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COVID-19 As Metaphor: Susan Sontag's Seminal Essay Reimagined

Updated: Apr 5, 2023

By Walter Holland

As a follow-up to Susan Sontag seminal 1979 essay, Illness as Metaphor, and her 1989 follow-up AIDS as Metaphor, I have tried to apply her analysis to the current COVID-19 pandemic and its portrayal by and impact on American society. About Sontag's AIDS as Metaphor essay, Wickipedia writes:


“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. Despite the fact that it is a heterosexual disease as well as a global issue, it is still 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.” ________________

Earlier during her own bout with breast cancer, in Illness as Metaphor , Sontag had reflected on the comparisons between society’s portrayal of the TB epidemic of the 19th Century with the response to cancer in the 20th. Again, Wikipedia summarizes:


“Teasing out the similarities between public perspectives on cancer (the paradigmatic disease of the 20th century before the appearance of AIDS), and tuberculosis (the symbolic illness of the 19th century), Sontag shows that both diseases were associated with personal psychological traits. In particular, she says that the metaphors and terms used to describe both syndromes lead to an association between repressed passion and the physical disease itself. She notes the peculiar reversal that "With the modern diseases (once TB, now cancer), the romantic idea that the disease expresses the character is invariably extended to assert that the character causes the disease–because it has not expressed itself. Passion moves inward, striking and blighting the deepest cellular recesses."

Sontag says that the clearest and most truthful way of thinking about diseases is without recourse to metaphor. She believed that wrapping disease in metaphors discouraged, silenced, and shamed patients. Other writers have disagreed with her, saying that metaphors and other symbolic language help affected people form meaning out of their experiences. . .

. . . llness as Metaphor served as a way for Susan Sontag to express her opinions on the use of metaphors in order to refer to illnesses, with her main focuses being tuberculosis and cancer. The book contrasts the view points and metaphors associated with each disease. Tuberculosis was seen as a creative disease, leading to healthy people even wanting to look as if they were ill with the disease. However, lack of improvement from tuberculosis was usually seen as lack of passion in the individual. Tuberculosis was even seen as a sign of punishment by some religions, such as Christianity, leading the afflicted they deserved their ailment.

Sontag then made the comparison between the metaphors used to describe tuberculosis and cancer, with cancer being defined as a disease that afflicts people who lack passion, sensuality, and those who repress their feelings. Sontag also mentioned how multiple studies have found a link between depression and people afflicted with cancer, which she argues is just a sign of the times and not a reason for the disease, since in previous times physicians found that cancer patients suffered from hyperactivity and hypersensitivity, a sign of their time.” ________________

It has occurred to me of late that the COVID-19 virus has begun to lend itself to Sontag’s analysis. And if she were alive, she might have found it a continuation of this “metaphorizing” of illness by our society. For as she posits both TB and cancer were associated and attributed to flawed personal psychological states. TB was associated with creativity and passion. One who lived a reckless life of passion and excessive creative aspiration, one which pushed beyond the boundaries of mainstream society and propriety, were believed to be more stricken by the disease. This idea of linking decadence and depravity with illness, diseases of the body with diseases of the soul, has long been with us The pale, effete, emaciated forms of Egon Schiele’s drawings were a case in point. The depravity of his models was linked visually in the eyes of bourgeoise beholders with their stricken lasciviousness. In Schiele’s case he died by Spanish Flu but to many it was the risk he had taken by his sexual license and impropriety.

Victims of illness were being punished for their “sins.” As Sontag suggested Christianity saw the affliction of TB as punishment for base, sinful behavior. La Traviata, the opera, is first-and-foremost a story of a passionate courtesan who dies from TB after leading a life of reckless abandon and forbidden love. La Bohème as well portrays the world of Parisian Bohemia, that community of impoverished artists, that seedbed and breeding ground for the dreaded disease. And Mimi dies presumably made vulnerable and infected by her passion for and involvement with the artist Rodolfo. Thomas Mann also in his Magic Mountain shows how those too sensitive and of a delicate emotional and artful nature, are more prone to the mortal disease. Cancer likewise for Sontag was the modern inverse. Those who suppressed their passion, their anger, and were deeply depressed and repressed in their emotions, were most likely the ones to “get” cancer. The inverse of TB, cancer fell into the realm of self-denial, self-neglect, abstinence, loneliness, an inner wish to deny the body and engage in self-sacrifice or the very lack of passion. I am reminded of the movie The Song of Bernadette, the young saintly girl, later nun, who saw a vision of the Virgin Mary at Lourdes. In the movie, at the end, she dies a horrible death from cancer, suffering in her saintliness, tested, tormented, “martyred” for her devotion, her rejection of the venial for the spiritual.

