...The Nature of Suffering,Continued
Persons do things. They act, create, make, take part, put together, wind,
unwind, cause to be, and cause to vanish. They know themselves and are
known by these acts. More than the requirements of a role, more than is
necessary in a relationship, more than they know themselves, and some more
(or less) than others, things come out of their mouths, or are done by
their
hands, feet, or entire bodies that express themselves. When illness makes
it
impossible for people to do these things, they are not themselves.
Persons are often, to one degree of another, unaware of much that
happens to them and why. Thus some things in the mind cannot be brought to
awareness by ordinary reflection, memory, or introspection. Where some
have
behaved, in recent times, as though a person was only a political being,
others
have acted as if the only important part of a person was solely his or her
unconscious mind. The structure of the unconscious is pictured quite
differently
by different scholars, but most students of human behavior accept that
such an
interior world exists. People can behave in ways that seem inexplicable
and
strange even to themselves, and the sense of powerlessness the persona may
feel in the face of such behavior can be a source of great distress.
Persons have regular behaviors. In health, we take for granted the details
of our day-to-day behavior. From the moment of awakening in the morning to
the manner of sleep at night, a person's behavior follows a customary
pattern.
Persons know themselves to be well as much by whether they behave as
usual as by any other set of facts. If they cannot do the things they
identify with
the fact of their being, they are not whole.
Every person has a body. The relation with one's body may vary from
identification with it to admiration, loathing, or constant fear. There
are some
who act as though their body's only purpose was to carry their heads
about.
The body may even be a representation of one parent, so that when
something
happens to that person's body it is as though an injury was done to a
parent.
Into this relationship with the body every illness must fit. Disease can
so alter
the relationship that the body is no longer seen as a friend but as an
untrustworthy enemy. This is intensified if the illness occurs without
warning so
that the person comes to distrust his or her perceptions of the body. As
illness
deepens, the person may feel increasingly vulnerable or damaged. Much was
made a few years back of the concept of body image and the suffering
caused
by disease-induced alterations of that image. The body does not actually
have
to be altered to cause damage to the wholeness of the person-- damage to
the
person's relationship with the body is sufficient. Just as many people
have
recently developed an expanded awareness of self as a result of the
changes
in their bodies from exercise, so the potential always exists for a
contraction of
self through injury to the body.
Everyone has a secret life. Sometimes it takes the form of fantasies and
dreams of glory, and sometimes it has a real existence known to only a
few.
Within that secret life are fears and desires, love affairs of the past
and
present, hopes of fantasies, and ways of solving the problems of everyday
life
known to only the person. It is proper that they remain secret-- a
separate,
private life that cannot be predicted from what is known of the public
person.
Modesty is not merely a behavior that hides one from public view; it hides
the
parts of a person what are none of the public's business. There are
cultures
where women have their pubic hair removed. It is no surprise that in those
societies privacy is not allowed. Disease may not only destroy the public
person but the secret person as well. A secret beloved friend may be lost
to a
sick person because he or she has no legitimate place by the sickbed. When
that happens, the sick person may have lost that part of life that made
tolerable
an otherwise embittered existence. The loss may be of only the dream-- the
wish or fantasy (however improbable) that one day might have come true.
Such loss can be a source of great distress and intensely private pain.
Every person has a perceived future. Events that one expects to come to
pass vary from expectations for one's children to a belief in one's
creative
ability. Intense unhappiness results from a loss of that future-- the
future of the
individual person, of children, and of other loved ones. It is in this
dimension of
existence that hope dwells. Hope is one of the necessary traits of a
successful
life. Alisdair MacIntyr's definition is unsurpassed: "Hope is in place
precisely in
the face of evil that tempts us to despair, and more especially that evil
that
belongs specifically to our own age and condition... The presupposition of
hope is, therefore, belief in a reality that transcends what is available
as
evidence." No one has ever questioned the suffering that attends the loss
of
hope.
Everyone has a transcendent dimension-- a life of the spirit, however
expressed or known. Considering the amount of thought devoted to it
through
the ages, the common wisdom contains very little about transcendence,
which
is all the more remarkable given its central place in the relief of
suffering. It is
most directly dealt with in mysticism and in the mystic traditions both
within and
outside formal religions. But it seems evident that the frequency with
which
people have intense feelings of bonding with groups, with ideals, or with
anything larger and more enduring than the person-- of which patriotism is
one
example-- is evidence of the universality of human transcendence. The
quality
of being greater and more lasting than an individual life gives this
aspect of
persons its timeless dimension. However, the profession of medicine
appears
to ignore the human spirit. When I see patients in nursing homes who seem
to
go on forever, existing only for their bodily needs, I wonder whether it
is not
their transcendent dimension that they have lost.
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