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LETTER LXXVIII – Illness and Attitude. Perspective Matters

June 4, 2025, 7:28 p.m.

Seneca's Wisdom: Navigating Adversity

One of Seneca's longest and, in my opinion, most fascinating letters to Lucilius essentially distills a fundamental Stoic principle: we don't control many things and events, but how we react to them is always within our power. Seneca was no stranger to misfortune, illness, adversity, and setbacks. In fact, getting to know his history might lead one to the opposite conclusion. I don't recall ever encountering his confessions about the darkest thoughts that sometimes plague a portion of the population – thoughts of suicide. Yet, even this did not escape Seneca himself, who admits that, exhausted by his health condition, he thought about it more than once. However, each time, the thought of his father stopped him; he simply couldn't do that to him. He wasn't reflecting on how brave he was for being ready to end his life, but rather on how far from brave his father would be if he had to endure the pain of losing such a close person.

"There are times when even to live is an act of bravery."

It seems our times are not so different from others in terms of suffering. Suffering has been, is, and appears it will remain with humanity for many, many years, whether we like it or not. In the movie 'The Devil's Advocate,' one of the main characters, John Milton (played by Al Pacino), utters these words:

"Pressure. Some people, you squeeze them, they focus. Others fold."

It's a bit similar with suffering. Some people go through it, keeping their goal in mind, their reason for enduring such a difficult period, or for whom they endure it. They constantly see a specific point on the horizon guiding them like a lighthouse guides a ship on a dark, stormy night. The others, however, break at the first signs that suffering is coming. They convince themselves they aren't ready for it, that it's too much for them, that they can't fight, often exaggerating the situation. They create additional pain in their minds that doesn't exist in reality, falling into a vicious cycle that's incredibly hard to escape, all while undermining their own capabilities. They write themselves off from the start, often at a point when they don't even fully know what they're up against.

A question might arise: is there a way, a recipe, an algorithm for dealing with such difficult, often dramatic situations? Seneca claims there is, and he shared it.

Comforting Thoughts

"What nonsense and rubbish!" That was my initial reaction! However, after a moment's thought, I realized I was wrong. It's been known for a long time that our attitude matters. Years ago, when I watched one of the first seasons of the series 'Grey's Anatomy,' there was a scene where doctors debated the sense of performing an organ transplant on a patient who had a very negative attitude towards it, or didn't even fully want the transplant. I don't remember the full context of that episode, but the point was that the patient's attitude had a real impact on whether the body would accept the transplant. Of course, it's just a TV show, and I'm not a doctor nor do I have a medical background, but from what I understand, this is a very real situation, and often the state of our psyche has a crucial impact on the body's physiological processes. Seneca writes:

"anything which raises his spirits benefits him physically as well"

And everything indicates he was right. However, I cannot ignore a problem that constantly occupies my mind as I write about this. There are people who do not exhibit such comforting thoughts, who are more pessimistically realistic in the face of various difficulties. For them, it will be much, much harder to implement such comforting thoughts, to switch and reprogram themselves into a "focus on the positives and look hopefully at both the present and potential future" mode – it's simply absurdly difficult. For such individuals, trying to implement this new way of thinking will seem like self-deception, like saying and thinking things that aren't truly in their head, that don't naturally form in their mind, and that are rejected at the initial stage. Fortunately, the level of difficulty does not indicate an impossibility of achieving this goal.

Friends

In an epidemic of loneliness, presenting the argument of friendship as an important auxiliary element during periods of illness and suffering can be like a nail in the coffin for many people. How many? According to several independent sources, approximately 8% to 13% of adult populations in America and Europe have no close friends. This is a heartbreaking statistic, especially since trends indicate a deepening of this crisis. Lonely people are more prone to negative emotions, sadness, stress, and anxiety, which can lead to serious health problems. Seneca was grateful for the presence of his friends, for their comforting remarks, for conversations, for diverting his attention from suffering and pain, for shared laughter, for conversation! For a simple conversation.

"There is nothing, my good Lucilius, quite like the devotion of one’s friends for supporting one in illness and restoring one to health, or for dispelling one’s anticipation and dread of death."

