Unit 8 Section 2 Exercise 8 Epidemics Stigma: The Case of AIDSSontag

Stigma infiltrates the experience of illness. Think of illness-associated stigma we have discussed in various contexts, for example, the substance-abusing patient, the patient with disabilities, patients with mental health problems, patients with illnesses we can’t explain. Few have written about stigma as eloquently as Susan Sontag. In two seminal works, Illness as Metaphor and AIDS and its Metaphors, Sontag has written about the metaphors through which people express their interpretation of dreaded illnesses, notably cancer and AIDS in modern times, but also of once-unmanageable diseases such as TB and leprosy. The stigmas associated with cancer and AIDS are transmitted, one might say ‘virally’, through these metaphors—they infiltrate our language and infect it with prejudice.

Sontag’s Illness as Metaphor made a big impact when she analyzed the language of warfare that is often used to characterize the medical ‘attack’ on cancer. She argued that the stigma of cancer, an insidious killer, reflects back on the sick individual and becomes, through a metaphorical process, the afflicted person’s ‘fault.’ In other words, the person got cancer because of their depression, repressed sexuality, or a history of trauma.

In her treatise on AIDS, Sontag exposed the political co-opting of AIDS to stigmatize all sorts of social groups, whether they be Africans or gays, or to confirm cliches about poverty and race. AIDS, at the time of Sontag’s writing, was still uniformly deadly. Because of this, apocalyptic views of society surfaced with the AIDS epidemic: AIDS was, among other things, interpreted as a new plague, one of the many threats that hover over us. It is an idea she had already expressed in Illness as Metaphor: “Our views about cancer, and the metaphors we have imposed on it, are so much a vehicle for the large insufficiencies of this culture: for our shallow attitude toward death, for our anxieties about feeling, for our reckless improvident responses to our real ‘problems of growth,’ for our inability to construct an advanced industrial society that properly regulates consumption, and for our justified fears of the increasingly violent course of history.” (p. 87) Thus, the idea of AIDS as ‘pandemic’ itself is a metaphorical reflection of doomsday ruminations prevalent in a society confronted with a multitude of sweeping ills. The ‘cure’ is to divest illness of its metaphors and recognize it for what it is: “…it is highly desirable for a specific dreaded illness to come to seem ordinary. Even the disease most fraught with meaning can become just an illness. It had happened with leprosy, though some 10 million people in the world, easy to ignore since that almost all live in Africa and the Indian subcontinent, have what is now called, as part of its wholesome dedramatization, Hansen’s disease…. It is bound to happen with AIDS, when the illness is much better understood, and above all treatable.”

Study questions

1. How does the fact that AIDS is an epidemic heighten the stigma associated with it?
2. In response to Sontag’s final sentence, has her prediction come true? To what extent has AIDS become ‘dedramatiicized?’