Metaphors can be a fantastic part of any language. They support the creation of an image where a basic description would not be adequate. To go from, ‘The snow covered the ground’ to ‘There was a carpet of white covering the ground’—there is a world of difference between the images created by the first and second phrases. As a teacher, seeing the second phrase in a piece of writing, your heart begins to soar and there is hope that you’ll hit the targets for English this year.
Within health, metaphors are often used to explain things. This is reflected in the advertising of charities who support illnesses such as cancer, when their tag lines are things like, ‘Let’s fight cancer together!’ Let’s take that word ‘fight’ for a moment.
Fight: to take part in a violent struggle involving the exchange of physical blows or the use of weapons, or a struggle to overcome, eliminate, or prevent.
The idea of fighting an illness can help you to understand what lies ahead of you in your treatment plan. Nevertheless, if your cancer is life limiting, are you deserving of death because you didn’t fight hard enough to beat it? It could even be considered that the idea of fighting an illness can actually cause an extension of pain through trying one more drug to give you a little more time.
In the infertility and loss communities, many of us are not strangers to the idea of the fight to become parents. We fight to lose weight for treatment. We fight to raise enough money for a cycle. We fight to find out why things are not working out. In the UK, we fight with clinical commissioning groups for a chance to create a baby. We are also seen to be battling with our bodies.
All these military metaphors are regularly used when discussing illness as they almost create a story. A story of one’s life, you could say. This is not a new turn of medical parlance. Louis Pasteur described germs as invaders, and Thomas Sydenham, on probing the character of illness, said, “…murderous array of disease has to be fought against, and the battle is not a battle for the sluggard.” Whilst in training, medical professionals are taught in immunology about how the white blood cells attack the invading microbes. The battle language of illnesses becomes firmly entrenched in their practice, which opens up a situation where this language is applied to all medical circumstances. It can also be seen as an accurate mode of building a good relationship with patients, as even if it is a more figurative mode of communication, it is communication nonetheless. It is an entirely appropriate image when thinking of germs as the enemy and the immune system as an army going into war, but is it correctly used in situations where it is a persistent illness? Your body is fighting a cold, but is it fighting infertility?
We have completely accepted these terms of description for illnesses, especially in cases of chronic disorders such as infertility, cancer, or HIV, but the question is, are they appropriate? When it is a matter of the immune system being the cause of infertility and the body has incorrectly identified the foetus as the enemy, is it correct and self-compassionate to figuratively identify the body as a battleground when it’s your ‘maybe baby’ being hit by ‘friendly fire’? It has been pointed out in medical literature that using this combative language can lead to higher levels of anxiety, pain and a poorer quality of life. If you describe someone’s discovery of a reproductive disorder as a battle, that instantly splits the outcome into two possible endings. They either win or lose that battle. What is a win in the infertility battle? Is it becoming a parent? What if there is no genetic possibility that you can achieve this? Is it then a battle lost? Are you then assigned to a book of failures? There is also an antagonistic tone to the word ‘battle’. You become caught up in war that you will never win. The patient, trying new regimens of acupuncture, PIO (progesterone in oil), and a plethora of vitamins, is engaged in a new form of military strategy. Does a child signify the enemy beaten? Does the transition to ‘childlessness not by choice’ mark the end of the struggle?
For those who manage to have a child, the language of war persists as you are deemed a survivor. A survivor conjures images of those who managed to escape Auschwitz or other atrocities of war. Are you truly a survivor when the battle is not truly won? We are all aware that a child does not necessarily equal the end of the war. You are still infertile; how can you be completely cured of your widely varying causes for infertility? Having a baby does not mean that you will have no further losses as, sadly, being pregnant does not teach your body what to do. You cannot truly beat infertility.
For some people, the military metaphor in illness can be a positive and important factor in understanding their disorder. The fight, when seen as a challenge, can be imagined as a time for personal growth; a time for courage and resilience. A time to come back ‘with all guns blazing’! It’s ultimately down to you and your personal preference as, realistically, metaphors are not good or bad things—they are merely words that create an image, and you will decide, based on your history and values, as to what that image purveys. You can choose the treatment for your form of infertility and you can choose how to describe it.
So how do you view your past? Has it been a battle, a journey or a rollercoaster? Are you a warrior, no matter whether you got your baby or not?