In ancient Greek mythology, Pandora is said to have unleashed a range of curses upon mankind. Curiosity led her to open a box1 entrusted to her husband, out of which death, sickness, and a host of other evils escaped.2 But left behind, so the story goes, was hope.
One way to read this (the most common way, I think) is as a sort of consolation. That despite all the evils mankind are forced to endure, we are able to cling to the light of hope. That through hope, we can find the strength to keep going, in the face of sometimes immeasurable pain and suffering. But I've long suspected (both before my accident, and especially since) that the allegorical message of the myth is the opposite: that hope is the worst curse of them all.
The reasons for thinking this way were brought home to me when reading some passages of Adam Smith's moral philosophy that a colleague and I had assigned to students last week. Despite being most famous as a founding father of economic thought, and in the popular imagination believed to be a proponent of untrammelled market activity, Smith is in fact absolutely clear that the pursuit of wealth, even if successful, cannot make a person happy.
This is because, for Smith, the real source of happiness lies in psychic tranquillity, and for which we need only a fairly minimal level of economic security, combined with friendship, and, crucially, an acceptance of our present situation (whatever that may be). Constantly pursuing more subverts psychic tranquillity by making one dissatisfied with one’s situation. Whilst we typically think that acquiring more will give us the means to become happier, this paradoxically subverts the very happiness we seek by ensuring we stay dissatisfied. We end up on a sort of psychic treadmill, chasing an imagined endpoint of happiness that constantly recedes. (Smith makes the point most explicitly with regards the pursuit of monetary gain, but it applies also to things like status, or in my case, publishing academic articles.)
In making his case that the key to happiness is acceptance of one’s situation, whilst thereby disavowing the drive for constant betterment, Smith deploys a dramatic example. He asks the reader to imagine a person whose leg is blown off by a cannon, and what this means in terms of the victim’s long run potential for happiness, now that he will forever be dependent upon a wooden leg. Crucially, however, Smith urges us to pose the question from at least two angles: regarding the physical ailment itself, and what the person concerned makes of it.
Regarding the loss of a leg, cool reflection on the matter should enable one to see that, in the long run, this is a physical disadvantage that need not stand as a permanent obstacle to happiness. Once the initial pain and shock has receded, and once the amputee has had time to process the situation, it should be possible for him to come to view the loss of a leg as essentially an inconvenience. Sure, nobody wants to lose a leg. But if it does happen, so long as one has retained enough material resources to avoid economic hardship, and likewise maintains the company of good friends, and is thus able to secure tranquillity of mind, then it should be possible to once more live a life marked by happiness. The physical ailment in itself ought, in the long run, to be no obstacle to this; what is crucial is that the person who has suffered the disability is able to accept the situation, and hence allow their baseline psychological functioning to achieve tranquillity. Losing a leg is bad. But it is not the end of the world, as many a happy amputee will testify.
For Smith, it really is acceptance that is crucial. He contrasts the man with a wooden leg to the unhappy case of one Joanna of Castile, grieving the death of her husband King Phillip. In attempting to comfort her, a monk relayed to Joanna the story of a previous king who was restored to life thanks to the fervent praying of his widowed wife. Although offered with good intentions, the effect of this tale upon Joanna was disastrous. She attempted to repeat the legend and pray her husband back to life, first resisting his burial, then later exhuming his corpse, and constantly tending to it, watching with frantic anxiety for the moment when he would be restored and thus deliver her happiness. Needless to say, such happiness elluded her. But what she also denied herself was the possibility of any new happiness, which first required her to accept the brute facts of the situation and move on. Or to put it another way, what Joanna most needed was to abandon the hope that her husband would live again. Rather than setting her free, hope kept her prisoner.
And so, to tetraplegia.
I can’t shake the feeling that I am Joanna of Castile, when I need to learn to become the man with a wooden leg. But it’s not easy.
On the one hand, I'm in the same sort of situation as the man whose leg is blown off by a cannon. His leg isn't growing back, and neither is my spinal cord. If I’m going to have any chance of being happy again, I need to accept that this is the reality. Nobody would deny that being in a wheelchair, with virtually useless hands, is a great deal more inconvenient than having a wooden leg. But Smith would rightly point out that being in a wheelchair, with virtually useless hands, is not, given enough time, a permanent obstacle to mental tranquillity. Plenty of happy tetraplegics prove it to be so (and indeed, I have met some of them). If I first accept my situation, and allow my psychology to adjust to it, it should be possible to escape the pit of despair. On the other hand, the man with the wooden leg just needs to glance down at his body for confirmation that his leg is gone, and it isn't coming back. By contrast, every time I look at myself, it's still all there, and so it's hard to shake the belief that surely it will just start working again, as it did for 36 years. The simple fact that I can’t see the lesion in my neck makes it hard to believe both that it's there, and that it's not going away.
Unlike Joanna of Castile, I am not beset by a monk feeding me legends of miracle recovery. But like her, I am consumed by a hope that holds me back. This comes in the form of longing for medical and technological advances that somehow “cure” spinal cord injury. This is indulged by regular Google searches along those lines. Like the other night, when I went down the rabbit hole of investigating NVG-291, the leading candidate for a therapeutic treatment, currently in phase 1b/2a human trials. Riding the high of hope, I convince myself that I'm only going to have to do this for a few years, and then I'm going to get my life back. Hence, I just need to keep going a little longer. But then the hope wears off, and reality hits: that even if it lives up to the most optimistic hopes, NVG-291 is only going to restore partial functions, and will anyway take years to arrive in a clinically administered setting. And even if it does arrive, I am not getting my old life back, because that life is now definitively over. Nothing short of a magic wand can give me what I want. To that extent, I'm in the same boat as Joanna, praying over her dead husband's corpse. Except not quite the same boat, because medical science really does make progress, and the previously impossible sometimes becomes possible, whereas praying never brought anybody back. And so the hope sparks again, the cycle sets off once more, and acceptance fades into the distance, taking happiness with it.
