Illness as Metaphor & AIDS and Its Metaphors

“Modern disease metaphors specify an ideal of society’s wellbeing, analogised to physical health, that is frequently anti-political as it is a call for a new political order.”

Illness as Metaphor & AIDS and Its Metaphors is an eloquently incisive dissection of how diseases used as metaphors limit, twist, and bring forth several other meanings that can jeopardise and vaporise their medical definition. This, in turn, can have a strange, harmful effect to people who have these diseases and the people within their “communities.” More than that the usage of metaphors not only in a literary sense but also to the advantage of any political agenda (to alienate/isolate a minority, incite ridiculous fear to the public, et cetera), the show more romanticisation/stigmatisation of these diseases along their accompanied demise are fascinatingly magnificent additions to their history of metaphors throughout the years.

Sontag, although perhaps a bit repetitive here and there, is seamless: from tuberculosis as a fashion trend, a standard beauty in all its pale and sallow, gaunt glory, cancer as an overused metaphor (ex., as “unqualifiedly and unredeemably wicked”) which mentally affects patients with cancer and its further association to a type of extremism that causes displacement and discrimination (ex. “Islam is spreading like cancer”) to the AIDS epidemic in ‘80s US where it's labelled as the “gay plague” and how this perpetuated, exacerbated the already ingrained hatred and prejudice on top of the government’s intentional inaction. This painfully claimed a lot of lives. Sadly, bigoted beliefs still exist today in those who choose to be ignorant and stupid. And similar to what’s currently happening, there is a pattern of justified discrimination, this time of a racial kind, with the initial identification of COVID19 in Hubei, China. Asians—Chinese and people mistaken as Chinese (because of people’s narrow idea of what Asians look like and the lack of geographical knowledge)—are subjected to verbal abuse even physical violence across the globe. And this doesn’t stop there, people of colour also receive worse, little to no medical attention because of the implicit social hierarchy established particularly in western countries. This slim book does not end here, it inspects countless of metaphors I'm afraid to blabber about.

By the end, Sontag's polemic is unforgettably powerful and strikingly remains frighteningly relevant during this pandemic we are all in. It is despairing that she predicts these metaphors will be obsolete in the future, maybe it's indeed better, but it seems to me they only pile up like clothes in an otherwise already full closet, metaphors we use at our disposal without critically thinking of their lasting impact. show less

Cancer phobia, some people say, is worse than cancer. Well, not really... But true up to a point. Being afraid of a disease, be it cancer, AIDS, or whatever else, can be debilitating. And who of us doesn't know people that are scared to death of cancer, or of AIDS? And how can we all not be scared (maybe even terrified) of these diseases, when in our eyes they're not just diseases but are loaded with a whole lot of different meanings, mainly linked to death...

Susan Sontag's essay on cancer (& her later essay on AIDS) deal with these diseases as metaphors of whatever is bad, evil, reprehensible, sinful about human experience. Especially with cancer, the metaphor is more poignant, since, cancer still has unknown causes, at least up to a show more point: of course cancer now is much better understood, but in '78, when Sontag wrote the first essay, cancer was mostly unknown territory. Obviously, when we're talking about unknown territory, unknown (& mysterious) causes, there's a lot of theoretizing & projecting: anyone can project their own ideas on this white wall of ignorance. And so people 'fight' cancer, 'win the battle' against cancer, 'have cancer personalities', 'cause' their cancer or whatever else. It was even worse with AIDS, especially in the '80s: then it was widely (& stupidely) believed that this new disease was the payback for the free sexuality of the '70s, & especially of the sexuality of homosexuals.

Susan Sontag's essays tackle these issues & show the metaphors & prejudices of illness as what they are. They are important, clearly-written essays, & if today some of these ideas appear obvious or widely known, remember that Sontag talked about these things many years ago, being one of the first people to address the issue. show less

"Nothing is more punitive than to give a disease a meaning—that meaning being invariably a moralistic one."

These past two years, given the COVID pandemic and the other illnesses that have emerged during this period, have been anxiety-inducing for those who often have fears of falling ill. Being one of these people, a book recommended to me to "unveil" illness, as a friend described it, seemed a necessary read.

Using mostly TB, cancer, syphilis, and, later in the second part of the book, AIDS, Sontag examines the metaphors and meanings given to illness. Certain facts I had never known, such as the romanticization of some aspects of tuberculosis, were fascinating to read. For instance, the obsession with thinness still present that can show more be traced to the late eighteenth century romanticizing weight loss due to TB. Or that it is (or was at the time this book was published) common professional practice in certain countries like France not to tell patients that they have cancer.

Sontag explained in the introduction to the second part of the book, that it was her cancer diagnosis that had prompted her to write the first section which had been published years earlier. Spurred by what she calls an evangelical zeal to spread her message, she wrote this book. Which is incredible, given the clarity of thought and breadth of references encountered; I couldn't have guessed the pressures and anxiety that brought this work.

From the fears of suffering and death that creates the metaphors around illness to the ways the metaphors lead to stigma and hurt those who should be seeking professional treatment, this book brilliantly does what its writer set out to. Sontag is thorough in all the ways illness both exposes existing oppressive structures and prejudices and solidifies, and, even, expands them.

