You’re heading down some empty street on the way to your clerkship, fishing for the last nanogram of caffeine in your disposable cup. You’re in a hurry, but a trash can sits ahead of you, open and unfilled. You toss the cup without stopping and hear the thud of cup on pavement. You look back. There it is in the gutter about five yards back. You consider leaving it. You’re in a hurry, not to mention the strain from bending at your knees and waist. People litter all of the time. Besides, what’s the point if it’ll just end up on the ground again in some landfill? And those landfills will keep growing until someday, you think, the earth will be one big piece of trash–a planet-sized coffee cup rolling around in the cosmological gutter. You grumble quietly, spiraling from a misthrown piece of trash to the heat death of the universe. Over your grumbling, you hear the whisper of someone behind you.
You’re right to be skeptical, the Nihilist says. If nothing matters in the long run, then why pretend anything matters now? Pick up trash, build a hospital, write a blog post, and the universe will blast it all to dust eventually. A group of Aesthetes materialize to your right. They clamor that the wonders of beauty, sensation, and personal experience escape the confines of time. Two Existentialists leap onto the scene. Meaning isn’t given but is created, they say. Human purpose is maintained through motivated action. But again, the Nihilist whispers. Even if meaning is a human construction, it requires at least another human to recognize it. Meaning unappreciated by the human mind is just another unobserved tree falling in the unobserved woods. At this point, the Existentialists begin infighting, the Aesthetes have wandered off to the MoMa, and the problem remains stubbornly in place. But another voice speaks out: So what? They say. Yes, the universe is cold and indifferent, but the human mind still hungers for meaning. What is to be done about this hunger? Asks the Absurdist.
Unlike the other discontents, the Absurdist accepts nihilism’s premise that the world is meaningless but further acknowledges the question of how one should respond. This conflict between the world and the human mind (i.e. the Absurd) is not a site for resignation, but a modest sort of revolt. Absurdism acknowledges the universe’s impermanence but argues that we should live in spite of it. We must find worth in the struggle itself, the Absurdist says.
This all sounds very romantic, you think, but what does this struggle even look like? Where is the substance? You are running late now and you have no time left to contemplate abstractions. But as you look forward, you are reminded of where you are headed and why you are headed there. Like yesterday, and the day before, you are on your way to confront this reality. Your training in medicine is a long-winded introduction to inevitabilities: the eventual failure of health, the recurrence of disease, and the limits of intervention. The Nihilist speaks a final time: Don’t take another step.
And yet, despite those whispers over your shoulder, it does not occur to you to stop. If there is one thing you have learned so far, it is that illness was never a problem to be solved, but a force to be resisted and delayed and hindered. Even if the universe doesn’t care, those people that will depend on your actions do. Frankly, who cares about what the universe thinks when the person in front of you has stopped breathing? Why consider existential despair when there is a man out there whose heart has stopped? A woman whose brain is bleeding? A child who can’t quite make out those words on the whiteboard?
Within your own small reality, contained by those finite pieces of space and time you occupy, an entire community will depend on this revolt that you have only just begun. As a matter of fact, you’re getting ahead of yourself. First, you should probably learn how to take a half-decent medical history. You change your mind. First, you should make it to your clerkship on time. You ready yourself to break into a run.
Then you turn around. You walk the five yards back. And you pick up the cup.
Now you run.
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