When Bad Things Happen to Good People

Hidden Brain

This Hidden Brain episode follows historian Kate Bowler's experience of being diagnosed with Stage IV colon cancer and her study of how people try to impose order, meaning, and control on tragedy.

Key takeaways

• Kate Bowler says her diagnosis shattered her assumptions that good choices would lead to good outcomes and that life would eventually make sense.
• Bowler categorizes common responses to suffering as minimizers, teachers, and solutions people, arguing they often try to convert pain into a lesson or a solvable problem.

Main topics

• cancer diagnosis and the loss of explanatory control
• social responses to suffering, including minimizers, teachers, and solutions people

Notable quotes

I am not leaving this. I'm not leaving this room until you give me another scan.

Conclusion

The episode offers a thoughtful, emotionally grounded account of how suff

Transcript preview

Speaker 4 (0:00) This is Hidden Brain. I'm Shankar Vedanta. Speaker 4 (0:03) In 1759, the French writer and philosopher Voltaire published a satirical novel about a young man and his tutor. Speaker 4 (0:15) Pangloss, the tutor, instructs the student, Candide, that they live in, quote, the best of all possible worlds. As the story unfolds, Candide witnesses war, disease, natural disasters, torture, and death. Speaker 4 (0:33) Pangloss encounters many of these tragedies himself. Yet, no matter what happens, he continues to insist that everything is unfolding exactly as it should. Speaker 4 (0:44) It's from this character that we get the word panglossian, describing someone who relentlessly maintains that everything is for the best. Speaker 4 (0:54) Most of us are not as optimistic as Pangloss. But many of us do carry assumptions in our heads about how life works, that good choices lead to good outcomes, that the world is fair, and that everything will make sense in the end. Speaker 4 (1:10) These assumptions are often unconscious and unarticulated until something happens to destabilize us. Speaker 4 (1:20) This week on Hidden Brain and in a companion episode on Hidden Brain Plus. When bad things happen to good people. Speaker 7 (1:43) For many of us, going further isn't a choice. It's a feeling we can't ignore because ambition has a way of outgrowing where it began. Speaker 7 (1:55) Turning dreams into direction. Speaker 7 (2:00) Every journey brings us closer to the life we imagine. Speaker 7 (2:06) So, where will your journey take you? Etihad. Beyond Borders. Speaker 4 (2:15) Modern life gives us remarkable control over our surroundings. We can navigate unfamiliar cities, communicate across continents, and order almost anything with the touch of a button. Day after day, the world responds to our wishes. It's easy to start believing that life itself works this way, that with enough effort, planning, and good decisions, we can shape our destiny. But sooner or later, many of us encounter a reality that refuses to submit to our wishes. At Duke University, historian Kate Bowler has studied the currents that shape people's cultural and religious worldviews when they encounter these unexpected events. She's also had occasion to think about this in the context of her own life. Kate Bowler, welcome to Hidden Brain. Speaker 8 (3:03) I'm so glad to be with you. Speaker 4 (3:06) Kate, by the time you were in your mid-30s, you had achieved some significant personal and professional milestones. What was your life like at the time? Speaker 2 (3:15) Well, I finally got my ridiculous dream. I know not everyone wants to be a historian when they grow up, but both my parents were professors, and all I wanted was to live in a tower with many Speaker 8 (3:30) books and gargoyles. And so when I got a job, like right out of grad school at Duke University, it was truly so much better than I ever thought I could achieve. Speaker 4 (3:40) You were also, I understand, married, and you just had a child? Speaker 8 (3:45) Yeah, I married my high school sweetheart and I'd had years of infertility and finally had this like squishy little baby that smelled like applesauce and cookies and just Speaker 2 (3:58) like, Speaker 8 (3:59) I was just one of those like seasons in the sun. This kid came to me as a complete. revelation. I never thought I could have him. And so when I was finally just, he's in my arms, it really felt like everything had come together. Speaker 4 (4:22) So amid all these positive developments, you'd also been experiencing some stomach pain, and I understand this was bad enough that it would make you periodically keel over for a few minutes? Speaker 8 (4:34) It was like very sharp, sudden pains, and it would just come and go. So I would be walking down the hallway and then all of a sudden just like double over and need a