I read Natasha Wiggin’s (1) article with interest, 24 hours or so into my third cycle of chemotherapy for metastatic colon cancer. Our use of metaphor does appear to follow societial preoccupations – e.g. the persistence of seafaring metaphor in common parlance and those of war and combat when utilized in biomedical practice and so beautifully illustrated by Susan Sontag in her two seminal essays (2).
Those of us with the disease at my Cancer Centre, talk openly with each other about our shared experience. Together we create our narratives and, it is this fortnightly or three-weekly conferencing that gets us through as we collectively receive (or perhaps I should say, are infiltrated by) our drugs intravenously.
With these people I hear little metaphor, but I do hear talk of feelings, friends, families and the wider impact of the illness. When family visit, or medical staff are in attendance, the conversation often changes, and I begin to hear metaphors.
It occurs to me that metaphor may fill the space created by uncertainty. And so where there is uncertainty, and ignorance, both within the physician and within the patient, we use metaphor to bridge those uncomfortable gaps in conversation when we don’t know what to say - an awkward and ill-considered attempt to make both sides feel better. I hear this too from friends in their written and spoken communications (mostly written) and in family groups and, of course, also from the health care professionals. But it doesn’t seem to be a part of the here and now conversations between those of us in the centre.
I suggest that more active listening and less talking to fill the uncomfortable silences could improve the quality of communication with my physician, my nurses and my family – to allow our mutual ignorance and uncertainty to be shared. This way we may feel more human and less embattled.
(1) Personal View: Stop Using Military Metaphors for Disease. Natasha M Wiggins: BMJ 28 July 2012: Volume 345: p31.
(2) Susan Sontag: Illness as Metaphor. 1978. AIDS and its Metaphors, 1988
Rapid Response:
Re: Stop using military metaphors for disease
I read Natasha Wiggin’s (1) article with interest, 24 hours or so into my third cycle of chemotherapy for metastatic colon cancer. Our use of metaphor does appear to follow societial preoccupations – e.g. the persistence of seafaring metaphor in common parlance and those of war and combat when utilized in biomedical practice and so beautifully illustrated by Susan Sontag in her two seminal essays (2).
Those of us with the disease at my Cancer Centre, talk openly with each other about our shared experience. Together we create our narratives and, it is this fortnightly or three-weekly conferencing that gets us through as we collectively receive (or perhaps I should say, are infiltrated by) our drugs intravenously.
With these people I hear little metaphor, but I do hear talk of feelings, friends, families and the wider impact of the illness. When family visit, or medical staff are in attendance, the conversation often changes, and I begin to hear metaphors.
It occurs to me that metaphor may fill the space created by uncertainty. And so where there is uncertainty, and ignorance, both within the physician and within the patient, we use metaphor to bridge those uncomfortable gaps in conversation when we don’t know what to say - an awkward and ill-considered attempt to make both sides feel better. I hear this too from friends in their written and spoken communications (mostly written) and in family groups and, of course, also from the health care professionals. But it doesn’t seem to be a part of the here and now conversations between those of us in the centre.
I suggest that more active listening and less talking to fill the uncomfortable silences could improve the quality of communication with my physician, my nurses and my family – to allow our mutual ignorance and uncertainty to be shared. This way we may feel more human and less embattled.
(1) Personal View: Stop Using Military Metaphors for Disease. Natasha M Wiggins: BMJ 28 July 2012: Volume 345: p31.
(2) Susan Sontag: Illness as Metaphor. 1978. AIDS and its Metaphors, 1988
Competing interests: No competing interests