but he insisted, “it’s only natural”. Then again, I don’t think it would ever occur to him to climb Kilimanjaro.
3 thoughts on ““It’s only natural””
This man’s suffering is not because he has gut problems, but because he doesn’t want to have gut problems. Applications of Buddhist attitudes to psychotherapy, such as “Mindfulness-based CBT” or “Acceptance and Commitment Therapy” have the potential to leading him to a good life. It is possible that approach may actually get rid of his gut ache, but even if he doesn’t, he can live in contentment. Get him to read “The Happiness Trap? by Russ Harris.
Sorry. On re-reading I’ve found one typo.
That’s very true – you appear to have a consistent approach to life’s vicissitudes