In his book The Emperor of All Maladies: A Biography of Cancer, cancer physician Siddhartha Mukherjee recounts the history of a disease that has haunted humans for millennia. Paleopathologists, he says, have discovered evidence of cancer in a human jawbone dating to 4000 BC, and descriptions of a disease sounding very much like cancer appear in an Egyptian papyri from 2500 BC. Karkinos, Greek for “crab,” first appears as a medical term in about 400 BC, around the time of Hippocrates. “Crab” vividly describes the mysterious illness: a firm, subcutaneous mass, like a shell, which seems able to crawl through the body and create pain “like being caught in the grip of a crab’s pincers,” says Mukherjee.
Claudius Galen, a second-century Greek doctor, classified illnesses according to the four humors, the wide range of human diseases caused by an imbalance of blood, mucus, yellow bile, or black bile; and cancer’s hard carapace, he said, was the result of an excess of black bile. Galen’s taxonomy prevailed in Western medicine for well over a thousand years, spawning an exotic range of cancer treatments designed to restore the body’s balance of fluids, including ointments and salves made from crab’s eyes, goat’s dung, tortoise liver, boar’s tooth, fox lungs, and extracts containing arsenic and lead.
But with the development of the modern medical autopsy, physicians’ understanding of cancer began to shift from speculation to observation, marking the beginning of modern cancer treatment. Upon examining the bodies of men and women killed by the disease, doctors could find no evidence of “black bile,” discovering, instead, a wide range of tumors throughout the different bodies they were dissecting. At this time the language of cancer—the description of its location within the body, properties of various tumors, observations of their growth and spread—became much more useful. Doctors discovered that, unlike the ominous “black bile,” which could be anywhere and everywhere in the body and generate random outcroppings, cancerous tumors were local and could sometimes be removed. The cure was often worse than the disease: until the development of antisepsis in the mid-nineteenth century, surgery usually led to massive infection, often fatal. But antisepsis, along with the discovery of reliable, safe anesthetic, combined with the empirical discoveries of the modern autopsy, marked the beginning of a revolution in cancer treatment.
“To name an illness is to describe a certain condition of suffering—a literary act before it becomes a medical one,” writes Mukherjee. “A patient, long before he becomes the subject of medical scrutiny, is, at first, simply a storyteller. To relieve an illness, one must begin, then, by unburdening its story.”
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I have always trusted that medicine is precise, objective, and empirical, so storytelling is the last thing on my mind when the radiologist takes an x-ray of my knee or the lab tech draws my blood to check my cholesterol. But like every other cultural activity, medicine is entwined with narrative and metaphor, those great, ancient, world-making gifts. God made Adam creation’s first gardener, but before any of the digging, planting, or grafting, the first task for the human was literary: give names to the creatures, from the aardvark to the zorilla and everything in between. All of our ongoing acts of naming, including those of the cancer researchers, are a continuation of that same primordial language-arts assignment. It’s the story: the story’s the thing, and Mukherjee’s incredible book is saturated with narrative and metaphor.
Storytelling and mythmaking are ancient and global practices, and as with all things cultural, story and myth evolve, adapt, and are renewed in the rich, drawn-out process of cultural transmission. But something new has emerged in Western culture, not an evolution but a drastic break with the process itself. The grand cultural narratives we have long been telling to one another and to ourselves in order to shape our minds and lives and communities have been undermined and discredited because those primary literary and spiritual creative acts of naming and storytelling have become suspect. Language, we are lately told, is nothing but a social construct and therefore arbitrary, making meaning amorphous and indeterminate. All of the grand metaphors, under the guise of theology, politics, society, and human nature, are fundamentally ideological, tools of power and domination and violence. No longer confident that our word- and world-makings are in any way sacred callings, language and meaning are largely up for grabs. Meaning is secondary at best, fundamentally subject to the overarching demands and machinations of power.
The grand cultural narratives we have long been telling to one another and to ourselves in order to shape our minds and lives and communities have been undermined and discredited because those primary literary and spiritual creative acts of naming and storytelling have become suspect.
And this in a time when a near-infinity of writing is available via the internet. When a medieval monk copied a manuscript, not only did he write with such care and attention so as to not make even a single spelling or transcription error; he illuminated texts to highlight the sacredness of words. Writing was an act of worship; elevation. Today, by comparison, we are so entirely saturated in words they seem disposable. At a superficial level, the glut of throwaway words seems like an innocuous sign of the times. Twitter hashtags, an updated Facebook mood status, dozens of “likes” for your Instagram post of today’s expensive brunch are as forgettable as they are trivial, and the catchy, provocative, punchy slogans that clog up browser sidebars to get us to shell out cash are a seemingly harmless hybrid of the seductive and the fatuous, hardly a matter of life and death. But even supposedly disposable words can be potent and dangerous. Tossed-off tweets can inflame real hatred—can suggest that a president would support an insurrection, can suggest that a public figure would support the burning of a downtown—and once you begin excavating the painful truths beneath the glamorous sheen of advertising slogans you wind up having to think about labor conditions, the ecological impact of production and consumption, and toxic-waste disposal; then on to the great perennial, existential questions about well-being and health, rights and community, justice and violence, life and death, all of which center, in one way or another, on questions about the “person.”