minute. And I thought, well, this is like not normal. So I went to every doctor who would have me. And because I'm at the university, it was really only like a tube building over walk to try to see every single specialist. But every time they couldn't find anything on a scan and said it was probably normal. Speaker 4 (5:03) Hmm. You had one memorable meeting with a gastrointestinal surgeon. Paint me a picture of that encounter, Kate. Speaker 8 (5:10) By the time I got this appointment, I was truly at my wit's end. I didn't look well. I looked like sweaty and like my mouth was tinny with like the saliva that you get from being in too much pain. I looked. fried. I felt fried. And then when I just got yet another, there's nothing we can do, I lost it. I was like, I am not leaving this. I'm not leaving this room until you give me another scan. Speaker 4 (5:39) And what happened? Speaker 8 (5:41) I went and did the scan and went home. I figured they'd find something in my gallbladder. There was some talk of like maybe it was just kind of like wonky numbers in my gallbladder and they would just have to do a minor surgery and no big deal. And so I was at the office the next day. I was walking on my little treadmill and got a phone call from a nurse who I'd not met. And she said, that the results of my scan showed and then it was very blurry in my mind like I I knew she was talking and I couldn't figure out what the words meant it was something about how it was everywhere and I said I'm sorry I don't understand what's everywhere and then she said cancer And I couldn't. I think she was trying to, like, get me to come into the hospital right away. But all I could think to say was, but I have a son. Speaker 2 (6:47) Because it was, like, it was honestly the best argument I could think of, like, why it shouldn't, why this can't happen and why this shouldn't be me. And I, Speaker 8 (6:57) like, left my office in my work outfit, went to the hospital, got admitted, got changed into one of those blue... rough cotton gowns and felt like I suddenly started a very different life. Speaker 4 (7:26) So you were 35 years old at the time, Kate, and you went from basically nothing to stage four cancer in one conversation. Speaker 8 (7:37) Yeah, that's right. And I honestly, I don't even think I knew what cancer was. Like, I didn't have cancer in my family. I knew it sounded bad. I thought it was something that happens to you if it's passed on to you or you have something obvious. It just... Speaker 8 (7:55) truly had not one framework in my mind that it could happen to me. Speaker 4 (8:06) I'm wondering what conversations you had with your husband, Kate. Speaker 8 (8:10) I'm sure that the things that happened in those, like, in what feels to me like forever, probably only happened in like two days. But it felt like it was just a whole, a whole new world. I had, I just, I had to suddenly say everything. I love you. I'm so sorry. Please take care of our son. Has anyone called my parents? Like, it's the weirdest thing. You're not sure if you should prepare everyone for the worst or if you should suddenly start acting like I was somehow going to find my way out of this. Speaker 4 (8:54) You're a religious person, Kate. Did you find yourself praying at the time? Speaker 8 (8:59) Prayer is not, I don't know, it's just always been like breathing for me. And all of it was. Speaker 8 (9:10) rage. Like, we're just rage. I can't believe this is, you know, and just like, God, why is this happening to me? Haven't I been faithful this whole time? I sometimes think of it as like, you've got 2 p.m. prayers and 2 a.m. prayers. And like, 2 p.m. prayers are like pretty reasonable. They are nuanced. They have some measure of like, okay, I can see the reality of this whole thing. 2 a.m. prayers are like, God, make it stop. I will do anything. And there's also a complete surrealness to it. Like, is there anything I can do? God, I swear to you, if I get through this, I will, you know, do anything you want, be anyone you want. Just get me out of this. Speaker 4 (10:01) At times like this, Kate, I think what we end up mourning is not just what's happening to us, but we also mourn the things that we thought that we would do and we fear that we are not going to be able to do. Talk about that. What were the dreams that you were mourning that were not going to come true now? Speaker 8 (10:19) I really wanted to see the pyramids when I was little. I got a hieroglyph set. Why wasn't I an Egyptologist? Why didn't I work for the UN? What about all these people I thought I would be and places I thought I would go? And the person in particular I thought I would make my son by being able to go everywhere with him. I used to change his little diaper in those sweet middle-of-the-night moments and be