In the excerpt from Nick Hornby's "How to Be Good," the author contrasts the conventional idea of happiness with the harsh reality of survival. He uses a powerful metaphor involving a knife in the stomach to illustrate how, in dire circumstances, the focus shifts from the pursuit of happiness to simply staying alive. This metaphor underscores the gravity of one’s situation and suggests that, at certain points, survival takes precedence over all else.

Hornby emphasizes that the act of pulling the knife out symbolizes the risk of worsening one’s situation, leaving individuals with a choice that may not guarantee happiness but rather aims to maintain their current state, even if it feels like a compromise. The conventional wisdom he refers to favors maintaining a strategy that, while uncomfortable, may prevent further harm. The passage invites readers to reflect on how perspectives on happiness can change under the weight of life-threatening challenges.