I frequently talk with patients who do not want to take medication. It's pretty understandable; nobody wants to take pills. No one wants to start taking insulin. No one wants to wear CPAP at night. Sometimes, people are relieved or hopeful about starting medication, but not really excited. I spend a lot of my time talking to people about things nobody wants. Illness, disease, serious problems, death. These are things we generally do not like to think about.
The challenge is that while nobody wants to take medication, nobody wants to have a heart attack either. Taking medication might be lousy, having a heart attack is lousier. Wearing CPAP might be lousy, being tired all day is even worse. Nobody wants the treatment, but we want the illness even less.
Our lives are filled with many things– including both illness and treatments for illness– that cause us to suffer. The fact that our lives are filled with suffering (and joy too! But that’s for another time), creates all kinds of responses– some helpful, some much less so.
This gets particularly complicated when people blame themselves for the situation, as is particularly common with addiction. “I brought this on myself” is something that I hear a lot. There is often a feeling– both by patients and society in general– that there are people that want to suffer. If you think this, here’s a challenge: the next time you are at a party,tap your glass and get everyone’s attention. Say, “Everyone that would like to have an addiction to alcohol, or to drugs, or would like to have cancer, please come over here.” See how many takers you get.
Suffering, illness, and disease are a part of the human condition. Yes, there is a huge amount we can do to limit this. Paradoxically, sometimes the fact that we can make choices to prevent illness gives us a false sense of security, and makes us even more upset when we do get sick. We protest even more strongly, I’ve done all the right things! Why is this happening to me? Sometimes, they are a consequence of our choices, but often they occur in spite of our choices. In neither case are they things we want or choose for ourselves.
Life doesn’t unfold according to our preferences– we all know this intellectually, but we still spend tremendous energy resisting what’s unpleasant. We resist the diagnosis, the treatment, the side effects, the very idea that our bodies might not obey us forever. We tell ourselves stories to push reality away—I feel fine, It’s not that bad, I’ll deal with it later. It’s a quiet rebellion against the truth that our bodies will fail us.
Much of our pain comes from our attachment to how we think things should be. We believe our bodies should always work, our minds should always be clear, our genes should not put us at risk; that our lives should follow a certain plan. When reality breaks from that script, much of our suffering happens because of our attachment to the script. The pill itself is small; the war we wage against needing it is enormous. We suffer twice—first from our refusal to let it be true, then from the thing itself.
Accepting things as they are sounds simple, but it is one of the hardest things we can do. It can feel like surrender, like giving up. Accepting life on its terms, accepting reality as it is does not equate to surrender. Facing the hard, unmoving reality of illness forces us to discover, (often reluctantly) that when we stop demanding that life be different, the struggle softens. Acceptance isn’t passivity—it’s seeing clearly. It’s acknowledging that life moves according to its own rhythm, not ours, and that peace comes from alignment more than control.
What we call “lousy” is often the friction between our ideas and reality. Taking pills, wearing a mask to sleep, checking blood sugar—we often feel these are reminders that life is not ours to control. But if we stop treating those reminders as insults, they can become teachers. The uncomfortable parts of life point us to something essential: the capacity to meet each moment as it is, not as we wish it were. Meeting each moment exactly as it is, and fully being with it, is what Buddhists call enlightenment.
The irony is that the more we resist the reality of our suffering, the more we suffer. Conversely, the more we embrace it, the more we accept it as a part of our life, the less it hurts. Fixing things is great, and I love doing that, but not everything can be repaired. Freedom comes from releasing the belief that everything can, or needs to be, fixed. Nobody wants this—but when we stop insisting that it should be otherwise, we often find peace.
I am deeply interested in growth, and while I wish illness on no one, I also see how often it is a portal to tremendous growth, and an expansion of the capacity to meet life as it is. I see patients wrestling with the gap between what they want and the reality of our bodies and circumstances. I watch people resist, argue, bargain, and sometimes finally let go. And in those moments of release, there’s a shift.
Love,
Doc
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