Stoicism and Surgery by Robert S. Colter

As a professor of philosophy, and of ancient philosophy in particular, I have been studying Stoicism at some level for over 20 years. It is one thing to study it as a dry academic subject, and an entirely different thing to apply it to one’s own life, especially in the systematic way that Stoicism invites us to. I want to share a recent experience that, for me at least, was an example of how Stoicism can fit into one’s life, even in quite difficult circumstances.
I began writing this reflection from a hospital bed in Hamilton NZ. I just had my catheter removed (oh what freedom!), and was still awaiting the passing of wind (the lovely New Zealand euphemism for farting), the next great milestone to be achieved! What better time to reflect on Stoicism and its role in my week?
My week began with great excitement as I embarked upon a long-planned journey from my home in the US to NZ in order to, among other things, deliver a talk on Stoicism to a number of philosophers at a conference, as well as to do some sightseeing and other tourist activities. The journey is of course a long one, and I was a bit anxious about it, primarily about whether I would be able to sleep on the long flight over the Pacific. I did sleep a bit, although not as much as I hoped, and arrived in NZ in good spirits, looking forward to delivering my talk.
I was staying with a friend and colleague of long standing, and arriving at his home proceeded with my unpacking. We then had a nice lunch, went to the local campus where we worked on some projects for a few hours. Next we took a walk along the local river and park, enjoying the sights, and talking about the different varieties of flora and fauna to be found in NZ vs the US. All very pleasant (at least in a way appropriate for preferred indifferents) and exactly what I had been hoping for as the beginning of my visit. But there was a storm on the horizon that I could not yet see. I would soon have the opportunity to reflect on Zeno’s quip, after learning that he had lost everything in a shipwreck, “Fortune bids me to become a less encumbered philosopher.”
I had started to feel some discomfort in my abdomen sometime during our walk, and it was slowly increasing. I mentioned it to my companion, and we decided it must be the after effects of the long trip, and would soon pass, at least after a trip or two to the toilet. Seemed quite reasonable. So I proceeded to the event I had planned for the evening, but before the event was over, I found myself being attended to as I lay on the cold concrete, sweating and in pain. The fine people at that event delivered me to my friend’s home, where I made a number of futile attempts to use the toilet.
Soon the pain increased many fold, and I began vomiting, and the ambulance was called, and the Emergency Department, and pain, and … Those who may be medically inclined might recognize a likely culprit – an obstructed bowel (and please no witty comments about philosophy professors being full of shit).
I don’t remember too many details of those hours, but the ones I do recall are vivid. I recall, being bent over double by pain, saying to myself “you are but an impression, and not at all the thing you appear to be” and “you are nothing to me.” Shockingly, I felt a shift in both my attitude and perception of the pain, albeit minor (it still hurt pretty severely!) and temporary (lasted for a few seconds). Later, with a bit more clarity, I was able to recall Epictetus words more fully, from the Enchiridion:

From the start, then, work on saying to each harsh appearance, “You are an appearance, and not at all the thing that has the appearance.” Then examine it and assess it by these yardsticks that you have, and first and foremost by whether it concerns the things that are up to us or the things that are not up to us. And if it is about one of the things that is not up to us, be ready to say, “You are nothing in relation to me.”

It took a while, but I was finally seen by the doctor, who proceeded to send me upstairs to the ward I still occupied several days later. There were a couple of days of attempts at non-surgical intervention, but in the end surgery was required. I was still hooked up to machines and my guts hurt. My family remained in the US, and I missed them (less stoically that I ought to have). I am all the way across the world from my home, and while perhaps no longer in deadly medical peril, still there is much discomfort, and many plans, including my return, remain up in the air.
Once again, I find some comfort in a number of stoic reflections: Cleanthes’s Hymn to Zeus keeps popping up:

Lead me, Zeus, and you too, Destiny,
Wherever I am assigned by you;
I’ll follow and not hesitate,
But even if I do not wish to,
Because I’m bad, I’ll follow anyway.

