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Every parent and child I meet who overcomes or succumbs to illness is challenged to reconcile their fate with their faith in the goodness of the world. They never reason or parse like theologians, and by no means do they all express a faith in any kind of God, but they all find strength and will to wake up every day to a job tremendously more difficult than mine. A child complains one morning at the breakfast table of numbness in one arm, and then collapses from a catastrophic cerebral bleed (or pulls a steaming rice cooker down upon her head, or rides a scooter headfirst into a speeding taxi), and a parent's world suddenly collapses. It's a privilege and a burden to be witness to other people's tragedies, to watch them proceed from stunned disbelief to miserable acknowledgment to stoic acceptance and then beyond to the place I can't quite enter myself, a place in which they are both fully aware of how completely horrible life can be and yet still fully in love with it, possessed of a particular buoyancy of spirit that is somehow heavier than it is light.

I can't say if I believe in the God who knows us and cares for us down to the last hair of our head, and so I don't feel obligated to reconcile such a being with the ugly facts of the chromosomal syndrome trisomy 13, or teenage myelogenous leukemia, but I am pretty sure one need look no further than people's responses to adversity to find evidence that there is something in the world that resists tragedy, and seeks to overturn the evils of seeming fate.

The last and least of my professions, after physician and student, is fiction writer, and I'd like to think that the little tragedy-resisting organ in me is the one that generates stories. They are ghastly, depressing stories for the most part, about ghosts, and zombies, and unhappy angels managing apocalypses, and people attempting to bring the dead back to life, but they are a great comfort to me. I write fiction mostly to try to make sense of my own petty and profound misery, and I fail every time, but every time I come away with a peculiar sort of contentment, as if it was just the trying that mattered. And maybe that's the best answer to the patently ridiculous problem of trying to reconcile all the very visible evil and suffering in the world with the existence of a God who is not actually out to get us: We suffer and we don't give up.

Chris Adrian's second novel, The Children's Hospital, was published by McSweeney's. He is a pediatrician and divinity student in Boston.

From the May 2007 issue of O, The Oprah Magazine.

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