Sisyphus is burned out. It’s not simply that the work is grueling. He just can’t see the point of it anymore. None of the old strategies are working—not rebellion, not resignation, not even a passive-aggressive slow-walk down the mountain. Shaking his fist at the gods feels like an empty gesture now. Naturally, his workplace wellness program has been no help. All they had to suggest was an online yoga class. Desperation has finally driven Sisyphus to a Zoom appointment with his “primary care provider,” who has called in a prescription for Zoloft and Ativan.
Sisyphus hasn’t filled the prescription. He knows his reluctance makes no sense. He is drinking way too much. The mere thought of a boulder gives him a sick feeling in his stomach. Wouldn’t happiness be preferable to depression? Wouldn’t serenity be better than dread? There is no rational, evidence-based reason for Sisyphus to refuse the medication. Double-blind, randomized trials have shown antidepressants supplemented by anxiolytics to be at least 20 percent more effective than placebo in subjective quality-of-life assessments among mortals condemned to perform futile work for eternity.
When the coronavirus emerged early last spring, many of us reached for Albert Camus’s novel The Plague. But as the pandemic stretched into the winter, The Myth of Sisyphus began to look like a better choice. We appeared to be facing some kind of existential reckoning, even if it wasn’t clear exactly what the reckoning was. Forced confinement had left many of us feeling trapped and lonely. More than a few of us were stunned by the colossal failure of the American social and political systems. Poorer countries with more solidarity and cultural trust were handling the pandemic far better than we were. For some, the reckoning felt deeply personal. If there is nothing like the death of someone you love to make you reconsider the hours you have left on earth, there is nothing like mourning that death by Zoom to make you rethink the way you want those hours to end. Many of us were tempted to moralize the virus, imagining it as a punishment directed at those who had defied the commandments of our designated moral authority. Too bad about poor Sisyphus, we thought, but he brought it on himself.
The question of how to treat Sisyphus lies at the heart of Robin Downie’s new book, Quality of Life: A Post-Pandemic Philosophy of Medicine. According to Downie, Emeritus Professor of Moral Philosophy at the University of Glasgow, the COVID-19 pandemic ought to make physicians rethink the fundamental ethos of medicine, which has produced an individualistic, consumerist, science-worshiping form of medical practice. Physicians consider themselves enlightened when they emphasize the importance of improving their patients’ “quality of life” rather than simply curing their diseases, yet most of them have a narrow, unexamined view of what that entails. Downie would not deny that Sisyphus has a poor quality of life, of course. Nor would he dispute that he faces a serious problem. Yet not all suffering is a medical problem, and not all remedies for suffering include medical intervention. What else does a physician have to offer?