Let’s Fight! Illness Metaphors and Their Many Uses

Anita Wohlmann considers how authors of illness narratives have consciously reworked the “fight” metaphor. 

This essay was first presented as part of “Narratives of Illness”, the SELMA Medical Humanities Seminar Series at the University of Turku, Finland, convened by Marta-Laura Cenedese and Avril Tynan.

Metaphors can be used for many purposes. Take the well-known metaphor that compares illness with a fight. He died after a long fight. She lost the fight. Let’s fight this cancer – and make sure you win!  

The metaphor can help explain, make familiar and convey how someone feels. It can help build someone’s courage and move them from shocked immobility to agency. Metaphors can also narrow down and limit our perspective. They can impose cultural norms and even stigmatize: fighting is considered heroic, while capitulating is shameful. Metaphors can mess with our minds, provoke misunderstanding and entail a skewed vision of reality.

As a matter of fact, every metaphor is built on a mistake: it claims that one thing is something else when that is actually not the case. Illness is not a fight! It might feel like a fight though, and there are indeed many similarities that ring true. But the fact that this metaphor feels right is also an indicator for how ingrained it is in our way of thinking and speaking about illness.

But there are also important incompatibilities in the metaphor. Not all illnesses are associated with fighting and battle. High blood pressure, for example, needs to be managed, controlled, adjusted, and monitored. We typically don’t fight it.

If a metaphor proves mistaken or limiting, the solution seems obvious: we can replace it or invent a new one. In my research on illness writing, I made a surprising discovery though: while all writers criticized the fight metaphor, they nonetheless continued using it. In part, this is understandable: since the metaphor has become so normal, it takes an extra effort to work around it. But there’s something else I noticed: the writers actually use the fight metaphor very consciously, they actively engage with it, work with it and, in doing so, remake it so that it fits their individual needs.

The writers I am alluding to are well known in medical humanities: Audre Lorde, Arthur Frank, Anatole Broyard, and Susan Sontag. That Sontag appears in this list may come as a surprise: as one of the most outspoken critics of illness metaphors, she is an unlikely candidate for a continued use of a problematic metaphor. However, when we look at her diaries and at her son’s recollection of his mother’s own experience with cancer, it becomes clear that Sontag, too, was stuck with metaphor. In her essay “Aids and its Metaphors,” we find a potential explanation. Sontag maintains that “metaphors cannot be distanced just by abstaining from them. They have to be exposed, criticized, belabored, used up” (179).

What does it mean to belabor a metaphor?

In her essays on illness metaphors, Sontag demonstrates what such a belaboring might look like. One of her strategies is to trace and describe metaphors. Sontag collected illness metaphors from numerous (con)texts, for example films, novels, and political speeches. This tracing enabled her to illustrate how deeply the fight metaphor, among others, has infiltrated our way of thinking about illness. It also allowed her to use another strategy: comparison. In “Illness as Metaphor,” Sontag shows how the concept of “fight” is used differently for different targets, namely cancer and tuberculosis. Through comparison, she reaches a fuller, more complex understanding of how the fight metaphor is used.

Belaboring a metaphor can also involve other strategies. Audre Lorde, for example, wrote about her illness experiences in The Cancer Journals (1980) and in “The Burst of Light: Living With Cancer” (1988). Calling herself a “black woman warrior poet” (Cancer 19), she embraces the notion of fight as part of her identity and as being equal to other features that characterize her. She makes the fight metaphor her own, and she even refers to the legendary Amazon warriors of Dahomey as potential role models. As a critical warrior activist, Lorde also, of course, challenges the same notion. She does so, among others, by stretching the definition of what it means to win the fight. Winning, she says in “A Burst of Light,” can mean many things:

We all have to die at least once. Making that death useful would be winning for me. I wasn’t supposed to exist anyway, not in any meaningful way in this fucked-up whiteboys’ world. I want desperately to live, and I’m ready to fight for that living even if I die shortly. Just writing those words down snaps every thing I want to do into a neon clarity . . . For the first time I really feel that my writing has a substance and stature that will survive me. (61)

In belaboring the fight metaphor, Lorde comes to define victory on her own terms. There is much more to say about Lorde’s (re)use and broadening of the word “survival”. The point I am trying to make here is that Lorde creatively reworks the problems of the fight metaphor from within. She adjusts it to her own needs, her personality, and her activism. And by examining it critically and creatively, she finds more and more nuanced meanings.

Lorde’s strategies are, in part, a form of resistance against patriarchal, racist, and homophobic language and concepts – a fight she fought all her life. But I would like to suggest that her belaboring of the fight metaphor for cancer achieves more: rethinking the metaphor also adds renewed meaning to her struggles, a more profound knowledge of who she is, and it provides an aesthetic pleasure that comes from imaginatively playing with words and meanings and reshaping them. Lorde was also a poet, after all.

The visual artist Banksy also offers a refreshingly new reading of the source domain “fight.” In rethinking the type of weapon and the purpose of the fight, he too stretches the meanings of fight. He invites us to see, for a moment, the Gaza conflict in a shockingly and surprisingly different way: as a pillow fight.

Does belaboring a metaphor work every time? Probably not. Do these strategies redeem the illness-as-fight metaphor? No, it remains problematic.

What are the gains then?

First, rethinking an existing metaphor and learning about different strategies to do so, is a valuable skill. After all, we cannot not use metaphors. Moreover, inventing new metaphors can be arduous, and the new ones may not necessarily be better.

Secondly, rethinking the fight metaphor – for example by tracing, comparing, appropriating and stretching it – has other gains: it creates a more profound, critical knowledge of what we are dealing with, it can make us feel more at home in a language that is imposed on us, and it might even be a pleasant, reenergizing, and rewarding experience.


Anita Wohlmann is associate professor in Contemporary Anglophone Literature at the University of Southern Denmark. She is a member of the “Uses of Literature” Research Group (DNRF 127). Further information here.

More on this topic in her forthcoming book Reusable: Metaphor in Illness Writing (working title, to be published at Edinburgh University Press in 2022).

A open-access article on metaphors in health care, co-written with Susanne Michl, can be found here.


Lorde, Audre. ‘A Burst of Light’. A Burst of Light: Essays. Sheba Feminist Publishers, 1988, pp. 49-134.

Lorde, Audre. The Cancer Journals. Aunt Lute Books, 1997.

Sontag, Susan. Illness as Metaphor and AIDS and its Metaphors. 1978. Penguin Classics, 2002.

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