Not to Counterfeit Being Sick

I have known men who affected illness for the advantages it brought — exemption from duty, the tender attentions of others, a useful excuse for avoiding what they did not wish to undertake. It is a comprehensible strategy. What I find remarkable is how rarely it remains a strategy. The man who begins by pretending to be ill, and is treated as ill, and rests as the ill rest, and is spoken to in the careful tones reserved for the infirm — this man does not usually end by discarding the role when it has served its purpose. He has, by then, entered the role. He is the sick man.

This is the precise mechanism by which a temporary convenience becomes a permanent condition. We are creatures of our habits, and the deepest habits are the habits of self-presentation, because we spend our whole lives inside them and rarely notice that we have put them on. The soldier who pretends to be frightened to avoid a dangerous assignment discovers that he is frightened. The man who plays the fool to escape responsibility discovers that he has lost the respect that would have made responsibility supportable.

“Those who yield to their disease, and suffer it to master them, lose the benefit of their health, and accustom both the body and the soul to a dependency they cannot afterwards shake off.”

I say this with some feeling, being a man who has had genuine cause to be preoccupied with his health. The kidney stone does not require me to counterfeit anything — it announces itself plainly enough. But I have had to guard against the opposite temptation: the temptation to inhabit illness too fully, to organize my life entirely around the management of pain, to let the invalid become my primary identity. There is a kind of surrender in this that goes beyond the body — a surrender of the will, of the engagement with life, that health requires even from the genuinely sick.

Health, even imperfect health, is an achievement of attention. The body left entirely to its own devices will find more to complain of. The mind that takes up residence in the body’s complaints will find them expanding to fill the space available. This is not to say that suffering is imaginary — it is not — but that we have more influence over the size it occupies in our lives than we generally suppose, and that the choice to insist upon living, not upon suffering, is one of the genuine moral choices available to us.