Susan Sontag Illness As Metaphor Quotes

Depression is melancholy minus its charms.

Illness is the night side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.

Theories that diseases are caused by mental states and can be cured by will power are always an index of how much is not understood about a disease.

A large part of the popularity and persuasiveness of psychology comes from its being a sublimated spiritualism: a secular, ostensibly scientific way of affirming the primacy of spirit over matter.

Nothing is more punitive than to give a disease a meaning - that meaning being invariably a moralistic one.

EVERYONE WHO IS born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick,” Susan Sontag wrote in Illness as Metaphor. “Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.

Abuse of the military metaphor may be inevitable in a capitalist society, a society that increasingly restricts the scope and credibility of appeals to ethical principle, in which it is thought foolish not to subject one's actions to the calculus of self-interest and profitability. War-making is one of the few activities that people are not supposed to view 'realistically'; that is, with an eye to expense and practical outcome. In all-out war, expenditure is all-out, unprudent--war being defined as as an emergency in which no sacrifice is excessive.

Theories that diseases are caused by mental states and can be cured by will power are always an index of how much is not understood about the physical terrain of a disease.

One feature of the usual script for plague: the disease invariably comes from somewhere else. The names for syphilis, when it began its epidemic sweep through Europe in the last decade of the fifteenth century are an exemplary illustration of the need to make a dreaded disease foreign. It was the "French pox" to the English, morbus Germanicus to the Parisians, the Naples sickness to the Florentines, the Chinese disease to the Japanese. But what may seem like a joke about the inevitability of chauvinism reveals a more important truth: that there is a link between imagining disease and imagining foreignness.

Any important disease whose causality is murky, and for which treatment is ineffectual, tends to be awash in significance. First, the subjects of deepest dread (corruption, decay, pollution, anomie, weakness) are identified with the disease. The disease itself becomes a metaphor. Then, in the name of the disease (that is, using it as a metaphor), that horror is imposed on other things. The disease becomes adjectival. Something is said to be disease-like, meaning that it is disgusting or ugly.

Twentieth century women's fashions (with their cult of thinness) are the last stronghold of the metaphors associated with the romanticizing of TB in the late eighteenth and early nineteenth centuries.

Etymologically, patient means sufferer. It is not suffering as such that is most deeply feared but suffering that degrades. —Susan Sontag, Illness as Metaphor

Apocalypse is now a long-running serial: not “Apocalypse Now” but “Apocalypse From Now On.” Apocalypse has become an event that is happening and not happening. It may be that some of the most feared events, like those involving the irreparable ruin of the environment, have already happened. But we don’t know it yet, because the standards have changed. Or because we do not have the right indices for measuring the catastrophe. Or simply because this is a catastrophe in slow motion. (Or feels as if it is in slow motion, because we know about it, can anticipate it; and now have to wait for it to happen, to catch up with what we think we know.) Modern

Because it is a world event—that is, because it affects the West—it is regarded as not just a natural disaster. It is filled with historical meaning. (Part of the self-definition of Europe and the neo-European countries is that it, the First World, is where major calamities are history-making, transformative, while in poor, African or Asian countries they are part of a cycle, and therefore something like an aspect of nature.)

Apocalypse is now a long-running serial: not “Apocalypse Now” but “Apocalypse From Now On.

To describe a phenomenon as a cancer is an incitement to violence. The use of cancer in political discourse encourages fatalism and justifies “severe” measures.

The age-old, seemingly inexorable process whereby diseases acquire meanings (by coming to stand for the deepest fears) and inflict stigma is always worth challenging, and it does seem to have more limited credibility in the modern world, among people willing to be modern - the process is under surveillance now. With this illness, one that elicits so much guilt and shame, the effort to detach it from these meanings, these metaphors, seems particularly liberating, even consoling. But the metaphors cannot be distanced just by abstaining from them. They have to be exposed, criticized, belabored, used up.

Choroba jest nocną stroną życia, naszym bardziej uciążliwym obywatelstwem. Od dnia narodzin każdy z nas posiada bowiem jakby dwa paszporty - przynależy zarówno do świata zdrowych, jak i do świata chorych.

