Belfast Telegraph

A brief time spent in your sickbed can teach us to slow down, take stock... and face up to mortality

Cycle of life: Dr Paul Kalanithi
Cycle of life: Dr Paul Kalanithi

By Mary Kenny

We talk a lot these days about having "agency" - our capacity to exert our own will - and "bodily autonomy" - our rights of ownership over our own body. But if there's one thing that totally wipes out notions of "agency" and "bodily autonomy"it's illness.

When you fall ill, you resign all those affirmations of your bodily entitlements. You crawl back into bed craving rest and semi-oblivion. You don't own your own body anymore. It's been taken over by another force - the bacteria, which is now calling the shots. There have been a variety of winter bugs doing the rounds over the past couple of months, and for 10 days or so, I copped a nasty strain of whatever it was. So did lots of people.

Being ill is part of the human condition, and yet the experience can take us by surprise. It's astonishing how the landscape changes. Life becomes colourless. Everything seems difficult and wearisome. You have to drag yourself to the kitchen or bathroom. Food is a matter of indifference and the effort to make a cup of tea seems too much bother. A lot of things that appeared important last week now somehow don't matter.

What you have to do - and it goes against the grain - is to succumb. Give up. Admit that the illness has "agency" over you. I hate cancelling appointments and meetings, because I feel I'm letting people down (and I may also be losing revenue, which is a further annoyance), but that is a form of egotism.

The world will get along very nicely without you, and if you can't fulfil a commitment, things will quickly re-adjust. Illness is a strain on the body, but it is also a discipline for the character, a lesson in humility, a time for reflection, and a rehearsal for death. When you're feeling extremely ill, you don't really care whether you'll live or die: just let me lie here quietly and go with the flow, whatever that is. Self-pity can set in: if I expired in the night, would anyone care?

"Illness is the night-side of life, a more onerous citizenship," wrote Susan Sontag in her famous essay Illness as Metaphor. "Everyone who is born holds dual citizenship in the kingdom of the well and in the kingdom of the sick." We prefer our wellness realm, but sooner or later, we are obliged to identify as citizens of the darker place.

But we resist. When I was a child, you weren't allowed to "give in" to feelings of being unwell with too much alacrity.

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There was a stoical tradition. If you had a headache you had to try curing it the natural way first: lie down in a darkened room. If symptoms persisted, you were eventually permitted an aspirin. Admitting to illness too easily might soften your character and make you unfit for life's tribulations. And "faking it" was unlucky. "Mocking is catching," went the warning. Selective illness was also ruled out. If you weren't well enough to go to Mass, you weren't well enough to go to the pictures.

And yet, as I lay on my recent sickbed, contemplating my lack of agency and bodily autonomy, I cast my mind back to the times when I was genuinely ill, as a child and a young person, and how kindly I had been cared for by my family. They looked after me, they cosseted me, they called the doctor - and paid for his ministrations too.

Never once, I now reflect, did I thank them. Never once did I show my appreciation. Took it all for granted. How I wish I could go back in time and express my gratitude now!

I still don't believe in rushing for antibiotics at the first sign of sickness - and for many conditions, they don't work anyway. But in the end, I did need a form of penicillin to tackle the infection and I felt duly grateful to Alexander Fleming. I thought of all those people who perished from TB - still within living memory, in the 1940s - before drugs became available. A little boy in our Sandymount neighbourhood had to be isolated, alone, in a sort of garden shed because he was tubercular - he died.

There is a big difference between a nasty winter infection and a serious or fatal illness. But one can be a preparation for the other.

Paul Kalanithi, the doctor who documented his own last, fatal illness in his post-mortem memoir, When Breath Becomes Air, wrote that what patients sometimes say to a medic during a challenging illness is "Do you think my life has meaning? Did I make the right choices?" It's literally sickening to realise that sometimes you didn't. Being laid low helps to give you the opportunity to experience all the flashbacks - malady makes you reflect on life.

When you're in a state of total lassitude, you realise that one of life's greatest gifts is energy. There are also thoughts about compassion. Was I really compassionate enough when I sat by the bedside of others? Quite often, I was not. There's a passage in Ulysses when Joyce recalls witnessing the convulsions of his dying mother and how much he just wanted to escape this scene, to live life. Joyce's honesty is both horrible and compelling. It's true - the healthy often just want to avoid the sickbed. Susan Sontag writes that sick people have often been shunned.

My late brother Carlos believed that it was good for us to catch a brief winter illness - it taught us to slow down, rest, stop rushing about and clear out the system. Illness surely plays a part in the cycle of life and in making us face our powerlessness and mortality.

Belfast Telegraph


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