These kinds of metaphors
inhibit people from seeking treatment early enough, or from making a greater effort to get competent treatment. The metaphors and myths, I was convinced, kill. (For instance, they make people irrationally fearful of effective measures such as chemotherapy, and foster credence in thoroughly useless remedies such as diets and psychotherapy.) I wanted to offer other people who were ill and those who care for them an instrument to dissolve these metaphors, these inhibitions. I hoped to persuade terrified people who were ill to consult doctors, or to change their incompetent doctors for competent ones, who would give them proper care. To regard cancer as if it were just a disease—a very serious one, but just a disease. Without “meaning.” And not necessarily a death sentence (one of the mystifications is that cancer = death).28
* * *
Cancer had been mythologized for millennia. The ancient Greek physician Galen believed that “‘melancholy women’ are more likely to get breast cancer than ‘sanguine women,’” she wrote. And Sontag would never have written the book if descendants of these ideas had not persisted in the contemporary world. In the popular mind, the “contemporary cancer personality” was a “forlorn, self-hating, emotionally inert creature.”29 As a result, she wrote, the patient was stuck with “not just a lethal disease but a shameful one.”30
In its modern guise, this mythology derived not from Galen but from Freud. The science of the nineteenth century had progressively dispensed with the kinds of ideas Sontag attacked. Until Freud reversed the positivist formula that “the mental is based on the organic,” disease had been “an alien which had somehow insinuated itself into the body of the patient.” In the prescient words of the young Sontag, writing in The Mind of the Moralist, “Freud’s general thesis—sickness conceived of as historical” was a dramatic reversal of the “anatomical, physical, and chemical factors” emphasized in Freud’s own medical education.
Like so much of Freud’s thought, these ideas, too, had been diluted, not least by Wilhelm Reich, a radical psychoanalyst who extended some of Freud’s detective-story metaphors into regions Freud himself would never have ventured. He even turned them against the master himself. In Sontag’s telling,
Freud was “very beautiful . . . when he spoke,” Wilhelm Reich reminisced. “Then it hit him just here, in the mouth. And that is where my interest in cancer began.”
Susan had, at one point, been keenly interested in Reich. In Illness as Metaphor, she identified him as the source of the modern association of cancer with sexual and emotional repression.31 “Nothing is more punitive than to give a disease a meaning,” she insisted.32 Cancer was simply a disease. It had no meaning.
Faced with this perverted symbolism, the writer acquired an unaccustomed role. “Not to confer meaning, which is the traditional purpose of literary endeavor, but to deprive something of meaning: to apply that quixotic, highly polemical strategy, ‘against interpretation,’ to the real world this time.”33 So she wrote in AIDS and Its Metaphors, the pendant to Illness as Metaphor she published in 1989. There, she reflected on her two and a half years in cancer treatment. She had seen how metaphors demoralized and even killed her fellow patients, forcing them to evince “disgust at their disease and a kind of shame.” They were “in the grip of fantasies about their illness by which I was quite unseduced.”34
* * *
The image of her unshakable allegiance to science consoled fellow sufferers, and became a chapter of its own in medical history. The camera alters even as it records, and her observations began to alter the stereotypes about the disease and its sufferers. In part thanks to her, cancer became just another disease. One could not make it less ugly or painful, but by mitigating the metaphors, Sontag also mitigated some of the additional psychological suffering that cancer patients needlessly confronted. Yet of all the disguised self-portraits in Sontag’s work, none is as poignant—or as revealing—as the one that emerges from the illness books.
