ABSTRACT
Responding to Susan Sontagâs groundbreaking text Illness as Metaphor, this article analyzes breast cancer as a figure of entanglement, drawing on Karen Baradâs theory of agential realism. Communication scholars have fruitfully explored discursive constructions of breast cancer, but a materialâdiscursive analysis of the disease, and the significant site it inhabits, provides a more robust account of the constraints and opportunities configuring bodies and social movements. To make the case, I show that agential realism is equipped to grasp breast cancerâs rhetoricity as it destabilizes binary codes of being, including language/matter, subject/object, and human/nonhuman. I then offer the concept of transmaterial intra-actionality to track entanglements of disease and target the political stakes of accounting for human and nonhuman life. I conclude with a call for corporeal solidarity: a posthuman politics that acknowledges connections across and through bodies.
The following passage appears on the cover of a collection of Susan Sontagâs two essays, Illness as Metaphor and AIDS and Its Metaphors:
In 1978, while recovering from cancer, Susan Sontag wrote Illness as Metaphor, the celebrated essay on the invented and often punitive uses of illness in our culture. It has become a classic that Newsweek recently called âOne of the most liberating books of its time.â Her aim was to strip cancer of its symbolic stigma and show that it is only a disease. She argued that the most truthful way of regarding illnessâand the healthiest way of being illâis to resist such metaphoric thinking.1
To free people from malignant meanings, Sontag calls for an end to illness as metaphor, which will keep cancer in its proper place within medical discourse. Writing after experiencing cancer and its treatment, Sontag argues for the abandonment of illness metaphors because equating the disease with evil and appalling events hurts persons with cancer by making them bear additional stigma. Conceptually, connecting cancer to bad behavior, undesirable bodies, and corrupt politics does damage by linking those with the disease to other dreaded things. Cancer becomes doubly destructive because it harms as a disease, plotting a damaging course though the body, and as a word, traveling through negative conceptual circuits. Sontagâs polemic against illness metaphorsâagainst interpretationâaims to replace harmful rhetoric with medical reality.
The demystification Sontag demands would stick to the fact that cancer is only a disease. If how we speak of cancer remains resolutely on the materialâcancer as matter, not as metaphorâthen human and cell bodies will be saved from unhealthy symbolism and people will seek treatment for a disease âwithout âmeaningâ.â2 Comparing cancer and tuberculosis, Sontag claims the route to excising illness metaphors from society is to find the cause and cure of disease:
The fantasies inspired by TB in the last century, by cancer now, are responses to a disease thought to be intractable and capriciousâthat is, a disease not understoodâin an era where medicineâs central premise is that all diseases can be cured . ⌠Now it is cancerâs turn to be the disease that doesnât knock before it enters, cancer that fills the role of an illness experienced as a ruthless, secret invasionâa role it will keep until one day its etiology becomes as clear, and its treatment as effective, as those of TB have become.3
Sontagâs claim is extraordinary given that neither the discovery of tubercle bacilli nor effective treatment stopped TB stigma and metaphors. Its transformation from âconsumption,â which was thought to be heritable, to contagious âTB,â resulted in a proliferation of public health campaigns and infectious stigma. The disease, no longer spread genealogically or borne by the brilliant and artistic, became known as bacteria penetrating bodies through the coughing, singing, laughing, and talking of others. That speech can spread TB animates ideas of contagious discourse and the materializing force of language as it identifies matterâs agency and materialâdiscursive intra-actions producing illness. Ingested through the lungs and able to attack any body part, TB showed the same symptoms as consumptionâweight loss, bloody coughs, painful aspirationsâwith the causal shift changing the diseaseâs stigmatic identity, not eradicating it. TB emerged as an object of dread and medical defense apparatuses, including sanatorium, surgery, vaccine, and a âmagic bulletâ cure called streptomycin.4
Doubting medicineâs ability to provide relief from metaphoric thinking, Paula A. Treichler observes, âafter sociological explanations for AIDS gave way to biomedical ones involving a transmissible virus ⌠images of AIDS as a âgay diseaseâ proved too alluring to abandon.â5 The linking of AIDS with homosexual men helps to explain why the United States left it to flourish in certain bodies and populations and how when it jumped the binary between âthose at riskâ and the âgeneral population,â it became a disease of a different kind.6 Shifting from âgay-relatedâ to âhumanâ immunodeficiency informed, rather than immunized, the entanglement of matter and meaning producing HIV/AIDS.
