I was in my upstairs office when I heard the doorbell ring. I ran downstairs to open the door, unable to see through the opaque window who was on the other side. I opened the door, and there stood an elderly Black man and woman, well dressed, with leaflets and literature. I immediately recognized that this was an unsolicited proselytization.
“Can I help you,” I inquired. The woman handed me a pamphlet and asked, “Do you believe that human suffering will end?” I glanced at the pamphlet but not really searching for the answer.
“I’m tied up at the moment, ma’am, but ‘no,’ I do not believe suffering will end.” I returned the pamphlet, thanked her, and closed the door.” I was borderline rude. I was pressed for time.
I might have answered “yes” to her question at one time, that human suffering will end one day, but how could I answer in the affirmative now, less than three weeks after the unthinkable loss of life of defenseless Israelis at the hands of Hamas terrorists. Carnage was the predominant image in my mind when I answered “no” as to whether human suffering will ever end.
The two individuals at my front door would no doubt beg to differ with me. Jehovah’s Witnesses believe the end of suffering is at hand, and God has promised to do away with all causes of human suffering, including crime, warfare, sickness, and natural disasters. I wasn’t in the mood to debate them, although had I been, I might have chosen to debate “sickness” rather than “warfare.” Each is equally deserving as a discussion point, but I’m a healer and not a politician.
I wanted to tell my unsolicited guests that, as a physician, I am committed to alleviating human suffering to the best of my ability through medical science and compassionate care. However, it is important to understand that suffering, in its various forms, is a part of the human condition. It is influenced by a multitude of factors beyond physical health, including psychological, social, and environmental factors.
While medical advancements continue to improve our ability to treat and prevent diseases, thus reducing physical suffering, it is beyond the scope of medicine to completely eliminate all forms of human suffering. This is because suffering is not just biological but also psychological, emotional, and existential.
However, this doesn’t mean we should stop striving to alleviate suffering wherever we can. As physicians, we are tasked with not only treating illness but also improving quality of life, providing comfort, and offering psychological and emotional support. These efforts, both big and small, contribute to reducing suffering in the world.
It’s also been said that suffering can sometimes lead to personal growth and resilience. Many philosophical and spiritual traditions argue that suffering is a necessary part of life and can lead to greater wisdom and empathy. As a psychiatrist, I don’t fully agree with that reasoning, especially as someone who has suffered in the past from serious depression. I would not wish it upon anyone.
Sir Winston Churchill was plagued throughout his life by recurrent episodes of severe depression, which he ruefully characterized as his “black dog,” a faithful companion, sometimes out of sight, but always returning.
According to the Oxford English Dictionary, the first use of the phrase “black dog” to describe melancholy and depression was in 1776 by Dr. Samuel Johnson, the creator of the English Dictionary, who suffered from clinical depression. Johnson called his melancholia “the black dog” in conversations and correspondence with his friends. Andrew Solomon, in The Noonday Demon: An Anatomy of Depression, states that both Abraham Lincoln and Winston Churchill “suffered from depression [and used] their anxiety and their concern as the basis for their leadership.”
I find it hard to believe that severely depressed persons can be effective leaders given that severe depression results in marked indecisiveness, apathy, complete loss of pleasure (anhedonia), and slowed down mental and physical activities to the point of paralysis (psychomotor retardation). All of these features hamper the ability to lead.
William Styron, author of Sophie’s Choice, said: “The pain of severe depression is quite unimaginable to those who have not suffered it, and it kills in many instances because its anguish can no longer be borne.” Styron’s memoir, Darkness Visible, discusses his public fight with depression, and his advocacy has helped others who have struggled with mental illness. Unlike another book I have read, The Secret Strength of Depression, depression has no silver lining. We are not better for having survived it. In fact, we are more likely to experience it again.
The late 60 Minutes host Mike Wallace was also very public about his battle with depression and suicide (overdose). He had difficulty eating, sleeping, and concentrating, and even after revealing to a family physician that he was worried about his mental state, Wallace said the doctor told him, “You’re a tough guy. You’ll get through it.” Wallace’s wife, Mary, believed he was suffering from clinical depression, but the doctor reportedly told the couple, “Forget the word ‘depression’ because that’ll be bad for your image.”
Had Wallace been successful in completing suicide, what would his image have been then? It would literally have been buried six feet underground, and the image of his legacy would have been tarnished. Fortunately, Wallace sought psychiatric treatment and regained his health through psychotherapy and antidepressant medication.
I’ve witnessed too much suffering in my career – from sickness and mental illness alone, let alone other types of suffering mentioned by the Jehovah’s Witnesses. My lived experience as a physician would have been the basis of informing them that I believe it’s unlikely that human suffering will ever completely cease. However, I would have added that it is our duty as physicians, and as members of society, to work tirelessly to alleviate suffering as much as possible, and in the words of William K. Root, MD, to “be worthy to serve the suffering.”
Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia, PA. He is the author of Every Story Counts: Exploring Contemporary Practice Through Narrative Medicine.