She catalogs the superstitions that oppress the cancer patient. She quotes her adolescent heroes Thomas Mann (“Symptoms of disease are nothing but a disguised manifestation of the power of love; and all disease is only love transformed”) and André Gide, whose hero comes down with tuberculosis “because he has repressed his true sexual nature.”35 She quotes a contemporary New York psychologist’s outline of the “basic emotional pattern of the cancer patient.” They share “a childhood or adolescence marked by feelings of isolation,” and then lose, in adulthood, their “meaningful relationship,” at which point they develop a “conviction that life holds no more hope.”36 She furthermore cites a nineteenth-century description of the cancer patient as one whose life consists of “deep and sedentary study and pursuits, the feverish and anxious agitation of public life, the cares of ambition, frequent paroxysms of rage, violent grief.” In Renaissance England, she wrote, people believed that “the happy man would not get plague.”37
This portrait of repression, inwardness, and sadness—the one she denounces as punitive and medieval—coincides, however, exactly with the self-portrait in her journals, the hidden self that she almost never allowed to appear in public or in her writings: the persona, or mask, that she had evolved as a means of survival. “I’m responsible for my cancer,” she wrote. “I lived as a coward, repressing my desire, my rage.”38 Susan blamed herself bitterly. “She came to New York [in the 1950s] where people were writing about Eros and death and things like that,” said Don Levine. “She had bought into all of that, and that’s when she starts thinking, Maybe I did give myself cancer.”39
Her alienation from her body was so extreme that she had to remind herself to bathe. She neglected her health in astonishing ways. She never exercised. She barely slept. Sometimes she forgot to eat, and sometimes she gorged. She was a heavy smoker—and lied about her habit even to her oncologist.40 But in Illness as Metaphor—in her zeal to transform her story of guilt, shame, and fear into something usable—she acknowledged none of this. Instead, she dismissed “crude statistics brandished for the general public, such as that 90 percent of all cancers are ‘environmentally caused,’ or that imprudent diet and tobacco smoking alone account for 75 percent of all cancer deaths.”41 She does not say what is crude about these statistics, or display any interest in the science behind them.
The pathogenesis of cancer is extremely complex; the disease strikes for all sorts of reasons. But under the onslaught she lost her ability, so recently acquired, to distinguish between tragedy and drama. Her dismissal of personal responsibility—for some cancers, for some people—made contracting cancer from chain-smoking Marlboros sound as inexplicable as being dashed to pieces by a meteor. She chose to dissociate her choices from any potential responsibility for her disease, and created, instead, a story about why she had been saved. She credited her survival to her own determination to be treated by the most radical methods, and to the doctor who had administered them. At the heart of this story was an impossible paradox. She was not responsible for her illness—but she was responsible for its cure.
* * *
In a peculiar homage to the power of metaphor, she could only destroy one mythology—the old ideas of the guilt-ridden victim of sexual repression and moral depression—by putting another in its place. Even when the body asserted itself as aggressively as it did in 1975, Sontag testified to the importance of metaphor by reshaping her story, replacing one mind-driven mystification—the Freudian-Reichian—with another, which she called “science.”
“My mother loved science with a fierce, unwavering tenacity bordering on religiosity,” David said.42 But in later tellings her cure relied less on science and more on what might be called the power of positive thinking. She spoke of Leonard Bernstein’s wife, Felicia Montealegre, once famed as the most beautiful woman in Chile, diagnosed with cancer at the same time. Montealegre and Susan spoke often about their shared ordeal. Felicia had a better medical outlook but died anyway—because, Susan came to believe, she had a defeatist mind-set
.43
She believed that she had prevailed because she was determined to survive. That meant making up her mind not to die, and putting up with hideous amounts of pain. Toward the end of her life, she became intrigued by the cycling champion Lance Armstrong, who, like her, had been left for dead—only to triumph over cancer: “You have moments, for sure, moments of weakness where you think, I’m going to die or perhaps I’m going to die,” he said. “I was totally committed, totally focused and I had complete faith in my doctors, in the medicine, in the procedures.” The words, David said, could have been Susan’s.44
The story she told
was not in fact the way that my mother had experienced her surgery and subsequent treatment for breast cancer as they were taking place. But it was the way that she came to remember it and it was this “rewriting” that informed the way she lived from that time forward.