Seneca felt motivated by this aura of friendship, motivated to live and endure whatever fate brought him. It was also comforting to feel that even if illness defeated him, he would still be present in the thoughts and hearts of his friends. His spirit would live on.

Medical Recommendations

Medical doctors didn't pull all-nighters studying and cram their minds with Latin terms just so their recommendations and prescriptions could be completely and thoughtlessly ignored. If something ails someone, they should go to a specialist – and a good specialist isn't easy to find – and then follow their advice. This is a necessary condition in most cases if we want to get back on our feet or achieve another desired outcome. Medicines, exercise, diet, things and activities to avoid, and those we should embrace. All of this applies; we need to muster a pinch of trust.

Accepting the Idea of Death

It seems to me that death was once more present than it is today, especially in times when the vast majority of society relied on agriculture, and larger families lived on these farms, which involved caring for the elderly and accompanying them on their journey to the other side. Today, there's a trend of people moving away from villages, from small and medium-sized towns, and a growing influx of young, ambitious blood towards large metropolises where individualism, competitiveness, and loneliness in a crowd reign, in exchange for access to education, a larger job market, and better public services. There isn't even the death of animals here, and for grief and coming to terms with the loss of a loved one, we get a day off work, or two, or maybe a week? For the funeral, sorting out formalities, organizing the wake, and reflecting on what this death meant to us and what steps lie ahead. Maybe a week is an exaggeration; to be honest, I've never heard of someone getting a whole week off to process such an event, for example, the loss of a parent. Either way, we have somewhere between 24 and 168 hours to digest the situation and return to productive work at a similar level as before. Whether this is good or not, I'm not going to judge, but I know these are just brief moments where we remember death. Many of us are terrified by it: what if I get seriously ill and die? It would be better to get used to it and remember that it's part of our natural process. Each of us is condemned to death.

"You will die not because you are sick but because you are alive. That end still awaits you when you have been cured. In getting well again you may be escaping some ill health but not death."

We shouldn't worry about it so much.

For Seneca, the worst aspects of illness are three things: the fear of death, physical suffering, and the necessity of giving up activities that brought us pleasure. As for physical suffering, for Seneca, it is either brief or bearable. This makes sense; there are known cases where pain is so immense that it causes fainting. Apparently, the nervous system is so overloaded that the body begins to 'cut off' the unfortunate person from consciousness and enters an emergency state. This is hardly comforting, because even 'bearable' pain can be absurdly consuming of our attention and much of our energy, giving absolutely nothing in return. Perhaps one day I will glean more from Seneca's words than my current reflection.

In the letter, there is also the argument that a characteristic of enlightened people, people who have dedicated themselves and their lives to philosophy and the pursuit of wisdom, is that they can separate their body from their spirit. In case of physical ailments that may exclude them from many activities, they can always direct all or most of their attention towards the spirit and seek satisfaction and fulfillment there. This sounds beautiful, but is it true? For it to be true for me, I must add that the satisfaction and fulfillment possible to find in this divine element does not fill the void that often arises when someone ceases to be able to do the things that made them "feel alive," for which someone felt they were even created, called to do. And in this case, time does not always heal all wounds, and certainly does not always make the scar completely disappear.

However, I agree 100% that constantly emphasizing how bad one has it, how much one suffers, what a tragic state one is in – this is completely unnecessary. There is nothing helpful in it; it gives nothing to anyone, it doesn't make doctors try harder to help us, or treat us more seriously, and talking like this after the illness has passed, after one has managed to get back on track, is even more absurd. In these difficult, hopeless moments, there is no other option. One must clench their fists very tightly, lift their head up, and stand up to fight, if not for oneself, then for others, to set an example that it is not over yet.

You will be demonstrating that even if one cannot always beat it one can

always bear an illness. There is room for heroism, I assure you, in bed as anywhere else. War and

the battle-front are not the only spheres in which proof is to be had of a spirited and fearless

character: a person‟s bravery is no less evident under the bed-clothes. There is something it lies

open to you to achieve, and that is making the fight with illness a good one.