{"id":10755,"date":"2011-08-23T14:02:11","date_gmt":"2011-08-23T13:02:11","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=10755"},"modified":"2011-08-24T16:33:56","modified_gmt":"2011-08-24T15:33:56","slug":"stephen-ginn-metaphors-in-medicine","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2011\/08\/23\/stephen-ginn-metaphors-in-medicine\/","title":{"rendered":"Stephen Ginn: Metaphors in medicine"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.bmj.com\/columns\/icons\/stephen_ginn2.jpg\" alt=\"Stephen Ginn\" width=\"90\" height=\"110\" align=\"left\" \/>Metaphors are widely used by both healthcare professionals and lay people when talking about matters of health. Despite this their role is largely unrecognised. This is a shame, I feel, as they can have a powerful effect on the practice of medicine and the experience of illness.<\/p>\n<p>A <a href=\"http:\/\/www.pineforge.com\/upm-data\/6031_Chapter_10_O%27Brien_I_Proof_5.pdf\">metaphor is a way<\/a> of understanding and experiencing one kind of thing in terms of another.\u00a0Many complex concepts are understood in this way and they are integral to the way we understand things.\u00a0<!--more--><\/p>\n<p>The essayist Susan Sontag was one of the first to identify the widespread use of metaphor in relation to certain diseases. She wrote <em><a href=\"http:\/\/en.wikipedia.org\/wiki\/Illness_as_Metaphor\">Illness as Metaphor<\/a><\/em> whilst being treated for breast cancer and visited the topic again in 1988 with <em><a href=\"http:\/\/en.wikipedia.org\/wiki\/AIDS_and_Its_Metaphors\">AIDS and its metaphors<\/a><\/em>.<\/p>\n<p>Sontag argued that metaphors attach themselves to certain diseases and these metaphors exert influence on patient and public attitudes. With both HIV and cancer Sontag argued that metaphors introduced an unhelpful emotional dimension when a more detached scientific approach was required.<\/p>\n<p>Two main sorts of metaphors have been suggested. (1) &#8220;Biomilitary&#8221; metaphors represent disease and the body\u2019s response to it in terms of &#8220;attack&#8221; and &#8220;defence.&#8221;\u00a0 By contrast with &#8220;bioinformationist&#8221; metaphors the body, in both health and disease, is seen as a communication system with \u201creceptors,\u201d \u201ctransmitters&#8221; etc.<\/p>\n<p>Particular diseases attract metaphorical description more readily than others. Biomilitary metaphors are pervasive in discussions of cancer. By contrast heart disease is discussed almost exclusively in terms of the mechanical metaphor of plumbing.<\/p>\n<p><a href=\"http:\/\/mh.bmj.com\/content\/33\/2\/93.full#xref-ref-9-1\">Arguably<\/a> metaphors don&#8217;t merely describe similarities; they create them.\u00a0As well as illuminating they can also conceal. It can be hard to think of cancer in a way that is not biomilitary,\u00a0but wars honour battles which can make the transition to hospice care problematic. Mechanical metaphors for heart disease are also limited as they hold no place for lifestyle modification. I don\u2019t agree with Sontag that metaphor should be eliminated from the discussion of medical illness.\u00a0In fact I don\u2019t actually believe that it would be possible to talk about disease without them.\u00a0But they have a hidden power that should be understood.<\/p>\n<p>If you choose a metaphor, choose it wisely.<\/p>\n<p>1.<a href=\"http:\/\/mh.bmj.com\/content\/33\/2\/93.full\"> Montgomery SL. Illness and image: on the contents of biomedical discourse. In: Montgomery SL.The scientific voice. New York and London: Guilford Press, 1996:134\u201395.<\/a><\/p>\n<p><strong>Stephen Ginn<\/strong> is the <em>BMJ<\/em> editorial registrar. He writes a personal blog at: <a href=\"http:\/\/www.frontierpsychiatrist.co.uk\/\">http:\/\/www.frontierpsychiatrist.co.uk<\/a> Follow him on Twitter at: <a href=\"http:\/\/www.twitter.com\/psychiatrist\">http:\/\/www.twitter.com\/psychiatrist<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Metaphors are widely used by both healthcare professionals and lay people when talking about matters of health. Despite this their role is largely unrecognised. This is a shame, I feel, [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2011\/08\/23\/stephen-ginn-metaphors-in-medicine\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-10755","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Stephen Ginn: Metaphors in medicine - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2011\/08\/23\/stephen-ginn-metaphors-in-medicine\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Stephen Ginn: Metaphors in medicine - The BMJ\" \/>\n<meta property=\"og:description\" content=\"Metaphors are widely used by both healthcare professionals and lay people when talking about matters of health. 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