I am a Biomedical Hums student and have debated issues like this often. I am also a cancer patient, which I feel gives me a unique outlook.
How do Patients Perceive Metaphors?
Cancer is difficult, at times it is the embodiment of suffering. I am speaking from experience, as a cancer patient currently in remission. When I was sick, I was congratulated on "being brave" and "fighting" cancer. I was commonly called a "cancer victim" and was told that I would "beat cancer", but I felt that I wasn't really doing anything. In fact, all I was trying to do was survive. Those metaphors rang in my head long after my illness. I often think about what these metaphors imply about those who are not so fortunate. It brands them as losing the "battle", because in fights or battles there are winners and losers. There are more metaphors like these, I am a pre-medical student and I hear about cancer cells "attacking" or "retreating" like they are sentient and malevolent. The battle plan of cancer is no more coordinated than a little league football game, yet we act as though it is following a plan to destroy us. While we may personify cancer, it is nothing more than our cells replicating too fast. So why do these metaphors comfort us so much? Are they here for comfort, or do we lack the vocabulary to adequately describe cancer without them?
This language erects a barrier between a patient and the person speaking. That's because no patient feels strong at that point in their life, we feel lonely and in pain. We don't feel like heroes or soldiers. Branding cancer patients as heroes can feel quite patronizing even when it's not meant to be. Instead of using this terminology, try to understand what is actually happening. Society has, for some reason, found it acceptable to not learn about diseases, and instead judge the patient at face value. If cancer was understood in the mainstream like the cold or the flu, patients wouldn't be so shunned. They wouldn't feel guilty for losing the battle or feeling weak. The idea that they are soldiers establishes an undertone that they should always feel strong. This is unacceptable because any type of patient should know it's okay to feel weak. Next time you meet a cancer patient (or any patient for that matter), ask them about their illness. If you don't feel comfortable asking them about their condition, treat them like you would anyone else. Ask them about sports they watch or the weather or literally anything. They may even find a discussion that's not centered around their disease refreshing. This is not a new concern either, this has been discussed since the late 70's.
Susan Sontag and Metaphors
If you don't know who Susan Sontag is, I highly recommend you read some of her publications. She is truly one of my favorite authors. Susan Sontag's book: Illness as a Metaphor, was published in 1978, and let me tell you it's a work of art; Sontag tackles this exact issue and spoiler alert: she is not a fan of metaphors... at all. In the introduction to her book she says " the healthiest way of being ill - is one most purified of, most resistant to, metaphoric thinking."(1) Sontag has many assertions about metaphors and cancer in this work, but I would like to focus on one right now.
The assertion that I would like to discuss is that metaphors create mystery, and a disease that is shrouded in mystery is one that feels "morally contagious." (6) This is something that I feel is overlooked by people who use metaphors, simply because it may not be considered. Using metaphors sometimes excludes the science and truth of a disease, this mystifies the disease and suddenly cancer is an unknown lurking in the darkness of ambiguity wearing a shroud of misinformation. Unknowns intimidate and scare people, cancer patients already look different and we know it. The ambiguity of cancer can be uncomfortable to some, and even cause them to avoid those with cancer. Shunning cancer patients is not something that has changed. I have personally experienced the awkward avoidance and the lamentable glances as if I was dead. I wasn't made fun of outright, shunning in today's society is much more subtle, but remains ever-present nonetheless. While I support a lot of Sontag's contentions, I do not support all of them. Susan Sontag contends that metaphors do not ever hold a valuable place in the world of disease, I believe that there are instances that metaphors may be helpful.
Are Metaphors Helpful At All?
I am certainly not a fan of metaphors is most cases. I do think they have some value to us, though. Metaphors are extremely calamitous to our knowledge of anything if that's where we stop. It's like building a house and stopping at the foundation, it's not going to be a very comfortable home. (yes I did use a simile in an article against this type of language) Metaphoric language is a useful tool to reach a new plane of knowledge. It is not a zenithal state of knowledge about a subject, in other words if you stop at the metaphors you don't understand something very well. Despite this, unless you are a healthcare professional, patient, or relative/friend of a patient this is where most people stop in their understanding. Then when they see someone sick, they stand there quite awkwardly and don't know what to do. This is different from how patients were treated in the past though. A lot of people thought that someone with cancer was possessed by a demon, or was being punished by God. This is definitely not a popular school of thought now. As time has moved on, patients have been ridiculed less. That is helpful, but still not ideal. While there aren't people speaking out against the ill, there is still a lot of work to be done on how we treat ill people. Nonetheless, there have been great strides in the recent years on the treatment of patients by society.
Metaphors mystify something that can be understood so much better. They separate the sick from the rest of society and it doesn’t need to be that way. Learning the right things to say is so easy. You don’t need a medical degree to understand the basics of cancer. Even knowing a little is better than using metaphors. Knowing that metaphors create undertones and implications of unfair expectations is important. People that are that sick are not different. They are weak, tired, and scared; your support could go a long way. So please next time you see someone sick, have a conversation with them about sports or the weather, something they can enjoy talking about. If you’d like to talk about their illness try not to use metaphors, instead use everyday language.
Illness as a Metaphor Citation
Sontag, Susan. Illness as Metaphor. Allen Lane, 1978.
This content reflects the personal opinions of the author. It is accurate and true to the best of the author’s knowledge and should not be substituted for impartial fact or advice in legal, political, or personal matters.
© 2020 AM Hewitt