When Illness Is a Metaphor

Recovery is a complex word. While those in 12-step communities see it as a continually active state, most of us think of recovery as finite, liminal: between illness and health, injury and healing.

Since receiving a diagnosis of breast cancer in 2015, I have "recovered" from a bilateral mastectomy, reconstructive surgery, a hip replacement, a rotator cuff injury, lymphedema flares, bronchitis that became pneumonia, a months-long period of severe idiopathic hives. Although some of these conditions are ongoing, the eye of the storm tends to blow over, such that acute illness ends and recovery begins, and then recovery, too, passes and life returns to normal.

Or rather, "the new normal,” as we sometimes call our lives after illness. Yet even that, somehow, fails to capture the constant shape-shifting of living in a human body.

What might it mean, psychologically, to exist in a constant state of recovery, never to quite…arrive? I came face to face with this question when, on my way to pick my 15-year-old up from school last week, I got into a car accident that left me with a broken clavicle and a host of other injuries. The airbag—which likely saved my life—ravaged my already-traumatized chest when it deployed, leaving seatbelt-shaped massive bruising across my torso. My neck and shoulder are so swollen it’s hard to differentiate where one ends and the other begins; my right ankle is too big to fit into socks or shoes; my shoulder blades feel battered no matter how I arrange my body. Just looking at the photos of my totaled car, I’m palpitatingly grateful to be alive—to have broken a clavicle rather than my neck or back. December 7 was not the day my children lost their mother, or my husband became a widower. I am lucky and I know it. And yet…

I’m angry too. I’m frustrated. I’m worn down.

To commemorate five years cancer-free, at the onset of 2021 I decided to reclaim my body. Fortunate enough to be working entirely online during the pandemic, I took full advantage of Zoom by throwing myself into Pilates and even hiring a personal trainer at far lower rates than I could have achieved in person.

I had my work cut out for me. Chemo had sent me reeling into instant menopause, and between that and the osteoarthritis that led to my hip replacement, I’d put on 15 pounds. I had lost much hip-flexor strength, and my lymphedema arm was weaker and stiffer than its counterpart. Although I no longer walked with a limp as I had before the hip replacement, appearing able-bodied, my osteoarthritis still left me in chronic pain.

Suddenly, though, I was showing up for workouts with my trainer and Pilates instructor and taking daily walks. I started following a Mediterranean diet, and in the second half of 2021 lost half the weight I’d put on over the past five years. Doing a roll-up was no longer difficult. I’d started hiking again—truth be told, with far more zeal than I’d ever done when I was younger. A friend even told me my posture had changed, becoming more like a dancer’s again like when we first met. By Thanksgiving 2021, I was feeling stronger, more agile, more “like myself” than I had since before cancer.

Enter the shock of two cars careening, the crunch of metal, the explosion of airbags into flesh and bones. As smoke rose from the hood of my car and I panicked that the vehicle would burst into flames, I struggled to open my driver’s side door, but it was crushed shut. Despite my broken clavicle, I managed to escape my seatbelt and crawl to the passenger’s side, hurtling myself out into the 19-degree air, rushing around on my swelling ankle muttering how I needed to call a Lyft for my high schooler who thought I was on my way.

Flashes of the accident come in fragments. Refusing to get into the ambulance because I was afraid it would not be covered by insurance. Being able to walk, still, on adrenaline, when my best friend drove me to the ER, but then losing the ability, my body starting to shake violently as the shock set in. Sobbing in my ER room—a thing I’d never done through cancer surgeries or chemo—because the pain was so extreme I didn’t know how I was supposed to get into my second-floor apartment when I couldn’t even move well enough to get out of a hospital gown into my street clothes. Morphine shot into an IV. And ever since: sleepless nights, unable to turn over; it being an event to get myself to the bathroom or to put my arm into its sling. Canceling physical training. Canceling Pilates. Canceling even a dental appointment. Staying mostly in my bedroom so as not to have to face the stairs. A constant beat in my head droning, Back to square one, back to square one.

Susan Sontag famously argued that illness is not a metaphor…except that sometimes, of course, it is. In the five (endless) days since my accident, I have questioned intensely what it meant, this past year, to start feeling “like myself” again due to increased strength, fitness, weight loss. Who is the self I felt like, exactly…and if I had not been her in the five years since my cancer diagnosis, who had I been? Who had launched my business, gone back to my Ph.D. program, written my memoir, raised my children from gangly tweens into young adults, married the love of my life, learned to play the drums? Who had that woman been if not, of course, me? And yet I’d often felt alien to myself as I’d yearned—without even being conscious of it—for the youthful, abled body I’d possessed before illness, before menopause, before becoming part cyborg, before turning 50. “More like myself again” meant, of course, like a younger version of Me. And I’d been so close…so achingly close.

Back to square one. If, of course, square one had ever included broken bones and prosthetic breasts and a metal hip and six missing lymph nodes and medication to eradicate the threat of estrogen from my system. There was no more returning to whatever square one had been than there was returning to myself at 46, before I’d ever been ill, when I had—like fortysomething women everywhere—absolutely no clue how gloriously young and vibrant I was.

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Sontag knew that illness as a metaphor is dangerous. We use it to Other those who make us uncomfortable or to correlate good health with virtue. But if doing a better Teaser or losing weight made me virtuous, who am I now that I can barely lift my left arm? Am I merely in a holding pattern of “recovery” until I can hurry up and become that woman again? How long will she last this time, before some other accident of fate or age snatches her away?

Illness is only a metaphor, perhaps, if we use it to hold ourselves at arm’s length from time. It does not “signify” our mortality, because we all inhabit our mortality fully every day, whether we choose to look it in the face or not. If the post-cancer, older version of myself has done the things I am proudest of in my entire life, has been the happiest incarnation of me, then why the hell have I been so excited to kick her to the curb and go backward?

These questions, of course, are bigger than my body alone—they are even bigger than the patriarchal expectations heaped upon all women to remain eternally young, thin, able, and conventionally attractive in order to be relevant, as, after all, even being a white, cis, straight, rich, able-bodied man will not save you from illness…and will certainly not save you from death. We are all, the human race, unlikely allies in our irrevocable mortality, and usually in our efforts to ignore it, believing “square one” just another hurdle to jump over, another battle to win.

This accident that could have killed me didn’t. But it’s given me just enough time to press pause on where, exactly, I thought my body was going. We can regain strength—we can recover—but we cannot go back in time. Our bodies are constantly moving targets. Whatever comes next for me—and for you—won’t be a “return” to ourselves, because our selves, too, are constantly evolving. Now, recovery strikes me as both an ongoing state and also only part of the picture. We recover and decay at once—is anything truer of the human condition?

I have lived to see another day, and whatever it brings, it will move, only and eternally, towards the new.