Summary:

This essay was written ten years after the author's Illness as Metaphor (see this database). Sontag begins by explaining the stimulus for her earlier essay: her own experience as a cancer patient. During that time, she discovered that cultural myths about cancer tended to isolate and estrange cancer patients. They suffered needlessly because of "meaning" attributed to their illness by society. A decade later, Sontag observes that attitudes about cancer have become more open and truthful. However, a new illness (AIDS) has arisen to carry forward the metaphorical banner.

AIDS brings together two powerful metaphors about illness. First, AIDS develops further the theme (seen earlier in cancer) of disease as invader: the enemy invades and destroys you from within. Thus, AIDS strengthens the use of military metaphors in medicine. The war against cancer is reincarnated as a war against AIDS. Secondly, because AIDS is a sexually transmitted disease, it also evokes the theme of plague-as-punishment.

Sontag's project in this essay is more focused than in the earlier book. She acknowledges that the medical and public health response to AIDS explicitly counters these myths. She concludes that "not all metaphors applied to illnesses and their treatment are equally unsavory and distorting" (p. 94). The metaphor she is most anxious to see eliminated is the military metaphor, both on an illness level (illness invades the person) and a societal level (social problems invade society).

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In this remarkable book of essays, Rafael Campo explores his coming-of-age as a gay Cuban-American physician. He presents us with a series of stories illuminating his childhood and college experience, skillfully interweaving them with narratives from his life as a young physician, especially his interactions with patients dying of AIDS. We follow the author from Amherst College, through Harvard Medical School, to his medical residency in San Francisco. At each step Campo is a close observer of human character and motivation--his own and others. At each step he asks, "Who am I? Who am I becoming?"

He discovers his identity as a gay man, an Hispanic man, a poet, and, finally, as a healer--not four identities, but one. He discovers, too, the healing power of connecting with patients, the "poetry of healing," something far different from the orthodox image of the physician-as-detached-or-distanced from his patients. Though Campo rejects the concept that physicians are agents for social change ("naive," he calls it), he brings sensitivity and poetry to bear on his continued search for "some way to give."

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In this book written for the layman, linguist George Lakoff and philosopher Mark Johnson cogently argue that metaphor is integral, not peripheral to language and understanding. Furthermore, "metaphor is pervasive in everyday life, not just in language but in thought and action. Our ordinary conceptual system, in terms of which we both think and act, is fundamentally metaphorical in nature." (p. 3)

The authors adopt a broad definition of metaphor, examine common phrases for metaphorical interpretation, and offer a classification system of metaphor. For example, orientational metaphors are found in our ordinary language and are part of the spatial organization of our lives. When one says, "He dropped dead" or "He's at the peak of health," one is using the orientational metaphor that we live by: "Health and life are up; sickness and death are down." This orientation is not arbitrary; the authors point out that one lies down when one is ill.

Other types of metaphors categorized by the authors are structural and ontological (e.g., making a non-entity into an entity: "We need to combat inflation," or setting a boundary on a non-entity: "He's coming out of the coma"). The authors also differentiate metaphor from other figures of speech, such as metonymy, which relies more completely on substitution: "The ham sandwich wants his check."

The second half of the book address issues more philosophical in nature, such as theories of truth and how we understand the world, including the "myths" of "objectivism," "subjectivism," and "experientialism." These theories are reviewed with metaphor in mind. For example, objectivism relies on the separation of man from the environment and the subsequent mastery over the environment. Hence objectivism is rife with metaphors which confirm such ideas as "knowledge is power."

The authors conclude by stating that metaphors provide "the only ways to perceive and experience much of the world. Metaphor is as much a part of our functioning as our sense of touch, and as precious."

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At the age of 21, shortly after moving to Ithaca, New York, to begin a new life with her fiance, the author experienced a stroke that left her aphasic and partially paralyzed. She returned home to Altoona, Pennsylvania, where she underwent months of physical therapy and rehabilitation.

This memoir takes us through the process of self-discovery by which Barbara Newborn learned first to understand and cope with her disabilities and then to overcome them. It recounts her depression and determination, her disappointment and exhilaration. Return to Ithaca ends about nine months after the stroke when the author had indeed returned to Ithaca to begin (once again) a new life.

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In 1984 Handler was a moderately successful 23 year old New York City actor, when he developed acute myelogenous leukemia. Strongly supported by his girlfriend and family, Handler underwent induction and, later, consolidation chemotherapy at Sloan-Kettering Memorial Hospital, where he also began his long experience (the "comedy of terrors" or, perhaps more appropriately, the "tragedy of errors") of a harsh, hostile medical environment populated by arrogant physicians, condescending nurses, and a host of unhelpful minor characters.

Handler carries us briskly through his first remission, the impact of his illness on his family and personal relationships, his experience with nonconventional healing (Simonton Cancer Center), his return to work on Broadway, his relapse, and the agony of a second round of induction chemotherapy at Sloan-Kettering.

Subsequently, he goes to Johns Hopkins Hospital to undergo the rigors of an autologous bone marrow transplant. At Hopkins he discovers to his surprise a medical setting far different from Sloan-Kettering: communicative, compassionate physicians and a patient-centered healing environment. Even the two hospitals' sperm banks reflect this radical difference in approach.

