Illness as Metaphor and AIDS and Its Metaphors

В нашем мире важные явления впредь не могут иметь локальный, региональный, ограниченный характер. Все, способное перемещаться, пребывает в динамике, и проблемы имеют либо неизбежно приобретают мировой характер. Перемещаются товары (включая изображения, звуки и документы). Перемещается мусор: ядовитые промышленные отходы (...) скапливаются в прибрежных городах Западной Африки. Перемещаются люди - в большем, чем когда-либо, количестве. Привилегированные беспрепятственно летают по воздуху, перемещаясь с континента на континент по делам или ради удовольствия. Те, у кого нет привилегий, перемещаются из деревней в города и -легально или нелегально - из одной страны в другую. Вся эта физическая мобильность и взаимосвязь (с сопутствующим растворением табу, социальных и сексуальных) так же жизненно необходима для функционирования передовой или мировой капиталистической экономики, как и циркуляция товаров, изображений и финансовых документов.

Investigations carried out by a few doctors in the last century showed a high correlation between cancer and that era’s complaints. In contrast to contemporary American cancer patients, who invariably report having feelings of isolation and loneliness since childhood, Victorian cancer patients described overcrowded lives, burdened with work and family obligations, and bereavements. These patients don’t express discontent with their lives as such or speculate about the quality of its satisfactions and the possibility of a “meaningful relationship.” Physicians found the causes or predisposing factors of their patients’ cancers in grief, in worry (noted as most acute among businessmen and the mothers of large families), in straitened economic circumstances and sudden reversals of fortune, and in overwork—or, if the patients were successful writers or politicians, in grief, rage, intellectual overexertion, the anxiety that accompanies ambition, and the stress of public life.

Nineteenth-century cancer patients were thought to get the disease as the result of hyperactivity and hyperintensity. They seemed to be full of emotions that had to be damped down. As a prophylaxis against cancer, one English doctor urged his patients “to avoid overtaxing their strength, and to bear the ills of life with equanimity; above all things, not to ‘give way’ to any grief.” Such stoic counsels have now been replaced by prescriptions for self-expression, from talking it out to the primal scream. In 1885, a Boston doctor advised “those who have apparently benign tumors in the breast of the advantage of being cheerful.” Today, this would be regarded as encouraging the sort of emotional dissociation now thought to predispose people to cancer.

Supporting the theory about the emotional causes of cancer is a growing literature and body of research, and scarcely a week passes without a new article announcing to some general public or other the scientific link between cancer and painful feelings. Investigations are cited—most articles refer to the same ones—in which out of, say, several hundred cancer patients, two-thirds or three-fifths report being depressed or unsatisfied with their lives, and having suffered from the loss (through death or rejection or separation) of a parent, lover, spouse, or close friend. But it seems likely that of several hundred people who do not have cancer, most would also report depressing emotions and past traumas: this is called the human condition.