One set of messages of the society we live in is: Consume. Grow. Do what you want. Amuse yourselves. The very working of this economic system, which has bestowed these unprecedented liberties, most cherished in the form of physical mobility and material prosperity, depends on encouraging people to defy limits. Appetite is supposed to be immoderate. The ideology of capitalism makes us all into connoisseurs of liberty—of the indefinite expansion of possibility. Virtually every kind of advocacy claims to offer first of all or also some increment of freedom. Not every freedom, to be sure. In rich countries, freedom has come to be identified more and more with “personal fulfillment”—a freedom enjoyed or practiced alone (or as alone). Hence much of recent discourse about the body, reimagined as the instrument with which to enact, increasingly, various programs of self-improvement, of the heightening of powers.

Tumor angiogenesis exploits the same pathways that are used when blood vessels are created to heal wounds. Nothing is invented; nothing is extraneous. Cancer’s life is a recapitulation of the body’s life, its existence a pathological mirror of our own. Susan Sontag warned against overburdening an illness with metaphors. But this is not a metaphor. Down to their innate molecular core, cancer cells are hyperactive, survival-endowed, scrappy, fecund, inventive copies of ourselves.

Nothing is invented; nothing is extraneous. Cancer’s life is a recapitulation of the body’s life, its existence a pathological mirror of our own. Susan Sontag warned against overburdening an illness with metaphors. But this is not a metaphor. Down to their innate molecular core, cancer cells are hyperactive, survival-endowed, scrappy, fecund, inventive copies of ourselves.

Consumption was understood as a manner of appearing, and that appearance became a staple of nineteenth-century manners. It became rude to eat heartily. It was glamorous to look sickly. “Chopin was tubercular at a time when good health was not chic,” Camille Saint-Saëns wrote in 1913. “It was fashionable to be pale and drained; Princess Belgiojoso strolled along the boulevards … pale as death in person.” Saint-Saëns was right to connect an artist, Chopin, with the most celebrated femme fatale of the period, who did a great deal to popularize the tubercular look. The TB-influenced idea of the body was a new model for aristocratic looks—at a moment when aristocracy stops being a matter of power, and starts being mainly a matter of image. (“One can never be too rich. One can never be too thin,” the Duchess of Windsor once said.) Indeed, the romanticizing of TB is the first widespread example of that distinctively modern activity, promoting the self as an image. The tubercular look had to be considered attractive once it came to be considered a mark of distinction, of breeding. “I cough continually!” Marie Bashkirtsev wrote in the once widely read Journal, which was published, after her death at twenty-four, in 1887. “But for a wonder, far from making me look ugly, this gives me an air of languor that is very becoming.” What was once the fashion for aristocratic femmes fatales and aspiring young artists became, eventually, the province of fashion as such. Twentieth-century women’s fashions (with their cult of thinness) are the last stronghold of the metaphors associated with the romanticizing of TB in the late eighteenth and early nineteenth centuries.

But the effect of the military imagery on thinking about sickness and health is far from inconsequential. It overmobilizes, it overdescribes, and it powerfully contributes to the excommunicating and stigmatizing of the ill. No, it is not desirable for medicine, any more than for war, to be “total.” Neither is the crisis created by AIDS a “total” anything. We are not being invaded. The body is not a battlefield. The ill are neither unavoidable casualties nor the enemy. We—medicine, society—are not authorized to fight back by any means whatever.… About that metaphor, the military one, I would say, if I may paraphrase Lucretius: Give it back to the war-makers.

In the countdown to a millennium , a rise in apocalyptic thinking may be inevitable . Still , the amplitude of the fantasies of doom that AIDS has inspired can't be explained by the calendar alone , or even by the very real danger the illness represents. There is also the need for an apocalyptic scenario that is specific to “ Western ” society, and perhaps even more so to the United States. (America, as someone has said, is a nation with the soul of a church — an evangelical church prone to announcing radical endings and brand-new beginnings.) The taste for worst-case scenarios reflects the need to master fear of what is felt to be uncontrollable. It also expresses an imaginative complicity with disaster. The sense of cultural distress or failure gives rise to the desire for a clean sweep, a tabula rasa. No one wants a plague, of course. But, yes, it would be a chance to begin again. And beginning again — that is very modern, very American, too.

