Illness As Metaphor

Franz Kafka was a Bohemian novelist and short story writer who published such acclaimed works as The Trial, The Castle, and the short story “Metamorphosis.” His work was a major influence on Sontag’s writing and criticism, although it may seem less obvious to include his writing in a book about science and illness. However, Kafka suffered and died from tuberculosis, and, moreover, TB was a topic in many of the epistolary correspondences he conducted at the time. These include his line to his friend Max Brod that he had “come to think that tuberculosis…is no special disease, or not a disease that deserves a special name, but only the germ of death itself, intensified...” (19).

Kafka, besides elucidating the sensation of TB, figures prominently into Sontag’s argument about the character and social perception of tuberculosis. In particular, his work is useful in proving three key ideas to her argument. The first is how doctors often chose not to disclose diagnoses to patients suffering from mysterious or fatal diseases. Here, she quotes Kafka writing to a friend after a doctor visit, “Verbally I don't learn anything definite…since in discussing tuberculosis…everybody drops into a shy, evasive, glassy-eyed manner of speech” (7). The second is the idea of how illnesses become synonymous with psychological traits. On this point she cites Kafka when he writes, “I'm mentally ill, the disease of the lungs is nothing but an overflowing of my mental disease” (54). Last is how illness, particularly TB, was seen as a dramatization or representation of what occurred mentally within the victim. As Kafka wrote in his diary to himself after his TB diagnosis, “the infection in your lungs is only a symbol” (44).

Wilhelm Reich was an Austrian doctor and psychoanalyst who is famous for contributing many radical ideas to the world across a wide array of subjects including psychology, therapy, psychoanalysis, Marxism, theories of sexuality, the sociology of fascism, humanities, and pseudoscience. Reich was a genius and a controversial figure. He performed experiments with Albert Einstein and was also arrested by the FBI. He died in a federal penitentiary in Lewisburg, Pennsylvania, in 1957 at the age of 60.

Reich’s ideas about the relationship between emotional repression and illness are of the utmost importance to Sontag’s argument about social misunderstandings and mistreatments of illness and its victims. On cancer, Reich wrote, "a disease following emotional resignation—a bio-energetic shrinking, a giving up of hope” (23). He even wrote of Sigmund Freud, his intellectual mentor, that his cancer began when Freud gave into resignation, because of an unhappy marriage.

Sontag also looks to one of the paradoxes in Reich’s thinking to show how easy it is to slip into harmful metaphors about illness. In his seminal book from 1933, The Mass Psychology of Fascism, Reich argues that the fear of syphilis was reconfigured and transmuted onto mass feelings of anti-Semitism. Sontag lauds this conclusion but notes that Reich could not transfer this thinking back onto his own usage of illness as metaphor in his understanding of cancer’s relation to the patient. On this point, it is notable that Sontag, perhaps to avoid the missteps in logic that felled Reich, calls out her own use of disease metaphors in previous writings towards the end of the text.