We have some real evidence that language and words still seem to have serious power and meaning, but our shared common sense of that power and meaning is wobbly at best. Even that general sense of the “person” is anything but general; we no longer share anything like a basic response to Wendell Berry’s question: What are people for? The Christian narrative tells us the human being is made in the image of the divine, formed from dirt and breathed into by God the Creator, and that story has been absolutely essential to our politics and culture. But those teachings have been disputed, discredited, and discarded, leaving us, at least for the time being, in a grand, haunting metaphor void.
We have some real evidence that language and words still seem to have serious power and meaning, but our shared common sense of that power and meaning is wobbly at best.
In Mukherjee’s “biography” of cancer, research and treatment of the disease move forward as the language and narrative of the illness move closer to the actual flesh and blood of the patients. It is the truth, not abstract thought, that heals: the more precise the narrative, the more effective the treatment. By contrast, our disparate and disputed metaphors for what a human being is seem to be carrying us ever further away from meaningful, effective treatments for our cultural and psychic maladies. It becomes ever more difficult to diagnose, let alone treat, our human condition when we are entirely unclear about what it actually means to be human. Absent any kind of shared, basic anthropology, the ethical problems pile up quickly: How is it possible to discern a compelling moral oughtness to our behavior if we believe that the human is nothing more than stardust plus time plus chance? What if the evolutionary biologists are correct, having us pegged as the most highly advanced primates? Does that then imply significant, detailed moral obligations? If so, how, exactly? And which ones? Are the modern ethicists and anarcho-primitivists right, that a human is just another animal, no more or less meaningful than Fluffy or Fido, mongoose or mouse? Or does a self-described reductionist like E.O. Wilson have us properly pegged as blind carriers of genes, slaves to our DNA? What if we are economic beings, Homo economicus, the value of each person measured by his or her contribution to the GDP? The Industrial Revolution gave us a powerful image of the human as complex, fleshy machine, now taken up and digitized by the priests and apostles of Silicon Valley, but we don’t hold machines accountable for their “actions.” What moral impetus then for us, mere meaty hardware? Maybe the most pervasive image of the human, at least in North America, is hard to see precisely because it’s right under our noses: the human as consumer, in which case George Bush’s “go shopping” response to 9/11 was exactly right. Maybe that’s the closest thing we have to a shared anthropology: our most cherished understanding of what it is to be human is that we are free to choose. It is choice itself, not the substance of the choice, that we insist on. Homo eligens: the deciding being. Absent any general agreement as to what we really are, it’s you pick your meaning and I’ll pick mine.
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I don’t mean to be nostalgic for some imaginary, sentimental golden age when folks said what they meant and meant what they said because they all believed in a capital-g God, but I recognize my need to be cautious. I am at the age when I’ve got increasing symptoms of GOMS (Grumpy Old Man Syndrome), the first sign of which was when I caught myself saying, “Well, now, when I was a kid . . .” Warning us against exactly this sort of thing, Annie Dillard writes, “The good times, and the heroic people, are all gone. Everyone knows this. Everyone always has. The mournings of the wise recur as a comic refrain down the vaults of recorded time.” Duly noted: even a small dose of historical relativism can help keep in check the latest crest of anxious fretting over cultural decline and whatever it is the kids are up to nowadays.
That said, a polite, nonjudgmental nod at the erosion of long-standing cultural traditions is the quintessential posture of our postmodern, hyper-capitalist, postcolonial, constructivist, tolerant, connected, mediated, tribalized, technologized, globalized, individualized, post-truth times. Kindly accept whatever comes and goes and you’ll find some place that you can fit in just fine. Stand firm for something, claim to actually believe something significant and true, and, bolder yet, suggest that it’s not just true for you but for others as well, and you’ll find yourself in a hard swim against a very, very powerful tide.