Despite equating curing disease with curing metaphor, Sontagâs argument provides two cues for this article because of her belief in a medical discourse, cleansed of metaphoric contaminants, spreading through society to heal how we communicate disease. Firstly, Sontag depicts language as something that obscures and inscribes matter. Her exposition of illness metaphors is excellent, but it relies on an inscription model of language that divides meaning from materiality. Secondly, Sontagâs treatment of language and matter invites a radical rethinking of their relationship critical to studies of communication. We can better grasp the meaning and matter of disease by tracking how it destabilizes the language/matter divide, rather than erecting this binary before analysis gets off the ground. Or, to put it another way, using the binary as a prophylactic against the contamination of language by matter and matter by language. Responding to Sontag, this article analyzes breast cancer as a figure of entanglement, drawing on Karen Baradâs materialist theory of agential realism. In so doing, I show how breast cancer provides a location, or localized resolution in phenomena (i.e., a âthingâ we attempt to grasp), which destabilizes binary codes of being, including language/matter, subject/object, and human/nonhuman. I then offer the concept of transmaterial intra-actionality to track entanglements of disease and target the political stakes of accounting for human and nonhuman life. I conclude with a call for corporeal solidarity: a posthuman politics creating connections and commitments across and through bodies. This agential realist account amplifies the alternate starting points and conclusions of disease analyses that refuse to use inscription models that render matter passive or, worse, meaningless.
Language/matter
Communication scholars have argued for the recognition of language as a materializing force, rather than as mere reflection of material reality or immaterial ideal. But a funny thing happened on the way to recasting languageâs relation to reality. According to Celeste Condit, âThese attacks on the view of language as reference, well taken as they are, have not successfully fused the distinction between language and reality, the idea and the thingâ; instead âin most cases, theorists have succeeded merely in reversing the hierarchyâin elevating the sign over the referent, the ideal over the material (often effacing the material).â7 Condit wonders if the privileging of language seduced rhetoricians because it is an âattractive reversal that puts language âon top,â even if the relationship is still a binary, hierarchical one.â8 For Nathan Stormer,
The dualism of language (emblematic of culture) and reality (emblematic of nature) is one outcome of conceptualizing rhetoricâs ability to produce material change by way of individualsâ speech. Correspondingly, in rhetorical studies the unit of theory and analysis has usually remained the humanist subject working to make an impression on the material world through speech-like activity.9
Whether we aim to suppress illness metaphors following Sontag or deconstruct them through rhetorical analysis, our focus remains trained on language without giving matter its due.10
Feminist theorist and theoretical physicist Karen Barad elaborates a materialist theory that rejects the discursive privilege informing inscription models and linguistic turns:
Agential realismâs reconceptualization of the nature of matter and discursive practices provides a means for taking account of the productive nature of natural as well as cultural forces in the differential materialization of nonhuman as well as human bodies. It thereby avoids the privileging of discursive over material concerns and the reinscription of the natureâculture dualism.11
Reality, on this account, is a dynamic process constituted through materialâdiscursive practices. Agential realism regards matter as active in the worldâs becoming, not as passive stuff needing human signification to have meaning. Barad avers that matter produces meaning and meaning affects what materializes or ceases to be: âMeaning is not an ideality; meaning is material. And matter isnât what exists separately from meaning. Mattering is a matter of what comes to matter and what doesnât.â12 We cannot then gaze innocently upon human or cell bodies, pace Sontag, and stripping meaning from matter is neither doable nor desirable. Barad contributes to the study of communication by retiring questions about whether language reflects or creates reality and using quantum physics to argue matter and meaning are entangled down to the tiniest, most ostensibly âatomicâ elements of reality.13 She theorizes a causal relationship between âspecific material configurations of the world (i.e., discursive practices/(con)figurations rather than âwordsâ) and specific material phenomena (i.e., relations rather than âthingsâ). This causal relationship between apparatuses of bodily production and the phenomenon produced is one of âagential intra-action.ââ14 Agential intra-action corrects constructivist accounts granting language too much power and objectivist accounts positioning nature as prediscursive facticity.
An agential realist approach, therefore, reorients analyses of phenomena constituted as subjects and objects (e.g., cancer patient, breast cancer), which we habitually grasp as separate things in order to make sense of the situation. Indeed the desire to put things in order is at the heart of this habit. Agential realism acknowledges cancer patients and breast cancer as entangled intra-active phenomena, not discrete, independent entities that interact. Phenomena, including and exceeding the human, are processes enacting boundaries, attributing properties, and making agential cuts that become sedimented into embodied concepts and solidified components (e.g., âShe has breast cancerâ; âIt is breast cancerâ).15 These concepts and components include the materialâdiscursive subject, âshe,â and materialâdiscursive object, âbreast cancer,â not only the latter, due to the co-constitutive emergence of gendered disease and diseased gender.16
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