In Illness as Metaphor, Susan Sontag traces the language we use to describe disease (particularly tuberculosis and cancer) to illuminate the embedded meaning and effects of metaphor on the patient’s understanding of their body and healing. She argues that “the most truthful way of regarding illness… is one most purified of [metaphoric thinking]” (Sontag, 3). While use of militarized metaphors might have negative impacts on the patient, Dhruv Khullar in “The Trouble with Metaphors,” explains the desire and need for use of metaphors in doctor and patient communication. However, he also explores how less violent alternatives might be employed, or whether doctors can follow their patient’s lead. 

Sontag points to the rise of bacteriology in the 1880’s when the military metaphor became popular (Sontag, 66), and Khullar gives credit to a physician of the 17th century, Thomas Sydenham, for establishing the military metaphor tradition. When disease is framed as the enemy, how does it impact the way we address our bodies? If the patient is the soldier and the illness the enemy, is it a moral failure to not go through remission? It seems that militarized metaphors set the patient up for failure especially when it comes to chronic illness. But even if the illness is able to be “fought off,” how does this violent language impact the way we view our experience of illness and healing? 

Dr. Khullar cites a study that shows that doctors are often perceived as better communicators when they use metaphors, even with militarized metaphors the patients might respond with a boost in morale. But the likening of the virus or illness as enemy and the body as soldier has the possibility of adding stigma to the patient and their experience of illness. The way we respond to metaphors might be similar to the different ways we respond to discourse. While metaphor is a powerful tool to communicate messages unsaid, the hidden message could be the key or detrimental to healing, depending on the patient. If there is any possibility the metaphor could be wielded in flexible, creative ways to support the patient and their relationship to illness, then doctors should be trained in the art of metaphor. 

A couple of years after Dr. Khullar’s paper, “Healing Without Waging War: Beyond Military Metaphors in Medicine and HIV Cure Research” by Jing-Bao Nie, et al. was published and explores alternative metaphors for describing illness, particularly in China and Sub-Saharan Africa. The authors argue that the metaphors we ascribe to illness reflect a larger discourse (in the Foucauldian sense), that which reveals “established social practices and power relationships” (Jing-Bao, et al). The authors explore alternative approaches to metaphors in illness, with an emphasis on a shift toward more peaceful metaphors. The authors further suggest that a shift to less adversarial metaphors might be a comprehensive first step toward demilitarization. 

In order to use metaphors as a supportive tool for patients, the militarization of our language must be challenged.  Seeing the world through the lens of war and military is not innate to human nature, nor should it be considered the default way to understand the world. Rather, the embedding of military metaphors in our language to describe our bodies reveals the extent to which militarization, colonization, and imperialism have restricted our imagination within the culture of an imperial nation. This restriction of imagination makes it hard for Americans to conceive of a framework of interactions (be they social or biological) outside of the one that positions subject versus other, where subject must dominate/conquer. 

Sontag mentions how the development of Christianity has impacted the way we understand illness when she writes, “with the advent of Christianity... a closer fit between disease and ‘victim’ gradually evolved. The idea of disease as punishment yielded the idea that a disease could be a particularly appropriate and just punishment” (Sontag, 43). The Gospels of the New Testament were written during a time where the boundaries between myth and reality were blurred, this consideration discussed in Reza Aslan’s Zealot might allow the lens of metaphor to be applied when reading the bible, for example the stories of Jesus healing the sick. Whether one believes this to be sheer historical fact or metaphor, the message passed through time remains the same, namely that illness is a punishment for turning away from faith (or conversely that illness can be cured through good faith). I read the metaphor in this instance as “disease as a mark of deviance”. This metaphor manifested into practice in the United States with Mary Baker Eddy and Phineas Quimby, following the epistemic contests outlined by Owen Whooley in chapter 1: Choleric Confusion in Knowledge in the Time of Cholera.

Mary Baker Eddy’s Christian Science and Phineas Parkhurt Quimby’s New Thought shares the view that illness is not physical but psychological (or perhaps more theological in Eddy’s case). There is plentiful scholarship on how religious evolution in the United States has impacted the way we understand laws, morals, and ethics, but how has it impacted the way we understand and speak about medicine and our bodies? Is there continuity between the metaphors of illness in the bible, the ways they evolved with science and medicine during and after cholera in the US, and the rejection of vaccines and public health and safety measures by some groups of Americans? These philosophies are transcendental insofar as they reject the material science of illness, or at least consider it misled. 

Considering that anti-vaccine, anti-masking, and COVID-19 conspiracy discourse is often aligned with the New Thought related to Phineas Quimby, how pervasive has the metaphor of illness as divine will, or punishment been throughout history? Does the use of militarized metaphor isolate people from their religion? This question comes to mind when I consider people I know well to have turned away from religion, particularly Christianity, after a diagnosis or experience with illness. Suggestions for peaceful metaphors are offered in “Healing without Waging Wars,” such as challenging the idea of war as something aggressive rather than preventative, as well as the idea of a journey rather than a battle. In Arundhati Roy’s recent piece The Pandemic is a Portal, she describes the COVID-19 (and illness at large) to be an opportunity to give attention to and challenge the social tensions that disease so well exacerbates. Illness as journey instead of a battle and pandemic as a portal instead of a war allow me to look to the future with hope instead of despair. 
 

Works Cited 

Aslan, Reza. Zealot: the Life and Times of Jesus of Nazareth. Allen & Unwin, 2017. 

“Chapter 1: Choleric Confusion.” Knowledge in the Time of Cholera: the Struggle over American Medicine in the Nineteenth Century, by Owen Whooley, University of Chicago Press, 2013, pp. 31–72. 

Khullar, Dhruv. “The Trouble With Medicine's Metaphors.” The Atlantic, Atlantic Media Company, 7 Aug. 2014, www.theatlantic.com/health/archive/2014/08/the-trouble-with-medicines-metaphors/374982/.

Nie, Jing-Bao, et al. “Healing Without Waging War: Beyond Military Metaphors in Medicine and HIV Cure Research.” The American Journal of Bioethics, vol. 16, no. 10, 2016, pp. 3–11., doi:10.1080/15265161.2016.1214305. 

Prothero, Stephen R. "Eddy, Mary Baker." Encyclopedia of American Religious History, edited by Edward L. Queen, et al., Facts On File, 4th edition, 2018. Credo Reference, https://proxy.swarthmore.edu/login?url=https://search.credoreference.com/content/entry/fofr/eddy_mary_baker/0?institutionId=568. Accessed 22 Sep. 2020.

Prothero, Stephen R. "Quimby, Phineas Parkhurst." Encyclopedia of American Religious History, edited by Edward L. Queen, et al., Facts On File, 4th edition, 2018. Credo Reference, https://proxy.swarthmore.edu/login?url=https://search.credoreference.com/content/entry/fofr/quimby_phineas_parkhurst/0?institutionId=568. Accessed 22 Sep. 2020.

Roy, Arundhati. “Arundhati Roy: 'The Pandemic Is a Portal': Free to Read .” Financial Times, 3 Apr. 2020, www.ft.com/content/10d8f5e8-74eb-11ea-95fe-fcd274e920ca. 

Sontag, Susan. Illness as Metaphor. Allen Lane, 1978.