How do we explain this seeming paradox? How did a man so weak and sickly become known for toughness and endurance? Perhaps the answer lies in his attitude toward pain and illness, and the Stoic techniques he used to cope with them.
Marcus was nearly fifty, an old man by Roman standards, at the outbreak of the First Marcomannic War. Nevertheless, he donned the military cape and boots, rode forth from Rome, and stationed himself on the front line. He spent much of his time at the legionary fortress of Carnuntum, on the other side of the Alps, by the banks of the Danube in modern-day Austria. Cassius Dio tells us that at first Marcus was too frail to endure the frigid northern climate and address the legions assembled before him. It was a dangerous and physically grueling environment, even for an emperor. To make things worse, with large numbers of men living in close proximity, the military camps were especially vulnerable to outbreaks of the plague. Nevertheless, Marcus typically shrugged off the hardships of life on the northern frontier by quoting the poet Euripides: “Such things accursed war brings in its train.” They were to be expected, in other words.
Despite his health problems and the inhospitable environment, Marcus would spend over a decade commanding the legions along the Danube. In The Meditations, he thanks the gods that his body held out for such a long time under such physical duress.2 He survived the two Marcomannic Wars and the Antonine Plague, nearly making it to the age of sixty at a time when the odds of doing so were poor. Indeed, although he suffered from recurring health problems, he managed to live longer than most of his contemporaries. Still, the sudden transition to military life must have been a tremendous physical challenge for him. It’s therefore no surprise that his writings frequently reveal evidence of his psychological struggle to cope with physical problems.
He’d been preparing himself to face this inner battle for most of his life, though. Over the years, Marcus had gradually learned to endure pain and illness by utilizing the psychological strategies of ancient Stoicism. During the war, in writing The Meditations, he reflected on these techniques as part of his ongoing practice. These notes reflect a state of mind attained from more than three decades of rigorous Stoic training. In other words, his attitude toward pain and illness during the northern campaign didn’t come naturally to him; he had to learn it.
The Meditations isn’t our only insight into Marcus’s thinking, though. In the early nineteenth century, the Italian scholar Angelo Mai uncovered a treasure trove of ancient letters between the Latin rhetorician Marcus Cornelius Fronto and several other notable individuals, including his student Marcus Aurelius. We can’t date the individual letters precisely, but they appear to span the whole period of Marcus and Fronto’s friendship, until the latter’s death around 167 AD at the height of the Antonine Plague.
Their correspondence is remarkable for several reasons. For the first time, scholars could peek into Marcus’s private life and witness his true personality. Far from the popular caricature of a Stoic as someone coldly austere, Marcus shows remarkable warmth and affection toward Fronto and his family. His style of writing is casual and good-humored. He tells Fronto, for instance, of the time he was riding in the countryside, dressed as a regular citizen, when a shepherd rudely accused his companions of being a band of common rogues. Marcus rode laughing into the flock, playfully scattering the sheep to break up the argument. However, the shepherd wasn’t amused and threw his cudgel at them, yelling as the young men fled the scene. It’s difficult to imagine that twenty years later the author of these affable and easygoing letters would find himself gravely noting down Stoic meditations upon seeing the severed body parts littering the frigid battlefields of Pannonia.
There’s something else, though, about these letters that stands in marked contrast to The Meditations: the amount of small talk, and sometimes even griping, that goes on about various health conditions. Fronto was roughly twenty years Marcus’s senior and was particularly fond of complaining to him about his assorted aches and pains. In one instance, Fronto lists the regions of his body most afflicted during the night by widespread pain—“my shoulder, elbow, knee, and ankle”—which he says prevented him from writing to Marcus in his own hand.3
In another letter he writes,
After your departure I was seized by a pain in the knee, mild enough, it is true, for me to be able to walk with due caution and use a carriage. Tonight the pain has set in more violently, but not so badly that I cannot easily bear it when lying down, if it does not get any worse.4
Sometimes Marcus gets drawn into gossiping with Fronto about his own health problems.
As to my present state of health, you will be able to judge that easily enough from my shaky handwriting. It is true that as regards my strength, that is beginning to come back, and nothing remains, besides, of the pain in my chest; but the ulcer is working on my windpipe.5
This particular letter was written before Marcus was acclaimed emperor. It shows that by the age of forty, perhaps much earlier, he was already suffering from the kind of symptoms that would afflict him throughout his reign. In these letters, though, there’s no evidence of the Stoic techniques for coping that we find a decade or more later in The Meditations.
As a youth, Marcus was fit and enjoyed physical activity, as we’ve seen. While at Rome, he was trained to fight in armor, probably by gladiators, using blunted weapons for practice. He also enjoyed hunting and particularly loved to spear wild boar from horseback. He went fowling as well, hunting birds with nets and spears.
So our overall picture of Marcus in his youth is one of a strong, athletic young man. As he aged into his forties and fifties, though, he became physically frail, and that seems to be how subsequent generations remembered him. Writing in the fourth century, for instance, the Emperor Julian imagines Marcus’s skin looked diaphanous and translucent. Marcus even referred to himself in a speech as a weak old man, unable to take food without pain or sleep without disturbance. The Meditations also mentions him obtaining remedies for coughing up blood and spells of giddiness.6 He particularly suffered from chronic chest and stomach pains. He could manage only small amounts of food, taken late at night. Scholars have offered different diagnoses, the most common being chronic stomach ulcers, although he probably suffered from multiple health problems.
After the initial plague outbreak at Rome, Marcus’s court physician, Galen, prescribed him the ancient compound known as theriac, a mysterious concoction made from dozens of exotic ingredients, everything from bitter myrrh to fermented viper’s flesh and a small quantity of opium. Marcus believed that regular doses of theriac helped him endure the pain in his stomach and chest as well as his other symptoms. He stopped using it for a time because it was making him too drowsy, but he resumed taking a modified version with a reduced quantity of opium. He therefore seems to have taken theriac judiciously and in a mild form.
In any case, the medicine clearly didn’t eliminate the pain and discomfort Marcus felt. Like many people who suffer from chronic pain, he had to develop other ways of coping. Over the years, therefore, Marcus came to depend on the psychological techniques of Stoicism as a way of living with health problems, especially as things became tougher for him after joining the army on the Danube. During the misery of the Antonine Plague and the carnage of the Marcomannic Wars, he must have witnessed countless people dealing with their own suffering, some better than others. Over the course of his life, he learned a great deal by studying how a handful of exemplary individuals endured severe pain and illness. He interpreted that wisdom through the lens of Stoicism and then distilled it into The Meditations.