But COVID-19 I would suggest has gained a more socio-economic-racial stigma in this contemporary moment. The virus as many have said exposes, lays bare the “disparity” of our economic system, the racial divide along income, educational, and state of health fault lines. The virus and its assault and strain on our health care system, our social safety net, our economic paradigm and our very ideals of exceptionalism and meritocracy, have revealed in our daily dialogue and journalistic discussions, our elite social commentary, and certainly in our leaders, the “metaphors” and personal psychological and sociological “assumptions” we have attached to this virus. The virus has laid bare what was already self-evident, the fundamental lethal illness that was already plaguing our society.

We speak that it is novel, that the virus somehow happened out of the blue, burst forth in China, then took America unaware, and that only now we realized we had no immunity. But I would suggest the virus has become emblematic of our own denial, our blind-spot, our self-deceptive thinking and our failure to confront what we already knew was there. True the virus is an inert organic biological entity, a public health occurrence, a scientific variant in a whole family of respiratory viruses already genetically decoded and defined, but we have responded to it in the same way we have responded to the socio-economic, and racial illness and potential lethality that the virus merely points to, the illness that has long plagued our nation and its governance, its system of social reward, social belief, its “infrastructure.”

The “virus” like the racism, the economic disparities, the inequities, the lack of social mobility, the loss of pride and promise, the poor and biased educational system with its for-profit greed; the blatant racism, the new populist and xenophobic tide sweeping our country, had long spread and festered inside us. It daily killed off hundreds nearly thousands of our citizens by its numerous deadly symptomatic spread: unbridled gun violence in the inner cities of the country; life expectancies plummeting already for Blacks and Latinos; Black communities in Chicago and Philadelphia and Newark and New York becoming killing grounds, where Black and Brown and Yellow life was tenuous; where profiling and police violence and stray bullets flew freely costing innocent lives.

So when we say the virus took us by surprise, we are excusing ourselves, expiating our guilt, shucking our culpability and failing to realize our own poor lack of planning, our indifference, our failure to protect the most “vulnerable” among us, our persons-of-color. This virus came as no surprise to our disenfranchised underemployed brethren at the very bottom of the pile. They already had been dying in record numbers day by day. They had to live with the death toll long before we bothered to report it on national TV. Who made profiles of their victimhood on cable TV? The virus has become a call to “action” but “action too late.” But we knew it was coming, had to come, and we knew who would be its likely victims, the most vulnerable among us, the most unvisited zip-codes, the detour towns, the place no one delivered to; whether we acknowledged it or not.

The health care system was already ripe for failure in this country. The virus merely showed us what we already had experienced. Those that could pay and were White could expect more attention, more empathy, and better outcomes; exhausting the medical breakthroughs and high-tech medical wizardry for the rest. Public clinics shuttered, Planned Parenthood driven out, moved to far-off neighborhoods of affluence, rural hospitals closed.

COVID-19 had early on gained the perfect correlative with our current populist President and his followers. He and others like him could label it as the “Chinese Virus.” The virus traveled, smuggled across borders with dangerous intent as illegal—just as the President proselytized his perceived threats from immigrants, refugees, asylum seekers, migrants, invading and mingling with us, bringing danger everywhere. Indeed, to sum up, the virus was seen as foreign, part of a mass influx, a stampede at our borders, threatening to overwhelm our prosperity, our freedoms, our children, our loved ones. Under cover of darkness, in our factories, in our farm fields, in our slaughter houses, they were an invisible yet visible threat.

For migrants and refugees, like the virus, brought with them death. The President has time and again suggested at his rallies that Mexicans bring crime, that all those fleeing impoverished, “wetbacks” from Central America have brought nothing but violence and rape and gang warfare and drugs to our great nation. COVID-19 was a virus waiting for a host, a carrier, and it found the perfect agency in the President, in the Republicans, in the White majority and the White middle-class, in Wall Street brokers, in CEOs, in Dot.Com Trillionaires, in all the privileged and the comfortable, and all those “Independent” voters, those “Trumpers” with their chanting and their rage, and all those liberal effetes who looked the other way while broadcasting their outrage on Facebook. We were long infected, suffered minor symptoms ourselves while still others in the 1% were asymptomatic, never troubled by polluted drinking water, by poverty-level paychecks, unsafe streets, second-class educations, never faced the diagnoses of early diabetes, hypertension, obesity, asthma.

But having a co-morbidity had become the “new normal” for many Americans in this nation for years. They had faced it bravely everyday, without "personal protective equipment" at their disposal. In fact, that shortage was rampant and had been for centuries. They were given no protection, neither legal or economic, either physical or in state of health, neither in living environment or opportunity. They had no gloves or masks to shield them from hatred. They were on their own as they served and waited on many other Americans who were far more safe and well-protected, and amply in supply of security and rescue should they need it.

