Sickness and Salvation
- Aids and its Metaphors by Susan Sontag
Allen Lane, 95 pp, £9.95, March 1989, ISBN 0 7139 9025 2
- The Whole Truth: The Myth of Alternative Health by Rosalind Coward
Faber, 216 pp, £12.99, June 1989, ISBN 0 571 14114 5
Each of these polemical books considers health and illness in recent Western history. Each moves in to large areas of disputation and advertisement, involving sections of the medical and paramedical professions, the academy and the media, with populations of patients, families, commentators and consumers. Each is launched against beliefs and ways of speaking seen to be retrograde and damaging; each communicates a broadly progressive politics and brings to bear long-developed skills in argument and writing. Their concerns intersect; at several points, the arguments are similar.
The reasons why one book is so much more productive than the other are mattters of writing, of the self-inscription of each writer in her work, of the legible understandings of the task in hand. One book exists because a highly-regarded writer has visited the domain of a destructive epidemic – much as she, and Jane Fonda, once visited Vietnam. Those visits probably did help in shifting consciousness; I’m not so sure about this one. The other book comes out of work on the ideology of new fashions in health-care and health-talk – work which is understood as, centrally, a job of writing. The difference is crucial.
Aids and its Metaphors is a short essay (90 pages), explicitly offered as a kind of sequel to Illness as Metaphor, written in 1976 when Susan Sontag was herself a cancer patient. Both show clear lines of affinity with her work in quite different areas. Twenty-five years ago, in Against Interpretation, she argued for a criticism which attended first, descriptively, to aesthetics, to the intrinsic properties and total character of a work, setting ‘meaning’ in abeyance. ‘In place of a hermeneutics we need an erotics of art,’ she said. It was a call, almost a manifesto, which resonated compatibly with the incipient politics of the decade.
Sontag mediated the works of Benjamin, Barthes, Genet, Godard, Resnais, Bresson, Riefenstahl and Canetti to that American audience which listens first to what is spoken from New York. Every essay, in her lively early collections, enacted her declaration of faith in the indissoluble quiddity of the artefact. You do not peel away the text to reveal the subtext, as though the surface was no more than packaging; you don’t replace the object or the text with a verbal simulacrum; you rather try to serve its existence by writing about what it is and what it does. (The interpretation, of course, begins with the selection of objects.)
When it came to cancer, Sontag stuck to her intellectual guns with exemplary consistency and courage. But while her responses to the life and work of a given artist or writer provided for expanding effects, Illness as Metaphor worked – or meant to – in the opposite direction. The objective was to belittle, deliberately: to get rid of ‘meanings’, of the mythic shadows cast by life-threatening disease, and concentrate strictly on the material facts of it, the chemistry and physiology, the business of treatment, survival or non-survival.
In the course of her argument she produced a highly literary, writerly and readerly essay, patterned with tall shadows, and other, older voices sounding constantly behind her own: the quotations on illness range from the Greeks to Keats and Stendhal, Chekhov, Katherine Mansfield and Auden. The not-so-curious fact is that when people claim to have found the essay helpful in their own and others’ time of illness, it’s not because it persuaded them to make less of the situation, but rather that it proposed links they had not previously thought about between history, writing and present bodily experience. In a few good bookshops you can find it on the shelves marked Health and Healing, rather than – or as well as – in Literature, under the author’s name. The practical value which puts it there lies not in Sontag’s insistence on practicality itself, but in the way the essay is in fact an interpretative artefact, a weaving together of connections, a transformation.
The full text of this book review is only available to subscribers of the London Review of Books.
Vol. 11 No. 19 · 12 October 1989
Sylvia Lawson’s enthusiasm for the strengths of Rosalind Coward’s The Whole Truth: The Myth of Alternative Health (LRB, 31 August) leads her to gloss over at least one striking problem. That is the way Coward lumps together all and any alternative remedies, therapies and philosophies. Whether by design or not, she has thus simply adopted the rhetorical strategy of mainstream medicine and science, whose institutions have an obvious interest in discrediting any alternatives. We are all familiar with this technique, otherwise known as damning through association, and often used against the Left. (Let’s assume Coward is a socialist: would she herself therefore accept a close association with revolutionary communism?)
Such a crude strategy diminishes the value of her book. What worries me particularly is that in adopting it, she aligns herself willy-nilly with people whose views are highly problematic in relation to one of her aims (which I happen to share): namely, greater social and political awareness, and therefore more real choice, in such matters. It is useful to recall here (and I for one shall never forget) a recent late-night television show. It featured a smug and aggressively-biased Jonathan Miller, mixing personal abuse with laughable positivist nostrums, and John Maddox, the fearsome editor of Nature, in full cry after a bemused Frenchman – and the only working scientist present – whose crime was to have conducted research the results of which could be construed as supporting homeopathy. I can assure Coward that these people have even less interest in politicising or democratising medical discourse than your average faith-healer. Yet by its approach, her book casts its lot in with them, and will undoubtedly prove (selectively quoted) grist to their mill.
We do need a sharp social critical sense – but one set firmly in the context of a pluralist medical glasnost, and not restricted to a highly interested and selective debunking. The latter will only strengthen those whose complacency and arrogance has already contributed considerably (in ways which Coward leaves unexamined) to the rise of alternative medical practices. In that case, she cannot complain if people continue to put matters of health and disease into other hands, including their own; and even if that does offend a marxisante sensibility, one which whispers that since structure is more real or important than agency, most agents are fools, and personal responsibility largely a chimera. I imagine the BMA would agree.
As far back as 4600 years ago, herbalists in China began to experiment on the human body and went on to discover the pulsory system, acupuncture, anesthesia, the circulatory system, all internal organs, human anatomy, physiology and pathology. They concluded that good health was the result of maintaining harmony and balance in the body with proper nutrition. Attention was also given to suppleness, beauty and longevity, and herbs were consumed to strengthen and control the brain. Since records were kept of these studies (some on jade), they cannot be considered mythical and to regard them as ‘alternative’ in any way is woefully provincial. As someone returned to life and high energy by eating herbal foods based on the knowledge gained nearly five thousand years ago, I can testify to the ingeniousness of past and present studies in this field. However, as one of those ‘transformed individuals’ (as Ms Coward would call me), I am now surprised by the amount of people who choose (however unconsciously) to be ill rather than to be well. This is perfectly understandable to me and if Ms Coward has not discovered that it does take an act of will to face health (which can sometimes be as frightening as sickness), then she has not looked deeply into the psychology of disease. I would not dare to say where the mind takes over from the body, or vice versa, where sickness is concerned. But I am sure of one thing: an open mind is a good beginning to a healthy and harmonious way of life.
Vol. 11 No. 21 · 9 November 1989
We at After Dark (an Open Media production for Channel Four) noticed with interest Patrick Curry’s letter on alternative medicine (Letters, 12 October). He refers to a recent late-night television show and I suspect he means an edition of After Dark. However, for the record, our programme ‘Alternative Medicine’ was not broadcast all that recently (it went out on 3 September last year, over a year ago) and although Jonathan Miller was present, as was a French scientist, ‘John Maddox, the fearsome editor of Nature’, was not on the programme; nor is Mr Curry’s statement that there was only one working scientist present an accurate reflection of the composition of that night’s programme.