Feature Metaphors and cancer A project at Lancaster University has been connecting linguistics, computer science and healthcare. Elena Semino explains how the experience of researching metaphors for cancer has been rewarding, challenging, moving, and occasionally entertaining too. Metaphors and cancer Babel The Language Magazine | May 2015 15 Feature Metaphors and cancer uch of what “People who are backgrounding others. When happens ill with cancer are metaphors work well, they can when help us to understand things we are ill often expected, or even feel better about them. involves or encouraged, to When they work badly, they can spoken ‘fight’ their cancer confuse us or make us feel worse. Mand written communication. in order to survive. The metaphors we use for We speak about our symptoms cancer have been the topic to family, friends, nurses and When someone dies of a lot of discussion, both in doctors; we read information of cancer, they are academic books and papers, online, in books, on medication sometimes described and in the media. In particular, packets, etc.; nurses and doctors many people have criticised the discuss our symptoms and as having lost use of metaphors such as the treatment among themselves and their ‘battle’ with ‘fight’ against cancer, because write notes and reports for one the disease. Both it can increase people’s anxiety another. Getting better partly or even make them feel guilty if depends on all those different ‘fight’ and ‘battle’ they don’t get better. Writing in types of communication working are examples of the Guardian newspaper in April well, so that we get the best metaphors that are 2014, Kate Granger, a doctor with possible diagnosis, care and incurable cancer, says: treatment. In addition, our conventionally used in ‘She lost her brave fight.’ If anyone own well-being throughout the English to talk about mutters those words after my experience can be affected by the experience of death, wherever I am, I will curse how our illness is talked about, in cancer.” them. informal or medical interactions, […] in charity campaigns, in the I do not want to feel a failure about media, and so on. something beyond my control. I At Lancaster University, we conventionally used in English refuse to believe my death will be have studied the language that to talk about the experience of because I didn’t battle hard enough. is used to talk about cancer cancer. (The Guardian, 25/4/2014) today in the UK, and particularly Metaphors involve talking the metaphors that are used by and, potentially, thinking about Kate Granger is not alone healthcare professionals, people one thing in terms of another, in feeling like this, and many with cancer, and family carers where the two things are healthcare professionals in the looking after a loved one with different but we can see them UK are aware of the potential cancer. The study involved a as similar in some way. For negative consequences for large team consisting of myself, example, being ill with cancer patients of the Fight metaphor. four other linguists (Veronika and fighting a battle are different As a result, recent policy Koller, Andrew Hardie, Zsófia things, but we can see them as documents in the National Demjén and Jane Demmen), a similar. Among other things, Health Service do not use this computer scientist (Paul Rayson) both are difficult and dangerous; metaphor, but talk instead about and a palliative care researcher both can make us feel anxious; cancer as a ‘journey’. Journey (Sheila Payne). both can lead to death. However, metaphors do not involve an metaphors do not simply reflect enemy, nor victory or defeat, Why study metaphors and pre-existing similarities between and are therefore felt to be more cancer? things. They can also create positive for patients than Fight People who are ill with cancer are similarities. The Fight metaphor metaphors. All of this, however, often expected, or encouraged, for cancer, for example, can leads to some questions that to ‘fight’ their cancer in order make us see the cancer as an linguists can help answer: what to survive. When someone dies evil enemy, and not getting metaphors are actually used by of cancer, they are sometimes better as a defeat. Linguists and people involved with cancer described as having lost their psychologists say that different from different perspectives? And ‘battle’ with the disease. metaphors frame the experience what evidence is there that some Both ‘fight’ and ‘battle’ are of cancer in different ways, metaphors are better for patients examples of metaphors that are highlighting some aspects while than others? 