A Time to Find Meaning

“Even when disease cannot be cured, there is often a way to use this difficult experience to know more intimately the value and purpose of your life.”

Rachel Naomi Remen
1 November 1999

“Even when disease cannot be cured, there is often a way to use this difficult experience to know more intimately the value and purpose of your life.”

It is only quite recently that illness has been defined as a function of the body. At the beginnings of medicine, the shamans or medicine men defined illness not in terms of pathology but in terms of the soul. In this older wisdom, illness is seen as “soul loss,” a loss of direction, purpose, meaning, mystery and awe. According to these ancients, healing required an attention not to the body but to the realm of spirit, a recovery of the soul.

Illness and suffering draw the soul and its issues closer. Much of what I know about spirit I have learned from listening to people with cancer in my work as a physician and from my own experience with chronic illness. These experiences have taught me that spirit is not just a human capacity; it is a human need. This seems especially true in times of loss, in times of illness and crisis. At such times, spirit is strength.

What then is spirit? Spirit is the basis for the value of every human life; it is the source of our dignity and the foundation of our experience of integrity despite bodily change. The capacity for spiritual experience is so universal that every language has its own name for it: the Atman, the Ne-shuma, the Ra, the Ru-ach, the Divine Spark. We call this capacity the soul.

The language of the soul is meaning. We may first discover the soul when life events awaken in us the need for meaning. In the setting of a chronic illness, even people who have never considered this dimension of experience before instinctively reach for personal meaning. Meaning helps us to see in the dark. It strengthens the will to live in us.

Many years ago when I went to medical school, the meaning of illness was seen as irrelevant. But we did not know much about healing then; our focus was on cure. But these things are mutually distinct; expertise cures but it is meaning that heals us. Many things that are beyond cure can still heal. I suppose one might even say that there is a healthy way to have a disease. Even when disease cannot be cured, there is often a way to use this difficult experience to come to know more intimately the value and purpose of your own life. An illness will mean something different to every person who is touched by it.

Experiencing spirit and meaning does not require us to live differently; many of us already live far more meaningful lives than we realize. Meaning does not change the particulars of our lives; it changes our experience of those particulars. Finding meaning requires seeing beyond the superficial to the essential, seeing what is familiar and even commonplace in new ways. When this happens, many people who have seen themselves as victims are surprised to recognize they are heroes.

Illness often naturally initiates a movement towards greater wholeness and perspective. As a physician, I have accompanied many people as they have discovered in themselves an unexpected strength, a courage beyond what they would have thought possible, an unsuspected sense of compassion, and a capacity for love far deeper than they had ever dreamed.

Through illness, people may come to know themselves for the first time and recognize not only who they genuinely are, but what really matters to them. In illness, people sometimes abandon values they inherited with their family name—values that they have never questioned before—and find the courage to live in new ways.

Often these ways are more soul-infused. In all the years that I have listened to people with cancer, no one has ever said to me that if they died, they would miss their Mercedes, even if such a car and all that it represented had been the focus of their lives for many years.

The capacity for spirit and meaning are present in all human beings. My experience as both physician and patient has led me to believe that illness is often an awakening to this capacity and a profound spiritual path. What challenges and even diminishes the body can evolve and strengthen the soul.

This column is adapted from Dr. Remen’s foreword to Meditations on Diabetes: Strengthening Your Spirit in Every Season, by Catherine Feste, published by the American Diabetes Association.

Rachel Naomi Remen

Rachel Naomi Remen

Rachel Naomi Remen, M.D. is Associate Clinical Professor of Family and Community Medicine at U.C.S.F. Medical School and co-founder and medical director of the Commonweal Cancer Help Program. She is author of the bestseller, Kitchen Table Wisdom: Stories That Heal.