Part 3

A few years ago a young man came to me, suffering from too much thinking. He had just been graduated from college and his head was full of confused ideas and emotions. He was also very tired, having overworked in his preparation for examinations, and because he had not taken the best care of his body. The symptoms he complained of were sleeplessness and worry, together with the inevitable indigestion and headache. Of course, as a physician, I went over the bodily functions carefully, and studied, as far as I might, into the organic conditions. I could find no evidence of physical disease. I did not say, "There is nothing the matter with you"; for the man was sick. I told him that he was tired, that he had thought too much, that he was too much concerned about himself, and that as a result of all this his bodily functions were temporarily upset. He thought he ought to worry about himself, because otherwise he would not be trying to get well. I explained to him that this mistaken obligation was the common reason for worry, and that in this case, at least, it was quite unnecessary and even harmful for him to go on thinking about himself. That helped a little, but not nearly enough, because when a man has overworked, when he has begun to worry, and when his various bodily functions show results of worry, no reasoning, no explanations, can wholly relieve him. I said to this young man, "In spite of your discomforts, in spite of your depression and concern in regard to yourself, you will get well if you will stop thinking about the matter altogether. You must be first convinced that it is best for you to stop thinking, that no harm or violence can result, and then you must be helped in this direction by going to work with your hands--that will be life and progress, it will lead you to health."

Fortunately I had had some experience with nervous illness, and I knew that unless I managed for this man the character and extent of his work, he would not only fail in it, but of its object, and so become more confused and discouraged. I knew the troubled mind, in this instance, might find its solace and its relief in work, but that I must choose the work carefully to suit the individual, and I must see that the nervously fatigued body was not pushed too hard.

In the town where I live is a blacksmith shop, presided over by a genial old man who has been a blacksmith since he was a boy, and in whose hands iron is like clay. I took my patient down to the smithy and said, "Here is a young man whom I want to put to work. He will pay for the chance. I want you first to teach him to make hand-wrought nails." This was a good deal of a joke to the smith and to the patient, but they saw that I was in earnest and agreed to go ahead. We got together the proper tools and proceeded to make nails, a job which is really not very difficult. After an hour's work, I called off my patient, much to his disgust, for he was just beginning to be interested. But I knew that if he were to keep on until fatigue should come, the whole matter would end in trouble. So the next day, with some new overalls and a leather apron added to the equipment, we proceeded to another hour's work. We went on this way for three or four days, before the time was increased.

The interest of the patient was always fresh, he was eager for more, and he did not taste the dregs of fatigue. Yet he did get the wholesome exercise, and he did get the strong turning of the mind from its worry and concern. Of course, the rest of the day was taken care of in one way or another, but the work was the central feature. In a week, we were at it two hours a day, in three weeks, four hours, and in a month, five hours. He had made a handsome display of hand-wrought nails, a superior line of pokers and shovels for fireplaces, together with a number of very respectable andirons. On each of these larger pieces of handiwork my patient had stamped his initials with a little steel die that was made for him. Each piece was his own, each piece was the product of his own versatility and his own strength. His pride and pleasure in this work were very great, and well they might be, for it is a fine thing to have learned to handle so intractable a material as iron. But in handling the iron patiently and consistently until he could do it without too much conscious thinking, and so without effort, he had also learned to handle himself naturally, more simply and easily.

As a matter of fact, the illness which had brought this boy to me was pretty nearly cured by his blacksmithing, because it was an illness of the mind and of the nerves, and not of the body, although the body had suffered in its turn. That young man, instead of becoming a nervous invalid as he might have done, is now working steadily in partnership with his father, in business in the city. I had found him a very interesting patient, full of originality and not at all the tedious and boresome person he might have been had I listened day after day, week after week to the recital of his ills. I was willing to listen,--I did listen,--but I also gave him a new trend of life, which pretty soon made his complaints sound hollow and then disappear.

Of course, the problem is not always so simple as this, and we must often deal with complexities of body and mind requiring prolonged investigation and treatment. I cite this case because it shows clearly that relief from some forms of nervous illness can come when we stop thinking, when we stop analyzing, and then back up our position with prescribed work.

There may be some nervous invalids who read these lines who will say, "But I have tried so many times to work and have failed." Unfortunately, such failure must often occur unless we can proceed with care and with understanding. But the principle remains true, although it must be modified in an infinite variety to meet the changing conditions of individuals.