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I’m trying to make sense of language and metaphor that maybe seems like a trifling exercise alongside a global pandemic, the background threat of extremist politics and responses to them, civil wars in Ethiopia and Uganda, carbon in the air, and power-mongering politicos. After all, everyone seems to be getting along fine with language as it is. We still send birthday greetings, still send flowers on Valentine’s Day, still type caustic, witty replies in the comments section, still look for language, awkwardly, when we hear of another death. There’s no shortage of words floating around. But there remains some fundamental connection between words and flesh, the mysterious braid of thought, word, and deed, and when that relationship is wound with suspicion, doubt, and cynicism rather than love, we pretty quickly wind up slogging around in vertigo-inducing arbitrariness. With meaning in flux, our greater collective moral ambitions are eroded by our inability to even speak clearly to one another. The center is missing; “The glue is gone,” says Edward Hoagland. Freed from the supposed tyranny of our grand narratives, free to choose, we have cut the thread to history and to the transcendent, and genuine communion is the first casualty.
Freed from the supposed tyranny of our grand narratives, free to choose, we have cut the thread to history and to the transcendent, and genuine communion is the first casualty.
It is nothing new that men and women tell lies, break promises, and deceive others, or that ideologues use propaganda to hijack meaning in the service of unholy ends, but our collective suspicion and distrust of language seems like something different. So while the partisan camps scream back and forth at one another, the rumbling remnants of deconstructionist rhetoric make it impossible to know where to begin to establish anything like common ground. It has become very, very hard to argue compellingly why any of this really matters because we supposedly now inhabit a “post-truth” era, a phantasmagoric mix of critical theory, raw power, populism, and serious cultural wobbliness. Faith in words erodes, language becomes unusably soft, and any claim to genuine meaning sets the supposedly respectable intellectuals hollering “Fascism!” I find cut-up, dislocated abbreviations and slogans that make up texts, tweets, and posts annoying, but that grand disintegration of meaning, the supposed arbitrariness of truth, the fundamental, seismic separation of words from flesh keep me up at night. Pilate’s “What is truth?” unwittingly presages our postmodern, post-truth world. Can words actually carry meaning, or are they nothing more than blunt instruments of ideology and power? Can words convey truth, or is that an idea well past its best-before date?
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I’m way out of my league here, I know. I am not a philosopher, theologian, or linguist. These are some seriously big issues I’m trying to work with here, and by this point you and I can both see I’m in way over my head. I’m trying to braid together a cord of language, meaning, and life itself, and if you tease out any one thread, the cord weakens or breaks. My attempt to articulate a philosophy of language in a few thousand words is reckless, but my quest is fairly urgent because what I’m trying to do mostly is persuade myself that we can still use language meaningfully, still say something real about our deepest longings and loves.
I’m a part-time lay minister at an Anglican church, and, until pandemic restrictions made it impossible, I would spend a lot of time over breakfasts at the local diner, pastoring people in my congregation, mostly young men, all of whom are struggling to discern some kind of genuinely meaningful calling amid the various roles they enact: the well-paid worker or the unemployed, single or married, father to some or childless. Over more than a decade I’ve had hundreds of conversations with a man I know who’s been paying for sex for years, trying to break the habit he knows won’t get him what he really wants. I’ve spent a lot less time but still a helluvalot of emotional energy with the middle-aged father of two who came to me to say he wanted to be a good father; meanwhile he was wandering further and further from home, searching for elusive happiness way outside the edge of domestic orbit until he finally drifted beyond the gravitational pull of his vows and left his wife for another woman, hoping for satisfaction in an ad-hoc mid-life Plan B. I’ve spent dozens of hours with a sensitive young man with a drinking problem who recently started the twelve steps. I remember conversations with the husband who told me he was going to leave his wife because he wanted to “play the field.” For more than five years I’ve been having occasional breakfasts with the father with two young boys who stays with his wife not out of a speck of affection but simply because he gave his word; last month they decided to get a divorce. I have had countless cups of coffee with the husband trying to hold on to his marital vows as his wife’s existence is decimated by mental illness, and many long, weighty talks with a young dad who recently tried to kill himself. And on and on and on it goes.
I sit there, dumbstruck by the gravity of their situations; dumbstruck, too, by the ubiquitous, underlying skepticism about language and meaning. I dig through my familiar religious vocabulary for words like “vows,” “covenant,” “faithfulness,” “forgiveness,” and “grace,” and I’m not afraid to use the “s” word—“sin.” But every one of those words feels tinny and malleable as soon it comes out of my mouth. “I have tried to learn the language of Christianity . . . and I feel the falseness,” writes the poet Christian Wiman, “or no, not even that, a certain inaccuracy and slippage, as if the equipment were worn and inadequate—at every step.” I’m not even confident using the word “love,” which, it seems to me, is what everything hinges on. That great suspicion of language is in my head too, not just “out there” where story and meaning are so thoroughly distrusted. So I sit, listen, eat my breakfast, try to find ways to encourage, call them back to hard-to-picture promises of love and fidelity, what they could do, who they could be. I offer them my presence and promise to meet them when they need. I carry their trust, as much as they feel they can hand to me, and I offer communion, even as I struggle to find the words. And as they speak, I circle with them around the miracle of being, trying to see through the poisonous vapors of betrayal, disappointment, suffering, trying to find something real and solid to hold on to. I cannot take on the disintegrated meaning in any other way. I am here, I am for you, even if I am not on your side. I am recalled to the trust and care, meaning sustained with words over cups of bottomless coffee and the breakfast special at the corner diner.
