Illness as Metaphor and AIDS and Its Metaphors

by Susan Sontag

Cancer is a demonic pregnancy.

“Death and disease are often beautiful, like … the hectic glow of consumption.”

and all disease is only love transformed.”

The early Romantic sought superiority by desiring, and by desiring to desire, more intensely than others do. The inability to realize these ideals of vitality and perfect spontaneity was thought to make someone an ideal candidate for TB.

The passive, affectless anti-hero who dominates contemporary American fiction is a creature of regular routines or unfeeling debauch; not self-destructive but prudent; not moody, dashing, cruel, just dissociated. The ideal candidate, according to contemporary mythology, for cancer.

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.

Psychological theories of illness are a powerful means of placing the blame on the ill. Patients who are instructed that they have, unwittingly, caused their disease are also being made to feel that they have deserved it.

To calm the imagination of the invalid, so that at least he should not, as hitherto, have to suffer more from thinking about his illness than from the illness itself—that, I think, would be something! It would be a great deal!

The most terrifying illnesses are those perceived not just as lethal but as dehumanizing, literally so.

This separation is a main point of one of European culture’s principal iconographical traditions, the depiction of Christian martyrdom, with its astounding schism between what is inscribed on the face and what is happening to the body. Those innumerable images of Saint Sebastian, Saint Agatha, Saint Lawrence (but not of Christ himself), with the face demonstrating its effortless superiority to the atrocious things that are being inflicted down there. Below, the ruin of the body. Above, a person, incarnated in the face, who looks away, usually up, not registering pain or fear; already elsewhere. (Only Christ, both Son of Man and Son of God, suffers in his face: has his Passion.) Our very notion of the person, of dignity, depends on the separation of face from body,1 on the possibility that the face may be exempt, or exempt itself, from what is happening to the body. And however lethal, illnesses like heart attacks and influenza that do not damage or deform the face never arouse the deepest dread.

Leprosy and syphilis were the first illnesses to be consistently described as repulsive.