I see a great many people who are conscientiously trying to get well from nervous exhaustion. They almost inevitably try too hard. They think and worry too much about it, and so exhaust themselves the more. This is the greater pity because it is the honest and the conscientious people who make the greatest effort. It is very hard for them to realize that they must stop thinking, stop trying, and if possible get to work before they can accomplish their end. We shall have to repeat to them over and over again that they must stop thinking the matter out, because the thing they are attempting to overcome is too subtle to be met in that way. So, if they are fortunate, they may rid themselves of the vagueness and uncertainty of life, until all the multitude of details which go to make up life lose their desultoriness and their lack of meaning, and they may find themselves no longer the subjects of physical or nervous exhaustion.

IDLENESS

O ye! who have your eyeballs vex'd and tir'd, Feast them upon the wideness of the sea. KEATS.

Extreme busyness, whether at school or college, kirk or market, is a symptom of deficient vitality; and a faculty for idleness implies a catholic appetite and a strong sense of personal identity. STEVENSON.

It is an unfortunate fact that very few people are able to be idle successfully. I think it is not so much because we misuse idleness as because we misinterpret it that the long days become increasingly demoralizing. I would ask no one to accept a forced idleness without objection or regret. Such an acceptance would imply a lack of spirit, to say the least. But idleness and rest are not incompatible; neither are idleness and service, nor idleness and contentment. If we can look upon rest as a preparation for service, if we can make it serve us in the opportunity it gives for quiet growth and legitimate enjoyment, then it is fully justified and it may offer advantages and opportunity of the best.

The chief trouble with idleness is that it so often means introspection, worry, and impatience, especially to those conscientious souls who would fain be about their business.

I have for a long time been accustomed to combat the worry and fret of necessary idleness--not by forbidding it, not by advising struggle and fight against it, but by insisting that the best way to get rid of it is to leave it alone, to accept it. When we do this there may come a kind of fallow time in which the mind enriches and refreshes itself beyond our conception.

I would rather my patient who must rest for a long time would give up all thought of method, would give up all idea of making his mind follow any particular line of thought or absence of thought. I know that the mind which has been under conscious control a good deal of the time is apt to rebel at this freedom and to indulge in all kinds of alarming extravagances. I am sure, however, that the best way to meet these demands for conscious control is to be careless of them, to be willing to experience these extravagances and inconsistencies without fear, in the belief that finally will come a quiet and peace which will be all that we can ask. The peace of mind that is unguided, in the conscious and literal sense, is a thing which too few of us know.

Mr. Arnold Bennett, in his little book, "How to Live on Twenty-four Hours a Day," teaches that we should leave no time unused in our lives; that we should accomplish a great deal more and be infinitely more effective and progressive if we devoted our minds to the definite working-out of necessary problems whenever those times occur in which we are apt to be desultory. I wish here to make a plea for desultoriness and for an idleness which goes even beyond the idleness of the man who reads the newspaper and forgets what he has read. It seems to me better, whether we are sick or well, to allow long periods in our lives when we think only casually. To the good old adage, "Work while you work and play while you play," we might well add, "Rest while you rest," lest in the end you should be unable successfully either to work or play.

A man is not necessarily condemned to tortures of mind because he must rest for a week or a month or a year. I know that there must be anxious times, especially when idleness means dependence, and when it brings hardship to those who need our help. But the invalid must not try constantly to puzzle the matter out. If we do not make ourselves sick with worry, we shall be able sometime to approach active life with sufficient frankness and force. It is the constant effort of the poor, tired mind to solve its problems that not only fails of its object, but plunges the invalid deeper into discouragement and misunderstanding. How cruel this is, and how unfortunate that it should come more commonly to those who try the hardest to overcome their handicaps, to throw off the yoke of idleness and to be well.

When you have tried your best to get back to your work and have failed, when you have done this not once but many times, it is inevitable that misunderstanding should creep in, inevitable that you should question very deeply and doubt not infrequently. Yet the chances are that one of the reasons for your failure is that you have tried too hard, that you have not known how to rest. When you have learned how to rest, when you have learned to put off thinking and planning until the mind becomes fresh and clear, when you are in a fair way to know the joy of idleness and the peace of rest, you are a great deal more likely to get back to efficiency and to find your way along the great paths of activity into the world of life.

