Simon Sahner explores the twofold language of illness  Illness – A Metaphorical Battle

When it comes to illness – especially serious illness – we often resort to language that makes it sound like we’re heading into battle. Our new columnist, Simon Sahner, knows from his own painful experience that martial metaphors can help us endure the burden of a sick body – and fight for recovery.

A few days ago, I called the appointment office of a university hospital eighteen times. Each time the line was busy, or I waited for the phone to ring ten times before hanging up. On my nineteenth attempt, someone finally picked up. I rattled off the words that had somehow become second nature to me: tumour follow-up, thigh, thorax, CT, MRI. Three minutes later, the appointment was set.

Fighting the Enemy

I’ve been doing this for almost ten years. Each time, I fall back into the language of an illness that surrounded me daily for about a year. It’s a language that has two dimensions: a literal one and a metaphorical one. In the literal dimension, we describe the illness for what it is: a medically definable process in the human body. In my case, it was a bone tumour in my right thigh that may have already formed micrometastases in the lungs. This language level explains exactly what the illness is, but it says very little about how deeply, and in what ways, it impacts our lives. This is why we have developed a metaphorical dimension, to find a way of expressing what an illness does to us. In the case of cancer, in particular, this often takes the form of a language of struggle, of war, resistance and endurance. The illness becomes the enemy we must confront.

Hardly any other disease is seen as such a tangible enemy as cancer. We can wage wars against an enemy. In 1971, then US President Richard Nixon declared a “war on cancer”. Oncologist Siddhartha Mukherjee uses this metaphor in the foreword to The Emperor of All Maladies, describing his book about cancer as a “history of a war”, claiming there are “victories and losses, campaigns upon campaigns, heroes and hubris, survival and resilience”. Cancer appears here as an enemy we can face.

Strictly speaking, however, this metaphor is misleading. Cancer is a disease that arises from within the body – it is not an enemy that attacks from the outside. While external factors may contribute to its development, the disease ultimately grows within our body, which in this way turns against itself.

By framing a tumor metaphorically as something alien to the body, we can construct a narrative of war in which we are the heroes battling a dangerous enemy. This approach is essential for coping with the disease on an emotional level. Only when cancer is declared an enemy attacking our own body can we go to war against it.

Motivating Metaphors

This has a psychological effect on both patients and doctors. By wrapping cancer in metaphors and, in a figurative sense, declaring war on it, we are simply motivating ourselves to confront a challenge. The war narrative we construct functions like a commander’s rallying speech, preparing his troops for battle ahead.

Metaphors play a crucial role in how we talk about illness, because diseases often present themselves to us in highly abstract ways. We feel the symptoms and suffer their consequences, yet we almost never see the tumour or virus. Language, then – as so often – is a way to give shape to what we cannot see, yet still fear, turning it into images that help us process and play out our emotions.

Conversely, we often use medical terms such as cancer, virus, epidemic or fever curve to metaphorically describe other processes that have nothing to do with illness. It is a metaphorical language game with two sides, which Susan Sonntag also describes in her famous essay Illness as Metaphor. I will explore this topic in the next issue of this column.

February 2026