Sure, the metaphor hounds are well-meaning when they try to soften the blow of a calamitous diagnosis. The two top contending metaphors for facing disease are (1) doing battle with it, and (2) going on a journey. Yes, I get it, war imagery can be energizing and drive the patient and family to do diligent research and pursue any treatments that bear a reasonable promise. And yes, a journey might comfort some who think of joining others who are on the same trajectory, especially if the endpoint involves arriving home to a congenial God. But for some people, these particular images are as off putting as the bromides they have to endure from family, friends and medical professionals.
Think about the military imagery for a moment. Our bodies do have natural defenses, with our antibodies doing their best as the good little soldiers they are. Medicine acts as reinforcements to join the fight. But we ourselves do not have to employ our mental faculties in a certain fashion to add money to the war chest. The effort itself to do so can be draining, as we feign cheerfulness and optimism. And what if the war effort results in a long drawn out inconclusive struggle with the disease, like so many wars in our world like the conflict with Afghanistan? Or even worse, what if “our side” starts to lose or even face final defeat? Then the patient will feel they lost the battle, and God forbid think they did not try hard enough or that they failed their loved ones. You get the idea how this might be a risky metaphor. And even apart from that, wars are a negative phenomenon to dwell upon anyways.
Given the inherent negativity of war and the image of division within our bodies, it is tempting to think of a journey as oh such a sweet and nonviolent alternative. But journey to what? Even if the journey is to God, or if not so dramatic, a journey to physical or mental limitations, what if you do not want to undertake such a journey just yet? (Excuse me, Sir, I’d like to get off at the next station and I want my money back.) In the image of a mandatory journey, there is no sense of control, and this can be scary. I think too, it obscures the idea of our whole lives as being a journey, which we do play a part in shaping. We have some control, making choices that shape the subsequent stages of the journey, creating as many pleasant or at least educational stopovers as possible. In contrast, the disease journey image may make the patient feel the disease is boss and that they have no say in what will happen.
For those readers who do relate to these images, that is terrific. My concern is when people foist these metaphors upon those who might feel distressed by them, or when the timing is wrong. So what to do? Whether you are the one who is sick or you know someone who is, the picture is complex. Let us take the latter. I think when a health professional is searching for metaphors it should be more towards the end of the process of offering help rather than at the beginning. One has to know a lot about the person in question to ascertain what might fit, and that takes time. One has to know the sick one’s attitudes toward disease, how they’ve coped in the past, what in life has given them meaning, and what they most care about. If the patient takes a scientific approach and is agnostic at best, the journey metaphor might strike them as pure hocus-pocus. A pacifist might not appreciate the war metaphor, and so on.
Just like a bromide, the proffered metaphor can be the lazy and anxious way to attempt a quick salve (or salvation). Real help takes an investment in time (oh, that!) and attentive eliciting of concerns and attitudes and beliefs. Real help is making way for the sick person to create or co-create with you their own metaphors if any. If you are currently chronically sick, do you have your own image for making sense of it? Do you have your favorite “pet peeve” images?
Since I want to leave the reader with at least one example of another sort of metaphor aside from battles and journeys, I will offer my own. I am not now chronically sick much less facing the end, but I can imagine what might work for me: I find nature, when it is peaceful, a great source of solace, and I subscribe to the notion of God as a Presence. So I think for me, as a part of nature myself, that my metaphor of choice will stem from that. Perhaps I will feel more and more blended into it and more at one with it and with the Presence that dwells there and dwells within me as well.