"Over There." On the other hand, the stories that floated back to us from the war zone ill.u.s.trate in the most powerful way what the human body can do when necessity forbids the slightest attention to its needs. One of the best of these stories is Dorothy Canfield"s account of Dr. Girard-Mangin, "France"s Fighting Woman Doctor." Better than any abstract discussion of human endurance is this vibrant narrative of that little woman, "not very strong, slightly built, with some serious const.i.tutional weakness," who lived through hardships and accomplished feats of daring which would have been considered beyond the range of possibility-before the war.
Think of her out there in her leaky makeshift hospital with her twenty crude helpers and her hundreds of mortally sick typhoid patients; four hundred and seventy days of continuous service with no place to sleep-when there was a chance-except a freezing, wind-swept attic in a deserted village. Think of her in the midst of that terrible Battle of Verdun, during four black nights without a light, among those delirious men, and then during the long, long ride with her dying patients over the sh.e.l.l-swept roads. Listen to her as she speaks of herself at the end of that ride, without a place to lay her head: "Oh, then I did feel tired! That morning for the first time I knew how tired I was, as I went dragging myself from door to door begging for a room and a bed. It was because I was no longer working, you see. As long as you have work to do you can go on." Then listen to her as she receives her orders to rush to a new post, before she has had time to lay herself on the bed she has finally found. "Then at once my tiredness went away. It only lasted while I thought of getting to bed. When I knew we were going into action once more, I was myself again." Watch her as she rides on through the afternoon and the long dangerous night; as she swallows her coffee and plum-cake, and operates for five hours without stopping; as she sleeps in the only place there is-a "quite comfortable chair" in a corner; and as she keeps up this life for twenty days before she is sent-not on a vacation, mind you, but to another strenuous post. [51]
[51] Dorothy Canfield: The Day of Glory.
This brave little woman is not an isolated example of extraordinary powers. The human race in the great war tapped new reservoirs of power and discovered itself to be greater than it knew. Professor James"s a.s.sertions are completely proved,-that "as a rule men habitually use only a small part of the powers which they actually possess," and that "most of us may learn to push the barrier (of fatigue) further off, and to live in perfect comfort on much higher levels of power."
How? The practical question is: how may we-the men and women of ordinary powers, away from the extraordinary stimulus of a crisis like the great war-attain our maximum and drop off the dreary mantle of fatigue which so often holds us back from our best efforts? It may be that the first step is simply getting a true conception of physical fatigue as something which needs to be feared only in case of a diseased body, and which is quite likely to disappear under a little judicious neglect.
In the second place, fatigue shows itself to be closely bound up with emotions and instincts. The great releasers of energy are the instincts. What but the mothering instinct and the love of country could uncover all those unsuspected reserves of Dr. Girard-Mangin and others of her kind? What is it but the enthusiasm for work which explains the indefatigable energy of Edison and Roosevelt? If the wrong kind of emotion locks up energy, the right kind just as surely unlocks great stores which have hitherto lain dormant. If most people live below their possibilities, it is either because they have not learned how to utilize the energy of their instinctive emotions in the work they find to do, or because some of their strongest instincts which are meant to supply motive power to the rest of life are locked away by false ideas and unnecessary repressions, and so fail to feed in the energy which they control. In such a case, the "spring tonic" that is needed is a self-knowledge which shall release us from hampering inhibitions and set us free for enthusiastic self-expression.
Nervous Fatigue
What of the Nervous Invalid? If the normal man lives constantly below his maximum, what shall we say of the nervous invalid? Fatigability is the very earmark of his condition. In many instances he seems scarcely able to raise his hand to his head. Sometimes he can scarcely speak for weariness. Frequently to walk a block sends him to bed for a week. I once had a patient who felt that she had to raise her eyelids very slowly for fear of over-exertion. She could speak only about two or three words a day, the rest of the time talking in whispers. She could not raise a gla.s.s to her lips if it were full of water, but could manage it if only half full. A person nearly dead with some fatal disease does not appear more powerless than a typical neurasthenic.
If it he true that acc.u.mulation of fatigue is promptly fatal, what shall we say of the woman who says that she is still exhausted from the labor of a year ago,-or of ten years ago? What of the business man who travels from sanatorium to sanatorium because five years ago he went through a strenuous year? What of the college student who is broken down because he studied too hard, or the teacher who is worn out because of ten hard years of teaching? There can be but one answer. No matter what their feelings, they can be suffering from no true physiological fatigue. Something very real has happened to them, but only through ignorance and the power of suggestion can it be called fatigue and attributed to overwork.
