Ethon Lowe | Living to die, and dying to live

One of my most revered and respected patients, 70-year-old Ms M, was carried to my office four weeks ago, extremely weak from vomiting and diarrhoea. I remember her pleading look of despair and her barely audible whisper (not wanting her friends to hear her). "Dr Lowe, I want to die."

She had drunk a potent herbicide. Sadly, she died in hospital a few days ago. Her words kept haunting me, and I keep wondering, why did she come to me if she wanted to die. Was this her way of getting attention? A cry for help? A forlorn hope that I could relieve her of her physical, if not mental, anguish?

Another patient and friend left his wife after 30 years of marriage, shacked up with a young girl, gave her a house, only to have the girl leave him for a younger man. A disappointed love, hopes shattered, he drank weedkiller. He had hopes of happiness and love, but fulfilment rarely satisfies.

Nothing is so fatal to an ideal as its realisation. The realised desire develops new desire, and so on, endlessly. Another friend, struck from practising medicine, his marriage on the rocks, retired to a hotel with the intention of slashing his wrist. Luckily, he heard one of his favourite musical symphonies. Suddenly, he realised that there was still hope.

Sooner or later, everyone discovers that perfect happiness is unrealisable - but few pause to consider the antithesis: that perfect unhappiness is equally unattainable.

Human suffering is relative. One can still have hope even in the most horrific conditions - a spectacle of a beautiful sunset in a Nazi concentration camp, for example.

Rebound

Yes, the human spirit can rebound despite seemingly insurmountable odds. People losing their jobs, going through a divorce, most will relatively quickly revert to their 'normal' selves. Even quadriplegics from car accidents seem to fit this pattern. Depressive illnesses which interrupt the mind's natural mood and affect so many lives can be treated with cognitive therapy and medication.

Is there a correlation between happiness and material prosperity? People in poverty report lower levels of well-being than people comparatively better off. But after a certain level of income, there is practically no relationship between income levels and subjective well-being. Lottery winners, in most cases after a relatively brief period of well-being, soon revert to their previous selves.

Is trying to be happier like trying to be taller? Studies (Review of General Psychology, 2005, Lyubomirsky . 9:111-31) have shown that about 50 per cent of our happiness is due to our genes of which we have no control, like height and eye colour; but 40 per cent is determined by our behaviour - choices we make, taking control of our lives, ample room for improvement of our lives; and only 10 per cent is due to life's circumstances - our birthplace, income, family background, etc.

Happiness lies in achievement rather than what you have. To exercise one's capabilities and wisdom, one might pay the penalty of pain and disillusionment, but isn't unhappy wisdom preferred to blissful ignorance?

No doubt, death is terrible. Much of its terror disappears if one has lived a good life. Unfortunately, man cannot reconcile himself to death. Therefore, he resorts to religion, which promises immortality.

Just as theology is a refuge from death, suicide is the final refuge from life. Diogenes, the Greek Cynic philosopher, is said to have put an end to himself by refusing to breathe; what a victory over the will to live!

But for me, Alex de Tocqueville, the French sociologist ( 1805-1859), has the last word: "In order to gain happiness in this world, a man must refuse to yield blindly to the first onrush of his passions, learning rather to sacrifice the pleasure of the moment, for the lasting interest of his whole life".

- Ethon Lowe is a medical doctor. Email feedback to columns@gleanerjm.com and ethonlowe@gmail.com.