Chapter 5: Worry About Health and the Body

A Week of Waiting

Tomasz is fifty-two and works as the caretaker of a primary school. He fixes doors, paints walls, clears snow from the paths and knows the name of almost every child. Last Tuesday he went for a routine check-up, and the doctor asked for a blood test. "Probably nothing," the doctor said, "but let us make sure." The results will take about a week.

Tomasz has never been ill in his life, or at least never seriously. But since Tuesday, he has started to notice his body in a new way. A small ache in his side seems important. A morning when he feels tired seems like a sign. He remembers a colleague who became ill suddenly some years ago, and he cannot stop thinking about him. At night, he lies awake listening to his own heartbeat, which seems louder than usual.

He has also started looking things up on his phone. He types in his symptoms and reads pages and pages of possibilities, most of them frightening. Each page leads to another. He knows that this makes him feel worse, but he cannot stop. It feels as if he is doing something useful, as if by reading enough he could find the answer before the doctor does.

Worry about health is one of the most common and painful kinds of worry. Our bodies carry us through every day, and when something seems wrong with them, everything else seems to shake. The waiting is often the hardest part. We do not yet know what is happening, so the mind fills the empty space with the worst possibilities it can find.

Before we look at what the Stoics said, one thing must be said clearly. If you have a symptom that worries you, the right step is to see a doctor or another qualified health professional and follow their guidance. What Stoicism can offer alongside that is help with the worry that surrounds health: the waiting, the imagining and the fear.

The Body Is Not Fully Up to Us

In the very first passage of the Handbook, which we met in Chapter 1, Epictetus lists the body among the things that are not up to us (Epictetus, Enchiridion 1). Many readers find this surprising. Surely my body is the most "mine" of all things? But think again about what Epictetus means. You can choose many things about how you treat your body: what you eat, how you move, how you rest, whether you see a doctor. Those choices are yours. But whether an illness appears, how your body responds to treatment and how long you will live are not decided by your choices alone. Genes, age, accidents, the environment and simple chance all play their part.

This might sound like bad news, but the Stoics saw it differently. If your health is not fully up to you, then you are not to blame for every illness, and you do not have to carry the impossible job of controlling your body perfectly. Your job is smaller and clearer: to take sensible care of your body, to seek help when it is needed and to meet whatever happens with as much courage and good sense as you can.

Epictetus had personal reasons to think about this. Ancient stories say that one of his legs was lame. He did not hide this or pretend it did not matter. Instead, he made it part of his teaching. In the Handbook, he says that illness is an obstacle to the body, but not to your choice, unless your choice decides to give up. Lameness, he says, is an obstacle to the leg, but not to your choice. If you say this about everything that happens, you will find that each thing is an obstacle to something else, but not to you (Epictetus, Enchiridion 9).

What does it mean that illness is not an obstacle to "you"? Epictetus is talking about the self that chooses: the part of you that decides how to think, how to treat others and how to meet your circumstances. A person with a painful illness may not be able to walk far or work long hours. But they can still be kind, honest, patient and brave. They can still love their family and learn new things. The body may be limited, but the person is still there, still choosing.

It is important to say this gently. Illness and pain can be very hard, and Epictetus' words are not a way of saying, "It does not matter." Of course it matters. The Stoics would call good health a preferred thing, something it is natural and sensible to want. Their point is that even when health fails, a person's worth and goodness do not fail with it.

Seneca in the Sickroom and Marcus on Pain

Seneca had poor health for much of his life. In one letter, he tells Lucilius about a long period of illness he suffered as a young man, when he became very thin and weak. He says that what helped him most was not medicine alone, but his studies and the support of his friends. Their encouragement, their visits and their conversation gave him strength (Seneca, Letters 78).

In the same letter, Seneca gives his friend advice about being ill. Do not make your troubles heavier by complaining about them, he says. When you tell yourself again and again how much you are suffering, the suffering seems to grow. He also reminds Lucilius that even on a sickbed, a person can still do something worthwhile. They can show the people around them that illness can be met with patience and courage. That, too, is a kind of work (Seneca, Letters 78).