After surviving his transplant and a subsequent round of serious infections, Handler resumes his life. He realizes that most of the time nowadays he is not in touch with the sense of joy and gratitude for each moment that the illness taught him. Yet, these feelings exist below his consciousness; sometimes he steps through "a little doorway near the floor of my consciousness" and experiences his life in a simpler, more profound way.

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This small but dramatically funny, tender, provocative and ultimately political book is a series of interviews with a diverse group of over 200 women about their vaginas: young and old, married and single; heterosexual, bisexual, and lesbian; working class women, professional women, and sex workers; women of various races. As the author points out, some of the monologues are verbatim, some are composites, some are her invented impressions. The subjects, which all have to do with vaginas, include such topics as what a vagina looks like, what goes in and comes out of vaginas, menstruation and birth, and more playfully, "If your vagina got dressed, what would it wear?" or "If your vagina could talk, what would it say, in two words?"

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This is a memoir, one that tells of a family’s move from California to the more rarefied life of the Alaskan wilderness. Living in a trailer and, later, a house they build, the family struggles with harsh winters and little money, maintaining their belief in the superiority of this way of life over what the parents had begun to experience as enervating in the mainland U.S.

At the age of seven, Natalie is savagely attacked by a neighbor’s sled dog. The attack leaves her with half of her face and numerous other serious wounds. In and out of consciousness as her mother and the neighbors await an ambulance, she remembers "the dogs, and their chains, and my own blood on the snow," (50) as well as the sensation of being moved on the stretcher and hearing one of the neighbor’s children say "Natalie’s dying."

Doctors told her parents she would not be likely to survive more than two days, and this memoir tells of her survival against the odds, spending years in and out of hospitals with numerous surgeries. Kusz weaves tales of her family’s history (her father was a Polish Russian) and the intense love that sustained them throughout her healing and arduous recovery and, later, her teenage pregnancy (and decision to keep the baby) and, finally, her mother’s early death and the progress of the family’s grief and recovery.

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William Morton first introduced ether anesthesia in 1846. This was followed shortly by nitrous oxide and chloroform. Within a few years, surgical anesthesia was being used throughout the United States. However, widespread acceptance did not mean universal usage. Physicians and surgeons debated the risks and benefits of anesthesia. Anesthesia was thought to be dangerous. Some argued that pain was a necessary part of life, that it made people stronger, and/or that it was a punishment from God. Others argued that anesthesia constituted an abuse of medical power.

Surgeons took care to select appropriate patients for anesthesia, while performing surgery without anesthetics on others. Women, people of higher social and economic classes, and people of the white race were thought to be more sensitive to pain than men, the poor, and Negroes and American Indians. Likewise, the young experienced pain more than the elderly. Certain procedures (e.g. major limb amputations and prolonged tissue dissection) were also thought to require more anesthetic than others (e.g. natural childbirth or ENT surgery). These beliefs carried over into practice, as evidenced by records from the Massachusetts General Hospital and other hospitals in the mid-19th century.

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Scarry argues that pain is the most absolute definer of reality. For the person in pain, there is no reality besides pain; if it hurts, it must be real. This characteristic of pain makes it useful politically. In torture, for example, the reality of the one being tortured is reduced to an awareness of pain, while the torturer’s world remains fully present. This is realized most emphatically when torture is described as information-gathering. The torturer insists on questions that for the tortured are no longer of any concern.

War also makes use of pain. In the dispute that leads to war, one country’s beliefs are pitted against another’s. Both sides’ positions are thus called into question; if there is disagreement about the facts, it becomes apparent that the facts are based in opinion, not reality. The injured bodies of war re-connect the victor’s beliefs with the material world. If the injured body is the ultimate in reality, the injured bodies of war can be used to signify the reality of the victor’s position. Simultaneously, the pain of individuals in war is transferred to inanimate objects or large groups. Thus, one speaks of "Division Six" being wounded or weapons being disabled.

This language also uses the absolute reality of the body in pain to secure the truth of a cultural/political position. Scarry discusses the reality-producing quality of pain in Judeo-Christian scriptures, Marx, and humans’ relationships with inanimate objects.

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This book, which is subtitled "Seven Paradoxical Tales," contains seven of Oliver Sacks' clinical stories of persons whose unusual neurological deficits teach us something about the way the brain (and, therefore, the mind) works. In "The Case of the Colorblind Painter" an artist learns to adapt to a completely black-and-white world after sustaining trauma to his occipital lobe.

"The Last Hippie" portrays a man whose ability to form new memories was destroyed by a massive midline brain tumor; he still "lives" in the 1960's. "A Surgeon's Life" depicts a Canadian surgeon with Gilles de la Tourette Syndrome, showing how he is able to live as a respected member of the community and practice surgery despite this disabling condition. "To See and Not See" tells the tale of a man in his 50's who is suddenly able to see after being blind since early childhood.

In "The Landscape of His Dreams" Sacks introduces a painter who, after a serious illness in the 1960's, apparently developed extraordinary and persistent "waking visions" of Pontito, his hometown in Italy. For many years he has obsessively painted remarkably accurate scenes of Pontito. "Prodogies" and "An Anthropologist on Mars" both deal with autism. The first tells of an autistic boy from England who has remarkable skill in visual memory and drawing; the second is about an autistic woman with a Ph.D. in animal science, who teaches at Colorado State University.

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