Stories of Real People. Perhaps if we look over the stories of a few people who have been members of my household, we may work our way to an understanding of the truth. We give only the barest outline of the facts, thinking that the c.u.mulative effect of a number of cases will outweigh a more detailed description of one or two. The most casual survey shows that whatever it was that burdened these fine men and women, it was not lack of energy. No matter how extreme had been their exhaustion, they were able at once, without rest or any other physical treatment, to summon strength for exertions quite up to those of a normal person.
The second point that stands out clearly to any one acquainted with these inner histories is the conviction that in each case the trouble was related in some way to the unsatisfied love-life, to the insistent and thwarted instinct of reproduction. In some cases no search was made for the cause. The simple explanation that there was no lack of power was sufficient to release inhibited energy. But in every case where the cause was sought, it was found to be some outer lack of satisfaction, or some inner repression of the love-force.
From Prostration to Tennis. One young woman, Miss A., had suffered for ten years from the extremest kind of fatigue. She could not walk a block without support and without the feeling of great exhaustion. Before her illness she had had a sweetheart. Not understanding her normal physical sensations when he was near, she had felt them extremely wicked and had repressed them with all her strength. Later, she broke off the engagement, and a little while after developed the neurosis. Within a week after coming to my house, she was playing tennis, walking three miles to church, and generally living the life of a normal person.
Making Her Own Discoveries. Then there was Miss B. who for four years had been "exhausted." She had such severe pains in her legs that she was almost helpless. If she sewed for half an hour on the sewing machine, she would be in bed for two weeks. Although she was engaged to be married, she could not possibly shop for her trousseau. Two years before, a very able surgeon had been of the opinion that the pain in the legs was caused by an ovarian tumor. He removed the tumor, a.s.suring the patient that she would be cured. However, despite the operation and the force of the suggestion, the pains persisted.
After she had been with me for a few days, she sewed for an hour on the machine. In a day or so she took a four-mile walk in a canon near the house and, on returning in the afternoon, walked two and a half miles down town to do some shopping. I did not make an a.n.a.lysis in her case because she recovered so quickly,-going home well within two weeks. But she declared that she had found the cause while reading in one of the books on psychology. I had my suspicions that the long-drawn-out engagement had something to do with the trouble, but I did not confirm my opinion. A long engagement, by continually stimulating desire without satisfying it, only too often leads to nervous illness.
Afraid of Heat. Professor X., of a large Eastern college, had been incapacitated for four years with a severe fatigue neurosis and an intense fear of heat. Constantly watching the weather reports, he was in the habit of fleeing to the Maine coast whenever the weather-prophet predicted warm weather. After a short re.education, he discovered that his fatigue was symbolic of an inner feeling of inadequacy, and that it bore no relation to his body. Discarding his weariness and throwing all his energies into the Liberty Loan Campaign, he found himself speaking almost continuously throughout one of the hottest days in the history of California, with the thermometer standing at 107 degrees. After that he had no doubt as to his cure.
In Bed from Fear. Miss C. was carried into my house rolled in a blanket. She had been confined to her bed except for fifteen minutes a day, during which time she was able to lie in a hammock! It seems that her illness was the result of fear, an over-reaction to early teaching about self-abuse. Her mother had frightened her terribly by giving her the false idea that this practice often leads to insanity. Having indulged in self-abuse, she believed herself going insane, and very naturally succ.u.mbed to the effects of such a fear. After a few days of re-education, she was as strong as any average person. Having no clothing but for a sick-room, she borrowed hat, skirt, and shoes, and walked to church, a three-mile walk.
Empty Hands. Miss Y., a fine woman of middle age, suffering from extreme fatigue could neither sleep nor eat. She could only weep. She had spent her life taking care of an invalid girl who had recently died. Now her hands were empty. Like many a mother whose family has grown up, she had no outlet for her mothering instinct, and her sense of impotency expressed itself in the only way it knew how,-through her body. As there is never any lack of unselfish work to be done, or of people who need mothering, she soon found herself and learned how to sublimate her energy in useful activities.
Defying Nature. One young man from Wyoming had felt himself obliged to give up his business because he could neither work nor eat. It soon cropped out that he and his wife had decided that they must not have any children. With a better understanding of the great forces which they were defying, his strength and his appet.i.te came back and he went back to work, rejoicing.
