ABSTRACT
The use of metaphor has been unconsciously repressed and consciously suppressed in medicine, and this has negative consequences. Metaphors are explored as both the end product of a transformation (the ordinary into the extraordinary) and the medium through which that transformation is achieved (metaphors are good to think with, or imagine with). Metaphors, too, can be ‘dead’ (overused) and even malicious – they can mislead or corrupt, closing down thinking, and they can be mobilized on behalf of ideology and moral assumptions. Two leading (‘didactic’) metaphors that once had verve and impact in medicine – ‘medicine as war’ and ‘the body as machine’ – are introduced as now ‘dead’ and potentially ‘malignant’, or stigmatizing, metaphors. Metaphors thus shift their meanings historically. Studies of the appearance of metaphor in medical texts, through corpus linguistics analyses, suggest that metaphor use is suppressed, and this needs to be explained.
Metaphor use extends beyond texts to performances or activities. Specific use of metaphor does not account for the overarching historical shaping of medicine through didactic metaphors (again, ‘medicine as war’, ‘body as machine’ and also ‘illness as a journey’). Metaphor in medicine has several functions – for example, the body can be conceived as a landscape and territory that can be exploited (‘harvesting’ organs). Metaphors are not, then, for ornamentation, but serve deeper purposes such as shifting the register of thinking and shaping whole cultural landscapes. Metaphors promote ‘thinking otherwise’, against the grain of convention.
