My working understanding of illness metaphors is that they have great power, which can have positive and negative impacts, often both -- even from the same metaphor being used in the same context. The clearest way I can imagine to go about exploring this subject is breaking it down into a few distinct groupings and considering the pros and cons of each. The ones that occur to me most naturally are as follows: Metaphors in the context of illness, illness in the context of metaphors, and of course illness on its own. I suspect these will overlap, but I am also hoping to gain something from thinking through this with such specific distinctions in place -- maybe there is something important there.

Metaphors in the Context of Illness

       Metaphors used in this context are often written or spoken with the intention of sugarcoating the reality of a sick person, or making it more relatable to those who do not understand the experience of illness (or that specific illness). They are more specific than a simile, as was stated in our first class discussion, because a metaphor states that something is something else, as opposed to simply being “like” or “as” something else. They are useful in this way for describing the gravity of a feeling. Hypothetically, if a sick person can come up with the perfect metaphor to describe their illness, the person they are speaking to will have no trouble at all comprehending exactly the experience being described, no matter how serious. In my mind, this is the goal of illness metaphors. 

       However, illness metaphors clearly have a slew of other uses. Metaphors can be used to hide the truth of a disease from a patient because the truth is seen as taboo or too painful, as is the practice in France and Italy (Sontag, 7). But maybe this instance is not metaphorical as much as simply neglecting to utter the truth to a patient. Although I understand the rationale for this choice, I do not think that hiding patients from their mortality is fair to them. In my mind, at the end of the day, what is going on in an individual’s body is their business before it is anyone else’s, so the idea that other people get to decide what the patient in question knows interferes with their right to physical autonomy. 

       The practice of hiding a diagnosis (particularly a terminal one) from a patient does make society’s deep-rooted fears regarding illness, death, and dying incredibly clear. Perhaps we do not actually need metaphors to express the realities of illness, they are just far easier to cope with than a genuine understanding of the way, for example, our own cells multiply unchecked and compress our organs until they cease to function. I can imagine how that experience may feel like a betrayal of one’s own body that is too emotionally challenging to grapple with for some. Now I am thinking that maybe the inability to face these realities means that metaphors about them do not actually serve their purpose. No matter how close a metaphor comes to evoking the experience of having a given disease, there will always be a difference between understanding a comparison and living that reality. It reminds me in many ways of translating languages, another thing we have talked about in class. Finding the right metaphor to accurately describe an experience is just like translating said experience into words another person can understand. This is an incredibly useful tool for the furthering of empathy and mutual understanding, but a translation is almost never entirely accurate in capturing the original feeling of a piece. 

Illness in the Context of Metaphors

       A key difference between this and the “Metaphors in the Context of Illness” section is that everything in this section is under the umbrella of metaphors, whereas everything in the previous section is under the umbrella of illness. Illness in the context of metaphors is highly militarized, another idea we have explored in our class discussions. I think that this is because the only way we can properly conceptualize the way diseases take over our bodies is by viewing disease as an invader to fight, and not a fact of life. 

       One nuance to consider, though, is that this fear of death is more common in Euro-American cultures. I do not know much about non-European/non-“western” conceptions of death, but one example is the practice of Homegoing ceremonies done in the Black American community when someone dies. This is not true of everyone, but some people may plan these services themselves in preparation for their own death, giving a lot of recognition to the idea that everyone will eventually reach “their time” to die. These services also tend to be more cathartic and visibly emotional than the more buttoned-up, somber services in majority-white churches to my knowledge, because they are a celebration of the life that was lived as opposed to the fact that it ended.

       Another thing to consider about illness metaphors is that the ways we conceptualize cancer and other diseases are often conflated. There is a big difference between the way viruses infiltrate healthy cells to multiply and the way cancer cells multiply out of control and push healthy tissue out of the way, but disease is often thought about as a monolith. Interestingly, I find the way viruses overtake healthy cells to be more of a militaristic method because they inject DNA into healthy cells, duplicate themselves, and then release copies of the viral cell, killing the original cell by bursting it from within. Cancer is commonly known as a killer, but the actual danger simply lies in that it pushes healthy tissues out of the way. This is a far less violent process in nature, yet cancer is more often considered a “battle” than a viral disease like influenza. Then again, people are generally far less likely to die of a viral infection than they are of cancer, so perhaps it’s just about our conception that there is a battle to be won, not the nature of the battle itself, which can vary greatly.

Illness on its Own

       Illness, with no metaphors or bells and whistles attached, is a very scary reality to face for most people in our society. Susan Sontag notes that death is perceived as “...an offensively meaningless event, so that disease widely considered a synonym for death is experienced as something to hide...” (Sontag, 8). I agree that our society sees shame in illness and death. However, this does not explain why death is considered meaningless. I do not think it is, and I am confused by why she does. In my mind death is a loss of the utmost gravity and something to be avoided at all costs, for the sake of oneself and those closest to you. I obviously cannot speak for all of society, but I do not think my perception is at all uncommon. Thinking about death this way, it makes sense that we would try to mask it or at least relieve some of the anxiety it produces by considering it through less pressing lenses. 

       Yet another issue with disease is its prevalence. Modern medicine meets so many illnesses with complete inability to act because there is so much we don't know about disease and the body.  I think ‘issue’ is not the right word to use here, but what I am trying to express here is the way by which practically everyone has some story regarding a serious illness, usually cancer, about themselves or a person they love. This means that the avoidance-of-harsh-truths that metaphors can provide is all the more valuable since it applies to so many people’s experiences. Then again, my thinking goes back to the idea that maybe metaphors actually bring us closer to reality. I don’t know which is more true.

Conclusion

       Generally, illness is something I do not often consider deeply. I find the contradictions to be overwhelming and ultimately hard to overcome. Writing this personal essay has not particularly helped me to clarify any of my conceptions of large societally-believed truths of illness, but I do feel that I have laid out a few possibilities clearly, which was my goal from the start.

Works Cited

“Illness as Metaphor. By S. Sontag. (pg 7, 8) Penguin Books: Harmondsworth. 1983.” Psychological Medicine, 1984, doi:10.1017/s0033291700015683.