The use of metaphors for illness and disease forms the subject of Susan Sontag's remarkable little book [Illness as Metaphor]…. (p. 294)
One can be critical of the process of converting illness into metaphor without having to fall back on a single-cause theory of disease. So why does Miss Sontag yoke them together so tightly? The answer, it seems to me, lies in her fear that any tendency to locate any responsibility for one's disease inside oneself may lead to a relentless scapegoating…. The desire not to add to the victim's terrible misfortune by identifying with any precision his actual responsibility provokes, in some people, the impulse to deny the evidence linking smoking and cancer. How much this impulse is strengthened by her single-cause theory of disease is unclear; yet it does seem that she believes that the only alternatives lie between absolving the individual of any responsibility, or blaming him totally for his predicament. Yet the answer to the cancer expert's, and indeed Miss Sontag's, dilemma is the realisation that smoking does not simply cause cancer any more than heavy drinking causes liver cirrhosis. It is a great pity that an otherwise scholarly, pungent and needle-sharp dissection of some of the woollier and moralistic notions that surround serious disease should be disfigured by a simplistic and excessively biological view of disease. It says a great deal for the power and persuasiveness of Susan Sontag's beautiful prose that the disfigurement is neither obvious nor lethal. (p. 295)
Anthony Clare, "The Guilty Sick," in The Listener (© British Broadcasting Corp. 1979; reprinted by permission of Anthony Clare), February 22, 1979, pp. 294-95.
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