Life Is Hard

Chapter One: Infirmity


You never forget the first time a doctor gives up: when they tell you that they don't know what to do-they have no further tests to run, no treatments to offer-and that you're on your own. It happened to me at the age of twenty-seven, with chronic pain, but it will happen to many of us at some point, with conditions that may be disabling or eventually fatal. The vulnerability of bodies belongs to the human condition.

I don't remember what movie we had gone to see, but I know we were at The Oaks, an old arts cinema on the outskirts of Pittsburgh, when pain stabbed me in the side, followed by an urgent need to urinate. After bolting for the bathroom, I felt better, but with a band of tension running through my groin. As the hours went by, the pain resolved into a need to pee, again, which woke me up at one or two a.m. I went to the bathroom-but as if in some bad dream, urinating made no difference. The band of sensation remained, insusceptible to feedback from my body. I spent a night of hallucinatory sleeplessness sprawled on the bathroom floor, peeing from time to time in a vain attempt to snooze the somatic alarm.

The next day started sensibly, with a trip to my primary care doctor, who guessed that I had a urinary tract infection and prescribed a course of antibiotics. But the test came back negative, as did tests for more abstruse conditions. The pain did not abate. From that point on, the time line is hazy. My memory is poor and medical bureaucracy defeated any attempt to have my records transferred from Pittsburgh to MIT when I moved eleven years later.

But I won't forget the principal episodes. First, a urodynamic study in which I was catheterized, asked to drink a vat of fluids, and made to piss into a machine that measured rate and flow and function. Normal. Second, a cystoscopy in which an apparently teenage urologist projected an old-fashioned cystoscope through my urethra in agonizing increments, like

Kieran Setiya is a professor of philosophy at the Massachusetts Institute of Technology and the author of Midlife: A Philosophical Guide. His writing has appeared in the Los Angeles Review of Books, The New York Times, the Boston Review, the London Review of Books, The Atlantic, and The Yale Review.

Praise for Life is Hard:

A humane, consoling guide to this vale of tears, with a glimmer of hope. The Economist

"Exceptionally rich and subtle."  Financial Times

Reflects what philosophy at its most helpful and humane can do. . . . insightful and empathetic Los Angeles Review of Books

An eloquent, moving, witty and above all useful demonstration of philosophy's power to help us weather the storms of being human not with rarefied theories about the best way to live, but by making the best of life as it really is. Oliver Burkeman, author of Four Thousand Weeks

Any attempt by a philosopher to help us live well not in spite of human suffering but in full acknowledgment of it is a welcome respite from so many too-tidy philosophical theories of human well being. A more honest and humane treatment is long overdue, and even if they are not ultimately consoled, readers will surely find themselves more connected to their own humanity from reading and reflecting on this book. The Wall Street Journal

Life Is Hard is a humane consolation for challenging times. Reading it is like speaking with a thoughtful friend who never tells you to cheer up, but, by offering gentle companionship and a change of perspective, makes you feel better anyway. The New York Times Book Review

Kieran Setiya argues that certain bracing challenges loneliness, failure, ill health, grief, and so on are essentially unavoidable. . . . But it s good, the book shows, to acknowledge hard experiences and ask how they ve helped us grow tougher, kinder, and wiser. The New Yorker

Kieran Setiya has produced the ultimate handbook of hardship. He shows why adversity is inevitable and why facing up to that reality, rather than insisting on simple-minded notions of happiness, offers the only path to living well. Daniel H. Pink, author of The Power of Regret, When, and Drive

Through carefully crafted examples, [Kieran Setiya] makes the case that philosophy can help us