Illness, Image, Metaphor: Cancer in Public Discourse

COURSE OBJECTIVE
The course consists of reading poetry, novels and autobiographies and watching films and documentaries about cancer. Each genre has different characteristics and possibilities in the ways metaphors and images are used.

COURSE CONTENT

Illness as Metaphor is a nonfiction work written by Susan Sontag and published in 1978. She wrote it during her own fight against breast cancer and challenged the "blame the victim" mentality behind the language society often uses to describe diseases and those who suffer from them.      

Aim of this Course
In 1978 Susan Sontag’s Illness as a metaphor was published. The claim she made was that metaphors and visual images in general, and in the case of cancer in particular, are harmful for the patient. Some commentators, in reflecting on her arguments, wondered whether these metaphors and images were in fact categories that play a role of their own in moral contemplation. Others discussed in what way these images and metaphors functioned as instruments, and, if so, whether they could (or should) be replaced by better instruments.

This course focuses on metaphors and images of cancer and their effect in reality. We will investigate the ways in which these metaphors and images influence the way we think about and understand the reality of the disease.

‘It is not trivial to understand how such labels of disease are created and internalized, how the ill are (and have been) perceived. For it is the perception of the patient, that structures the patient’s treatment, the patients status, the patients self-understanding, as well as the patients response to that complex interaction of social and biological forces that we call ‘disease’ (Gilman).

Our Impressions of Illness – Where Do They Come From?
Images of illness and health surround us. Perceptions of illness are not limited to the domain of medicine. We encounter (visual) representations of illness and health in many places: in hospital tvserials, films and paintings, in newspapers, literature, (web) advertisements, poetry, music, and sermons. And we are all acquainted with narrative expressions of pain, hope and fear in autobiographies, in fairy tales and on the internet. These impressions of illness and health concern us all – as doctors, as professional caretakers, as scholars, as ethicists, as journalists, and as patients and relatives.

This course focuses on images and metaphors of cancer, not only regarding the way in which we think about this collection of diseases, but also the way in which images and metaphors occur, especially in literature and the moving image. Three domains are involved that primarily generate their own images – the medical discipline, cultural world views and (popular) arts. Together, this range of images forms a mental horizon containing basic notions of illness and health. For the patient this mental horizon of shared images serves as a conceptual context to reflect on illness, to make sense of their disease, and can be taken as a starting point to act and to tell their personal story. Communication about health and illness – in public or in an individual encounter in the consulting room – implies an understanding of the different components of this mental horizon, because these will always colour the personal plots. This course presents professional and compatible tools from the medical discipline as well as from the humanities to analyse the cultural diversity of images, the conceptual universe they assemble, and their moral implications in daily life.

Body of Knowledge
Understanding the ingredients of medical imagination and narratives demands a formal body of knowledge. In this course we will focus on three academic fields: the medical discipline, and within the humanities, on the study of language and images. Presentations will be given on the persuasive and enduring power of different images, how images are connected and influence each other, or are transformed in history and have a variable impact in different media. The relevance of this course lies precisely in showing that these images partake in a collective discourse, that these images obey traditions of their own, are conventional, stylized, and are powerful in evoking ideas and viewpoints in individual lives. They are hence important to everyday practice. With a trained eye and an educated ear, professionals can act more adequately and accurately. The course also reveals the interplay between imagination and medical reality, which quite often determines positive or negative social evaluations as well as political and financial decisions.

TEACHING METHODS
Class meetings

TYPE OF ASSESSMENT
Written essay and an assignment completed for each class meeting