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The outbreak of Legionnaires’ disease in New York City during the summer of 2025, which caused at least six deaths and more than 100 cases, reminded me of the time that I had gotten sick with the illness.
I don’t know how I contracted the disease. I hadn’t been on a plane or in a hot tub, nor could I remember being anywhere near where I would have inhaled contaminated water droplets, the vector by which the bacteria spread. I felt lethargic and ran a fever. A test confirmed that I was sick with what was then a newly discovered form of pneumonia. My doctor immediately prescribed medication for me, as the disease, if untreated, can be fatal.
Soon after taking the new antibiotic, I began to feel better, but it did nothing to lift my mood. My wife, Lyn, who is a source of good humor, tried everything she could to lift my spirits—jokes, comic movies, wisecracks. Pep talks didn’t work, either. Words of encouragement fell on deaf ears.
I was depressed in a way I had never experienced before. When she left for work, I would call her for reassurance. I didn’t want to be left alone, I didn’t want to get out of bed, and I cried. This went on for a couple of days.
Then Lyn called my doctor and asked if my depression could be caused by the medication. He said that he never had a patient with that reaction, but it was possible. He prescribed a different antibiotic, and by the end of the day, my outlook returned to normal.
My bout with Legionnaires’ disease made real for me something I had known intellectually: Willpower has limits. I now give pause when making judgments about others who can be difficult, irritating, mean, unethical, and even criminal. I question when to hold people accountable for their actions and when to acknowledge the limits imposed by internal and external factors.
Judging others’ behavior can easily slide into being judgmental, excluding compassion and mercy. Not judging, though, may excuse everything. As a French aphorism has it, “To know all is to excuse all.”
Where to draw the line between caring and enabling has implications for personal relations, such as whether a child’s inattentiveness is a “won’t” or a “can’t,” and whether a person’s horrendous upbringing or psychological state renders the accused innocent. Not holding a person blameworthy is patronizing, but not taking extenuating circumstances into account can be brutal. As ethicist Kwame Anthony Appiah has pointed out, “the line between care and enabling is often blurry.”
Mostly, people need to be held responsible for their choices, good or bad. For philosopher Immanuel Kant, this is the basis of human dignity. When my mood lifted because I was given a different medication, I didn’t feel my dignity was undermined. It was being incapable of dealing with my depression that felt humiliating. A new pill allowed my old self to return.
Not all behavior is a matter of choice, as I learned from personal experience. Each situation is unique, and only those intimately involved can decide between accountability and compassion. It’s always a matter of judgment. Maybe I wasn’t trying hard enough, or perhaps my wife didn’t have the right jokes. All I know is that the first medication was stronger than any willpower I could summon up.
The Serenity Prayer, perhaps best known through its recitation at AA meetings, encourages accepting things that can’t be changed, changing the things that can, and having the wisdom to know the difference.
The ethicist and therapist/counselor in me tussle with one another, the former thinking that someone should be held answerable for their behavior and the latter knowing that for some, a “won’t” really is a “can’t.” I think back to my bout with Legionnaires’ disease, hoping I can wisely distinguish between accountability and sympathy.
