As a survival-happy species, our successes are calculated in the number of years we have extended our lives, with the reduction of suffering being only incidental to this aim. To stay alive under almost any circumstances is a sickness with us. Nothing could be more unhealthy than to “watch one’s health” as a means of stalling death. The lengths we will go as procrastinators of that last gasp only demonstrate a morbid dread of that event. By contrast, our fear of suffering is deficient.

Personally, I'm afraid of suffering and afraid of dying. I'm also afraid of witnessing the suffering and death of those who are close to me. And no doubt I project these fears on those around me and those to come, which makes it impossible for me to understand why everyone isn't an antinatalist, just as I have to assume pronatalists can't understand why everyone isn't like them.

A: There is no grand scheme of things. B: If there were a grand scheme of things, the fact – the fact – that we are not equipped to perceive it, either by natural or supernatural means, is a nightmarish obscenity. C: The very notion of a grand scheme of things is a nightmarish obscenity.

The sinister, the terrible never deceive: the state in which they leave us is always one of enlightenment. And only this condition of vicious insight allows us a full grasp of the world, all things considered, just as a frigid melancholy grants us full possession of ourselves. We may hide from horror only in the heart of horror. (“The Medusa”)

But even if ego-death is regarded as the optimum model for human existence, one of liberation from ourselves, it still remains a compromise with being, a concession to the blunder of creation itself. We should be able to do better, and we can. To have our egos killed off is second-best to killing off death and all the squalid byplay that flitters around it. So let all lands be small, and grower smaller and smaller until no lands are left where any human footstep need press itself upon the earth.

For optimists, human life never needs justification, no matter how much hurt piles up, because they can always tell themselves that things will get better. For pessimists, there is no amount of happiness—should such a thing as happiness even obtain for human beings except as a misconception—that can compensate us for life’s hurt.

Officially there are no fates worse than death. Unofficially, there is a profusion of such fates. For some people, just living with the thought that they will die is a fate worse than death itself.