16 Babel The Language Magazine | May 2015 Feature Metaphors and cancer Our study 2. So sorry to hear what your Are some metaphors always In order to answer those partner is going through. good or bad for patients? questions, one needs, first MM [Malignant melanoma] We contrasted particularly and foremost, large quantities is a hard road to travel both Journey metaphors in our patient of relevant language data. physically and mentally. data with what we call Violence With funding from the UK’s 3. Imagine it a bit like a scary metaphors, which include Fight Economic and Social Research fairground ride ... it might metaphors. We wanted to see Council (grant ES/J007927/1), be scary in places, but it will whether there is evidence that we collected a dataset or eventually stop and you can Violence metaphors are bad for ‘corpus’ of interviews with, and get off ... be strong, be brave patients, and Journey metaphors online forum contributions by, and you’ll be ok a better alternative. members of the three groups I 4. This journey is not a sprint We found plenty of mentioned earlier: patients with but a full blown marathon evidence to suggest that advanced cancer, family carers, but with the right endurance Violence metaphors can reflect and healthcare professionals. training one you can win. and reinforce feelings of In total, our corpus contains 5. They [a lot of medical staff] disempowerment, anxiety and approximately 1.5 million words. look on us all as just another even guilt: Even with a team as large as appointment, and into the ours, a corpus of this size cannot sausage machine we go. 7 It’s sad that anyone, but realistically be read in its entirety 6. Am I pathetic wanting that or especially younger people like several times in order to find what but I feel like a prisoner yourself, find themself with all the metaphors. Instead, we with all the rules about don’t this battle to fight. analysed a 90,000-word sample eat this don’t do that. 8. I feel such a failure that I am from the corpus ‘manually’, not winning this battle. by reading it and applying our As these extracts show, criteria for what counts as an patients use, amongst others, Example 8, in particular, instance of metaphor (including Fight metaphors (example 1), shows the potential negative both metaphorical expressions Journey metaphors (example consequences of seeing lack of and similes). We then used the 2), Fairground metaphors recovery as defeat; the patient computer-assisted methods of (including the simile in example can feel responsible for the Corpus Linguistics to analyse 3), Sports metaphors (example 4), failure of treatment, which is not the rest of the data on the basis Machine metaphors (example 5) their fault. of the findings of our analysis and Imprisonment metaphors On the other hand, some of the sample data. In this way, (example 6). Moreover, they use other patients use Violence we arrived at some answers for these metaphors to do different metaphors in ways that present the questions we asked at the things, such as: encouraging one them as determined, proud and beginning. another (examples 1, 3 and 4), empowered in their experience sympathising with one another of illness: What metaphors do people (example 2) and expressing with cancer use to talk about their frustration with the 9. My consultants recognised their experiences? illness (example 6) or with the that I was a born fighter. The cancer patients represented doctors and healthcare system 10 Cancer and the fighting of it in our data use a large variety (example 5). These metaphors is something to be very proud of different metaphors to talk also differ in how they frame the of. about different aspects of their patient within the experience experiences (NB: extracts from of illness, especially in terms Similarly, Journey metaphors our online data and interview of agency. In example 3, the are used in different ways by transcripts are reproduced patient is presented as active different people. Some patients exactly as in the original; all and empowered (‘with the right use them to position themselves names have been changed): endurance training you can in an empowered role and to 1. You have a lot to dig in and win’), whereas in example 6 the suggest an optimistic attitude fight for and I know you can patient is in a more passive and and a sense of companionship and will. Dust yourself down disempowered position (‘I feel with others: and prepare for the battle girl. like a prisoner’). Babel The Language Magazine | May 2015 17 Feature Metaphors and cancer journey has many twists and However, the patients use these turns that means no two metaphors to express a positive people go the exact same evaluation while the healthcare route. I think it is like trying professionals use them to express to drive a coach and horses a negative evaluation of the same uphill with no back wheels on attitudes and behaviours. the coach. Moreover, when patients 14. How the hell am I supposed describe themselves as ‘fighters’, to know how to navigate this they tend to place themselves in road I do not even want to be a position of control over what on when I’ve never done it happens to them.