What goes unsaid is that many patients display total commitment to fighting their disease, have complete faith in their doctors, and are willing to suffer insufferable pain—and die anyway. But willingness to suffer became the hallmark of her survival story. “She was proud of having dared to take this experimental and very painful treatment, much more painful than most people’s treatment at the time,” said David.45 This pride was common among cancer survivors. “You want to concoct the particular romance of why you were spared, in which you are the hero of that romance,” said the oncologist Siddhartha Mukherjee.46 This mythopoetic conception had a long history in the writings of survivors, said Mukherjee, who seek explanations:
“Oh, everyone else failed because they couldn’t find this doctor in Paris.” You don’t need to be in oncology to know how often these things are circulating through our culture. People are going to Mexico to juice, and then saying to themselves when they survive: “It’s because I had the guts and the smarts to go to Mexico to juice.”
In Sontag’s case, the paradox was the insistence that the mind could not make one sick—only that it could make one well. She could not escape the Freudian conception of the body “as a symptom of mental demands.” If this undermined her claims in Illness as Metaphor, it nevertheless served to inspire others, who otherwise might have silently accepted their disease as a moral judgment. She could be justly proud, as she told an interviewer, that “hundreds of people have written to me and have said that [the book] saved their lives, that because of the book they went to a doctor or changed their doctors.”47
Thus was Illness as Metaphor accidentally transformed into the very thing it deplored: a metaphor. It replaced one myth with another, and in place of a terrified, guilty woman came the “quite unseduced” Susan Sontag. As old theories about cancer were swept away by therapeutic advances—a “revolution of seeing”—this symbolic Sontag helped people: those who, as a result, got better treatment and survived; and those who, though they could not be saved, could at least die without being made to feel ashamed of having wasted their lives.
Part III
Susan Sontag, 1975. Photograph by Peter Hujar. © 1987 The Peter Hujar Archive LLC. Courtesy Pace/MacGill Gallery, New York and Fraenkel Gallery, San Francisco.
Chapter 24
Toujours Fidèle
In the fall of 1977, when Susan was in the final stages of cancer treatment, Don Levine came into Susan’s apartment and found, lit by a single lamp over the kitchen table, the first copy of On Photography. The house was silent, and he discovered Susan lying on her bed. When he congratulated her on the book, she asked: “But it’s not as good as Walter Benjamin, is it?”1
In her personal pantheon, Benjamin occupied pride of place; and in “Under the Sign of Saturn,” the essay she dedicated to him the following year, she describes those of his loves—collecting and books, fragments and ruins—that were also hers, and what she saw as his outstanding characteristic: his tortured, melancholy personality. “Since the Saturnine temperament is slow, prone to indecisiveness, sometimes one has to cut one’s way through with a knife,” she wrote, as one who knew what she was talking about. “Sometimes one ends by turning the knife against oneself.”2
It is a heartbreaking aperçu, one of many in the essay. It shows that, as an aphorist, Sontag was hardly inferior to Benjamin. “The only pleasure a melancholic permits himself, and it is a powerful one, is allegory,” Benjamin wrote, and Sontag quoted him approvingly.3 Allegory, in fact, is one of the great pleasures of this essay: Benjamin as a metaphor for Sontag, an exemplar of her own saturnine temperament, with a “self-conscious and unforgiving relation to the self, which can never be taken for granted. The self is a text—it has to be deciphered.”4 Because he sees the self as an aesthetic phenomenon, the melancholic becomes an ideal interpreter. He is uniquely positioned to see a world of which he can never really be a part, because it exists wholly outside himself: “Precisely because the melancholy character is haunted by death, it is melancholics who best know how to read the world.”5 The world, too, is a text, and through it the self travels, trying to decipher the world, a travel-writer. “Benjamin, of course, was both a wanderer, on the move, and a collector, weighed down by things; that is, passions.”6