Marcus Aurelius also suffered from poor health. Ancient historians tell us that he was often unwell, with pains in his chest and stomach, and that he ate very little. In his notebook, he copied a saying about pain that came from another philosopher, Epicurus, whose school disagreed with the Stoics on many things but whose words on this point Marcus found useful. In my own words: pain is neither unbearable nor endless, as long as you remember its limits and add nothing to it with your imagination (Marcus Aurelius, Meditations 7.64).

That last part, "add nothing to it with your imagination", is the key for health worry. When Tomasz lies awake listening to his heartbeat, he is not suffering from his blood test. The test is just a small tube of blood in a laboratory. He is suffering from what his imagination has added to it: the frightening pages, the memory of his colleague, the pictures of the worst outcome. The body may or may not have a problem. The imagination has certainly created one.

This is not to say that Tomasz should stop caring. If the results show a problem, he will need to act, and he will. But he can act much better if he arrives at that moment rested and steady, rather than exhausted by a week of imagined illnesses. Taking care of the body is up to him. Taking care of the mind while he waits is also up to him.

Mariam and the Pain That Stays

Mariam is forty-five and has lived with back pain for six years. She has seen several doctors, followed their advice and tried many things. Some help a little. Nothing makes the pain go away completely. On good days, it is a dull ache that she can ignore. On bad days, it is sharp, and she can hardly sit at her desk at the library where she works.

Mariam's worry is not about a single result. It is about the future. Will the pain get worse? Will she be able to keep working? Will she still be able to pick up her grandchildren in a few years? These questions come most strongly on bad days, when the pain is already loud. On those days, the worry and the pain seem to feed each other.

Mariam found Marcus' note about pain helpful, but not in the way she first expected. At first, she thought it meant that she should simply bear the pain bravely. That made her feel guilty on the days when she could not. Later, she understood it differently. Marcus was not telling her to pretend the pain was small. He was telling her not to add extra pain with her imagination. The ache in her back was real. But the picture of herself in ten years, unable to walk, was something her mind added.

So Mariam began to separate the two. On bad days, she says to herself: "My back hurts today. That is real, and I will take care of it as my doctor advised. But the future is not here today. Today, I only need to get through today." She has also learned to notice which parts of her life the pain does not reach. It does not stop her reading stories to her grandchildren from the sofa. It does not stop her laughing with her colleagues. It does not stop her being the kind of person she wants to be.

Mariam would be the first to say that this does not make the pain go away. People who live with long-term pain know that no single idea is a cure, and anyone in Mariam's position should keep working with their doctors. But she has found that her worry is smaller when she stops adding imagined pain to the real pain. As Epictetus might have put it, the pain is an obstacle to her back, but not to her.

Duc and the Midnight Search

Duc is sixteen. A few weeks ago, he noticed a small lump on his wrist. It does not hurt, but it frightened him. Instead of telling his parents, he started searching online late at night, in bed, with the screen glowing under the blanket. He has read about many conditions, some harmless and some serious. Every night he reads a little more, and every night he feels a little worse.

Duc's habit is very common, at every age. When we are worried about our bodies, searching for information feels like taking action. And sometimes good information does help. But late-night searching has a special danger. It gives us many possibilities without any way of knowing which one applies to us. It also tends to show us the most frightening possibilities, because those are the ones the worried mind pays most attention to.

If Duc sorted his worry into Epictetus' two columns, he would see something important. The lump itself is not up to him. What it is, the reading cannot tell him. But telling a trusted adult, and going to see a doctor, are completely up to him. These are the only actions that can actually give him an answer. The searching feels like action, but in fact it keeps him away from the one action that would help.

One evening, after a particularly bad night of reading, Duc told his mother. She was not angry, as he had feared. She made an appointment for the following week. The doctor looked at the wrist, asked a few questions and explained what it was. It was something common and harmless. Duc felt relief so strong that he almost laughed. Later, he said that the worst part had not been the lump at all. It had been the weeks of reading alone at night.

