Making it Literal (Susan Sontag)

Immunologists took over a language saturated with military terms from germ
theory in the 1960s. Now that these metaphors have been naturalized, their
figurative origins go largely undetected. But as Susan Sontag shows, in her book
Illness and its Metaphors, allow metaphors their head and we end up in a city
fll1der siege, with permanent monitoring, demagogic recruitment and red alerts.

The military metaphor in medicine first came into wide use in the 1880s,
with the identification of bacteria as agents of disease. Bacteria were said
to “invade” or “infiltrate.” But talk of siege and war to describe disease
now has, with cancer, a striking literalness and authority. Not only is the
clinical course of the disease and its medical treatment thus described, but
the disease itself is conceived as the enemy on which society wages war.
More recently, the fight against cancer has sounded like a colonial war with
similarly vast appropriations of government money-and in a decade
when colonial wars haven’t gone too well, this militarized rhetoric seems
to be backfiring. Pessimism among doctors about the efficacy of treatment
is growing, in spite of the strong advances in chemotherapy and
immunotherapy made since 1970. Reporters covering”the war on cancer”
frequently caution the public to distinguish between official fictions and
harsh facts; a few years ago, one science writer found American Cancer
Society proclamations that cancer is curable and progress has been made
“reminiscent of Vietnam optimism prior to the deluge.” Still, it is one
thing to be skeptical about the rhetoric that surrounds cancer, another to
give support to many uninformed doctors who insist that no significant
progress in treatment has been made, and that cancer is not really curable.
The bromides of the American cancer establishment, tirelessly hailing the
imminent victory over cancer; the professional pessimism of a large
number of cancer specialists, talking like battle-weary officers mired down
in an interminable colonial war-these are twin distortions in this military
rhetoric about cancer.

Other distortions follow with the extension of cancer images in more
grandiose schemes of warfare. As TB was represented as the spiritualizing
of consciousness, cancer is understood as the overwhelming or obliterating
of consciousness (by a mindless It). In TB, you are eating yourself up,
being refined, getting down to the core, the real you. In cancer, nonintelligent
(“primitive,” “embryonic,” “atavistic”) cells are multiplying,
and you are being replaced by the non-you. Immunologists class the body’s
cancer cells as “nonself. ”

It is worth noting that Reich, who did more than anyone else to
disseminate the psychological theory of cancer, also found something
equivalent to cancer in the biosphere.

There is a deadly orgone energy. It is in the atmosphere. You can
demonstrate it on devices such as the Geiger counter. It’s a swampy
quality … Stagnant, deadly water which doesn’t flow, doesn’t metabolize.
Cancer, too, is due to the stagnation of the flow of the life energy of the
organism.

Reich’s language has its own inimitable coherence. And more and moreas
its metaphoric uses gain in credibility-cancer is felt to be what he
thought it was, a cosmic disease, the emblem of all the destructive, alien
powers to which the organism is host.

As TB was the disease of the sick self, cancer is the disease of the
Other. Cancer proceeds by a science-fiction scenario: an invasion of “alien”
or “mutant” cells, stronger than normal cells (Invasion of the Body Snatchers,
The Incredible Shrinking Man, The Blob, The Thing). One standard science-fiction
plot is mutation, either mutants arriving from outer space or
accidental mutations among humans. Cancer could be described as a
triumphant mutation, and mutation is now mainly an image for cancer.
As a theory of the psychological genesis of cancer, the Reichian imagery
of energy checked, not allowed to move outward, then turned back on
itself, driving cells berserk, is already the stuff of science fiction. And
Reich’s image of death in the air-of deadly energy that registers on a
Geiger counter-suggests how much the science-fiction images about
cancer (a disease that comes from deadly rays, and is treated by deadly
rays) echo the collective nightmare. The original fear about exposure to
atomic radiation was genetic deformities in the next generation; that was
replaced by another fear, as statistics started to show much higher cancer
rates among Hiroshima and Nagasaki survivors and their descendants.
Cancer is a metaphor for what is most ferociously energetic; and these
energies constitute the ultimate insult to natural order. In a science-fiction
tale by Tommaso Landolfi, the spaceship is called “Cancerqueen.” (It is
hardly within the range of the tuberculosis metaphor that a writer could
have imagined an intrepid vessel named “Consumptionqueen.”) When not
being explained away as something psychological, buried in the recesses of
the self, cancer is being magnified and projected into a metaphor for the
biggest enemy. the furthest goal. Thus, Nixon’s bid to match Kennedy’s
promise to put Americans on the moon was, appropriately enough, the
promise to “conquer” cancer. Both were science-fiction ventures. The
equivalent of the legislation establishing the space program was the National
Cancer Act of 1971. which did not envisage the near-to-hand decisions
that could bring under control the industrial economy that pollutes-only
the great destination: the cure.