在超过一个半世纪的时间里，结核病为雅致、敏感、忧伤、柔弱提供了隐喻性的对等物；而那些似乎冷酷、无情、损人利己之事，则被类比为癌症(因此，波德莱尔于一八五二年在《异教徒学校》一文中指出:“对艺术的疯狂激情，是吞食其他一切的癌瘤……”)。结核病是一个暧昧的隐喻，既可以意指灾祸，又可象征高雅。癌症却从来就只被看作灾祸；在隐喻意义上，癌症是一种内在的野蛮状态。

As Susan Sontag pointedly observes in Illness as Metaphor, illnesses we don’t understand are frequently viewed as manifestations of inner states. The less we understand about a disease or a symptom, the more we psychologize, and often stigmatize, it.

Reassurances are multiplying in the United States and Western Europe that “the general population” is safe. But “the general population” may be as much a code phrase for whites as it is for heterosexuals. Everyone knows that blacks are getting AIDS in disproportionate numbers, as there is a disproportionate number of blacks in the armed forces and a vastly disproportionate number in prisons.

(Part of the self-definition of Europe and the neo-European countries is that it, the First World, is where major calamities are history-making, transformative, while in poor, African or Asian countries they are part of a cycle, and therefore something like an aspect of nature.) Nor has AIDS become so publicized because, as some have suggested, in rich countries the illness first afflicted a group of people who were all men, almost all white, many of them educated, articulate, and knowledgeable about how to lobby and organize for public attention and resources devoted to the disease. AIDS occupies such a large part in our awareness because of what it has been taken to represent. It seems the very model of all the catastrophes privileged populations feel await them. What

The binary of illness/wellness is always porous, whether or not we notice. In Illness as Metaphor, Susan Sontag wrote, “Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick.” I used to believe Sontag uncritically. Now I know that the two kingdoms don’t exist; it’s one kingdom, in a quantum state. We are all constantly both sick and well, sick/well, sick and well both, our body and immune system in conversation with a world rich in microbes, viruses, and bacteria, almost all of them either benign or beneficial, countless microbes in me here as I write and in you there as you read. The quantum state of sick/well. Let me take cancer, that disease so long synonymous with death. Cancer is not a binary. We’re willing to acknowledge this, but only when one has already crossed over into the sick category. Cancer has stages. Stage 1 cancer is still small, mostly easily treatable; stage 4 cancer is aggressive, malignant, deadly. Many prostate cancers require no intervention at all. They are subclinical. We live with them until something else kills us. Cancer is not black and white but gray, and further, there is no white to begin with. There is no absence of cancer as long as we have a body. We make cancerous cells every day our cells divide, which is to say every day. In order to keep living, and keep making—for example—new skin to push the outside world out, our cells have to divide. With each cell division, a cell will make mutations. Mutations are the raw material of cancer. Carcinogens and sunlight cause cancer because they cause mutations and damage to our DNA. But without cell division, no life. To risk cancer, to make it day by day, is to live. The absence of cancer is death. So cancerous cells are a normal part of life. In the popular imagination, we see the immune system as mainly protecting us from infectious disease, from bacteria and viruses. But just as importantly, our immune system protects us against cancer, the cells in our own body that mutate to become other, to pose a threat. At almost 40, I’ve certainly had cancerous cells in me, cells that mutate so they can divide and divide and divide. It’s my immune system that finds those cells and kills them so that I, a whole organism, can survive. But because I don’t have cancer doesn’t mean I haven’t had a cancer cell in me. I have, and survived it, so far.

But it is certainly true that were AIDS only an African disease , however many millions were dying, few outside of Africa would be concerned with it . It would be one of those “ natural ” events, like famines, which periodically ravage poor, overpopulated countries and about which people in rich countries feel quite helpless. Because it is a world event — that is, because it affects the West — it is regarded as not just a natural disaster. It is filled with historical meaning.

Reassurances are multiplying in the United States and Western Europe that “the general population” is safe. But “the general population” may be as much a code phrase for whites as it is for heterosexuals. Everyone knows that blacks are getting AIDS in disproportionate numbers, as there is a disproportionate number of blacks in the armed forces and a vastly disproportionate number in prisons. “The AIDS virus is an equal-opportunity destroyer” was the slogan of a recent fund-raising campaign by the American Foundation for AIDS Research. Punning on “equal-opportunity employer,” the phrase subliminally reaffirms what it means to deny: that AIDS is an illness that in this part of the world afflicts minorities, racial and sexual.

