Doing things with ideas and affects in the illness narratives of Susan Sontag and Eve Kosofsky Sedgwick

In her essay in this volume, Susan Sherwin analyzes the meanings we attach to the experience of illness and suggests that we transform the metaphors available to us to discuss breast cancer. As she notes, "metaphors structure the types of responses we are able to envision as appropriate to a particular domain," and, as such, our choice of metaphors-the ones we choose and the ones available for the choosing-have "ethical significance" (10). Sherwin is concerned in particular with the ways in which the biomedical response to breast cancer is structured by the dominant metaphors used to conceptualize that response. She notes that military metaphors are so dominant that they prevent us from imagining a response that does not require "engaging in deadly warfare, fought on the bodies of women" (12). Sherwin's critique is useful not only in understanding how such metaphors limit the biomedical response, but also in helping us understand how these same metaphors might limit the patient's response to her own illness experience. If the military metaphors predominate in the biomedical conception of cancer (and I think they do), then a related, and I think similarly limited and limiting response is available to patients: in order to respond "appropriately" to their cancer, they must be "patient" as this battle against cancer is waged on their bodies-that is, according to the Oxford English Dictionary's definition for the adjective "patient," bearing or enduring (pain, affliction, trouble, or evil of any kind) with composure, without discontent or complaint; longsuffering, forbearing; calmly expectant; not hasty or impetuous; quietly awaiting the course or issue of events, etc.; continuing or able to continue a course of action without being daunted by difficulties or hindrances; persistent, constant, diligent, unwearied. In a sense, then, to be patient is a form of heroism, though it is paradoxically a passive sort of heroism, as opposed to the active heroism that characterizes the doctor's position in the doctor/patient relationship. In fact, one definition of the noun-form of the word "patient" is: "a person or thing that undergoes some action, or to whom or which something is done; that which receives impressions from external agents...as correlative to agent, and distinguished from instrument; a recipient." (OED). What is expected, even required, of persons who are ill is that they perform a passively heroic mode of being ill, while their doctors perform an actively heroic mode of curing. Like Sherwin, in this essay, I too will not offer "specific advice about the decisions particular women should make when confronting the threat or reality of breast cancer in their lives" (5), nor do I mean to suggest that bearing or enduring pain or affliction with composure is a misguided response in the face of a lifethreatening disease. Rather, inspired by Sherwin's call to "supplement the dominant framework by developing alternative ways of thinking about health and disease" (16), I want to begin to imagine alternative understandings of breast cancer from the patient's side of the doctor/patient binary. In order to do so, I will consider two illness narratives1 that attempt to challenge the notion that the most effective way for a person who is ill to respond to his or her illness is to quietly await the course of events as determined by the institution of medicine as it does battle on the patient's body. I will look first at Susan Sontag's discussion of metaphor and illness, and her assertion that all metaphorical thinking must be banished from our response to illness. Although at first glance Sontag's work does not appear to be a personal response to her own experience of illness, I will show that her work might be read as, paradoxically, a depersonalized personal narrative of illness. In fact, Sontag depersonalizes and de-heroicizes her response to illness in order, in her view, to offer a strategy to others that she believes is most effective in the face of illness. Like Sontag, Eve Kosofsky Sedgwick also wants to challenge the passively heroic mode of being ill, but unlike Sontag, she does not believe that depersonalizing that experience is the only or best way to challenge this particular mode of being ill. Making use of her theoretical and political concept of "queer performativity" in relation to her personal experience of breast cancer, Sedgwick not only brings into play a concern for the effective, understood as that which is attentive both to the rhetoric and practices of politics, but also for the affective, understood as that which is attentive to the poetics and practices of suffering. While both Sontag and Sedgwick offer challenges to the structures and structuring of the experience of illness from the patient's side of the doctor/patient binary, they diverge from each other in their relationship to the affective and its place in their illness narratives. For Sontag, the affective has no place in accounts of illness, and she therefore formulates her challenge to the conventional ways we speak and write of illness in terms of an intellectual idea that has rhetorical effects. Sontag believes that by purifying the language we use to speak and write of illness, both of metaphor and of the affective that often gets expressed through metaphor, we will transform the experience of illness itself in necessary ways. Sedgwick, on the other hand, is not interested in purifying the language with which we speak and write of illness, but in queering it, and she formulates her challenge to the conventional ways that we speak and write illness in terms of an affective experience that has performative effects. Put succinctly, then, Sontag wants to change the way illness is experienced and narrativized by doing things with ideas, while Sedgwick wants to change the way illness is experienced and narrativized by doing things with affects.