bout of the flu, a chronic painful condition, a disabil-
ity, or a life-threatening disease. Because all readers,
even if we have not ourselves been severely ill, can
relate to the idea of Sontag’s two kingdoms, illness
is a frequent and powerful theme in literature. When
we are sick, we have a feeling of not being part of the
mainstream; we can concentrate only on the sick-
ness, the pain, and the discomfort, and in doing so,
we remove ourselves from life for a while. The sick,
then, are deviant; they are not normal. Literature
has a history of using illness to highlight deviations
from what is normal, both positive deviations and
negative ones.
Sociologists and medical professionals have sev-
eral different ways of explaining why illness has
such a powerful hold over our imaginations. Echo-
ing Sontag’s metaphor, the physician Michael Stein
says in The Lonely Patient that illness is a kind of
travel into a “foreign kingdom” or an “unrecognized
neighborhood” (10). The sick person is confused and
anxious, asking many unanswerable questions about
how to act, what to say, and how long the stay in this
“foreign kingdom” will be. Illness, then, can symbol-
ize a journey, albeit a frightening, disorienting one.
The writer and physician Oliver Sacks notes that
the word we use to describe that journey—sicken-
ing—has no counterpart: There is no “healthening.”
We usually use the word recovery, which indicates
we are retrieving our lost health from somewhere,
but it is the “sickening” that provides the powerful
metaphor (quoted in Stein 96).
This metaphor is so powerful, claims David B.
Morris in Illness and Culture in the Postmodern Age,
that “almost every era seems marked by a distinctive
illness that defines or deeply influences it” (50). In
the Middle Ages, the bubonic plague changed the
face of Europe, killing millions of people, approxi-
mately one fourth of the population. Not only did
millions die, but millions more lived in constant fear
of contracting the dreaded plague. In the Renais-
sance, what was known at the time as “melancholy,”
but what today we would call depression, pervaded.
In the late 17th and 18th centuries, sometimes
referred to as the Enlightenment, gout, a kind of
arthritis, and syphilis, a deadly venereal disease, held
sway. Doctors attributed both of these diseases to
the loosening morals of the upper classes, as gout
was mostly diagnosed among the wealthier citizens
who could afford treatment, and syphilis was the
product both of aristocratic promiscuity and the
urban poverty of the prostitutes they frequented.
In the 19th century, tuberculosis was the dominant
illness. With its victims weak, pale, and bedridden,
the disease seemed to indicate that the suffering
it brought purified those whom it struck, or at least
returned them to a natural state. Many artists and
writers of the 19th century died from tuberculosis,
including the writers John Keats, Emily Brontë,
and Robert Louis Stevenson and the composer
Frédéric Chopin, leading to the assumption that
those of artistic temperament were especially sus-
ceptible. In the 20th century, cancer took over as
the defining illness. Cancer is a brutal, seemingly
indestructible enemy that can attack out of nowhere
and that often must be fought by further brutalizing
the body with surgery, chemotherapy, and radiation.
It dehumanizes the patient. As such, it is an appro-
priate metaphor for the 20th century and the rise of
technology.
Many authors have harnessed the power of ill-
ness—its anxiety, its dread, its ability to drive people
apart and to bring them closer together—to tell
their stories. In Louisa May Alcott’s LittLe
woMen, for instance, Beth, the sweetest of the
March sisters, contracts scarlet fever while nursing
a poor family. Although she recovers, she lives life
in a weakened state and eventually succumbs. Her
death reminds the March sisters, especially Jo and
Amy, of the importance of family unity despite
disagreement. In Charles Dickens’s a christMas
caroL, Dickens uses the sickly, disabled figure of
Tiny Tim to illuminate the joy of Christmas. If this
poor creature can be happy, Dickens seems to say,
then so should we all be. A 20th-century take on ill-
ness can be found in Don DeLillo’s white noise.
Jack and his family have come simultaneously to fear
illness and to see it as inevitable. They take pills for
reasons they do not understand and receive vague
diagnoses that only serve to frighten them.
In addition to serving as a useful vehicle around
which to tell a powerful tale, illness has also func-
tioned as a more specific metaphor. For example, ill-
ness can also represent failure. The noted American
sociologist Talcott Parsons has described health as56 illness