[In the following review, Roudiez contends that AIDS and Its Metaphors is not as cohesive as Illness as Metaphor, but contends that the new essay effectively clarifies confusing facts and misconceptions regarding AIDS.]

In Illness as Metaphor (1977) Susan Sontag had contrasted tuberculosis, the disease that the nineteenth century found “interesting” and even “romantic,” with the “great epidemic diseases of the past, which strike each person as a member of an afflicted community.” In the seventies it was indeed assumed that such major epidemics were a curse of the past; and then AIDS burst upon us—or rather, it spread to the West and spawned a primal fear expressed by means of ugly metaphors.

These metaphors are viewed by [in AIDS and Its Metaphors] Sontag as having been produced by the cultural atmosphere of the eighties. There was, for instance, a reaction against the sexually permissive attitude that prevailed in the sixties; there was also the hyper-Christian, somewhat xenophobic stance affirmed during the early years of the Reagan administration and, in Europe, an increasing resistance to Third World immigrants; later, ecological concerns over the depletion of the ozone layer, dwindling rain forests, and atomic accidents encouraged a doomsday rhetoric. As a result, a complex cluster of metaphors has developed in which none is able to dominate discourse. Whereas cancer, which was at the center of Illness as Metaphor, was seen as “domestic subversion,” in the case of AIDS it is an outside agent that affects the system, giving birth to a “language of political paranoia” in which the vocabulary of science fiction reinforces military metaphors. However, AIDS, in the West, so far has not affected the entire population. Because at first it struck mostly homosexual men, these could be stigmatized as sinners, and metaphors of divine punishment were resurrected. Since the “source” of the disease has been identified as Africa, racist metaphors have inevitably surfaced.

A curious development is that, as the scope of the epidemic became obvious and no cure was in sight, the doomsday metaphors acted as a catalytic agent; nevertheless, “With the inflation of apocalyptic rhetoric has come the increasing unreality of the apocalypse.” There have been so many dire predictions in various domains that we have become inured, mainly because we are still alive and doing well. Who are “we,” however, if not the privileged, cultured, well-to-do elite of the West? And what does our attitude portend concerning the future of humanity?

The disease, like the times we live in, is fearsome and unsettling. Sontag's book, as it deals with the variegated metaphors people use in talking about AIDS, inevitably lacks the focus that made Illness as Metaphor so effective. This is hardly her fault, nor can I in a brief review adequately deal with the tight complexity of her account. It is, however, to her considerable credit that AIDS and Its Metaphors reveals the mental confusion—to say the least—that afflicts our society, as the meaning of John Donne's words, the scope of which he himself could not have fully grasped, is finally understood—“No man is an Iland, intire of itself; every man is a peece of the Continent, a part of the maine.”