Left-over Habits. Often a state of fatigue is the result of a carried-over habit. One of my patients, a young girl, had several years before been operated on for exophthalmic goiter. This is a disease of the thyroid gland, and is characterized by rapid heart, extreme fatigue, and numerous other symptoms. Although this girl"s goiter had been removed, the symptoms still persisted. She could not walk nor do even a little work, like wiping a few dishes. I took her down on the beach, let her feel her own pulse and mine and then ran with her on the sand. Again I let her feel our pulses and discover for herself that hers had quickened no more than was normal and had slowed down as soon as mine. After a few such lessons, she was convinced that her symptoms were reverberations for which there was no longer any physical cause.
Another young girl, Miss L., had had a similar operation for goiter six years before. Since that time she had been virtually bedridden. During the first meal she had at my house her sister sat by her couch because she must not be left alone. By the second meal the sister had gone, and Miss L. ate at the table with the other guests. That night she managed to crawl upstairs, with a good deal of a.s.sistance and with great terror at the probable results of such an effort. After that, she walked up-stairs alone whenever she had occasion to go to her room. Her heart will always be a little rapid and her body will never be very strong, but she now lives a helpful happy life at home and among her friends.
In cases like this the exaggeration proves the counterfeit. n.o.body could have been so down and out physically without dying. The exaggeration secures attention and gives the little satisfaction to the natural desires which are denied expression, and which gain an outlet through habit along the lines previously worn by the real disease. Many a person is still suffering from an old pain or an old disability whose cause has long since disappeared, but which is stamped on the mind and believed in as a present reality. Since the sensation is as real as ever, it is sometimes very hard to believe that it is not legitimate, but if the person is intelligent, a little explanation and re-education usually suffices.
Twenty Years an Invalid. Mr. S., from Ohio, had spent much of his time for twenty years going from one sanatorium to another. There was scarcely a health resort in the country with which he was not familiar. The day he came to me he felt himself completely exhausted by the two-block walk from the car. He explained that he could scarcely listen to what I was saying because his brain was so f.a.gged that concentration was impossible. When asked to read a book, he dramatically exclaimed, "Books and I have parted company!" I set him to work reading "Dear Enemy" but it was not a week before he was devouring the deeper books on psychology, in complete forgetfulness of the pains in his head. Playing golf and walking at least six miles every day, he rejoiced in a new sense of strength in his body, which for twenty years he had considered "used up." He is now doing a man-sized job in the business and philanthropic life of his home city.
Brain-f.a.g. This feeling of brain-f.a.g is one of the commonest nervous symptoms; and almost always it is supposed to be the result of intellectual overwork. Some people who easily accept the idea that physical work cannot cause nervous breakdown can scarcely give up the deep-rooted notion that intense mental work is harmful. Intellectual effort does give rise to fatigue in exactly the same way as does physical exertion, but the body takes care of the waste products of the one just as it does those of the other. Du Bois says that out of all his nervous cases he has not found one which can be traced to intellectual overwork. I can say the same thing, and I know no case in all the literature of the subject whose symptoms I can believe to be the result of mental labor.
The college students who break down are not wrecked by intellectual work. In some cases, one strong factor in their undoing is the strain and readjustment necessary because of the discrepancies between some of their deepest religious beliefs and the truth as they learn it in the cla.s.s-room. The other factors are merely those which play their part in any neurosis.
Re-educating the Teacher. School-teachers are p.r.o.ne to believe themselves worn out from the mental work and the strain of the strenuous life of teaching. Many a fine, conscientious teacher has come to me with this story of overwork. But the school-teacher is as easily re-educated as is any one else. I usually begin the process by stating that I taught school myself for ten years and can speak from experience. After I explain that there is no physical reason why the teachers of some cities are f.a.gged out at the end of nine months while those in other cities whose session is longer can hold on for ten months, and stenographers who lead just as strenuous a life manage to exist with only a two-weeks" vacation, they begin to see that perhaps after all they have been fooling themselves by a suggestion, "setting" themselves for just so long and expecting to be done up at the end of the term. Many of these same teachers have gone back to their work with a new sense of "enough and to spare" and some of them have written back that they have pa.s.sed triumphantly through especially trying years with no sense of depletion.
In any work, it is the feeling of strain which tells, the emotionalism and feeling sorry for oneself because one has a hard job. It is wonderful what a sense of power comes from the simple idea that we are equal to our tasks.
Sudden Relief. The story of Mr. V. ill.u.s.trates Professor James"s statement that often the fatigue gets worse up to a certain critical point, and then suddenly pa.s.ses away. Mr. V. was another patient who was "physically exhausted." When the rest of "the family" went clamming on the beach, he felt himself too weak for such exertions, so I left him on the sand to hold the bag while the rest of us dug for clams. The minute I turned my back he disappeared. I found him lying flat on his back, resting, behind the bulk-head. I decided that he needed the two-mile walk home and we all set out to walk. "Doctor, this is cruel. It is dangerous. My knees can never stand this. I shall be ill!" ran the constant refrain for the first mile. Then things went a bit better. Toward the last he found, to his absolute astonishment, that the fatigue had entirely rolled away. The last half-mile he accomplished with perfect ease. Needless to say, he never again complained of physical exhaustion.
