“It is diseases thought to be multi-determined (that is, mysterious) that have the widest possibilities as metaphors for what is felt to be socially or morally wrong.”
In 1977, two years after being diagnosed with breast cancer, Susan Sontag published Illness as Metaphor—not a personal account of her experience, but rather an examination of the ways our culture layers meaning onto illness in the metaphors we use to discuss it. The less the causes of illness are understood, the more likely it is to be seen in aesthetic terms (as TB was in the 19th century) or as a product of our grief, anxiety, or repression.
In the ancient world, diseases, particularly infectious ones, were always a sign of social wrongs—an answer to immoral behavior. The plague upon the city in Oedipus Rex, for example. Plagues were viewed as a divine punishment and purifier.
We can see examples in the Torah of this same thinking, even regarding individual afflictions. We like to cite “El na refa na la” as a prayer for healing (it has such lyrical brevity), but we tend to forget the fact that Miriam is stricken with scaly skin as a punishment for a loose tongue. If we look truthfully at that passage, Moses can only appeal this way for the curse to be lifted because God has cast it upon her. The genesis of this prayer is the view that disease is a punishment for immoral behavior.
As medical science has progressed over the centuries, and we’ve come to understand causes such as viruses and bacteria for scourges from TB to cholera to polio, we have mostly abandoned this way of thinking, although fundamentalists tend to resurrect it in a rather virulent way (witness the AIDS crisis).
Since the time that Sontag wrote this significant essay, we have made enormous strides in our understanding of how cancer works, particularly at the genetic level. But we still lag behind in our cultural understandings, in the way we talk about disease, especially cancer. Metaphors get embedded like fossils in our language. Since the causes of cancer are numerous and complex, and since it starts from within our own cells, it retains enough mystery that all manner of ideas can be applied to it. As Sontag writes, “Theories that diseases are caused by mental states and can be cured by will power are always an index of how much is not understood about the physical terrain of a disease.”
So, for instance, when you visit practitioners of alternative or complementary therapies, some of which can be very effective for managing side effects or the general stress and fatigue of treatment, you can often still be faced with attitudes that are a throwback to the idea that cancer comes from repressed emotions or desires. My massage therapist, otherwise a total godsend in my mind, suggested that because I used to want a breast reduction, that it was not a coincidence that breast cancer “manifested” itself. Other therapists have asked me what I think caused this, as though a childhood trauma or bout with depression were the answer. And there is all the talk about “blocked energies.”
All of which feels as punitive as the ancient idea that immoral behavior produces disease. It puts the blame on the patient. Not to mention the onus of curing oneself of one’s negative feelings or desires right at a time when even the most stable among us are prone to being fragile.
I’ve had many people in the last weeks and months tell me they are saying a Misheberach for me—some I know well, some hardly at all, friends of friends or colleagues of Micah—and it is very intense to think of the directed kavanah of so many people near and far, from San Francisco and Los Angeles to Jerusalem and even Tzfat. What are we praying for when we pray the Misheberach?
May the One who was a source of blessing for our ancestors, bring blessings of healing upon [insert name here], a healing of body and a healing of spirit. May those in whose care they are entrusted be gifted with wisdom and skill, and those who surround them be gifted with love and trust, openness and support in their care. God, let your spirit rest upon all who are ill and comfort them. May they and we soon know a time of complete healing, a healing of the body and a healing of the spirit, and let us say, Amen.
What I like so much about this version in particular is how it acknowledges that illness is not an individual affliction—it ripples out to touch so many, and the family, friends, caregivers, and community of the ill also need care, “wisdom and skill” but also “love and trust.” Trust is a doozy. I love that this prayer inherently recognizes the many facets of healing—the soul and the body, the individual and the community—and that it reaches towards that elusive thing “refuah shlemah,” a complete healing. Getting there requires both science and spirit--but hackneyed metaphors, not so much.