Part of the centuries-old conception of Europe as a privileged cultural entity is that it is a place which is colonized by lethal diseases coming from elsewhere. Europe is assumed to be by rights free of disease. (And Europeans have been astoundingly callous about the far more devastating extent to which they—as invaders, as colonists—have introduced their lethal diseases to the exotic, “primitive” world: think of the ravages of smallpox, influenza, and cholera on the aboriginal populations of the Americas and Australia.)

Kinglake’s influential book Eothen (1844)—suggestively subtitled “Traces of Travel Brought Home from the East”—illustrates many of the enduring Eurocentric presumptions about others, starting from the fantasy that peoples with little reason to expect exemption from misfortune have a lessened capacity to feel misfortune. Thus it is believed that Asians (or the poor, or blacks, or Africans, or Muslims) don’t suffer or don’t grieve as Europeans (or whites) do. The fact that illness is associated with the poor—who are, from the perspective of the privileged, aliens in one’s midst—reinforces the association of illness with the foreign: with an exotic, often primitive place.

And about the staggering prediction made recently by the World Health Organization that, barring improbably rapid progress in the development of a vaccine, there will be ten to twenty times more AIDS cases in the next five years than there were in the last five, it is assumed that most of these millions will be Africans.

One feature of the usual script for plague: the disease invariably comes from somewhere else. The names for syphilis, when it began its epidemic sweep through Europe in the last decade of the fifteenth century, are an exemplary illustration of the need to make a dreaded disease foreign.1 It was the “French pox” to the English, morbus Germanicus to the Parisians, the Naples sickness to the Florentines, the Chinese disease to the Japanese. But what may seem like a joke about the inevitability of chauvinism reveals a more important truth: that there is a link between imagining disease and imagining foreignness. It lies perhaps in the very concept of wrong, which is archaically identical with the non-us, the alien. A polluting person is always wrong, as Mary Douglas has observed. The inverse is also true: a person judged to be wrong is regarded as, at least potentially, a source of pollution.

Any disease that is treated as a mystery and acutely enough feared will be felt to be morally, if not literally, contagious.

But the idea that features of our personality may contribute to the onset of pathology is anathema to many. In her still-influential 1978 essay “Illness as Metaphor,” the late filmmaker, activist, and brilliant woman of letters Susan Sontag—then a forty-five-year-old cancer survivor—flatly and forcefully rejected the possibility that ill health might signify anything beyond bodily calamity. “Theories that diseases are caused by mental states . . . are always an index of how much is not understood about the physical terrain of a disease,” she wrote.[1] To assert that emotions contribute to disease was, for her, to promote “punitive or sentimental fantasies,” to traffic in “lurid metaphors” and their “trappings.” She found this view especially distasteful because she perceived it as a way of blaming the patient. “I decided that I was not going to be culpabilized.”[2] Sontag’s acerbic rejection of the mind-body connection resonated not only in intellectual circles but also in some of the most hallowed centers of medical thinking. A few years later, the New England Journal of Medicine’s future first woman editor, Dr. Marcia Angell, cited it approvingly, deriding as “folklore” the idea that “mental state is a factor in the causing and curing of specific diseases,” a “myth” for which the evidence is at best “anecdotal.” Like Sontag, Dr. Angell espied in this line of thinking an insidious patient-blaming tendency: “At a time when patients are already burdened by disease, they should not be further burdened by having to accept responsibility for the outcome.”[3] I agree wholeheartedly that no one, ever, ought to be made to feel guilty for whatever transpires with or within their body, whether that guilt arises from the self or is imposed from without. As I stated earlier, blame is inappropriate, unmerited, and cruel; it is also unscientific. But we have to take care not to fall into an easy fallacy. Asserting that features of the personality contribute to the onset of illness, and more generally perceiving connections between traits, emotions, developmental histories, and disease is not to lay blame. It is to understand the bigger picture for the purposes of prevention and healing—and ultimately for the sake of self-acceptance and self-forgiveness. My intent in reframing Sontag’s perspective, then, is to offer a more helpful view. I empathize with her apprehension about being blamed for becoming ill, even as I see her refutation of the mind-body confluence as misguided and scientifically untenable. A clear and honest look at the biographical factors that can disrupt our biological well-being helps us respond intelligently and effectively to illness—or preferably, to mitigate the risks in the first place. This is as true for individuals as for society.

Современный апокалипсис — это длинный сериал, не "Апокалипсис сегодня", а "Апокалипсис сегодня, завтра и так далее". Апокалипсис превратился в событие, происходящее и одновременно не происходящее.