Illness as Metaphor Summary
This controversial book-length essay by Susan Sontag explores the way in which the figurative language used to describe diseases such as tuberculosis and cancer has often expressed a psychological judgement on people afflicted with these diseases. In effect, Sontag argues, language has served to blame victims for conditions beyond their control.
Sontag begins with an examination of the metaphors that accumulated around tuberculosis, beginning in the nineteenth century, when a cure was yet to be found. It was believed that those suffering with the disease were literally being "consumed" by a passion that was being driven inward (hence the term "consumption"). The victims were thought to be somehow more sensitive, possessed of a superior sensibility. Sontag describes this phenomenon as "the first widespread example of that distinctively modern activity, promoting the self as an image."
As the ravages of TB began to wane due to advances in medical research, this illness replaced by cancer as the bearer of disease metaphors. The repression of intense emotion is again the source of the malady, according to popular conception, but now it takes the form of the malignant, cancerous tumor. In contrast to the romantic image of TB victims, cancer patients, Sontag claims, are psychologically stereotyped as dull, unfulfilled, bourgeois, and rigid (though these stereotypes have no basis on fact). Sontag quotes lines from Auden—"Childless women get it, / And men when they retire"—as an example of this.
Sontag proposes that the culture should abandon these stigmatizing tropes surrounding illness, which only add to the suffering of its victims, and instead adopt a purified language, which views a disease as only a disease, rather than as evidence of a terribly flawed character.
Sontag wrote this polemical book in the wake of her own arduous recovery from breast cancer. Although she nowhere mentions her own illness in the book, her own experience with a life-threatening disease (as she admitted in interviews) was the inspiration for her work.
Sontag’s main concern is to refute the idea that there are psychological causes of disease. To her, disease is a physical problem that is best treated by securing the best possible medical diagnosis and therapy. She is particularly disturbed by the idea that cancer, for example, can be induced through the repressing of emotions. She likens this belief to earlier notions that tuberculosis was somehow associated with the artistic sensibility or with especially sensitive natures. In the end, the disease, scientists discovered, had nothing at all to do with personality but with a bacillus that could be treated with antibiotics.
Sontag argues that a mystique envelops diseases such as tuberculosis and cancer, which is only dispelled when the physical causes of these illnesses are revealed. In the nineteenth century, for example, a body of Romantic literature associated tuberculosis with the long-suffering artist, just as cancer in Sontag’s own time was associated with certain inhibited personality types. Sontag draws on an impressive body of literature to demonstrate how art has shaped the public’s reaction to illness.
The consequences of such Romantic thinking are that the ill person feels doomed—even feeling that he or she has in some mysterious way caused the sickness. This sense of fate works against the patient’s efforts to secure the best medical treatment. It even prevents doctors from being honest with the patients for fear that the dreaded word “cancer” will sap the patient’s desire to get well. Sontag argues vigorously against this tendency to succumb to fear and shame, urging her readers to take charge of their own medical care by aggressively seeking the best treatment.
Illness as Metaphor , a groundbreaking book, grew out of Susan Sontag’s own struggle with disease. She was diagnosed with breast cancer and was given only a slim chance of surviving. Her first reaction was fear and self-blame....
(The entire section is 2,218 words.)