Katerina Dima
Preveza, Greece

 

“Sysphus, carrying the weight of his agony, forever.” Sisyphus, 1548, Titan Museo del Prado, Madrid, Spain.

Ancient Greek mythology teems with stories of morality, despair, and the philosophy of the absurd. No story, however, had a greater impact on this young, impressionable medical student than the story of Sisyphus.

Sisyphus was a popular and prominent figure of Ancient Greece, the successful king of the city of Corinth. As a man of wit and intelligence, he would consistently succeed in tricking the gods, murdering guests, stealing secrets, even cheating death himself—often through hubris, the ultimate crime. Only after his arrival to the Underworld did the gods catch up with him and condemn him to endlessly roll a giant boulder up a steep hill. To ensure his punishment Zeus enchanted the rock so it would roll away from his grasp just as he was about to reach the top. Thus, Sisyphus was condemned to an eternity of trying and failing, without ever achieving gratification, chained to a life of incessant misery.

This gives rise to the inevitable questions: how is Sisyphus to escape the true horror of this eternal damnation? Surely, no human could ever suffer such a meaningless punishment without losing one’s mind? So how is Sisyphus to find salvation? Had Sisyphus not already been dead, would taking his life release him? Would his punishment give him reason enough to put an end to the misery, putting an end to it all?

In 1942, Albert Camus attempted to challenge humanity’s perspective of the myth of Sisyphus and of the way we look at the absurdity of life. In the final chapter of his essay, Camus argues that Sisyphus is indeed hopeless. But “there is no fate that cannot be surmounted by scorn” is the conclusion he draws, leaving us thinking that Sisyphus, who just like any human being possesses a conscience, can acknowledge the futility of his punishment and accept his fate.¹ It is only then that he will be free; free of misery, free of hopelessness, free of the desire to escape. He must come to terms with the pointlessness of his existence if he is to exist at all.

Sisyphus had to carry out his punishment forever. Every day he would push that heavy boulder to the top, only to watch it slip away in an instant. Of the many parallels one can draw between his story and medicine, mental health comes closest. Today millions people in the world share the same feeling of despair that Sisyphus must have carried. Every forty seconds, a person takes their own life. Every forty seconds, someone chooses to stop carrying their boulder, in whatever form that may be.²

Of course we all carry our own boulders. Some are heavier, some lighter; some we have inflicted upon ourselves, some have been inflicted upon us by others. But for those living with severe mental illness and trauma, it becomes harder to push that boulder to the top and every time it crashes back down. Sometimes there is no strength left to carry the boulder anymore. Is it then that one decides to end their life? Does death truly seem like the only salvation?

This continues to be an unresolved matter of rigorous discussion and debate.³ What if the boulder does not represent a mental struggle, but a physical one? Can the unavoidable pain and suffering of a terminal illness justify assisted suicide? I think of my grandfather, who was seventy-two years old when he became terminally ill.

For the next decade I watched him descend from a lively, happy man who would walk to my primary school every day just to give me a few cents to buy chocolates, to a man confined in a small bed with no ability to move, speak, eat, or to simply be. For the last five years of his life he was but a lifeless body, and I could not look at him without feeling sorry for what had been left of the man I once knew. When they took him to the hospital for the last time, I asked myself if this was an appropriate ending to his life. I knew he would have never chosen this way out. He deserved better.

Every story, and every patient, is different. My grandfather was indeed far from conscious and thus could have never made a choice for himself. But perhaps someone else should be allowed to make the decision. Should doctors support and assist in this decision? Ultimately, is it not to the person, terminally ill or not, to decide how they want their life to end and preserve their dignity? I cannot state with confidence that I support physician assisted suicide. But I firmly believe that everyone is entitled to die without agony, just as much as they are entitled to live without it.

In the end, Sisyphus’s story seems like a perfect convergence of medicine and art. It transcends complicated ideas of existence and death, questions of morality and ethics or simply one’s outlook on life. Reading or thinking about it should encourage anyone to contemplate the big questions of life; it may even hide answers to many of them.

Somehow, Camus urges us, we must imagine Sisyphus happy. We must imagine our own selves happy, too, and in that vision find the strength to seek help and carry on. Two thousand years ago, the Stoics argued that happiness is found in accepting the moments as they come and not allowing ourselves to be controlled by our desires for pleasure, or our fear for pain. For Sisyphus, too, this approach seems to have been the only solution: he could either accept his fate or live the rest of his days in complete pain.

When we glimpse at Sisyphus from afar, however, we can never tell if he has managed to reach this ultimate level of endurance. And simply imagining Sisyphus happy is not enough.

 

References

1. Camus, A., The Myth of Sisyphus, Vintage International (1991), Chapter 4.
2. World Health Organization, (Depression and other Common Mental Disorders: Global Health Estimates, (2017) http://apps.who.int/iris/bitstream/10665/254610/1/WHO-MSD-MER-2017.2-eng.pdf.
3. James A. Colbert, M.D., Joann Schulte, D.O., M.P.H, and Jonathan N. Adler, M.D, Physician Assisted Suicide Polling Results, New England Journal of Medicine (2013) http://www.nejm.org/doi/full/10.1056/NEJMclde1310667#t=article.

 

End Note

1. Original edition of Camus’s The Myth of Sisyphus was published in French, by Éditions Gallimard in 1942.

 

---

 

KATERINA DIMA is a final-year medical student originally from a small town on the west coast of Greece. For the past five years she has been involved in students’ organizations, advocating for medical students’ rights and improved medical education. She is aspiring to pursue a career in Adolescent Psychiatry and one day fulfill her dream of teaching and inspiring young medical students. Apart from psychiatry, she enjoys reading about philosophy and exploring the wonders of the world.

 

Winter 2018  |  Sections  |  Psychiatry & Psychology