As the saying goes, it's the hope that kills you. My hope is a curse. I need it to die. I need to accept.
Maybe tomorrow.
In fact a vase, or pot, if the Greek is translated properly.
Which was done on purpose by Zeus, taking revenge upon humanity in response to the gift of fire delivered by Prometheus.
This morning, I blew £160 on a replacement filling. Afterwards, I walked four miles back home feeling pretty buoyant, despite my bank account having been holed a few inches above the waterline. I may be poorer, but I also no longer have what felt like the Chicxulub Crater embedded in one of my lower molars. Possibly I have embraced some of Adam Smith's philosophy of acceptance.
My grandfather worked for Shell for most of his life. Through his association with the company, he met the war hero Douglas Bader, who also worked in the oil business. Decades prior to this, in 1931, Bader lost both legs in an air crash. He described the accident as follows: “Crashed. Slow-rolled near the ground. Bad show”. Despite his injuries, he rejoined the RAF in World War II and achieved several aerial victories prior to being shot down and captured by the Germans, from whom he eventually escaped; an extraordinary achievement for a man with no legs. After being recaptured, he was interred in Colditz until the end of the war.
In WWI, over 41,000 British servicemen lost one or more of their limbs. I do not wish to discount the trauma that an injury of this nature can wreak upon the psyche. That being said, these men would have been able to observe others with similar injuries who had recovered and who were able to get around despite their handicap and lead relatively normal lives, and in some cases extraordinary lives. There was a body of reliable evidence upon which a recent amputee could establish his hope for a better future.
In the case of Joanna of Castile, there is no such evidence. There is what amounts to a ghost story. There would have been incidences of people returning to life as a result of being incorrectly identified as dead. That is understandable. I have seen people die. When they go slowly, sometimes it is hard to tell exactly when it happened. However, even in Joanna's time, there would have been abundant evidence that in the majority of cases, dead was dead. The spark of life is absent. They put you in the ground where you eventually rejoin the Scrabble tile bag of elements that were formed during and after the big bang. There was never any real basis for her to hope.
When I was diagnosed with Primary Sclerosing Cholangitis, I read as many of the medical journal articles as I could lay my hands on. In blank prose, that will at most rise to adjectives such as 'regrettable' and 'unfortunate', I learned what I could realistically expect, along with the best that I reasonably could hope for. I also made friends who had been diagnosed around the same time that I had been given my diagnosis. I was able to measure my experiences against their own. Occasionally the discussion would turn towards medical research currently underway, or bespoke treatment. Some people would get quite evangelical about this. The way I thought about, and still do, is to frame this research and these drugs as something that will benefit the next generation of sufferers. You can help them by participating in studies that will advance these new treatments. You can build hope, though you might not be the recipient if or when it bears fruit.
Now all of the friends are dead. All the journals tell me is that I have beaten the odds in terms of survivability, though not the disease which is unbeatable. By remaining hopeful, but moderating those hopes in accordance with hard evidence, I think I have achieved a balance between acceptance of the way things are today, and guarded optimism that things might be better in the future. I am grateful for the present, where I can walk along Southend seafront on a sunny morning in Autumn, and see the geese bobbing at the tideline, and rub my tongue up against my mended tooth.
In terms of the big far-flung hopes that are entertained by the likes of Joanna of Castile, my advice would be to allow others to dream them on your behalf. All over the world there are people researching the various technologies that might restore movement to individuals like yourself. Many of these dreams will remain just that – they were too far-fetched or they were ahead of their time. However, there remains a possibility that one day a new technology that began as the glimmer of a hope, nurtured by some venture capital, might be brought to you as an emergent reality backed by empirical data.
Paul, this reminds me of the prayer adopted by AA “God grant me the serenity to accept the things I can not change, the courage to change the things I can and the wisdom to know the difference.” These words offer comfort to some but each has their own life circumstances. I really do empathise with your situation. My brother in law passed away a few days ago. He had been suffering from Parkinson’s disease for several years but, prior to this, he was an avid sportsman, spent all his days, active, outdoors. He found this illness unbearable and at the end as he lost all control of his body. He was always strong and determined, always in control. and so, no longer wanting to live he no longer ate and declined rapidly. The family hired a private nurse to administer IV and care as (being in Lebanon) they feared the hospital would be bombed, but he saw no hope at all, and as my Irish family would say, he gave up the ghost. He was a strong man in every way so we could all see how difficult this illness was for him and the toll it took on him but with his death, which we can acknowledge as a release for him, his loss has been felt very deeply, and his physical presence leaves a big hole. However he had lived a long life, over 75 years of being fully active and healthy before deteriorating dying at age 84.
Please forgive me if I sound patronising, as I fear anything I may say might come across that way as I’m not in
your situation, I am not living it, but as someone else has said, this has been a short time to adjust, to accept this major life change and Paul, to be honest, I actually think you are doing incredibly well, back teaching, writing, you mentioned you had attended a wedding in one of your posts. I think you are courageous and a brave young man.