Your health is not under your control — A reminder

[image: yours truly, selfie at the emergency room; this is essay #298 in the Figs in Winter series]

As regular readers know very well, one of the foundational passages in ancient Stoic literature is found right at the beginning of Epictetus’ Manual:

Some things are up to us, while others are not. Up to us are opinion, motivation, desire, aversion, and, in a word, whatever is of our own doing; not up to us are our body, our property, reputation, office, and, in a word, whatever is not of our own doing. (Enchiridion 1.1)

In my experience, most people don’t deny that we control our conscious thoughts (the unconscious is a whole different matter), but are puzzled by the claim that we don’t control externals, and particularly the first entry in Epictetus’ list: body.

What do you mean I don’t control my body? Of course I do. I can decide to eat healthy, go to the gym, and see my doctor regularly, in order to practice preventive medicine. How is that not controlling my body?

Well, first off, the list of body-related things I just gave you is actually a list of judgments and decisions to act or not to act. It is my considered judgment that I ought to eat healthy, go to the gym, and see a doctor on a regular basis. And the decision to act on such judgments is, again, mine.

Want a good real life example of why such decisions and judgments still do not amount to having control over your body? I’m glad you asked. For many years — guided by my prohairesis — I have taken exactly the steps outlined above in order to maintain my health, with a pretty good degree of success, arriving at the ripe age of 57 with no surgeries or major diseases.

Then something happened at the beginning of this week. I was near the entry door to my apartment, intent on putting on my shoes to go outside. I bent toward the shoes, as I have done countless times since I started wearing shoes, when suddenly I felt a nasty snap somewhere in my lower back and collapsed to the floor in acute pain. My wife had to call an ambulance, as I couldn’t move without sharp pain. We spent eight hours at the emergency room, mostly doing nothing but reading and checking email.

The hospital staff did a couple of CT scans, and the doctor in charge told me that it is possible that I am suffering from an herniated disc, that is a bulging of the disk situated between my 4th and 5th lumbar vertebrae. I was told to go home, take pain suppressors and muscle relaxants, and see a specialist as soon as possible.

Which of course I did (again, judgment!). And the news seems to be better than expected. Although there is, indeed, a minor bulging of the inter-vertebral disc, it looks like the other day I simply pulled a major muscle on my back. Likely the result of too much sitting and slouching on the couch during covid. Call it another (minor) casualty of the pandemic. Allegedly, I should be getting back to normal within a couple of weeks, thanks to the above mentioned medicinals and some cold ice packs. I better, ’cause I’d like to attend my daughter’s wedding ceremony in Connecticut later this month!

The episode was a stark reminder, if any was necessary, that despite my good judgment about my health (well, okay, except for the slouching on the couch part), my body had decided to act out in a way that was as painful as unpredictable.

As soon as I felt the snapping and the pain I didn’t think about anything other than “WTF?” But seconds later, lying on the floor, I immediately thought about what was “up to me” in this situation. The answer: ask my wife to call an ambulance, obviously.

Once in the hospital, as I said, we had to wait a long time for me to get the scans, and then some more before the doctor came around to talk to us and eventually discharge me. So, again, what was up to me, given the circumstances? Not much! But before getting on the ambulance I had predicted that there might be long waiting times ahead, since my injury was not life threatening, so I brought my smart phone with me and got busy catching up with my readings. (Nice to have my entire library, with personal annotations, always in my pocket!)

My Stoic practice was useful also in another respect: I could have, as some do, become impatient with the staff, which didn’t seem very busy and yet didn’t appear to do anything about my condition. But I remembered Epictetus:

Here is the test of the matter, this is how the philosopher is proved. For fever too is a part of life, like walking, sailing, traveling. Do you read when you are walking? No. Nor do you in a fever: but if you walk aright, you have done your part as a walker; if you bear your fever aright, you have done your part as a sick man. (Discourses III, 10)

There is, I assure you, a place for virtue even upon a bed of sickness. It is not only the sword and the battle-line that prove the soul alert and unconquered by fear; a man can display bravery even when wrapped in his bed-clothes. (Letter LXXVIII.21)

And of course patience and good humor (not just mine, but my wife’s also) are the same attitudes that will allow me to handle the next few weeks of recovery. Will I get better, or will there be need for more tests and a more complex approach? I don’t know. I’ll cross that bridge if and when I’ll get there. Will I be able to attend my daughter’s wedding? In all likelihood, but always with the Stoic reserve clause: “if Fortuna allows.”

In the great scheme of things, of course, what I’m going through is small potatoes. My friend Rob Colter (co-host with me of the Stoa Nova Conversations) years ago had a much more serious, life threatening episode while he was traveling in Australia. He had to be operated, and he told me that right before going under he thought to himself, well, either I wake up or I don’t. In the first case things will have gone well. In the second one, I won’t be there to complain… Now, that’s what I call a Stoic attitude!

by Massimo Pigliucci. Stoicism, ethics, and philosophy of science. Complete index, by subject, at

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