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The Country of the Ill

IN HER GROUNDBREAKING BOOK, ILLNESS AS METAPHOR, SUSAN SONTAG DEFINED illness as both the landscape of biological disease and a socially constructed system of meaning. Together, biology and culture created another country, "the kingdom of the ill," a country one could enter at any time, perhaps never again receiving the return passport for the "kingdom of the well."' Sontag's book was a philosophical meditation on the cultural meanings ascribed to tuberculosis and cancer (and, in a second edition, AIDS). She chose not discuss her own experience of cancer, which had been the original spark for her researches. Since then, however, we have seen more and more books by both doctors and patients that intertwine personal experience with cultural analysis. Some prominent examples are: Arthur Kleinman's The Illness Narratives, Audre Lorde's The Cancer Journals, Kay Redfield Jameson's An Unquiet Mind, and Arthur W. Frank's At the Will of the Body: Reflections on Illness and The Wounded Storyteller: Body, Illness, and Ethics.2 In At the Will of the Body, Frank makes an important distinction between "disease" and "illness" that is helpful to cultural analysis. Disease is the supposedly "objective" phenomenon of the malfunctioning body-defined by "medical talk" that "uses disease terms that reduce the body to physiology"; disease makes "my body, my ongoing experience of being alive, [become] the body, an object to