Wednesday, 27 April 2011

Rolling rocks

Iain is usually charming and friendly, and has a good joke to tell about his time managing a pub. But not today.
He’s come to see me in my morning surgery, with a lot on his mind. His feet are playing up again. Then it’s ‘some funny do’s I’ve been having, you know like blackouts or something’: three or four of them in the past month
When I ask him to tell me more, he says (with a sheepish smile), ‘Well, I guess I’ve been drinking too much again’.  Indeed he has. Without much prompting he tells me he’s getting through at least half a litre of vodka a day, and doing so mostly on his own at home. And he is smoking more than 50 cigarettes a day. I know Iain has other medical problems. He has diabetes mellitus, which (unsurprisingly) is not well controlled, and high blood pressure. He retired five years ago. His three children are all now grown up and living away from home. 
Using my best consultation skills, I ask Iain to tell me more about his worries and concerns. He has a long list. Apart from his ‘blackouts’ and binge drinking, he reminds me about his painful feet. His teeth hurt a lot.  He is sleeping badly and is often irritable. He has little interest in ordinary things, such as watching television or reading. He rarely goes out of his house, partly due to the pain of walking. And he is distressed because he can no longer be bothered to see his children.
He leans forward and says, ‘You see doc, basically the problem for me is I just can’t see any point in getting up in the morning any more’. 
He talks about his loss of ability, his painful feet and the complications of his diabetes, both present and to come. He talks about his loss of purpose, how he used to be a successful pub manager and a caring father. But now he has no role, with either work or family. His life is futile, a relentless trudge through pain and disability. All he can see is a slow, inevitable path towards death.
Iain’s problems seem to me to be beyond the reach of medicine, and way beyond the relevance of any possible formal diagnosis.
Iain and I are facing a profound, existential question.  What, actually, is the point in his being alive? 
I find myself thinking about Sisyphus, condemned by the Gods to spend eternity rolling a huge rock up a mountain, only to see it fall down again as soon as he’s reached the top.  And then about Bruce Springsteen’s exhausted night shift worker:
I get up in the evening and I ain't got nothing to say. I come home in the morning, I go to bed feeling the same way. I ain't nothing but tired. Man, I'm just tired and bored with myself’.

In my next post, I’ll tell you how our conversation went on.  Meanwhile, I’d love to know how you’d respond to Iain.  Maybe you’ve been there yourself, or maybe you know other people who just can’t see any point in it all. What would you say, or do?  
Over to you, dear reader......


  1. for me ..depression takes hold in the absence of"hope" for the situation to improve..sometimes i wonder if it is a condition ...or a realisation that it "this is the way itis"...( that john couger melacamp song...ooh yeah life goes on ...long after the thrillof livin is gone....alcohol feeds depression and creates the vicious circle the first thing i would suggest ..would be to stop drinkin ..and maybe become involved in somethin that gave him a sense of "worth" or it voluntary work or maybe join some sort of "group" where he was interacting with like minded easy in theory ...i know .."staying in the moment" really helps but its a tricky one to master...harkin back ...or projecting into the future doesnt help! there you have it!!! very valuable opinion! is one big attempt to "ballet dance through treacle!!!

  2. It sounds like Iain has not only lost his sense of purpose but also lost respect for himself.

    I would try to encorage Iain to 'be kind to himself', and try to encorage him to want something better for himself.

    Then I would try and give Iain the 'belief' that he can manage his problems, and the 'courage' to try.

    I would motivate him to keep on trying even if he feals as though he is not making progress.
    And remind him that sometimes progress can be slow.

    Dont be afraid to try! Dont be afraid to fail!

    Life (Being Alive) is the most precious thing anyone of us have so lets try to make the most of it, because once your dead you dont get a second chance.

    Be Brave, Have Courage, Fight and Dont Give Up!

    (I spent about 90 mins typing & editing this, could gone on for pages & pages)

    The next questions are:
    How do you encourage him to be kind and to respect himself & his body?
    How do you give him belief and confidence that he can 'do things'.
    How do you give him courage and motivation to try?
    How do you help him face & over come his fears?