Bearing Witness — Sontag and the Body
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《新英格兰医药杂志》
It is the rare book in social medicine that does not cite Susan Sontag's opening sentence in Illness as Metaphor: "Illness is the night-side of life, a more onerous citizenship."1 The recent death of this literary scholar, novelist, and cultural critic from myelodysplastic syndrome is a profound loss for the intellectual and clinical study of medicine. Sontag's enduring interest in the capacity of language to shape experience led her, in such works as Illness as Metaphor (1978) and AIDS and Its Metaphors (1989), to recognize that illness and the representation of it are always colored by culture or tainted by fear. She highlighted the enormous power of doctors either to exacerbate patients' sense of victimization or to empower them to face or, at least, endure illness.
(Figure)
Susan Sontag at Columbia University, 2003.
Photograph by Charles Manley/CUMC.
Sontag's aesthetic criticism was equally relevant to medicine. In such works as On Photography (1977) and Regarding the Pain of Others (2003), she explored the consequences of witnessing the suffering of others, for the viewer and the sufferer alike. Although she was nominally addressing artists and political activists in these works, it was as if she were also carrying on a secret dialogue with doctors and patients, illuminating the important processes set in motion by the interplay between exposing the ill body and absorbing not only the sight of it but also the duty that the viewer, having seen it, bears toward it. Whether Sontag was witnessing the ethnic cruelty in Sarajevo or studying photographic representations of lynchings in the American South, her commitment to human dignity and her rage against state-sponsored violence propelled her to a moral clarity and personal accountability unavailable to those with less vision and courage. Her provocative positions on national and international policy and on public health debates polarized — and sharpened — the discourse, leading others, if not necessarily to agree with her, certainly to understand more clearly what they themselves thought.
Sontag understood the fundamentality of the body, its inability to be trumped — things we doctors learn in the operating room or from decades of caring for those who are chronically ill. Throughout her writing career, she focused on the body — physical suffering, sexual passion, chronic illness, torture, slow death. She insisted that illness be clothed neither in sentimentalizing palaver nor in accusatory moral decree. Sickness, she maintained, is neither a blessing nor a punishment but, rather, an objective, usually random occurrence that must be faced with logic and science and truth.
Sontag had always been drawn to medicine. She wanted to be a doctor and, until the end of her life, seemed to harbor some regret that she was not one of us. Instead, she had to place herself in our hands — multiple times, for serious illnesses, all of which, until the end, she bested. Her terminal illness was most likely caused by the chemotherapy she had received for breast and ovarian cancer 20 years earlier. Yet she had tremendous confidence in the power of medicine — perhaps more confidence than most physicians have. She seemed to feel vindicated or even aggrandized by demanding the most grueling, the most aggressive, the most daring treatments for her own illnesses.
As writer-in-residence at the College of Physicians and Surgeons of Columbia University during the fall of 2003, Sontag taught a seminar on works by Alphonse Daudet, Virginia Woolf, Leo Tolstoy, Thomas Mann, and Albert Camus, among others. Her students, who included scientists, doctors, nurses, writers, and humanities scholars, gradually absorbed her strange and transformative slant on health and illness. Oddly, in that seminar room with her, the doctors and nurses were not divided from the novelists and philosophers. We all reached common ground by beholding suffering and accepting the consequences of having witnessed it. We health care professionals talked about caring for the ill, how it affects us, how it changes our lives, how and to whom it matters. Sontag let us see how pivotal our medicine is to our lives — not by lecturing us or making us read Osler, but by unlocking within each of us our own private impressions. She led us, in the end, to confront our work with increased respect, responsibility, and gratitude.
Source Information
Dr. Charon is a professor of clinical medicine and the director of the Program in Narrative Medicine, College of Physicians and Surgeons, Columbia University, New York.(Rita Charon, M.D., Ph.D.)
(Figure)
Susan Sontag at Columbia University, 2003.
Photograph by Charles Manley/CUMC.
Sontag's aesthetic criticism was equally relevant to medicine. In such works as On Photography (1977) and Regarding the Pain of Others (2003), she explored the consequences of witnessing the suffering of others, for the viewer and the sufferer alike. Although she was nominally addressing artists and political activists in these works, it was as if she were also carrying on a secret dialogue with doctors and patients, illuminating the important processes set in motion by the interplay between exposing the ill body and absorbing not only the sight of it but also the duty that the viewer, having seen it, bears toward it. Whether Sontag was witnessing the ethnic cruelty in Sarajevo or studying photographic representations of lynchings in the American South, her commitment to human dignity and her rage against state-sponsored violence propelled her to a moral clarity and personal accountability unavailable to those with less vision and courage. Her provocative positions on national and international policy and on public health debates polarized — and sharpened — the discourse, leading others, if not necessarily to agree with her, certainly to understand more clearly what they themselves thought.
Sontag understood the fundamentality of the body, its inability to be trumped — things we doctors learn in the operating room or from decades of caring for those who are chronically ill. Throughout her writing career, she focused on the body — physical suffering, sexual passion, chronic illness, torture, slow death. She insisted that illness be clothed neither in sentimentalizing palaver nor in accusatory moral decree. Sickness, she maintained, is neither a blessing nor a punishment but, rather, an objective, usually random occurrence that must be faced with logic and science and truth.
Sontag had always been drawn to medicine. She wanted to be a doctor and, until the end of her life, seemed to harbor some regret that she was not one of us. Instead, she had to place herself in our hands — multiple times, for serious illnesses, all of which, until the end, she bested. Her terminal illness was most likely caused by the chemotherapy she had received for breast and ovarian cancer 20 years earlier. Yet she had tremendous confidence in the power of medicine — perhaps more confidence than most physicians have. She seemed to feel vindicated or even aggrandized by demanding the most grueling, the most aggressive, the most daring treatments for her own illnesses.
As writer-in-residence at the College of Physicians and Surgeons of Columbia University during the fall of 2003, Sontag taught a seminar on works by Alphonse Daudet, Virginia Woolf, Leo Tolstoy, Thomas Mann, and Albert Camus, among others. Her students, who included scientists, doctors, nurses, writers, and humanities scholars, gradually absorbed her strange and transformative slant on health and illness. Oddly, in that seminar room with her, the doctors and nurses were not divided from the novelists and philosophers. We all reached common ground by beholding suffering and accepting the consequences of having witnessed it. We health care professionals talked about caring for the ill, how it affects us, how it changes our lives, how and to whom it matters. Sontag let us see how pivotal our medicine is to our lives — not by lecturing us or making us read Osler, but by unlocking within each of us our own private impressions. She led us, in the end, to confront our work with increased respect, responsibility, and gratitude.
Source Information
Dr. Charon is a professor of clinical medicine and the director of the Program in Narrative Medicine, College of Physicians and Surgeons, Columbia University, New York.(Rita Charon, M.D., Ph.D.)