On Cancer and Global Suffering

My cancer has been promoted: I’m officially in stage 4. My doctors have found two cancerous nodules—a euphemism for “small tumors”—one on each of my lungs. I started chemo this week….



I don’t have any previous experience with this sort of thing, but judging from what I hear and read, I’m supposed to be asking why all this is happening, and why it’s happening to me. Honestly, those questions are about the farthest thing from my mind.



Partly, that’s because they aren’t hard questions. Why does our world have gravity? Why does the sun rise in the East? There are technical answers, but the metaphysical answer is simple: that’s how reality works. So too here. Only in the richest parts of the rich world of the twenty-first century could anyone entertain the thought that we should expect long, pain-free lives. Suffering and premature death (an odd phrase: what does it mean to call death “premature”?) are constant presences in the lives of most of the peoples of the Earth, and were routine parts of life for generations of our predecessors in this country—as they still are today, for those with their eyes open. Stage 4 cancers happen to middle-aged men and women, seemingly out of the blue, because that’s how reality works.



As for why this is happening to me in particular, the implicit point of the question is an argument: I deserve better than this. There are two responses. First, I don’t—I have no greater moral claim to be free from unwanted pain and loss than anyone else. Plenty of people more virtuous than I am suffer worse than I have, and some who don’t seem virtuous at all skate through life with surprising ease. Welcome to the world. Once again, it seems to me that this claim arises from the incredibly unusual experience of a small class of wealthy professionals in the wealthiest parts of the world today. We think we live in a world governed by merit and moral desert. It isn’t so. Luck, fortune, fate, providence—call it what you will, but whatever your preferred label, it has far more to do with the successes of the successful than what any of us deserves. Aristocracies of the past awarded wealth and position based on the accident of birth. Today’s meritocracies award wealth and position based on the accident of being in the right place at the right time. The difference is smaller than we tend to think. Once you understand that, it’s hard to maintain a sense of grievance in the face of even the ugliest medical news. I’ve won more than my share of life’s lotteries. It would seem churlish to rail at the unfairness of losing this one—if indeed I do lose it: which I may not.



The second response is simpler; it comes from the movie “Unforgiven.” Gene Hackman is dying, and says to Clint Eastwood: “I don’t deserve this. To die like this. I was building a house.” Eastwood responds: “Deserve’s got nothing to do with it.”



That gets it right, I think. It’s a messed-up world, upside-down as often as it’s rightside up. Bad things happen; future plans (that house Hackman was building) come to naught. Deserve’s got nothing to do with it.