We talk about a “new normal” with trepidation and talk of needed strategies and planning to deal with the situation of re-opening the economy, of getting the United Sates back to where it was before. But a “new normal” for whom? A “new normal” which rescues the privilege of before? Do we wish to return to that normal that had long been suspect and divided by extremes? Would we wish to further divide these united states into a more drastic vision of “normalcy”?: for some a “new normality” for others just the "abnormality" of the past? The very term “normal” I find problematic. Was institutionalized racism, economic "genocide", income inequality, “normal”? The virus and this pandemic did not destroy our long prevailing norms of immoral laws and regulations, of hidden and devious injustices (voter suppression, gerrymandering, photo IDs, credit-cards-only, etc., etc.), poor health, unpreparedness, a segregated society. It was never “normal” before this pandemic. Let us not kid ourselves. It was “abnormal” and getting worse. That we accepted little by little the degradation of our values, our beliefs, the erosion of our legal system, our institutions, by a President who lied, obfuscated, and chipped away by degree at what we once cherished or at least gave lip service to was slowly or rapidly being accepted, even celebrated by his base. We abdicated long ago; we gave up on the American “normal.” We accepted despair, hate, the unnatural, and the arrogantly unexplained, unanswered to, unapologized for, the false and the outlandish for which there was no responsibility; in short, we were becoming a country of madness and dysfunction and extremes since the turn of the century, certainly from 2016.

The virus has become the perfect metaphor for all these social ills that have long plagued American society. The metaphor of “social distancing” is not a new one in our country. We act as though it is a burden too great for us to bear, an inconvenience, a sacrifice, a terrible inequity, but White Americans have long social distanced from Blacks, Latinos, Amerasians, Brown people, Moslem people, Indigenous Native People. We have practiced it for decades, no, centuries. It has been our self-adopted behavior from the start. We’ve walled up in our penthouses, our condos, our coops, our McMansions, our gated communities, our well-equipped homes, for years and years, safe and protected, cleaning and disinfecting the filth from outside, the homeless man we brush against on the train, the subway, in the street; the kitchen help, the cooks, the illegals, the low-waged workers we have kept from view. Very few we ever acknowledged were even there. They were hands to pack our groceries, give us change, deliver our food, wash our cars, park our cars, deliver our mail, clean our schools, wash and fold our clothes, clean our pristine homes, drive us to the opera, take our blood pressure, tend our children, change their diapers, wash down our schools, nurse us at the hospital, greet us at the lobby door.

Social distancing has been everywhere in America for a long, long time. We enforced it each in our own way. Our theaters on and off Broadway were filled with White matrons and retired men, Boomers of a certain age. Seldom did we notice the lack of Black or Brown faces sitting in the audience. True, they were allowed on the stage, but always at a distance, that far removed view, which permitted us to exorcise our guilt and exercise our pity. Indeed American itself had become a giant stage play, one perpetual commercial on TV. We watched the happy and robust suggestion of smiling Black and Brown faces matched in biracial couples, families that looked much as our own, with the trappings and mark of wealth and success, selling products far beyond the average means. Capitalism thrived through the distant lens of falsities, we saw what we wanted, we made-believe that all was well.

But what we failed to deny that we had no immunity from the reckoning to come. We disregarded our weakness. Our economy was purely one of consumer consumption. We made nothing, manufactured nothing, invented nothing anymore. All of that was outsourced. All of that was sent to third-world countries. They would make, we would take. We had no antibodies, no innate character or self-reliance for survival. We spurned science. We spurned the intellectual. We embraced ignorance, and the populist spirit of “thinking from the gut,” “going solely on nerve,” “intuition, subjectivity beats objectivity” overrides fact. By our isolationism, our withdrawal from the truth, we made ourselves weaker. We denied ourselves exposure to the true global world, to the constant barrage of ills that faced us—climate change, poverty, sex trafficking, opioid addiction, suicide, gun violence, school shooting, fact. If we had addressed them, like the body’s own immune system we might have built day by day resistance, little by little fending off, neutralizing, confronting; from each dangerous assault we would have had “antibodies” enough to keep us safe, enough to bring us through this “unexpected” apocalyptic surge.

The virus will only be defeated and overcome by testing our resolve to change and prepare for the present and the future. We must strengthen our immunity as citizens and as a nation. We must universally test the civic strength, the empathy, the altruism of everyone, before they get back to work, before they are released, before they can spread the same viral menace as before.

Sontag was right. We must detach ourselves from the virus, the illness as symbol and metaphor. We must address it rationally, soberly, scientifically, not stigmatize the “victims.” We must accept that the virus does not discriminate, it does not chose rich from poor, or White from Black, or Black from Brown, or Yellow. We must understand that this pandemic was a long time in coming, not a sudden shuddering surprise. It could have been anticipated. It could have been prevented. It should have been foreseen.

Walter Holland, copyright, April 11, 2020, All Rights Reserved

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