like, wow, I just want to... I want to take you everywhere. I would say it over and over and over again. So the idea that I would not become all of those people and that somehow it would foreclose a story for everyone else. And it felt like there could have been so many more. Speaker 8 (11:07) Words. To discover. Speaker 4 (11:17) In the wake of her diagnosis, Kate struggled to deal with the ways her beliefs about herself and her life had been shattered. But as she began to share the news with others, she encountered a new problem. That's when we come back. You're listening to Hidden Brain. I'm Shankar Vedantam. Speaker 4 (11:47) This is Hidden Brain. I'm Shankar Vedanta. When someone we know experiences a tragedy, most of us instinctively want to help. We offer comfort, advice, prayers, whatever we can think of. These gestures are often sincere and generous, but they can also be driven by something we rarely acknowledge. Other people's tragedies force us to confront the possibility that our own lives are not as predictable or secure as we'd like to believe. Speaker 4 (12:21) Kate Bowler is a historian at Duke University. After she learned that she had stage 4 colon cancer, she found herself observing the ways people in her life reacted to her situation. Speaker 4 (12:32) Kate, some of your friends, and these were primarily your fellow academics, responded in a distinctive way to the news of your cancer. I understand it involved extensive use of Internet search engines? Speaker 2 (12:45) Yeah, I think Speaker 8 (12:46) researchers want to research. And there was a very frantic attempt to out-know this very sudden diagnosis. And so... Yeah, my colleagues just were looking into genetic mutation possibilities. I remember... Speaker 8 (13:11) How tempting that was. My mom found me one time at like one in the morning sitting in the middle of the floor. And I printed out all the blood work and all the paperwork and all the from everything that, you know, that everyone wanted to try. And I had them spread out around me. It looked like rings of a dine tree. And my mom said, oh, hon, like you can't out know this. Speaker 8 (13:40) And everything in me was like, yeah, but I have to try. Speaker 4 (13:45) Another group of your friends, Kate, responded somewhat differently. These were your hippie, crunchy friends. What did they say? Speaker 2 (13:54) They were very eager for me to explore the nutritional reasons why this had happened to me. I think every cancer opens up like a different kind of conversation about causality. And colon cancer gave me all the food medicine people. I got three new juicers, unwanted juicers. I got like, there had been a recent like spate of like cure your cancer with. Kale was very hot at the time. Speaker 8 (14:25) So I really got a lot of very highly specific diets, nutritional advice. People just like came over and poured vegetables on my doorstep basically. And the reason why that was more uncomfortable than the attempt to out know it was it was really starting to creep into the wasn't it your fault. Have you been eating a lot of red meats? I had somebody actually slap a cookie out of my hand at one point as I was like sitting Speaker 2 (15:00) after chemo, just absolutely exhausted. And like slap a cookie out of my hand because didn't I know that sugar causes cancer? And Speaker 8 (15:10) it was very, it was hard to go from. I'm now trying to live in a newly highly medicalized world where all kinds of things have to happen to your body that you don't get to pick. And then the second you get home now have all of everything that I put in my mouth be evaluated. Speaker 4 (15:36) So your academic friends were trying to help you think your way out of cancer. Your crunchy friends were trying to help you eat your way out of cancer. Speaker 2 (15:46) Yeah, that's exactly right. Speaker 4 (15:55) Now, you're a professor at Duke University's Divinity School, and many of the individuals you know are people of faith. I'm wondering how your religious colleagues and friends responded to the news of your illness. Speaker 8 (16:08) It was actually one of the most meaningful things I have ever experienced. Right after I was diagnosed, they held like an impromptu church service. And I saw the recording later. And it was, it was like shocking to me to see people that I'd only seen in very respectable settings, like beg and plead and weep. on my behalf. Like, the desperation that comes from a certain kind of faithfulness that, like, God hears, God might answer, maybe God might intervene. Speaker 4 (16:57) So you wrote about your diagnosis in an essay that was published in The New York Times, and you received many letters subsequently, Kate. Not all of them were as kind or as generous as your colleagues at Duke University. Tell me about some