I think you missed Macdonald's point. He's saying that "real life" is not simply the continuance of conscious existence, but "human thriving". If the man coul

I think you missed Macdonald's point. He's saying that "real life" is not simply the continuance of conscious existence, but "human thriving". If the man could achieve human thriving without health and without friends, then he'd be fine; it's precisely because he cannot achieve "human thriving" without health and without friends that that he says "I'm tired of life". Health problems, pain, and loneliness aren't life, but a form of death. So, MacDonald says, he's not tired of life -- he's tired of the continuance of conscious existence without life; he is, in fact, tired of death.