This does not mean every lump or symptom is harmless. Some are not. That is exactly why the right step is to see a doctor rather than to search alone. Whatever the answer, a real answer from a qualified person is better than a hundred frightening guesses in the dark.

What about Tomasz, the school caretaker with his week of waiting? Halfway through the week, he decided to stop searching on his phone. He told his wife what he was afraid of, and saying it out loud made it feel smaller. He kept working, kept fixing doors and kept greeting the children by name. When the fear came at night, he reminded himself that the result was not up to him, but his rest was. When the results came, the doctor asked him to make a few changes to his diet and to come back in six months. It was not nothing, but it was something he could manage, and he met it with a clear head.

Viktor Learning to Walk Again

Viktor is sixty-seven. Two months ago, he had an operation, and now he is in a long period of recovery. His doctors and his physiotherapist have given him a programme of exercises and short walks, a little longer each week. Some days he feels strong. Other days, his body seems to go backwards, and he worries that he will never be the man he was before.

What helps Viktor most is a small notebook in which he writes down each day what he did. "Walked to the corner and back." "Did the exercises twice." "Climbed the stairs without stopping." When he feels discouraged, he looks back over the pages. Day by day, the changes are tiny. Week by week, they are clear. His notebook does for his recovery what Marcus' notebook did for his mind. It reminds him of what is true, especially on the days when his feelings say otherwise.

Viktor has also found comfort in Seneca's letter about illness. Like Seneca, he has been held up by friends. His neighbour walks with him on Saturdays. His granddaughter calls every evening to hear how far he walked. He says that their support is part of his treatment, even if no doctor wrote it down. He has learned to accept help, which was hard for a man who always did everything himself.

Viktor's daily question is a Stoic one, though he would not use that word. Each morning, he asks: "What is my part today?" His part is to do the exercises, follow his doctors' advice, eat well, rest and be patient. The speed of his recovery is not fully his. When he thinks this way, he worries less about the distant future and does more of what helps in the present.

On the hard days, when his legs feel heavy and the walk to the corner seems too far, Viktor has learned not to judge the whole recovery by a single morning. He reminds himself that bodies do not heal in a straight line. His physiotherapist told him this at the start, and he has written it on the first page of his notebook. A bad day is information, not a verdict. He does what he can, rests when he must and tries again tomorrow.

Practical Steps: Caring for the Body, Calming the Mind

The first step is always the same: if you are worried about a symptom, see a doctor or another qualified health professional, and follow their guidance. This is the single most important action in the "up to me" column. It is better than any amount of thinking, reading or worrying. If you are frightened of going, as Duc was, tell someone you trust and ask them to help you take the step.

The second step is to sort your health worries into two columns. Up to you: making appointments, following advice, eating, moving and resting in sensible ways, asking questions, accepting help. Not up to you: test results, how your body responds, the speed of healing, what will happen in many years. Put your energy into the first column. Let the second column rest, as far as you can.

The third step is to "add nothing with your imagination", as Marcus advised. When you notice your mind painting frightening pictures of the future, say to yourself: "That is a picture, not a result." Some people find it useful to decide in advance where they will get information about their health. They choose their doctor and one or two trustworthy sources their doctor recommends, rather than searching widely and alone, especially at night.

The fourth step is to notice what your body's problems do not reach. Like Mariam, ask yourself which parts of your life and your character are still free. You may not be able to run, but you can still be kind. You may need to rest more, but you can still learn, laugh and love. This does not make the difficulty disappear. It reminds you that the difficulty is not the whole of you.

The fifth step is to let others help, as Seneca was helped by his friends and Viktor by his neighbour and granddaughter. Tell someone you trust what you are going through. Accept practical help when it is offered. Many people find this hard, but receiving help is not a weakness. It gives others a chance to show care, and it makes the load lighter for everyone.

A final word of care. Sometimes worry about health becomes so strong that it fills most of a person's days, even after doctors have given reassurance. If this happens to you, it is something a doctor or another qualified professional can help with, and it is worth mentioning to them directly. And if you ever feel that you might hurt yourself, or you are in danger, contact a helpline or a medical facility right away, and in immediate danger call your local emergency number.

