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Enough Is Enough

Enough Is Enough

How many times have I examined King (or Queen) Sisyphus in my office? Plenty. Who are those people I consider Sisyphean? Those patients who continue to repeat lifestyle behaviors or maintain toxic relationships that make themselves miserable and physically ill.

According to ancient Greek mythology, King Sisyphus ruled his kingdom from the city of Corinth. He promoted navigation and commerce but was a greedy and deceitful man. He found pleasure in cheating people out of what was rightfully theirs, routinely killed travelers and guests passing through Corinth, and did anything to prove he was a King who ruled with an iron fist. All of us have known people like King Sisyphus. His actions were a violation of xenia, the ancient Greek concept of hospitality, which fell under Zeus's domain.

The myth of King Sisyphus has many versions. The details of each version are beyond the scope of this blog. Each version ends in similar fashion: as a punishment for his trickery, King Sisyphus was made to endlessly roll a huge boulder up a steep hill. However the boulder was never allowed to reach the top of the hill. Just before King Sisyphus made it to the top, the boulder would magically roll down the hill to the low point of the valley. King Sisyphus had to return to his starting point and push the boulder to the top again, only to have the boulder roll back to is starting point in the valley. The maddening nature of the punishment ultimately made King Sisyphus realize that his efforts were useless and each time his punishment was almost over (if he reached the top of the hill), it started all over again giving him endless frustration.

Many authors and literary critics have sometimes described pointless or interminable as Sisyphean.

What does this have to do with patient care? Everything. I recently spoke to a patient about her weight. She is an educated, accomplished woman who has two children. She has struggled with weight issues all of her adolescent and adult life. Over the past six years, she comes to the office episodically to get her back on track. In a recent conversation she related that when she follows a restrained food plan, gets the appropriate amount of calories into her body every day and maintains a disciplined exercise activity, she will lose weight. However, there are times when she deviates from her food plan, gains all of the weight she lost and then some, ultimately leaving her depressed and desperate. Her mind begins to question the fairness of her individual physiology, she looks at other women behaving carelessly about their eating habits and decides that restraining the foods she eats is too difficult for her to maintain. When she gets to the point that she feels disgusted with herself, she returns to the office, asking for help.

"When I get to the point of deciding to lose weight again I do everything right. After two weeks. If I see no change in my weight. I just say the Hell with it. And eat anything I want." She is conscious of her decision making, knows it is the wrong thing to do, but she does it anyway only to the detriment of her health and well being. It is a difficult task to help her primarily because her worldviews are narrow and rigid about weight, comfort foods, fairness in life and she teeters on the edge of living in a state of absurdity most of the time.

She is not alone. Every day there are thousands of people who live pushing the boulder up the hill, only to have it fall back to the valley's starting point. It happens every day in every facet of life: dead end abusive personal relationships that never end, multiple repeat therapeutic adventures in drug rehabilitation centers that puts parents and family members in both emotional and financial ruin, gambling addictions that destroy the heart of the gambler as they are just trying to make one more bet or card play, people protesting the injustices of life in their eyes when their own inabilities to prosper become someone else's responsibility, medical insurance providers marketing caring and loving attitudes to their members until their members need assistance with their health and they are not covered for most of what they need to heal.

It is as if Zeus himself has displayed his own cleverness by enchanting the boulder into rolling away from every human faced with life challenges and before they reach the top, their temptations to experience life in its fullest again leads them down a path to an eternity of useless efforts and unending frustrations. Even if they experience the benefit of change, they revert to what they feel most secure at: ruining their life in one way or another.

There are those who break the vicious cycle of absurdity, make the changes necessary to recover and prosper, maintain the discipline to stay on point and thwart all those people in their life that continue to tempt them into going back to the way it was. Unfortunately no one, including me, knows on the front end who will be able to let the boulder roll down the hill one last time and walk away from a life of futility.

Only time reveals the answer to the question I have when I evaluate a new patient in our office: Is this patient just another version of King or Queen Sisyphus? Or have they decided that enough is enough.

Doc 

Posted by Amanda Sanders at 8:44 AM
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