March 4th, 2006

ozarque figure

Linguistics; language in healthcare; choosing a healing metaphor...

spider88 commented:
"I honestly don't know of a better metaphor. Immunology is in fact a battle to stay alive. What better metaphor would work? " and haikujaguar responded: "I'm with you on this one. You can't put a happy face on some things."

beckyzoole commented:
"This doesn't really make sense to me. Gardeners kill weeds just as dead."

And dteleki commented:
"Sorry, I can't take seriously that this one is a problem with misleading language. Smallpox, anthrax, mumps, measles, cholera, syphilis, polio, chicken pox, flu, bubonic plague, rabies, AIDS. The germs are an invading army. You have to kill them, kill them all, before they kill you. And they will kill you. The only way to stay alive is to learn to recognize them, and to annihilate them. [[Your body is a
battlefield.]]"


I don't expect to make any headway here, because this metaphor is so deeply ingrained in the American-English-speaking culture. I'll just state my case, and we [where "we" equals me-plus-those-of-you-who-embrace-the-medical-war-metaphor] can simply agree, peacefully, to disagree.

The combat metaphor for healthcare brings with it, obligatorily, a whole array of scenarios and scripts and concepts and vocabulary that are -- in my opinion -- very bad for your health. In combat, there can only be a winner and a loser, and in the American-English-speaking culture being a loser is totally unacceptable -- you have to get out there on the battlefield of your body and win, no matter what it takes to accomplish that. Do the massive surgeries, the medications with destructive side effects, the intrusive machines, the poisonous chemotherapies, the experimental procedures, make you utterly miserable? Is the treatment as agonizing as the disease? No problem, that's entirely normal and to be expected; war is supposed to be hell.

When you're sick and you function from within this metaphor, the cast of characters is fixed: there's the illness or disorder, with its armies of germs or viruses or toxic chemicals or [vamp till ready]; and there's you, with your armies of killer cells and mast cells and macrophages and [vamp till ready]. That's you and the illness; one is going to be the winner, and the other is going to be the loser, because those are the only choices available. And as dteleki says, your role is to kill those invading armies, kill them all. You can't give your body time and trust it to heal, the way you would if you'd only cut your finger; that's for cowards and deserters and losers. The only way to stay alive this metaphor allows is to annihilate the enemy, and all those horrible medical measures are your weapons and shields and intelligence in that war.

There are other metaphors available in American English. The situation when you're not well is that within your body there are entities that are incompatible with wellness, varying in their identity from one disease/disorder to another. Germs. Viruses. Tumor cells. Areas of hardness where hardness should not be. Plaques. Whatever. You can perceive the entities as weeds and droopy frail seedlings and send out your gardener cells to weed and prune and fertilize and aerate and mulch them. You can perceive the entities as elements within your self that are out of tune, and send out your musician cells to tune them. You can perceive the entities as areas of darkness throughout your body, and send out your lamplighter cells to fill them with radiant light. You can perceive the entities as rough surfaces and sharp edges and dangerous pointed bits and send out your carpenter cells to file and hammer them smooth and safe. There's a famous example of a cancer patient who was unable to accept the combat metaphor and who instead chose to send out giant catfish to clear his body of the tumor cells; he had always admired those catfish, and they served him well. You have the entire resource of your language available to you for constructing a metaphor of your choice.

The crucial difference is that with metaphors of gardening and music and lamplighting and scavenging and carpentry there is no winner or loser. No battle, and no battlefield. No obligatory vocabulary of death and destruction and horror and maiming and piles of slaughtered corpses. No shame if you prefer not to participate in slash/poison/burn "healing" measures and "heroic" measures -- saying no to that doesn't make you a coward and a deserter and a loser.

What happens to you when you're not well is largely a matter of communication. Your communication with the medical professionals you choose to consult. Your communication with your family and your circle of friends. Your constant self-talk. And the communication of your bodymind, with your neurotransmitters sending out the messages that activate and supervise -- or shut down and interfere with -- your body's natural healing mechanisms. I don't think that it's helpful to focus your communication when you're not well on a metaphor of death and killing and destruction. But it's the choice the American-English-speaking culture has made, it serves the medical and pharmacological industries well, and you're free to follow that path if that's your preference.