Illness As Metaphor

Susan Sontag

Nonfiction | Book | Adult | Published in 1978

A modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.

Download PDF

Summary

Chapter Summaries & Analyses

Chapters 1-3

Chapters 4-6

Chapters 7-9

Key Figures

Themes

Index of Terms

Important Quotes

Essay Topics

Tools

Beta

Discussion Questions

Themes

The Aestheticization of Illness

One historical and cultural trend that Sontag traces throughout the text is the aestheticization of illness. Another way of putting this is how diseases codify into an image or take on a life outside of the medical field and outside the direct relationship between patient and illness. Sontag makes the case for this phenomenon clearly with tuberculosis through myriad testimonials and writings from authors, poets, and playwrights. For example, Henry David Thoreau writes, “Death and disease are often beautiful, like…the hectic glow of consumption [another term for TB]” (20). The term aestheticization is often, for Sontag, a synonym or lead-in to the romanticization of a disease. Again, this can be seen in the way TB was understood culturally. Not only were its victims thought of as being soulful, poet, and melancholic, but it had a direct bearing on the fashion and look aspired to by the aristocracy, among whom, into the 20th century, it was fashionable to look pale and gaunt like a tubercular.

The aestheticization and romanticization of TB is for Sontag, “the first widespread example of that distinctively modern activity, promoting the self as an image” (29). Tracing this development serves an important function to Sontag’s overall argument. That is, creating a public image, be it romantic or aestheticized, alters the way people think and talk about diseases and victims. For example, the language and metaphors of TB, as awful as the disease was, possessed some positive and desirable traits. Cancer, on the other hand, lacked that romanticism, for as Sontag writes, “cancer is a rare and still scandalous subject for poetry; and it seems unimaginable to aestheticize the disease” (20). This means it lacks TB’s positive associations in the mind of the public, so when metaphors of cancer’s illness are used, they often are in the realm of warfare, battles, and violence. Ultimately, what Sontag points out is that these negative associations are passed onto the individual victims, who bare both the symptoms of the disease and the symptoms of its image in the public.

Illness as Representation for the Unknowingness of Life

One uniting aspect of TB and cancer, which is not shared by many other illnesses, is the element of mystery, both their mysterious causation and their elusive, mysterious cure. The more mysterious the disease, the more potent and wide-ranging its metaphors. A useful counterpoint is syphilis, which was a rampant disease for many centuries, including during the high time of TB, but whose perceptions and metaphors were hemmed in because of its known origins. Metaphors used around syphilis were often applied to sexual vagrancy, promiscuity, poverty, or general moral debauchery: “Contracting syphilis,” Sontag writes, “was a predictable consequence, the consequence, usually, of having sex with a carrier of the disease” (39). Thus, syphilitic metaphors often implied “a moral judgment...but not a psychological one” (39).

What creates the potent metaphors surrounding these two illnesses, which were soon to be joined by AIDS in the next decade, is that they reflect and, in some sense, can serve as sublimations of the mystery and unknowingness of life. These metaphors also hold the fears and anxieties of unknown causation of deadly diseases. Take this line by Sontag: “TB—like cancer today —always seemed to be a mysterious disease of individuals, a deadly arrow that could strike anyone, that singled out its victims one by one” (38). The mysteriousness prevents a definitive language from developing around the illness, and thus ideas and conceptions that are wrong become associated with the victim. Sontag writes forcefully, “Any disease that is treated as a mystery and acutely enough feared will be felt to be morally, if not literally, contagious. Thus, a surprisingly large number of people with cancer find themselves being shunned by relatives and friends” (6). Sontag’s larger idea is that there is a fear of the mystery of life and uncurable diseases can be seen as a manifestation of that fear.

How Metaphors Obscure the Victim’s Relation to Illness

A crucial element that Sontag is attempting to illuminate is how metaphors alter how victims receive treatment and how they are treated by others. What she is aiming for with the book is finding “the healthiest way of being ill” (3), and that, for her, comes from avoiding metaphors when discussing illness. One historical development that supports her claim is the way victims of TB and cancer often blamed psychological idiosyncrasies and “faults” for their diagnosis and, following the prevailing social logic, sought treatments that aimed to cure these “faults” rather than targeting the cause of the disease itself—or worse, the trajectory of whole fields of science chased treatments that had no actual effect on the disease. This is most clearly seen with psychosomatic treatments, miasmatic theories of air quality, and targeting the emotional state of the victim (which was likely an effect of the disease rather than its cause).

This theme becomes prominent in the book’s final chapters, where Sontag gives numerous examples of cancer metaphors (cancerous social developments, political ideologies, groups of people). Moreover, the treatment of cancer was seen as something very strenuous, difficult, and violent, and as such, cancer metaphors often implied these qualities: “To describe a phenomenon as a cancer is an incitement to violence” (84), she writes in the final chapter. Cancer metaphors are applied to many of the pernicious and potentially harmful elements of society (wars, fascism, injustice), and while the language perhaps helps elucidate and articulate these problems, it obscures and stigmatizes those who suffer from cancer: “The people who have the real disease,” she writes, “are also hardly helped by hearing their disease’s name constantly being dropped as the epitome of evil” (85). For Sontag, it would be more helpful for those suffering illness, like herself at this time, to exercise more caution in how the diseases are discussed, for as she’s shown throughout history, metaphors form our understanding and our approach to treatment of the disease and its victims.