“I’m going to kill you. Every day, I’m going to kill you, and then I’m going to bring you back to life. We’re going to hit you with chemo, and then hit you again, and hit you again. You’re not going to be able to walk. We’re practically going to have to teach you to walk again after we’re done.” Anonymous Oncologist[

When the cyclist Lance Armstrong was diagnosed with testicular cancer, an oncologist spoke the above words to him. The oncologist uses very powerful metaphorical language to describe the treatment that Armstrong will face. Metaphor is understanding and experiencing one kind of thing in terms of another. As an example, in her beautiful poem, Emily Dickinson describes hope as feathers:
Hope is the thing with feathers
That perches in the soul,

Metaphors can be thought of as a tool for understanding and describing what is not known and what is known.

In Emily Dickinson`s poem, hope is an intangible quality that can never be fully known or fully described (the not known) while feathers are known. When looking at descriptions, especially around an illness, (for example cancer), war and battle are common/ dominant metaphors. There are several reasons why this may be so.

Firstly, the battle metaphor is prevalent and almost unnoticed in society (the “battles” against terrorism, drugs, poverty, illiteracy, and teen pregnancy).

Secondly, a metaphor such as “battle” can signify important aspects of illness. There is a readily recognizable soldier (the patient), an enemy (the illness), a general (the physician), allies (family, friends, the health team), and weapons (including chemical, radiological, targeted “magic bullets” and nuclear isotopes).

Thirdly, the “battle” metaphor connotes a commonality of purpose ( we all will fight a common enemy of illness- all for one and one for all!).

Fourthly, a battle image may offer a patient a sense of autonomy and control over their illness. Images of powerful soldiers and focused aggression serve as strong counterpoints to the powerlessness and passivity often associated with serious illness.

Metaphors can be text or visual. A manufacturer of a drug designed for breast cancer designed a Patient Information Web Site to advise women to “FIGHT HARD and FIGHT BACK in your battle against advanced breast cancer.”
]Another advertisement for a drug for breast cancer treatment, features a woman wearing pink boxing gloves. Another shows a woman wielding a sword, and proclaims that the drug “fights as hard as she does.” Yet another Web Site announces that, “Jack is here today because he fought,” and admonishes the reader, “You must fight, too.”[ Cancer Battle Plan Web site.]

However, with Write 2 Right, things are never as them seem.

A “battle” can be viewed as masculine and violent. For some patients battle, conflict, fighting, and war may not he a preferred way of describing their illness.. As a patient with colon cancer said, “The standard comparison of cancer as a war to be fought—a ‘battle with cancer’—was less than palatable. I had already experienced real war in Vietnam and was not anxious to repeat anything closely resembling that.”[ Martin J: A monumental victory: Talk of the gown. Northeastern University Online Magazine.]

A battle metaphor may suggest that winning a war (defeating an illness) is possible and is really only a matter of fighting hard enough. But, if the illness is not curable, then the patient may feel it is their fault- they did not fight hard enough. They may feel like a failure and defeated: patients fail treatment instead of treatment failing patients. In a culture in which quitting and losing are not acceptable, deciding to for example opt out of treatment can leave patients feeling abandoned. In a culture in which quitting and losing are not acceptable, opting out of therapy can leave patients wracked with feelings of guilt and inadequacy.

The notion of a “battle” may encourage patients to keep fighting and fighting and fighting. Even though they are exhausted, they must be courageous and stiff-upper-lipped.

In any illness, there are no actual enemy invaders; the enemy is within the self. In a battle metaphor, a patient ends up battling with the self. Some of the limitations of a battle metaphor are further illustrated by the comments of Ric Blake, a patient with metastatic thyroid cancer:
“Doctors, I think, don’t get the nuts and the bolts. I have to look at my whole life, not just the disease, but my family, my job, my finances, my psyche. What concerns me then when the patient loses the battle, then they (the physicians) withdraw, they turn it over to someone else, and the patient’s left fighting the rest of the war by themselves… I want them to stick there, all the way to the end. Just “cause we’re gong to lose the war, doesn’t mean that everybody has to leave the field.”

An alternative metaphor (moving beyond the battle) may be the metaphor of a journey. A journey metaphor evokes possibility: for exploration, struggle, hope, discovery, and change. Paths may be winding and twisting and covered with brambles and bumpy and dark.
There may be uncharted byways and U turns and crossroads.
The walking or driving may be fast or slow or variable. The signposts may all have been stolen. There may be a taxi blocking the way.
People can devise their own metaphors based on things they know and value, and metaphors can potentially enable a person (writer) to describe what they want to say.

Jack Martin, Vice President for Business at Northeastern University, adopted a building project as a metaphor for his cancer treatment. He developed a set of metaphoric correspondences (setbacks such as radiation burns were “change orders” or “delays in the project”).
R.V. Young, suffering from metastatic prostate cancer found resonance with the metaphor of scaling Mount Everest. Treatment became a dangerous uphill slog. His need for oxygen and a cane (his metaphoric was “ice axes”) were transformed from symbols of disability to necessary tools for traversing the steep slope.. Other metaphors for illness are: a chess match, the clutches of a crab, a marathon, a drama, a dance and a collaborative project.
Lance Armstrong wrote: about his treatment:
“I had opened up a gap on the field. I knew that if I was going to be cured, that was the way it would go, with a big surging attack, just like in a race were my motivator, my yellow jersey… I began to think of my recovery like a time trial in the Tour de France). …I wanted to tear the legs off cancer, the way I tore the legs off other riders on a hill.”