Illness as Metaphor and Aids and Its Metaphors Book

A part of me thinks you shouldn't be allowed to write a book that's just your random, personal opinion about something, even though a bigger part of me wishes that that were my job.

I can see how this book was probably really important when it came out, and I'll bet it's done a lot of great things for people's thinking about illness. But although I did really love a few bits of it, on the whole I didn't like this much, even though I was expecting to. I was never totally sure whether this was because I was densely missing Sontag's point, or because I actually did disagree with her. Towards the end, she does acknowledge that people need metaphors, and makes the point that she's identifying ways that particular metaphors for cancer and AIDS have harmed people who suffer from what she insists should be thought of as "just diseases."

See, this is what I don't get. "Just disease?" What does this mean??? My mind doesn't bend that way! If you take away my metaphors, my brain will metastasize into a useless pile of jumbled cells, and I will die. Reading this, I felt like a junkie whose heroin supply was being confiscated by mean old doctor Susan Sontag, who wasn't offering me methadone or buprenorphine or even any pills to take the edge off. She was just chaining me to the radiator and making me cold-turkey it, and I just can't think like that! How'm I supposed to make sense of anything, let alone terminal illness, without use of metaphor? How is anyone? Also, how can I, as a non-scientist, understand the basic process of a disease without a mickey-mousey, simplified explanation of its process at the cellular level, and is there a metaphor for how the HIV virus or cancer cells spread that doesn't offend Ms. Sontag's sensibilities? Because I felt like she was doing that very common thing about complaining about everything people do, without trying to envision an alternative. This is kind of my global pet peeve that applies to the overwhelming majority of academic writing and these kinds of critical essays. It's really easy to tear a concept or practice down and complain about how bad everything is (oh, trust me, I know), but far more challenging to create a positive alternative (hey, don't look at me, I'm not getting paid for this!).

So yeah, maybe I misunderstood what Sontag was saying, that could be. Her first essay contrasts the poetic, appealing metaphors of tuberculosis with the cruelly stigmatizing metaphors of cancer, and ultimately I was left a bit confused about what her point was with this. It did make me less afraid of contracting TB (one of my clients was diagnosed with it the week before I read this!), since it sounds so glamorous and all, but I don't think that was what she was getting at. She wasn't saying that cancer and AIDS need more attractive metaphors, she was saying that they shouldn't have any, and I can't accept that.

Again, maybe this was my misreading, but I felt like Sontag was pathologizing use of metaphor, which isn't in itself a symptom of illness, and in fact is, as far as I'm concerned, necessary to human life (or at least this human's). I haven't personally experienced TB, cancer, or AIDS myself, but I have been diseased, and in my personal opinion a spoon full of metaphor helps the medicine go down, or at least has helped me to conceptualize and make meaning out of what otherwise just sucks and is basically senseless. Metaphor is the framework that makes all the chaos superficially intelligible. I know many metaphors are dreadful and ugly, but to me that still might be better than the void. Maybe the choice doesn't have to be so stark, and maybe we can replace the sicker metaphors with healthy ones, but even if I could think of a terminal illness as "just" a disease, I don't think I'd want to.

Again, maybe I'm missing the point. That happens sometimes! (Okay, a lot.) I also got a little concerned at some points that Sontag might overlook relatively concrete, scientific facts in service of her argument For instance, smoking can cause lung cancer, that's not just something they say to make cancer patients feel bad. And while obviously mind-body theories are extremely dangerous for the reasons she describes, I also don't think that acknowledging possible relationships between mental and physical health is inevitably false or stigmatizing, and I felt like she needed to deny that possibility at all costs. Sometimes when she said she just wanted to get at just the science, I wasn't sure I could trust her. I felt like (a) what's "just" the science? and also (b) what if you don't like the science, Susan?

Still, there was some terrific stuff in here, there was. Sontag ultimately did die of cancer, and I do think it's to her credit that she did so during an era in which the disease was far less stigmatized than it was when she wrote this essay, in response to her first diagnosis. Even though I take issue with some of what I think she was saying, I imagine it did do great stuff for people who shouldn't have to deal with the burden of harmful metaphors, on top of the pain of a serious illness. There's definitely value in diagnosing the problem -- "that's a metaphor, not a reality" -- which she did well here. I think my own problem started when she started prescribing -- "don't use metaphors" -- but whatever, I'm sure she did no harm.