“It’s only natural”

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.

The thunder rattles, the dog barks

As the world ages, we gain collective experience. Relationships between things are clarified: insecurity gives way to confidence, truth, gained through an insufferable struggle, turns into familiar axioms that don’t demand any sort of struggle.

The well-intentioned man who once encouraged our predecessors to remind themselves of humility, would be the very first to be ashamed of his naiveté, should he rise from the grave and see the successes of his descendants.

In every way, we have succeeded; in every way, we have become enlightened. As we progress, our beliefs become firmer: they morph from vague illusions into something tangible.

The thunder rattles, the dog barks, the stubborn halfwits triumph – these are the simple truths that we have garnered and on which our future well-being relies. We recognise as truths only those truths that smack us right in between the eyes and physically stimulate our senses. We record in our annals only those facts that have the advantage of being in the perfect tense.

Everything else is labelled as lacking evidence and attributed to the realm of nonsense, and because nonsense is axiomatically useless, we treat this “everything else” with skeptical condensendence if not with outright hatred.

Where our unquestionable truths come from, what effects the thunder has, why a dog barks, why stubborn halfwits triumph, and not good people – we don’t think about it and aren’t interested in explanations. We just take it as fact, immutable and irresistible. On hearing the thunder, we say: this is thunder. On hearing a barking dog, we say: this is a barking dog.

The meaning of all our aspirations and worries is to be free from all doubts forever and to create for ourselves a position of flawless confidence in which we could live without thinking.

Each individual has a preference for a certain framework: we each create a comfort zone, and then we only need to make sure that we don’t venture into the unknown. In front of us, a prize dangles on a string, on which our eyes are fixated and which serves as a guiding star in our journey.

It wouldn’t be fair to say that creating the comfort zone is easy – quite the contrary! There is nothing more fragile than the framework to which we so diligently cling, nor is there anything more insistent on disturbing it than the unknown, from which we so stubbornly run. Staying in the comfort zone requires us to constantly repel the unknown with hard work and even violence… But we persevere. Assuming that our morals have been simplified enough that they don’t impede us in the our zealous quest for the said prize, what happens when we finally sink our teeth into it? I will tell you: the minute we reach the prize, when we feel it in our hands at last, it turns out that its richness isn’t quite what we thought it would be – the prize itself has become a victim of the unknown that we so strenuously fought against. And so, even though we judge the dreamers with their nonsense, we too end up in pursuit of nonsense, crude and stupid.

The question is: what was it that we were fighting for?

This is my rather liberal translation from Mikhail Saltykov-Shchedrin’s Sign of the Times, c. 1863. Quite possibly its first English incarnationOriginal text in Russian.

Saltykov-Shchedrin Legkovesnie Priznaki Vremeni