Sunday, June 10, 2012

The Nature of Affliction and the Role of Fortune


One of my colleagues, a gifted academic physician in her late 40s. has just been diagnosed with a chronic autoimmune disease. In a great deal of pain, she is doing her job as best she can, relying on the rest of us to help out for as long as we can, hoping that this cursed affliction that is assaulting her body and spirit will somehow abate, but knowing full well that the natural history of her disease is more likely filled with debilitation and suffering, as her own T cells march relentlessly into her joints and elsewhere, exploding their cytokines like cluster bombs, destroying every healthy tissue n their path.

This is her second chronic autoimmune disease. The first, which commenced in her 20s, ending her promising career as a surgeon and required that she retrain in a less demanding field of medicine. In the meantime she has been fully engaged caring for mother who will die of a brain tumor within the next year.

The older I get, the more I'm struck by how much success in life, and satisfaction it hopefully brings, depends upon forces beyond our control.  The difficulties in my own life, most of which have been of my own making, seem modest compared to the good fortune visited upon me by forces that feel  beyond my control.  I was lucky to be born a Jew in America, lucky to have the enduring affection and unyielding loyalty of a mate I do not deserve, lucky to have produced two glittering children, one of whom at least has forgiven me my inadequacies as a father, lucky have all of the material comforts and economic security a reasonable person could want, lucky to have been in the right place and time to help write a landmark paper at a very young age that improved medical practice,  lucky to have stumbled into sharing this space with you. I've never been seriously ill or disabled, never lost a job, never buried a spouse, never felt the weight of discrimination, never worried about how the bills would get paid or what the future would hold.

And though I have mostly worked hard and overcome an obstacle here and there, I remain extremely skeptical that I somehow deserve my good fortune. Such a notion seems fatuous (to borrow your phrase) at the very least and sinister at the very worst. For one cannot argue that the more fortunate among us somehow deserve their good fortune without also embracing its counterpart,  that the unlucky and afflicted somehow somehow deserve their misery along with the indolent, the bigoted,, the inept and the criminal.


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