of the feedback you received. Speaker 8 (17:14) I thought that I had tried to write an article that was basically saying that it's incredibly painful to die in a Speaker 2 (17:22) culture where everybody has a reason. And one of the great ironies, of course, was that many people read that article and was like, oh my gosh, it feels like this woman would really like me to let her know what the reason is. I will send that to her now. And so I got like, I mean, thousands of pieces of mail. I got... Speaker 8 (17:41) banners with triumphant scripture that I was supposed to repeat over and over Speaker 2 (17:47) again so that I could be healed. I got, I mean, I think one of the meanest ones was somebody wrote the reasons why he thought that I probably deserved to die on the back of a church bulletin. And I think most of the attempts were trying Speaker 8 (18:03) to pour certainty over pain. And to say, let me fill in the spiritual gaps and give you a spiritual explanation for how God works. God is just. There must be something in here about God's justice that you're not acknowledging. God is understandable. Surely you can sift through your own spiritual past and find some kind of opening, some kind of causality. Or actually, maybe God has provided. a set of spiritual tools that you're not using. Let me explain them to you so that you know what to do. And some of them were from other religious traditions. Like for those who believe in reincarnation, don't worry, your story will go on. Or, I mean, I will never forget the like... Speaker 8 (18:53) The love in some of these very heartbreaking notes about like, Kate, I have wasted my own life. I wish there was a way that we could, that you could take a little of mine and I could take a little of yours and we could make a world that is fair. Speaker 4 (19:22) I understand that at one point one of your neighbors stopped by your house to share a sentiment with your husband. Speaker 8 (19:28) Yes, I had a neighbor stop by and she told my husband, well, everything happens for a reason. And he immediately just said, I'd love to hear it. I'd love to hear the reason my wife is dying. Speaker 4 (19:52) The responses to your illness were so consistent that you eventually divided them into different categories, and you describe these groups of people as the minimizers, the teachers, and the solutions people. Unpack those terms for me, Kate. Speaker 2 (20:09) Well, the minimizers are pretty sure that whatever is going on, it's probably not as bad as I think it is. These were at least, any sentence starting with at least is typically a minimizer. Speaker 8 (20:22) At least you're at a good hospital. I remember when we were in the earliest days really struggling with whether or not this would bankrupt me and my family and my parents, actually. At least, someone said, you have the intellectual resources to deal with it. I always wanted to push back of like, at least it's not stage five Speaker 2 (20:47) cancer. When do I graduate into your compassion? So yeah, at least minimizers are pretty easy to spot. The teachers... want you to learn something Speaker 8 (21:02) that might save your own life. And it could be an emotional lesson. It could be a medical lesson. But that there's always... Have I heard about, you know, drinking the blood of ducks from Albuquerque? Like, it could get increasingly, Speaker 2 (21:22) like, ridiculous. But Speaker 8 (21:24) there's just such a—in the face of this much pain and uncertainty, they need to hand you a lesson so that you can climb your way back onto the boat. The solutions people... Speaker 8 (21:38) are Speaker 8 (21:41) upset that there is not more certainty and that you should be on a quest to really solve the problem of pain. Speaker 8 (21:51) And so solutions people are not going to believe that you've ever done enough. And they're going to want to hear you say that there's a new clinical trial that you're in, that there's another faith healer that you're listening to or seeking out, but they will never accept that illness is likely something that's happening to you and not with your consent. Speaker 4 (22:23) So I'm hearing a common thread in all of these responses. People are trying in some ways to preserve a sense of logic and order around an event that was frightening in its randomness. Does that sound right to you as an explanation for these different veins of feedback and advice? Speaker 8 (22:41) Yeah, I think that's exactly right. There's a genuine discomfort with that degree of uncertainty. And the immediate next step is to try to transform a tragedy into a kind of lesson or staging ground for some kind of next step. And this seems to me to be like a deeply American impulse is that. There's no setback, just set up, that this can't simply be an undoing, that there