In the prefatory remarks to her magisterial essay “Illness As Metaphor”, Susan Sontag notes that we are all dual citizens of the kingdom of the well and the kingdom of the sick – although we all prefer to use only the one passport. She goes on to observe that, of course, illness is not a metaphor at all and that “the most truthful way of regarding illness – and the healthiest way of being ill – is one most purified of, most resistant to, metaphoric thinking.” I had known this once, yet preoccupied by my own history of mental distress and blinded by my professional malaise – for does not the fiction-maker engorge himself with the similitude of disparate things? – I had looked feverishly for what my bloody disorder was like. It seemed synonymous with my addictive illness – and also to be a bizarre antonym of vampirism, which, in turn, surely, was a metaphor for venereal disease? And also for tuberculosis, which in the 1900s was still viewed as repressive of an inflamed and passionate sexual appetite. I had trafficked in illness as metaphor, dealing as a novelist especially in that romanticising of madness that Sontag sees as “reflect(ing) in the most vehement way the contemporary prestige of irrational or rude (spontaneous) behaviour (acting out) …”
… Only a culture that had misheard Sontag’s advice and instead of excising the cancerously metaphoric assumed that it took benign forms could have witnessed such terrifyingly silly metastases. We may have tried to normalise cancer with fun runs and awareness weeks – yet still we “battle” against it in a war without end. Death, the real simile for disease – for when we are ill, do we not always feel like we are dying, even if it’s only a little? – remains, despite our secularism, the most metaphoricised phenomenon of all. As fast as we could eliminate the metaphors – our science helped them to proliferate. Metaphors were the iatrogenic disease of our era.
— Will Self, ‘The trouble with my blood’ in The Guardian