It is clear that I did not want to go through this medical emergency. My plans were wiped out. I did not give my talk, and I was unable to see all the sights I had anticipated. But none of that was up to me. The universe was in charge, and I am just a part of nature, and if this is what nature wills, the so be it. I can either choose to go along, or be dragged kicking and screaming.
Many times I faced more pain, even after surgery. And there was the loneliness, although I had daily visits from my friend and the nursing staff was wonderful. I found the following from Marcus helpful:
Everything that happens either happens in such a way that you are fitted by nature to bear it or in such a way that you are not. If, then, it comes about in such a way that you are fitted by nature to bear it, make no complaint, but bear it as your nature enables you to do; but if it comes about in such a way that you are not fitted by nature to bear it, again you should make no complaint, for it will soon be the end of you. Remember, however, that you are fitted by nature to bear everything that you can render bearable and endurable through the exercise of your judgement, by suggesting the idea to yourself that your interest or your duty demands it.
I will find the means to endure, or not. Many before me, and many still to come, have faced and will face trials such as mine, and even more severe. Thinking of these passage certainly decreased my anxieties and loneliness. I am no stoic sage, but these reflections give me at times some small comfort against the vicissitudes of life. But it is comfort that was not available to me before, and I am grateful for that.
I had found that I could endure. But then something even more unexpected occurred. A couple of days after surgery, I was conversing with my wife via Skype, and she noted, “You seem happy!” I was struck by this, since I hadn’t noticed it, and besides, what did I really have to be happy about, even if I had come to a point where I was no longer miserable?
I took a look around me. Perhaps like most of us, I often operate under the illusion that I have control of a great number of things in my life. I was raised in the mythology of the “self-made man” and the notion of “pulling oneself up by the bootstraps.” My situation here, however, was different. I had been forcibly stripped of the idea that my zone of control extended much beyond my hospital bed. As Epictetus points out, not even my body is truly under my control, and that was certainly true in my case. I was attached to a number of tubes and hoses, so that I couldn’t even get out of bed without assistance. Even when I could get out to bed, I could barely manage to walk the 100 feet of hallway outside my room. And, of course, I was unable to even fart, despite my best efforts.
So, I was reduced to doing my best to make choices a virtuously as possible, even if I didn’t think of it that way. I decided to treat everyone on the hospital staff with kindness and respect. When I attempted to move around the ward, I tried to do so with courage, knowing that it would be painful and difficult. I decided to wean myself from the pain medications as soon as I could, so that my cognitive faculties might not be so muddled. But, I did not totally forswear the medications, since being in too much pain might also make it more difficult for me to make virtuous choices. My zone of control had been reduced to such choices, or at least I had been compelled to recognize that those were its limits all along! The following passage from Epictetus seemed to capture my situation rather well:

Remember that you are an actor in a play, which is as the playwright wants it to be; short if he wants it short, long if he wants it long. If he wants you to play a beggar, play even this part skillfully, or a cripple, or a public official, or a private citizen. What is yours is to play the assigned part well. But to choose it belongs to someone else.

So, I could focus on what was mine, to play the part of the convalescent well. It was not my choice, but it was not mine to choose in the first place. And the result seemed to be that I was happy, as my wife seemed to note, or at least I was undisturbed and content with my lot, which may not be so far from happy.
As I finish writing this, some weeks after the incident, I can report that surgery was successful, and I am recovering nicely. I am thankful for the ways in which Stoicism, and especially these passages, have helped me through a difficult trial. I am now a bit more confident of my ability to remain in agreement with nature the next time something difficult occurs. And, perhaps I can even be content!
Robert Colter is Associate Lecturer in Philosophy at the University of Wyoming. His research is in ancient philosophy and the philosophy of education. He is also the founder and director of the Wyoming Stoic Camp.

3 thoughts on Stoicism and Surgery by Robert S. Colter

  1. thomasbaake says:

    I found this very helpful as I am in a similar situation.

  2. AlexOtt says:

    Thank you for this. I’m having surgery in a few days–major, yet routine heart surgery. And I’ve been using my Stoic practices to try to prepare. So far, it’s been working–I’m not a wreck! I’ve also been premeditating the day of surgery and the recovery to try to take the sting out of it a bit. Hopefully that’ll help a bit as well. This article was spot on.

  3. Paul Lanagan says:

    In a similar situation I found it useful to consider that the only thing that was up to me in that situation was how I reacted to it.

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