It is not so much the idleness, then, as the attempt to overcome its irksomeness, that makes this condition painful. The invalid in bed is in a trap, to be tormented by his thoughts unless he knows the meaning of successful idleness. This knowledge may come to him by such strategy as I have suggested--by giving up the struggle against worry and fret; but peace will come surely, steadily, "with healing in its wings," when the mind is changed altogether, when life becomes free because of a growth and development that finds significance even in idleness, that sees the world with wise and patient eyes.

In a way it does not matter, your physical condition or mine, if our "eyes have seen the glory" that deifies life and makes even its waste places beautiful. What is that view from your window as you lie in your bed? A bit of the sea, if you are fortunate, a corner of garden, surely, the top of an elm tree against the blue. What is it but the revelations of a God in the world? There is enough that is sad and unhappy, but over all are these simple, ineffable things. If the garden is an expression of God in the world, then the world and life are no longer meaningless. Even idleness becomes in some degree bearable because it is a part of a significant world.

Unfortunately, the idleness of disability often means pain, the wear and tear of physical or nervous suffering. That is another matter. We cannot meet it fully with any philosophy. My patients very often beg to know the best way to bear pain, how they may overcome the attacks of "nerves" that are harder to bear than pain. To such a question I can only say that the time to bear pain is before and after. Live in such a way in the times of comparative comfort that the attacks are less likely to appear and easier to bear when they do come. After the pain or the "nervous" attack is over, that is the time to prevent the worst features of another. Forget the distress; live simply and happily in spite of the memory, and you will have done all that the patient himself can do to ward off or to make tolerable the next occasion of suffering. Pain itself--pure physical pain--is a matter for the physician's judgment. It is his business to seek out the causes and apply the remedy.

RULES OF THE GAME

It is not growing like a tree In bulk, doth make man better be. BEN JONSON.

It is a good thing to have a sound body, better to have a sane mind, but neither is to be compared to that aggregate of virile and decent qualities which we call character. THEODORE ROOSEVELT.

The only effective remedy against inexorable necessity is to yield to it. PETRARCH.

When I go about among my patients, most of them, as it happens, "nervously" sick, I sometimes stop to consider why it is they are ill. I know that some are so because of physical weakness over which they have no control, that some are suffering from the effects of carelessness, some from wilfulness, and more from simple ignorance of the rules of the game. There are so many rules that no one will ever know them all, but it seems that we live in a world of laws, and that if we transgress those laws by ever so little, we must suffer equally, whether our transgression is a mistake or not, and whether we happen to be saints or sinners. There are laws also which have to do with the recovery of poise and balance when these have been lost. These laws are less well observed and understood than those which determine our downfall.

The more gross illnesses, from accident, contagion, and malignancy, we need not consider here, but only those intangible injuries that disable people who are relatively sound in the physical sense. It is true that nervous troubles may cause physical complications and that physical disease very often coexists with nervous illness, but it is better for us now to make an artificial separation. Just what happens in the human economy when a "nervous breakdown" comes, nobody seems to know, but mind and body cooeperate to make the patient miserable and helpless. It may be nature's way of holding us up and preventing further injury. The hold-up is severe, usually, and becomes in itself a thing to be managed.

The rules we have wittingly or unwittingly broken are often unknown to us, but they exist in the All-Wise Providence, and we may guess by our own suffering how far we have overstepped them. If a man runs into a door in the dark, we know all about that,--the case is simple,--but if he runs overtime at his office and hastens to be rich with the result of a nervous dyspepsia--that is a mystery. Here is a girl who "came out" last year. She was apparently strong and her mother was ambitious for her social progress. That meant four nights a week for several months at dances and dinners, getting home at 3 A.M. or later. It was gay and delightful while it lasted, but it could not last, and the girl went to pieces suddenly; her back gave out because it was not strong enough to stand the dancing and the long-continued physical strain. The nerves gave out because she did not give her faculties time to rest, and perhaps because of a love affair that supervened. The result was a year of invalidism, and then, because the rules of recovery were not understood, several years more of convalescence. Such common rules should be well enough understood, but they are broken everywhere by the wisest people.