Norman Cousins’ Anatomy of an Illness is a book as relevant today as it was upon publication in 1972. Cousins has a compelling story of overcoming the dismal prognosis of doctors. Most famously, when diagnosed with a degenerative ankylosing spondylitis, Cousins took his health into his own hands, feeding body and soul with an emphasis on laughter and the will to live.
Such a story does not universally win praise. You’ll notice that people who are fortunate—whether with money, good looks, or good health—are often discredited, their accounts of valor dismissed as good luck. We’d rather live under the unsupported notion that someone somewhere has it easy than take a hard look at what other people do exceptionally well.
Missing Laughter, Missing Life
As we said, not everyone was charmed by Cousin’s insights about the nature of health and the powers of the mind we often fail to tap into. If his book were more widely known today, it would likely face scorn. For an indication of why this might be the case, look no further than the scathing review of one Florence A. Ruderman. In “A Placebo for the Doctor,” Ruderman takes Cousins to task for his egomania and irresponsible dismissiveness of the medical establishment. Does her criticism hold water?
Ruderman calls into question the narrative framing Cousins work, writing, “It seems entirely possible that what Cousins had was an acute attack of an arthritic condition which then subsided, slowly, but quite naturally.” She also casts aspersions on his claim that he was earlier in life diagnosed with a serious heart condition. Given that Cousins eventually died of a heart attack, he seems to redeem some credit on that front.
The subject that seems to most get under Ruderman’s skin is that of humor. A good writer and sharp as a tack, it’s hard to imagine Ruderman without wit, but in condemning Cousins she buries any indication humor or good cheer. She writes, “I have a strong feeling that those who can find solace for the ills of the world, and for their own supposedly crippling and possibly fatal illnesses, in Candid Camera and similar ‘classics,’ are nearly indestructible in any case.”
We really are that simple
Au contraire, though we may grow up and put on the airs of sophistication, we remain tied to cumbersome physicality and the mysterious world we inhabit. Indeed, seemingly the most trivial factors—how many hours slept, the last time food was consumed, the pollen in the air—can drastically affect our outlook.
Yet, she goes on about “the movies, the joke-books, and so on,” demanding, “Is the will to live so easily manipulated, so dependent on trivial, superficial agencies, in anyone, even in Norman Cousins?” Clearly. Living in a world of unprecedented affluence, abundance, and opportunity, loads of people are listless and depressed. The big problems of life solved for so many of us, it seems it really is the small stuff that can make a difference.
This is no less true in medical circumstances as in others. The warm, personal touch of a doctor—a hand placed reassuringly on the arm of a patient—can make a tremendous difference in how news is received and the course of treatment discussed.
Seemingly trivial gestures create energy in the environment. Anyone with an ounce of emotional intelligence is aware of tension when walking into a room where a difficult conversation has just occurred. A person who is ill perceives the anxiety and despair in the people around him. Telling a joke can be enough to turn the tide of emotion. So small, so seemingly insignificant, jokes and movies can feed the soul.
A life without suffering?
Ultimately, Ruderman’s accusation is that Cousins didn’t have any real suffering to overcome. While allowing that “positive emotions” do, indeed, play a role in health, Ruderman wrongly relegates positive emotions to the general wellbeing attained through good genetics and beneficial life circumstances as painted with broad strokes. She claims that Cousins demonstrates “positive emotion” most “through his extraordinary freedom from all inner and outer stress: from any possible negative reality. There is nothing in what Cousins tells us (or what we know or can infer of the man himself) to suggest any serious emotional or intellectual strain, any stressful life circumstances. The pressures and constraints—the anxieties, frustrations, turmoil—of other lives, are not even dreamed of here.” In other words, it seems Ruderman is saying, Cousins knows nothing of suffering because he is a big, bad, white man.
Identity politics have been around for quite a while. It’s not just the past generation that has seen an obsession with what type of people allegedly have advantages in life. The pesky thing about people is an unwillingness to conform to their lot in life. It is the refuge of lesser minds to assume that someone by virtue of birth has an easy life in which everything is within his control and the terror of the abyss has no hold on him.
This is foolishness. To live is to suffer. In the words of the inimitable Kurt Cobain: “Nobody dies a virgin… Life f**ks us all.” Bit barbaric in the articulation, but Mr. Cobain has a point.
The power of the interior life
Life is not simply external phenomena happening to us. There is an interchange of external realities with our internal imaginative capacity. Ruderman’s overly simplistic mechanism for explaining good health and ill fails utterly to address why perfectly healthy young people from affluent, seemingly happy families end their lives through the reckless use of opioids. Control is, after all, illusory, and no one can determine the number of his days.
Ruderman wrote, “I have the same feeling in regard to those who think that the operation of their body’s natural processes is somehow due to their own brilliance or originality. This is the mentality of the cock who perceives clearly that his crowing made the sun rise.” It’s a lovely line, but she fails to credit Cousins where credit is due. He never claims to have brilliance, only ordinary hope that underlies a robust will to live. This is not beyond the reach even of those who live in severely constrained circumstances.
We all know people who spend years dying. No matter the malady, practically any disorder can be fatal.
Just as the “rain falls on the just and the unjust” (Matthew 5:45), it seems there can be a literal signification for Matthew 13:12. “For to everyone who has, more will be given, and he will have abundance; but from him who does not have, even what he has will be taken away.” Known as the Matthew Effect, there are real-world examples of how terribly unfair life is. Cousins did not come to his state of resilience overnight; most people don’t. In his book, Cousins explains how a childhood illness led to a misdiagnosis that was thought to be fatal, and, again, in early adulthood he was diagnosed with a fatal heart condition. In each instance, he grew in his conviction of the power of the human spirit to persevere. Nowhere does he claim it is magic or guaranteed to overcome any obstacle.
As with so many other situations, the person who won success in small stakes grows to conquer far greater ground. When the world was closing in and Cousins was met with pain and despair, he had cultivated the interior reserves to continue the race.
Regardless of situation, hope is an essential element of the interior life. No class of people is immune to the benefits of rightly ordered thinking and interior freedom. Rudermans of the world aside, we all can learn to appreciate a good joke and take the lighter side of life seriously.
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