[TW: chronic illness, depression, suicide]

We are our bodies.

That sounds obvious, but it isn’t.  Cartesian dualism thoroughly infiltrates the English language and many others.  Many of the ways in which we talk about our bodies describe them as things we own, or carry, or inhabit, as though we were somehow distinct from the skeletons and meat.

My sense of my own consciousness is firmly anchored in my eyes.  Everything else is ancillary, a wall of sensation at a distance or a weird intrusion from the outside.  When I dream, I rarely have legs.  My dream avatar pushes itself through crowds with its arms, or it is nothing but disembodied eyes, watching more than participating in the dream’s events.  When I am more than that in dream, I am watching myself do things from the outside, a lucid vantage point on third-person adventure.  In those dreams, my oneiric body is usually someone else entirely: a minotaur, a Mexican woman, a robot.  I don’t have a sense of touch in my dreams, even when I have hands.  Those differences are how I tell when I’m dreaming, or when I’m recalling events that happened in dream: I can’t touch anything, I don’t have feet, and people don’t have faces.  And the world is usually in hazy grayscale with flashes of red or green to indicate the assorted Chekhov’s guns my dream-narrator likes to set up on my behalf.

There may or may not be anything to diagnose in those patterns.  But all of them are illusions, the fantasies of a mind that often feels estranged from and confused by the letters its frontier outposts deliver to it.  For the rest of us, our bodies and minds are not as distinct as my oneiromancer wants me to think they are.  Within this lipid-rimed assembly of motors and struts is a complex of sensors and wires, connections that make the events of the hands and intestines and small of the back as real and immediate as any thought or emotion—and every thought and emotion as real as leaving one’s hand too long on the stove.  The brain is only the largest and foremost organ of the self, anchoring and integrating the activities of all the others.

We are our bodies.

And when those bodies go wrong, it attacks the very definition of us.

Wasting diseases take from us what we could once do.  Chronic pain fogs the mind, clogging its machinery with distraction.  The “sickness behaviors” we instinctively invoke when infected leave us weak and tired when we know we are capable of more.  Depression, bipolar disorder, and other mood dysfunctions flood us with unwanted thoughts and feelings that crowd out the wanted ones, rendering the whole machine alien and forbidding.

Did one of those sound different from the others?  It shouldn’t have.  Breakdowns of the brain are no more moral shortcomings or personal foibles than a broken leg or self-destructive marrow.  In turn, breakdowns of the miscellany are no less ours than dysfunctions of neurons and glia.  We are our bodies.  That reality places the owner of a chronic illness, in any organ, in an impossible bind: to recognize the dysfunction as such while being defined by it.  Chronic dysfunction entangles itself with a person’s idea of who and what they are and crowds out other thoughts, every interstice a reminder of who they would be without the damage, without the sickness.  That discrepancy makes every condition a potential nucleus for later depression and a source of existential pain separate from any ordinary pain it might inflict.

The only reasonable response to ongoing suffering is to relieve it, or to try.  And to those whose suffering defies our sincerest balms, the solace of oblivion is owed.

There is no dualism here.  There are no souls to be mistreated by being denied a meat-puppet to drag around.  There is no demiurge to consecrate pain for its own sake, no nobility in aggrieved silence.  There is only suffering and the last, desperate, costly effort to mitigate it, undertaken when the thought of persisting at all becomes too great a horror to bear.

We owe the world’s sufferers all of the support we can muster, that their faulty machinery can no longer impose itself on them.  And if and when that fails, we owe them understanding, empathy, and the tools to go quietly if they want them.  We owe the world’s tortured souls, cancer shells, and fibromyalgia ghosts an honest view of their final analgesia:

It is a tragedy that we could not do more for you.  It is a tragedy that your last moment of self-care was so costly.  It is a tragedy that your nightmare called for such extreme measures.

You were your body, and now you’re the imprint you left behind.

You are immortal, and you are free.