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Susan Sontag, the metaphors of illness and the militaristic understanding of the ill. (On Illness 17)

It is not easy to find readings regarding illness by patients who are humanists and ill themselves. This is easy to explain, in a sense. First, one must have been involved in the humanities for many years. Second, one must have fallen seriously ill. Third, and very importantly, during that period of illness one must have had enough physical and mental energy to be able to reflect and to write about the process of illness itself. The latter is no easy task; just try writing when you have some kind of physical pain. Or think of this common occurrence which, now that I have been seriously ill, makes me smile. When one reads the biography of many famous and important people such biographies usually end something like this,

“and then, quite unfortunately, such and such illness came suddenly into his life and suddenly he lost all his genius and his creative powers, and then the most brilliant mind became totally lost ..…, and then died in the year such and such ……” .

Why do I smile? Because such a narrative is highly incomplete, untrue, oversimplified and dangerous. Why is this so? Primarily because this kind of narrative seems to me to be a bit like the story of the monster that lives under our beds. But more importantly, it continues separating creativity and the most fundamental elements of our unique human condition, including our suffering, our physical fragility and our mortality.

Don’t you think it is odd to actually believe that somehow one produces less and becomes less creative and thoughtful PRECISELY when one comes to learn first-hand of the vulnerabilities which lie at the core of our humanity! For surely the greatest writers did not write about such topics by having simply READ about them (though reading about them will prepare us like no other exercise once they become present in our lives, or in the lives of those around us.) On the contrary, it is —-in part—- by living such moments that one’s creativity is energized and one’s potential reflection actualized more deeply. “But I have never gotten ill”, you might respond. “Good for you!” I say, “just do not forget that if this is so, those around you who fall ill will need even more of your help and practical wisdom when dealing with situations of crisis.” Hearing such narratives makes me think that in our world we are in constant fear of illness for we can only see it as the beginning of the end, rather than the end of a shallow beginning. Suffering makes no sense to us, and the sufferers much less so.

However that may be, the fortunate appearance of these three conditions is the main reasons why Susan Sontag’s Illness as metaphor is such a unique and precious book. It is a book for those seeking to make somewhat articulate that which is mostly held as unspeakable; particularly so in our age which sees in death and in the immobility of illness “the other” against which we must continually fight and guard ourselves from.

In this post, I will merely point to some of the reasons why this confluence is so unique. At least four elements stand out: 1. Sontag allows for insight into what it is for an ill person to write DURING illness itself; 2. Sontag points out the dangers underlying the kinds of metaphors we use when dealing with illness, metaphors which are unavoidable given our nature as self-interpreting animals (on this, see Charles Taylor who has also had great impact in the area of nursing); 3. She crucially reveals the most damaging of these metaphors, namely, the military metaphor as it is applied to illness in such a way that ironically who I am and my body become sworn enemies leading, in turn, to a dangerous dualistic tendency which emphasizes a separation from myself, demeaning me silently; and finally, 4. she points to one crucial interest in the connection created by political thinkers between the illness of the body and the illness of the body politic. I will briefly point to each of these dimensions. (more…)

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Choosing a doctor and knowing yourself.

In selecting a doctor, or better yet, in selecting doctors, it is inevitable that one will end up looking at oneself and at who one is. In my case, I have selected doctors both from traditional and alternative traditions; more importantly I came to be with doctors who suffered the transformation —Socratic in essence—- which leads from traditional medicine to alternative views, not simply of medicine, but of the human condition itself. The reason for my going these roads, though it is no easy road as both types of doctors have great suspicion of each other’s paradigm, was in part my deep belief in the importance of bilingualism with which I have been involved as ESL teacher for more than a decade and as citizen of Canada, one of the few official bilingual countries in the world.

In this respect, patients from the humanities are in special need of doctors who have been deeply involved with the humanities for only then can a mutual and healthy dialogue towards understanding, and maybe even recovery, can ensue. The work of doctor Pellegrino is here of great importance; see, for instance, his aptly titled “Educating the Humanist Physician; an Ancient Ideal Reconsidered. However, patients from the humanities must beware that the likelihood of such coincidence is not high and when illness is thrust upon us, there is little time and energy to make such connections.

One of the doctors I visited later in my illness told me very seriously I had to choose between one or the other of these treatments, and that it was my responsibility whatever I did. To this I answered calmly: “If this is so, if indeed one has to choose, then I have already made my decision a long time ago.” ( I had made my decision the very day I decided to dedicate my life to the humanities, 20 years earlier, when I was absolutely healthy.)

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In search of a meaning for physical pain.

Permanent and serious illness is almost inseparable from constant physical pain, be it through the illness itself, or through the therapy which one follows to regain one’s health. But physical pain is not the only type of pain with which the ill person must deal. Emotional and spiritual pain are summoned by the physical pain itself as a new condition is brought upon the person and specially those surrounding the ill. Later on, in another post, I will look at the ontological assault on the self which serious and chronic illness represents in terms of the loss of personal identity which the ill person must now face.

The ill suddenly see the narrative of their lives —which they have constructed through the years, even if they are few—- enter into an unknown and frightening domain in which the very possibility of a conscious narrative is in constant question. Pain arrests the normal possibility of narrative through action and reflection. Pain reduces all movement, pain removes all words (if you are healthy, just try to imagine one of those days in which you have a stomachache or headache). This is why it is of the utmost importance that the ill find all the means possible to understand their pain and give it a sense of meaning even when others do not see this as a possibility (of course, THEY do not have the pain!) This implies in part following, what is so common today, learning to “manage” one’s pain (for instance, the power of breathing). But this is an economic metaphor that reduces the spiritual potential hidden within each and every suffering person to a mere issue of control. Health is not a business, no matter how much we are forced to think so.

During the many years of recovery from my illness, I have had my share of very severe pain. Without going into the details (though actually I find it absolutely rare to find a person wishing to speak reflectively about pain; it seems to pain them more than the pain itself!) , I simply want to share a story which I always remember when pain comes around to visit me.

There are many such stories, but one needs to surround oneself by them. I myself simply recall the story of a young man from my dear Bogotá who on the very day of his graduation from school ——and having received a meritorious award for being one of the best high school students in the country—- was “accidentally” shot in the back. He was almost paralyzed completely. What he told one reporter I have never been able to forget. Paraphrasing, the young man said something like this when asked about his pain:

“Whenever I have pain I actually feel better for it tells me that I still have feeling in my limbs. It tells me my body is still trying to recover. It brings me hope. This motivates me everyday to try to move just a bit more each day.”

By moving a bit, he meant moving his toes.

When in pain, the ill —and those who surround them—- must search for such stories in order to bring a sense of purpose and narrative (see Charles Taylor, SotS) to their suffering, their shame, their vulnerability and their present weakness. Perhaps the greatest purpose can be the very recovery of the new narrative in sickness in which the patient finds himself. By giving his illness the sense of a story, the question of pain will still be present, yet secondary. (To this effect, I will post a sample diary sheet for the ill in the next post to record privately the daily happenings of their new situation. To this effect, I will also post a basic bibliography on illness which may open avenues for those who are ill.)

In contrast, I once heard a doctor say that he was a good doctor because he helped his patients as best he could. However, he added responding to a person who spoke as this post does, that he had to be honest and could see no purpose whatsoever in the pain and suffering of his patients. One wonders how such a bright and successful man could not see how contradictory his words were.

 

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