ABSTRACT
Two overarching, or didactic, metaphors have shaped medical culture – ‘the body as machine’ (introduced by Vesalius in the sixteenth century) and ‘medicine as war’ (or violence) (introduced by Thomas Sydenham in the seventeenth century). While these metaphors had a certain power and impact when first introduced, they have now become tired and inappropriate for contemporary medical practice. They are ‘dead’, even ‘malignant’, metaphors. The body as machine dehumanizes, and medicine as war stigmatizes – inappropriately situating both patient and healthcare provider as fighters engaging in a battle and violence, running against the grain of what persons may actually experience. Another key metaphor is ‘illness as a journey’ – again potentially running counter to patients’ experiences.
A counter-intuitive reading of ‘machine’ and the ‘mechanical’ is presented that allows us to challenge traditional mechanistic body metaphors. This model introduces a feminizing of the otherwise typically masculine ‘machine’. The feminizing impulse that pervades contemporary medicine may tip the scales towards the emergence of multiple new metaphors shaping future practices, also honouring, rather than dictating, patients’ unique experiences. Metaphors of humanizing and collaboration, central to patient-centred, inter-professional healthcare teamwork, may be established as leading metaphors, displacing machine and martial metaphors that once illuminated, but now dehumanize and objectify.
