A Pain in the Neck

By Theodore Dalrymple

All things considered—my age, for example, and my unhealthy lifestyle—I have little, physically, to complain of. My only real problem is osteoarthritis of my hands, now somewhat deformed.

The great Doctor Johnson used to take an objective observer’s interest in his own illnesses, finding them curious. He even performed small physiological experiments on himself. I do not go quite this far, but I note with puzzlement that the pain in my fingers flits from one finger to the other, without any real reason for it that I can detect. At any rate, there is always one finger that pains me above the others (at the moment, that in my right index finger predominates, but it might be different tonight). It is as if there were a certain fixed amount of pain to be distributed among my fingers, and if it does not go to one, it must go to another. In this, it is rather like the economy in the thinking of many people: One person’s share of the economic cake is another’s penury.

From time to time, I feel it necessary to take an anti-inflammatory pill, which certainly brings me relief. I take as few as possible, both on general principle and for specific reasons. I am not against pills as such—some have kept me alive for half a century—but still I share the common prejudice that one should take as little medication as possible.

A few days ago, I took one of these anti-inflammatories, a shiny white round pill of a dimension that, though large, normally gives me no trouble to swallow. To my alarm, however, it soon seemed to stick in my gullet and was most uncomfortable.

I did all the things that one is supposed to do in this situation, but the wretched thing remained unmoved. I swallowed warm liquids, I bent my neck forward, I moved my head in all possible directions, I ate a banana, I ate some crustless bread, but all to no avail. The stubborn thing was stuck.

It was not exactly painful, but the discomfort was impossible to ignore for long. I could distract myself by reading or writing, but as soon as I swallowed—one soon learns in these circumstances how frequently one swallows, which previously one has taken for granted—the discomfort became acute again. It was, so to speak, a hard pill to swallow.

It might not have been a pill at all that caused the sensation, however. It might have been caused by a small injury to the esophagus done by the passing pill. There was even the possibility of a purely psychological cause, though no one likes to think of himself as susceptible to such psychological infirmity.

Information and advice on the internet were distinctly contradictory, ranging from assurance that pills do not get stuck in the esophagus because they dissolve and therefore are nothing to worry about, to warnings against the dangers of waiting for them to dissolve because they might cause inflammation or even erosion of the organ’s surface. What was striking was that all views were expressed with equally magisterial certainty though they contradicted one another. Genuine skepticism is not a normal state of mind, whereas dogmatism is, and if people cannot agree over so simple a matter as what is the cause of an unpleasant bodily sensation, and what to do about it, it is scarcely any wonder that the realm of politics is one of ceaseless conflict.

But whatever the cause of my sensation, it soon became something of an obsession with me that could not be kept at bay for long. When it was time for bed, the sensation was still there. Some of the advisers on the internet said that sufferers should on no account lie down, but I have never been able to sleep for long while upright, and I do like my sleep. When I lay down, the sensation worsened, but there is more than one possible explanation for that worsening. Eventually, however, I was able to sleep.

The next morning, I was better. This was a great relief not only in itself but because it obviated a possible need to seek medical advice, which in England (where I was) has become not so much an obstacle race as an obstacle crawl. The prospect of having to beg humbly for attention, and possibly of having to exaggerate or tell lies in order to obtain it, to say nothing of the hours and hours of waiting, was almost worse than the condition from which I sought relief.

It is a commonplace that life hangs by a thread, but so does equanimity. The philosopher Hume, I think, said somewhere that a toothache is able to destroy any philosophy, and a minor inconvenience may soon obsess the most stoical of persons.

Not every such inconvenience has this ability, however. One learns to put up with many inconveniences, but others are impossible to ignore. Things minor in themselves may, like a constant drip of water on a rock, erode the mind. The destruction of the equanimity of human beings is not necessarily proportional to the seriousness of its cause—that is to say, the seriousness as seen and measured by others. Tell me what inconvenience you cannot tolerate, and I will tell you what you are.

It is because we are all so different in our likes and dislikes, our loves and our detestations, that it is hopeless to expect any purely utilitarian solution to our collective problems in life. Furthermore, as Francis Bacon once said, “Such being the workmanship of God as he doth hang the greatest weight upon the smallest wires.”

So do we all. We do not have such minds as can encompass all the world and all the happenings in it at the same time; the pill (or whatever it was) that was stuck in my throat occupied a hundred times more of my mind and attention than the great questions of our day. And this is not entirely a bad thing: For if people attended only to the great questions of their day, all that makes life worth living would go by default. Some questions must be settled purely in the abstract, some purely in the concrete, and many or most somewhat between the two. Monomaniacs don’t understand this.

First published in Taki’s Magazine