Yesterday could easily have felt largely wasted - I spent the morning going to a hospital for a clinic appointment that turned out to have been cancelled. 

I had arrived a bit early, so browsed the Welcome Institute's bookshop while waiting for the alleged clinic appointment. In my non-musical, non-film making life I teach medical students and postgraduate medical trainees. One of the topics that interests me is the philosophy of disease, the psychology of diagnosis, and communication in medicine. As I browsed, I noticed a slim volume - Susan Sontag's 'Illness as metaphor'. This isn't a new book - the now deceased author had first published the essay that makes up the bulk of this book in 1977 - but it retains a distinctive and fresh outlook on disease. 

Her central argument is that using disease as a metaphor (for example the Romantic image of tuberculosis in 19th century opera) or the use of metaphors in our description of disease (such as the military metaphors in the war against cancer) are dangerous. Dictatorships have justified the use of violent repression using the metaphor of cutting out the cancer in our society, and it could be argued that the medical profession at times has been total waging war on a malignant enemy, focusing on cure at all costs, regardless of the costs of friendly fire. 

Susan Sontag had breast cancer at the time of writing the book. This however is not a description of her personal experiences. It has an austere, impersonal, elegant intellectual rigor. It's lack of sentimentality is bold and, to me, engaging. Some of the medicine may have slightly dated, but the overall message, that we should be aware of how the metaphors we use shape our thinking, is still a profound challenge our use of language. Highly recommended to those interested in medicine or how language shapes our view of the world.

Malcolm Galloway

(In the unlikely event that anyone buys the book via this link I would get a small commission).