What Stoicism Does Not Say About Health

Because the Stoics spoke so calmly about illness and pain, their words are sometimes misunderstood. It is worth saying clearly what they did not mean.

They did not mean that illness is imagined or that a strong mind can cure the body. Seneca and Marcus both relied on doctors, and the ancient world took medicine seriously. When Marcus wrote that we should add nothing to pain with our imagination, he was speaking about the extra suffering that the mind creates, not about the pain itself. Real symptoms deserve real medical attention.

They did not mean that a person who feels afraid or sad about illness is weak. The Stoics recognized that some reactions arrive before we can think, and that even a wise person may turn pale at bad news. What they worked on was what came next: whether we let the fear grow into panic and endless worry, or whether we return, again and again, to the next sensible step.

They did not mean that people should hide their illness or refuse help. Seneca wrote openly about his poor health and about the friends who helped him. Viktor's neighbour and granddaughter, Mariam's colleagues and Duc's mother all show the same truth: carrying a health worry together with others is part of meeting it well.

And they did not mean that health does not matter. They called it preferred, something any sensible person would choose. Their point was only that our goodness, our courage and our kindness remain ours even when our health is uncertain. That is a source of strength, not a reason to neglect the body.

A Short Exercise: Questions for the Doctor and a Letter to Your Body

This exercise has two parts. The first is practical. The second is reflective. You can do them separately.

For the first part, if you have a health appointment coming up, take a page and write down the questions you want to ask. Worry often makes us forget our questions the moment we sit down in front of a doctor. Writing them in advance means your worry is turned into something useful. You might include questions such as: "What do you think this is?" "What should I watch for?" "When should I come back, or call?" "Where can I find reliable information about this?" Bring the page with you, and write down the answers, or ask someone you trust to come with you and help remember. This is one of the clearest ways of putting your energy into the part of your health that is up to you.

For the second part, find a quiet half hour and write a short letter to your own body. It may feel strange at first. Begin by listing some of the things your body has done for you over the years: carried you to work, healed cuts and bruises, held people you love, let you taste food and hear music, kept breathing through every night of your life. Then write honestly about what is hard now: a pain, a limit, a fear. Finally, write what you will try to do for your body in the coming weeks, within what your doctors advise: rest, gentle movement, good meals, keeping appointments, asking for help.

Many people find that this letter changes their relationship with their body. Health worry tends to treat the body as an enemy that might betray us at any moment. The letter reminds us that the body has mostly been a faithful companion, doing countless things without being asked. It also reminds us of Epictetus' point that the body is not fully up to us. We can care for it, but we cannot command it, and it is not a failure on our part when it struggles.

Mariam wrote her letter on a bad day for her back. She was surprised to find herself thanking her body for carrying her through six hard years. "I had only been angry with it," she said. "I had forgotten to notice how hard it was working." She keeps the letter in a drawer and reads it on the worst days.

If writing about your body brings up strong distress, stop and do something comforting instead. There is no need to force this exercise. It is one tool among many, and the most important tool for health worry is always the care of a qualified professional.

Chapter Summary

Epictetus counted the body among the things that are not fully up to us, and he taught that illness and lameness are obstacles to the body, but not to the self that chooses (Enchiridion 9). Seneca, often ill himself, found strength in his studies and his friends, and he warned against making suffering heavier by complaining (Letters 78). Marcus kept in his notebook a saying that pain is neither unbearable nor endless if we remember its limits and add nothing to it with our imagination (Meditations 7.64).

In practice, this means seeing a doctor and following their guidance, putting our energy into the parts of health that are up to us, refusing to add imagined illnesses to real ones and letting others help. Tomasz waiting for his results, Mariam living with long-term pain, Duc searching at midnight and Viktor walking a little further each week all show that caring for the body and calming the mind can go together.

In the next chapter, we will look at another great source of worry, one that touches almost everyone at some point in life: money and possessions, and the fear of not having enough.