There Is No Hierarchy of Suffering

(Photo by S.J. Pyrotechnic via Flickr)

Posting on Facebook that her beloved dog was doing well after hip surgery, a friend prefaced the report with a strenuous apology, acknowledging that this was no big deal in the scheme of things and assuring people that she was well aware of the horrific devastation of COVID-19.

I replied with a phrase I use often: “There is no hierarchy of suffering.”

We seem to think there is: We proceed as though someone has rank-ordered all that can go wrong, and we are terrified to seem oblivious to our own sorrow’s proper place low on that list. But even against a backdrop of large-scale suffering, everyday life continues to sling its small, stinging arrows. Yes, a sense of context and proportion helps keep the little stuff in perspective. But when we are constantly referring back, comparing, and measuring, we silence each other with our math.

There is no scale; it does not matter whose suffering outweighs whose. Life is not a game of “I can top that”; nor is there an etiquette that requires pain to reach a certain degree before it qualifies for mention. Thinking that way prevents us from sharing what happens to us, and it minimizes things that need to be known. At the start of #MeToo, Minnie Driver felt the need to write, “There is no hierarchy of abuse—that if a woman is raped [it] is much worse than if a woman has a penis exposed to her that she didn’t want or ask for … you cannot tell those women that one is supposed to feel worse than the other.”

Nor can you isolate, say, a friend who has been diagnosed with a serious disease, abruptly falling silent because you are suddenly ashamed to confide your lesser miseries. Life becomes way too lonely if we are afraid to grumble and cry out loud, and most of us would rather continue a mutual friendship than feel we have been raised up on a pedestal of misery. In other circumstances, times when people feel slighted or maligned or unjustly treated but are afraid to voice something that might be dismissed out of hand, all that pent-up self-pity can fester into something far more murderous or vindictive. This is one of the wedges driving our nation apart: Entire groups are competing to have their suffering acknowledged, and they are tired of hearing other groups’ suffering privileged.

Human beings, at least in competitive Western cultures, compare relentlessly. After surgery, we are either macho about how few painkillers we took or melodramatic about how long we were “on the table,” “opened up,” vulnerable. You win conversational points if you know someone who is living through the disaster of the moment, who is positive for COVID-19, who survived Hurricane Katrina. The trick is to brush up against real misery without letting it stick, so you can win the comparison without suffering the actual experience.

Still, as foolish as all this comparison can become, there is even more damage done when we forget to compare. It drove my husband crazy to hear years of media coverage of 9/11 but global silence after the genocide in Rwanda. At least half a million people died, probably closer to a million—about seventy percent of the nation’s Tutsi population, and a toll exponentially greater than the 2,996 killed on 9/11.

At the time I thought my husband cold. How could he not mourn obsessively, as I was, about the deaths of innocent Americans, some of them friends of friends, in an act of terror that symbolized danger to the rest of us for years to come? His point was that the rest of the world had been enduring atrocities far worse for centuries. I, meanwhile, had fallen into the old media trap: bigger headlines for a disaster in which Americans die; less ink for distant suffering.

Even certain diseases are elevated above others, considered more deserving of research and attention. “The idea of disease hierarchy was discussed as early as 1943,” writes Louise Stone, “when prestige was seen to be ‘based on the extent to which symptoms can—or cannot—be readily localized.’” As technology grew more sophisticated, “immediate and invasive procedures in vital organs located in the upper parts of the body” acquired prestige, especially when the patient was young. Breast cancer also carries cachet, thanks to successful awareness campaigns and fundraising. But disease in the nether regions? A disease without a diagnostic code? A disease common in the elderly? The prestige plummets.

It is easy to fall into the habit of comparison, of assigning importance and weight. Once, after interviewing a refugee who had been a journalist in Afghanistan—and had been tortured, acid thrown in his eyes, his ear cut off—and had escaped by crawling into a body bag—I listened to a friend rail about the need for a stop sign at an intersection in her subdivision.

I snapped.

All I wanted was for her to see how lucky we both were—no acid had seared our skin; we were not struggling to breathe inside a body bag—and stop fretting over something utterly trivial by comparison. But was it trivial? She was worried about little kids getting hit by cars that failed to stop. It was not her fault that she had never been tortured; she was working within her sphere of influence and doing all she could. Why did I insist on lining up their experiences side by side? His agony did not diminish her distress; both were part of life, and the only connection between them should have been empathy. That truism about paper cuts? They can hurt worse than major incisions. There are more nerve endings. And the little stuff hijacks our brain, because our guard is down. Friends should be people to whom we can confide our smallest woes and exultations, annoyances that are truly petty, misery that is no more than a muddy, self-pitying hippopotamus wallow.

Would I have reacted so warmly if my Facebook friend had gone on and on about her dog’s recovery without even acknowledging the larger crisis? Maybe not. Her sensitivity made it easy to reassure her. But I am also trying very hard to remember that one thing does not trump another; that any distress deserves a response; that one person may be tough enough to move through a crisis zinging with adrenaline while another is undone by a trip to the grocery store.

Do we triage to save our sympathy for “real” suffering? If so, I think we can relax. Sympathy, like love, comes in a limitless supply. But the emotional energy required to understand just how upset someone is over some seemingly trivial thing? That is finite. And we never have enough.