When the church’s theological rejection of sadness was secularised, sadness became a pathology requiring medical intervention. The medicalisation of sadness is the final cultural triumph of the Protestant smile. If Luther or Kierkegaard or Dostoevsky had lived today, we would have given them Prozac and schooled them in positive thinking. They would have grinned abortively – and written nothing. The truth of sadness is the womb of thought.