This book indeed unveils illness, and helps the reader to reach the understanding that illness is simply just that: the state of being physically unwell. That whatever pathogens that bring with them illness aren't punishment and that there are no symbols or signs attached to them, neither are these pathogens even consciously aware (simple as this is, it is strange that we often think or feel otherwise) of the harm they do to us. That humans aren't the only living beings that get sick and die. Our fear of suffering and death caused being responsible for the distance those who are healthy put between themselves and the ill, and all the messages, some rooted in and carried from religious thinking and some possibly even going further back in time, and the harm as a result. Of course Sontag is a very intelligent thinker and doesn't romanticize illness, nor does the reader, using myself here, come away from this book necessarily fearless of illness, but instead emerges from it more prudent. show less

Illness as Metaphor is highly polemical, and as such, is a suburb piece of polemic. Sontag, herself diagnosed with breast cancer at the time of the writing (a fact she does not disclose in the initial essay itself) compares eighteenth and early nineteenth century discourse about tuberculosis to present day language about cancer. Of course, "present day" for Sontag is 1977. This fact alone makes the book a compelling read -- simply considering how much the approach of Western medicine to cancer has changed in 30 years. Doubtlessly this essay itself has been a large contributor to this shift in thinking.

In a nutshell: Sontag argues that the word "cancer" has become little more than a metaphor for everything that is wrong and evil in the show more world, and this systemic demonizing of this illness in particular makes it all the more complicated for its patients, and fosters a range of stigmas that are virtually invisible to anyone not dealing with cancer themselves.

Reading the counterpoints and rebuttals to Sontag's thesis is compelling secondary reading as well. All together, a thorough inquiry into Sontag's propositions yields a much broader awareness of the "cancerous" language and metaphors we still use rather flippantly today." show less

This was much more a sociology paper than a discussion of medicine. Sontag wrote Illness after being diagnosed herself with cancer and being angered at how she was treated, at the assumptions and the attitudes people took towards her after hearing of her diagnosis. That's certainly a worthy topic, but the way she writes the essay it's a polemic of unsubstantiated statements supported by half-sentences taken out of context from a few major literary works. She name drops like there's no tomorrow (which perhaps at the time she feared), but it yields a writing style which is practically unreadable. Each paragraph is "bald unsupported or contradictory statement" followed by "one sentence summary of a novel involving someone who has the show more disease" followed by "bald unsupported statement". Take for example the following.

"As much as TB was celebrated as a disease of passion, it was also regarded as a disease of repression. The high-minded hero of Gide's The Immoralist contracts TB (paralleling what Gide perceived to be his own story) because he has suppressed his true sexual nature; when Michel accepts Life, he recovers. With this scenario, today Michel would have to get cancer."

What? How? Huh? Context? Analysis? Reasons for believing any of this? I've never read any book less willing to spend time convincing a reader other than by whacking me over the head. Every paragraph read to me: "This statement is true! Why? Because I said so!"

Fostering the frustration are statements like "According to the mythology of cancer, it is generally a steady repression of feeling that causes the disease. In the earlier, more optimistic form of this fantasy, the repressed feelings were sexual; now, in a notable shift, the repression of violent feelings is imagined to cause cancer." Where did she get this idea from? Who knows! There is nothing remotely like a source or an explanation, simply the declarative statement "this is how it is" which I happen to disagree with. That just leaves me thinking, Was this a common interpretation when she wrote it in the 70s? Or was this just the annoying ranting of some friend's rude husband at a dinner party? This piece was supposed to be very influential in its time. I have to take it for granted that at some point what she said about society's assumptions had some basis even though I have never heard the half of what she claims to be "common" metaphors. Perhaps the commonality of cancer, particularly breast cancer, has dissipated much of the false mythology of cancer in the intervening years? This is the most charitable way I can look at it.

The book also contained another essay, AIDS and its Metaphors. I appreciated this a little better because her style had matured so dramatically. Here she is no longer angry at having her personal life ripped open by the disease, so she no longer has to maintain the haughty righteousness of a disinterested professor. Here she is willing to refer to her own experiences and the writing is less polemical. I also am more familiar with the metaphors surrounding the AIDS epidemic, the simple association of death with diagnosis, among others.

I respect what Susan Sontag wrote in later years, but I still am amazed that Illness made any impact given how it is written. At the very least, it makes the assumption that the mention of disease in a half dozen 19th and 20th century novels is an accurate representation of society's interpretations of disease. Am I simply unaware of these metaphors today or did Sontag read 480% more into a few lines of Kafka and Mann than anyone else would? Hard to tell. In any case, it's the sort of gross stretching of literary criticism that most irked me in school. Hmph! show less

Reading Sontag is an experience of extraordinary clarity and lucidity, which are themselves powerful enough that it is easy to imagine that Sontag is declaring an unimpeachable, gospel-like Truth, and not simply a person sharing her opinions as best she can, because she believes they will be helpful.

Le pongo cuatro porque el primer ensayo me parece excelso y el segundo muy desigual. Se nota la distancia en tiempo entre uno y otro, se nota que en el primero Sontag se estaba enfrentando a las metáforas del cáncer, mientras que el segundo viene a raíz de una enfermedad que en ese entonces aún era desconocida y que no es a la que se tienen que enfrentar la autora. Además después de la distancia una vez más en tiempo, las metáforas del primer ensayo siguen siendo cercanas y tristemente vigentes, mientras que la segunda ya está desfasada y rebasada.