False Neuritis. Miss T. was suffering from fatigue and very severe pains in her arms, pains which were supposed to be the result of real neuritis, but which did not correspond to the physiological picture of that disease. A consultation revealed the fact that her love-instinct had been repeatedly stimulated, and then at the last, when it had expected satisfaction, had been disappointed. A discussion of her life, its inner forces, and her future aims helped to pull her together again and give her instinct new outlets. The pains and the fatigue disappeared at once.
Something Wrong. These cases are chosen at random and are typical of scores of others. In no single case was the trouble feigned or imaginary or unreal. But in every case it was a mistake. The sense of loss of muscular power was really a sense of loss of power on the part of the soul. Some inner force was reaching out, reaching out after something which it could never quite attain. As it happened, in every case that I a.n.a.lyzed, the force which felt itself defeated and inadequate was the thwarted instinct of reproduction. Like a man pinned to the ground by a stronger force, it felt itself most helpless while struggling the hardest. Just as we feel a thrill of fright when we step up in the dark and find no step there, so this instinct had gotten itself ready for a step which was not there. Inner repressions or outer circ.u.mstances had denied satisfaction and left only an undefined sense that something was wrong. The life-force, feeling itself helpless, limp, tired, had no way of expressing itself except in terms of the body. Since expression is itself a relief and an outlet for feeling, the denied desire had seized on suggestions of overwork to explain its sense of weariness, and had symbolized its soul-pain by converting it into a physical pain. The feeling of inadequacy was very real, but it was simply displaced from one part of the personality to another,-from an unknown, inarticulate part to one which was more familiar and which had its own means of expression.
Locked-up Energy. We do not know just how the soul can make its pain so intensely real to the body, but we do know that any conviction on the part of the subconscious mind is quickly expressed in the physical machine. A conviction of pain or of powerlessness is very soon converted into a feeling which can scarcely be denied. The mere suggestion that the body is overworked is enough to make it tired.
We know, too, that the instincts are the great releasers of energy. So it happens that when our most dynamic instinct-that for the reproduction of the race-is repressed, we lack one of the greatest sources of usable energy. The energy is there, but it is not accessible. Inhibited and locked away, it is not fed into the engine, and we feel exactly as though it were nil. Despite its name, the disease neurasthenia does not signify a real asthenia or weakness. Rather, it is a disorder in which there is plenty of energy that has somehow been temporarily misplaced. Then, too, we must remember that under the depressing influence of chronic fear, not quite so much energy is stored away as would otherwise be. All the bodily functions are slowed down; food is not so completely a.s.similated, the heart-beat is weakened, the breathing is more shallow, and fatigue products are more slowly eliminated. As Du Bois says, "An emotion tires the organism more than the most intense physical or intellectual work."
Avoid the Rest-Cure. It is a healthful sign that the rest-cure is fast going out of style. Wherever it has helped a nervous patient, the real curative agent has been the personality of the doctor and the patient"s faith in him. The whole theory was based on ignorance of the cause of nerves. People suffering from "nervous exhaustion" are likely to be just as "tired" after a month in bed as they were before. Why not? Physical fatigue is quickly remedied, and what can rest do after that? What possible effect can rest have on the fatigue of a discouraged instinct? Since the best releaser of energy is enthusiasm, don"t try to get that by lying around in bed or playing checkers at a health resort.
Summary
If you are chronically and perpetually fatigued, or if you tire more easily than the other people you know, consult a competent physician and let him look you over. If he tells you that you have neither tuberculosis, heart trouble, Bright"s disease, nor any other demonstrable disease, that you are physically fit and "merely nervous," give yourself a good shake and commit the following paragraphs to memory.
A CATECHISM FOR THE WEARY ONE
WHAT?
Q. What is fatigue?
A. It is a chemical condition resulting from effort that is very recent.
Q. What else creates fatigue?
A. Worry, fear, resentment, discontent, and other depressing emotions.
Q. What magnifies fatigue?
A. Attention to the feeling.
Q. What makes us weary long after the cause is removed?
A. Habit.
WHY?
Q. Why do many people believe themselves over-worked?
A. Because of the power of suggestion.
Q. Why do they take the suggestion?
A. Because it serves their need and expresses their inner feelings.