That even an apocalypse can be made to seem part of the ordinary horizon of expectation constitutes an unparalleled violence that is being done to our sense of reality, to our humanity. But it is highly desirable for a specific dreaded illness to come to seem
ordinary. Even the disease most fraught with meaning can become just an illness. It has happened with leprosy, though some ten million people in the world, easy to ignore since almost all live in Africa and the Indian subcontinent, have what is now called, as part of its wholesome dedramatization, Hansen's disease (after the Norwegian physician who, over a century ago, discovered the bacillus). It is bound to happen with AIDS, when the illness is much better understood and, above all, treatable. For the time being, much in the way of individual experience and soci;il policy depends on the struggle for rhctoric:il owiici
ship of the illness: how it is possessed, iissiitiilnlrd argument and in cliche. The age-old, seemingly inexorable process whereby diseases acquire meanings (by coming to stand for the deepest fears) and inflict stigma is always worth challenging, and it does seem to have more limited credibility in the modern world, among people willing to be modern-the process is under surveillance now. With this illness, one that elicits so much guilt and shame, the effort to detach it from these meanings, these metaphors, seems particularly liberating, even consoling. But the metaphors cannot be distanced just by abstaining from them. They have to be exposed, criticized, belabored, used up. Not all metaphors applied to illnesses and their treatment are equally unsavory and distorting. The one I am most eager to see retired-more than ever since the emergence of AIDS-is the military metaphor. Its converse, the medical model of the public weal, is probably more dangerous and far-reaching in its consequences, since it not only provides a persuasive justification for authoritarian rule but implicitly suggests the necessity of state-sponsored repression and violence (the equivalent of surgical removal or chemical control of the offending or "unhealthy" parts of the body politic). But the effect of the military imagery on thinking about sickness and health is far from inconsequential. It overmobilizes, it overdescribes, and it powerfully contributes to the excommunicating and stigmatizing of the ill.
No, it is not desirable for medicine, any more than for war, to be "total." Neither is the crisis created by AIDS a "total7' anything. We are not being invaded. The body is not a battlefield. The ill are neither unavoidable casualties nor the enemy. We-medicine, society-are not authorized to fight back by any means whatever. . . . About that metaphor, the military one, I would say, if I may paraphrase Lucretius: Give it back to the war-makers.
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