This book is comprised of two essays, the first, Illness as Metaphor was published in 1978 shortly after Sontag underwent treatment for her unnamed cancer (she just refers to it as “my own cancer (103)”), and the second, AIDS and Its Metaphors, was published in 1989 at the height of the HIV/AIDS crisis when the epidemic was only becoming to be understood and most diagnoses were viewed as a death sentence. The second essay is much more approachable than the first, primarily because there is a personal and honest feel to it that is lacking in the first. Sontag begins the AIDS essay acknowledging the first essay and in her opening to the AIDS essay she reveals that when she wrote the Illness essay she had recently undergone treatment for cancer but had specifically chosen to omit that fact from the content of her first essay. This revelation provides the personal touch that was utterly lacking from the stale and overly academic Illness As Metaphor.
I was drawn to this book after reading the excellent “biography” of cancer, The Emperor of All Maladies. Sontag’s book is mentioned often in that thoroughly engrossing and educational work and since I’ve had some familiarity with Sontag’s literary-criticism from my undergraduate education I was intrigued to explore what she had to say that inspired Mukherjee. Now having read it, I’ll say that my intrigue was mildly deflated. These two essays are full of a lot of great ideas and it is easy and approachable reading, yet the few good ideas are caught up in a sea of excessive and repetitive academic references and I found myself overly thankful that this was a short read that I could put back on the shelf after just a few hours.
Illness as Metaphor aims to compare and contrast the metaphors of Tuberculosis, a “romantic” disease that inspires “passions” with Cancer, which she likens to an ostracizing disease that leads to isolation and depression. Sontag provides a lot reference to 19th century writers like Keats, Shelly, and even early 20th century writers like Mann and Kaftka among plenty more to support her claims that Tuberculosis was conceived as a glamorous disease because its supposed cures prompted the ill (of course the wealthy ill) the luxury to travel to climates perceived to cure the disease and the consumption motivated artists to entertain their muse. She doesn’t provide as many literary references to cancer as she does TB, however for those she does, such as Tolstoy’s Ivan Ilych, she elaborates on the isolating nature of a slow death. Times have certainly changed from when Illness as Metaphor was written because these perceptions of both Tuberculosis and Cancer seem totally outdated with current medical advancement. Certainly, cancer is a diagnosis that lends itself to depression and adversity, but the medical culture has advanced dramatically and with support groups and organizations developed to support cancer patients, few feel the need to isolate themselves from society. TB on the other hand is hardly glamorous, it is perceived as a third-world disease and treatment is totally isolating in pressure sensitive hospital rooms with ongoing IV antibiotics.
Despite these shortcomings, what I did like about Illness as Metaphor as well as AIDS and Its Metaphors were the sections when Sontag allowed herself to step away from her annoying habit as a literary-critic that frequently name drops authors she has read to provide actual insight about what is happening in reality. I especially enjoyed the section were she discussed the use of military terminology to discuss the “war on cancer” and the “fight” or “battle” against cancer. Sontag eloquently clarifies this odd social norm by saying, “the Modern disease metaphors are all cheap shots. The people who have the real disease are also hardly helped by hearing their disease’s name constantly being dropped as the epitome of evil” (85).
In my own reflection on our current times, I have found it odd how pervasive cancer research foundations have infiltrated our markets to the point that the color pink now symbolizes a fight against breast cancer or when making a purchase at a supermarket I am asked by the credit card scanner if I want to donate to the fight against testicular cancer. Though partially noble in their effort, the complete day-to-day infiltration of these reminders of these diseases belittles the actual human struggle behind the disease by manipulating our emotions to support the cause. It is propaganda it its purest form, much like war propaganda is blatantly manipulative of human emotion. When purchasing a six-pack at Safeway do I need to have a reminder that my uncle passed away from testicular cancer as a guilty encouragement to invest in the cause to prevent that disease?
Sontag also goes into length about the use of disease to describe politics, and vice versa, to use politics to describe disease. I have often thought of the body’s makeup of cells as a reflection of order. Sontag elaborates on this thought by stating that “order is the oldest concern of political philosophy, and if it is plausible to compare the polis to an organism, then it is plausible to compare civil disorder to an illness… Illness comes from imbalance. (76)” Just as an ideal utopian society would be highly ordered and free from crime, injustice, and inequality, an ideally healthy human body would be free of disease. However, this metaphor leads itself along the dangerous road that characterizes the stigmas that those who are sick are ill due to their personal weaknesses or poor character judgement. No better example illuminates this than the early perceptions of the HIV/AIDS epidemic that stigmatized homosexuals with the “gay disease” as receiving what was due to them due to the “choices” inherent in their deviant lifestyle. Sontag disputes this stigma by clearly illuminating that homosexual culture was a victim as a scapegoat in the US culture that ignored the high rate of heterosexual AIDS cases in the other-worldly and far away continent of Africa. Furthermore, Sontag elaborates that the behavior considered as deviant was “hardly an invention of the male homosexual subculture, recreational, risk-free sexuality is an inevitable reinvention of the culture of capitalism, and was guaranteed by medicine as well.” (165)
The take home from this little book comprising two essays is that the language of illness and disease is pervasive in our culture. Although Sontag suggests that we step away from overtly using the metaphors of disease to describe the politics of life and using metaphors to describe the functions of disease, I don’t think that this is a possibility because as Sontag said herself, “all thinking is interpretation” (93).