The character born under the sign of Saturn was a liar (“dissimulation, secretiveness appear a necessity to the melancholic”) who needed his freedom (“Benjamin could also drop friends brutally”) and hid social unease with reading and writing (“the true impulse when one is being looked at is to cast down one’s eyes, look in a corner. Better, one can lower one’s head to one’s notebook. Or put one’s head behind the wall of a book”).7 The Saturnine was “always working, always trying to work more,” always feeling he was coming up short,8 fearing that death would snatch him before he could complete that work: “Something like the dread of being stopped prematurely lies behind these sentences as saturated with ideas as the surface of a baroque painting is jammed with movement.”9
The importance of work made relationships difficult:
For the melancholic, the natural, in the form of family ties, introduces the falsely subjective, the sentimental; it is a drain on the will, on one’s independence; on one’s freedom to concentrate on work. It also presents a challenge to one’s humanity to which the melancholic knows, in advance, he will be inadequate.10
The melancholic endeavors to protect his work at all costs, because without it his self will dissolve. He needs armor: not a real self but a means of sheltering the self. This may resemble the “Being-as-Playing-a-Role” toward which Sontag confessed such ambiguous feelings in “Notes on ‘Camp,’” but it is not a Warholian desire to be plastic; it is Being-Through-Playing-a-Role. As Susan was sometimes separate from Sontag, the being is sometimes separate from the role; but the role lets the being grasp a world in which he is irremediably alien. It allows him to shape a self he can only understand to the extent that it is like a book. He is a manic collector, made out of books and objects, and to lose those texts is to lose the self: the literal text, and the literal self. One reason for Benjamin’s suicide was that he was unable to retrieve the library he had been forced to leave behind Nazi lines.
Keenly aware both of his brilliance and of his shortcomings, the fragile, authentic, hidden self creates a scrupulous mask, a persona:
These feelings of superiority, of inadequacy, of baffled feeling, of not being able to get what one wants, or even name it properly (or consistently) to oneself—these can be, it is felt they ought to be, masked by friendliness, or the most scrupulous manipulation.
* * *
The standards to which Susan held herself were despotic, but they were also an inspiration to do more, to do better. “I try to imagine someone saying to Shakespeare, ‘Relax!’”
The words were Elias Canetti’s. She quoted them with warm approval in “Mind as Passion,” which closes Under the Sign of Saturn, the book she published in 1980, gathering essays previously published in The New York Review of Books.11 Her essay on Canetti—a Bulgarian-born Jewish British resident of Switzerland whose native language was Spanish and
who wrote in German—appeared almost exactly a year before he won the Nobel Prize. Even more than her essay on Benjamin, the Canetti essay is so autobiographical as almost not even to be about its purported subject.12 In Canetti, she saw how a person with great talents and great limitations—a person like herself—had found a path forward. In Canetti, the fatherless Susan discovered not only a model but a genealogy.
The essay begins with Canetti’s homage to the Austrian writer Hermann Broch, so eloquent that it “creates the terms of a succession.” The great modern writer, Canetti said, “is original; he sums up his age; he opposes his age.”13 This writer would be “a noble admirer”; he would be “constantly prodding himself with the example of the great dead, checking his mental temperature, shuddering with terror as the calendar sheds its leaves.” He would display a “heroic avidity.” He would vow—like Canetti at sixteen, like Susan even earlier—“to learn everything.”
“Mind as Passion” is an argument for the equality, and indeed the superiority, of mental passions to bodily ones: of preserving the body for the sake of the mind. “He is unperturbed by the possibility of the flagging of appetite, the satiation of desire, the devaluation of passion,” she wrote. “Canetti gives no thought to the decomposition of the feelings any more than of the body, only to the persistence of mind. Rarely has anyone been so at home in the mind, with so little ambivalence.”14 It was a recipe for guiltless unconcern with the body, for accepting the self as Benjamin described. Postcancer, this idea was even more attractive to Susan. Canetti was “one of the great death-haters of literature.” His habit of admiring worthy predecessors was a way “to do justice to each of his admirations, which is a way of keeping someone alive.” Literature gave life; and when life departed, literature preserved its memory.
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