AIDS and Its Metaphors

Illness as Metaphor was a response to Sontag’s experiences as a cancer patient, as she noticed that the cultural myths surrounding cancer negatively impacted her as a patient. She finds that, a decade later, cancer is no longer swathed in secrecy and shame, but has been replaced by AIDS as the disease most demonized by society. She finds that the metaphors that we associate with disease contribute not only to stigmatizing the disease, but also stigmatizing those who are ill. She believes that the distractions of metaphors and myths ultimately cause more fatalities from this disease.

Discussing illness in metaphorical terms is not new, but Sontag says that AIDS is the ripest opportunity for "metaphorizing" in recent years. Also, because its earlier years in the United States were marked by an affliction of very specific risk groups – homosexual men and intravenous drug users – it has been stigmatized. The patient’s illness is perceived to be the patient's fault, because of the unsafe habits that one seemingly has to pursue to contract it – "indulgence, delinquency – addictions to chemicals that are illegal and to sex regarded as deviant." Having these defined subgroups created a distinction between the ill and potentially ill and the general population.

AIDS is seen as a plague and as a judgment on the individuals suffering from it. It is often discussed as a consequence of decadence and a punishment for deviant sexual behavior.

Although HIV is likely not a new virus, its emergence changed attitudes towards illness and medicine. Infectious diseases have clearly not been as summarily defeated as society would have preferred to believe.

Generally, the many uncertainties about AIDS are the center of discourse on the illness, and reassurances that "the general population" is safe are multiplying. The judgments on the illness and the patients are still implicit in any discussion, and Sontag believes that detaching the guilt and shame from perspectives on this disease, and retiring the military metaphors from the discussion, will contribute to productive discourse on AIDS and help those who have contracted the illness.

To explicate her claims on the various metaphors attributed to AIDS and diseases more generally, Sontag employs a number of comparisons among AIDS, cancer, and historical illnesses.

Sontag defines metaphors as "giving the thing a name that belongs to something else", and notes that they have been used throughout history to discuss the body, illness, and health.

Sontag claims that AIDS has created a new concept of illness, where a patient is "ill" as soon as they are infected, whether or not they have shown any symptoms. She talks of tabulating cases of disease, where before the number was based on those with demonstrated symptoms but with AIDS is an almost arbitrary number. In this new vision of illness, one can lose their employment, their housing, and their place in society years before any changes in health.

Also, with modern advances in medicine, society had begun to believe that epidemics and incurable illnesses were a thing of the past. The advent of AIDS proved these conclusions to be wrong. The "plague" notion was revived, but when it had been previously used to conceptualize punishment of a society, it was adapted to be a punishment visited on an individual or small group.

Sontag discusses her views on the male homosexual culture prior to AIDS, saying that they had embraced the 1970s sexual culture of freedom. The view that all sexually transmitted diseases were easily curable had led to a mentality of getting what one wanted whenever one wanted it, and this was completely ended with the emergence of AIDS. Sex was suddenly viewed as a potential suicide or murder.

Christopher Lehmann-Haupt writes that although "valuable as both history and practical advice",[2] the work is missing conclusions and opinions that would make it more powerful. It is "hard to tell what Ms. Sontag's point of view is",[2] as she functions as both objective historian and attacker of views she disagrees with. Sontag doesn’t actually answer the questions of whether adapting behavior in the face of AIDS is the appropriate protection against infection, or how society should react to the epidemic. And her conclusion in the last pages, that the metaphors she is “most eager to see retired” are the set drawn from military vocabulary.[2] After the many topics discussed in the work, this seems a shallow point on which to end.

Paul Robinson writes that "the disease itself, and not the way we talk about it, is the true source of its horror,"[3] and turns Sontag's point that "we cannot think without metaphors" on itself. This indicates that, instead of attempting to deconstruct these diseases entirely, we should be asking "whether its metaphors are well or ill chosen."[3] Literary critic Camille Paglia writes that AIDS and Its Metaphors was an attempt by Sontag to play "catch-up" after twenty years of silence about gay issues. Paglia added that although she normally disagrees with "the gay-activist establishment", in her view Sontag was "rightly clobbered" by gay activists over the work.[4]