TB was a disease in the service of a romantic view of the world. Cancer
is now in the service of a simplistic view of the world that can turn paranoid.
The disease is often experienced as a form of demonic possession-tumors
are “malignant” or”benign, “like forces-and many terrified cancer patients
are disposed to seek out faith healers, to be exorcized. The main organized
support for dangerous nostrums like Laetrile comes from far-right groups
to whose politics of paranoia the fantasy of a miracle cure for cancer
makes a serviceable addition, along with a belief in UFOs. (The John
Birch Society distributes a forty-five-minute film called World Without
Cancer.) For the more sophisticated, cancer signifies the rebellion of the
injured ecosphere: Nature taking revenge on a wicked technocratic world.
False hopes and simplified terrors are raised by crude statistics brandished
for the general public, such as that 90 percent of all cancers are “environmentally
caused,” or that imprudent diet and tobacco smoking alone
account for 75 percent of all cancer deaths. To the accompaniment of this
numbers game (it is difficult to see how any statistics about “all cancers”
or “all .cancer deaths” could be defended), cigarettes, hair dyes, bacon,
saccharine, hormone-fed poultry, pesticides, low-sulphur coal-a lengthening
roll call of products we take for granted have been found to cause
cancer.. X-rays give cancer (the treatment meant to cure kills); so do
emanations from the television set and the microwave oven and the
fluorescent clock face. As with syphilis, an innocent or trivial act-or
exposure in the present can have dire consequences far in the future. It
is also known that cancer rates are high for workers in a large number of
industrial occupations. Though the exact processes of causation lying
behind the statistics unknown, it seems clear that many cancers are
preventable. But cancer is not just a disease ushered in by the Industrial
Revolution (there was cancer in Arcadia) and certainly more than the sin
of capitalism (within their more limited industrial capacities, the Russians
pollute worse than we do). The widespread current view of cancer as a
disease of industrial civilization is as unsound scientifically as the right-wing
fantasy of a “world without cancer” (like a world without subversives).
Both rest on the mistaken feeling that cancer is a distinctively
“modern” disease.

The medieval experience of the plague was firmly tied to notions of
moral pollution, and people invariably looked for a scapegoat external to
the stricken community. (Massacres of Jews in unprecedented numbers
took place everywhere in plague-stricken Europe of 1347-48, then
stopped as soon as the plague receded). With the modern diseases the
scapegoat is not so easily separated from the patient. But much as these
diseases individualize, they also pick up some of the metaphors of epidemic
diseases. (Diseases understood to be simply epidemic have become less
useful as metaphors, as evidenced by the near-total historical amnesia
about the influenza pandemic of 1918-19, in which more people died
than m the four years of World War I.) Presently, it is as much a cliche to
say that cancer is “environmentally” caused as it was-and still is-to say
that it is caused by mismanaged emotions. TB was associated with pollution
(Florence Nightingale thought it was “induced by the foul air of houses”),
and now cancer is thought of as a disease of the contamination of the
whole world. TB was “the white plague. “With awareness of environmental
pollution, people have started saying that there is an “epidemic” or “plague”
of cancer.

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