Mukherjee shows that the truer the metaphors, the better the treatment; in medicine, so as in the rest of life. Critical theory and its more diffuse and far-reaching descendants, skepticism and cynicism, want to persuade me there is no truth, that our world is now post-truth so just get on with it, yet here we are, going on using words anyway, as if they truly do mean something. And when my pastoral charge tells his wife, “I don’t love you; I haven’t loved you for years. And today I am leaving you,” some very real, tangible things take place. It’s a kind of black-mass incantation of de-creation, calling into being a very real, weighty cluster of feelings, responses, actions, and consequences that carry on and on.
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So that cultural slurry of philosophy and self-help sentiment that foists the burden of self-actualization on us, that we really can be true to ourselves, means people go around saying and doing all kinds of things that are simply untrue. And while I imagine a young, clever, critical-theory professor reading over my shoulder pointing out the gaping philosophical holes in my argument, it’s the fumbling, mumbling young father across the table from me, coolly trying to justify his infidelity, or the weeping young man with his face in his hands trying to find the courage to stay with his wife, or the middle-aged man recounting his lifelong self-hatred and suicidal ideation that I need to attend to. There is weight and meaning in the words I hear them use. What do I say? What should I tell them? I can see how words can be used to manipulate, mislead, wound, deceive, and abuse, but I trust that words can also tell the truth. I suppose that’s the elusive, mysterious thing I’m reaching at here: truth.
I like Mukherjee’s book for all kinds of reasons, but what has stuck with me most is how the truthfulness of words is serious business. The metaphors we use and the words we choose have actual consequences. Mukherjee describes the metaphors and shows how the image we use tells us what to do because it helps us see what we’re actually looking at. Metaphor is not simply poetic or decorative: it points to reality. Metaphor is a way to understand, and the better the metaphor, the better our understanding. “We may know that we are forming a conclusion on the basis of provisional or insufficient knowledge,” writes Wendell Berry, “but we must act, nevertheless, on the basis of final conclusions.” Life requires action and response, and some responses are better than others.
The truthfulness of words is serious business. The metaphors we use and the words we choose have actual consequences.
If to be human is to be a choosing being there’s not much real point in carefully trying to weigh the value of words and images because the choices are preferences. Of course this is empirically false: most of who and what we are is bestowed, not chosen. Life is gratuitous, meaning is a gift, and neither is a sheer act of will. I didn’t make myself, and neither did you. My parents made me the old-fashioned way, just like yours made you. I owe my capacity for language to others. I am a passable cook (I’d give myself a solid B+), but I grow and raise very little of my own ingredients. My backyard is too small for cattle; urban chickens aren’t yet legal. I can’t grow decent corn, and don’t have the acreage for wheat. I don’t make my own clothes or cars, and I didn’t build the computer I’m using to type this; but even if I could, I would need the history of technology and electronics plus the industries of resource extraction, trade and transportation, processing and manufacturing.
You get the idea; it’s the same for all of us. We depend on others; we need others. Our lives are not our own. We are connected, inextricably, to one another, not in touchy-feely imaginary ways but actually. Society is not a fluke, and it is not a blight. It is a gift. And ontology implies telos—what we are points to what we are for. If the human is anything anyone wants it to be, then do as you please. If life is a miracle, and we humans bearers of the image of God, we ought to care for one another. We are made for love, for binding together, for self-giving.
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There’s an authentic back-and-forth relationship between language and those who use it. Meaning is a product of a loving, mutual exchange. When we use words like “love” and “truth” and “life” with care, language can do extraordinary work, and do it well, even if it’s impossible to figure out precisely how it all works. “You can’t spend your whole life questioning whether language can represent reality,” writes Wiman. “At some point you have to believe that the inadequacies of the words you use will be transcended by the faith with which you use them. You have to believe . . . or you have to go silent.” In the opening pages of his masterpiece Real Presences, literary critic George Steiner writes, “Any coherent account of the capacity of human speech to communicate meaning and feeling is, in the final analysis, underwritten by the assumption of God’s presence. . . . The conjecture is that ‘God’ is, not because our grammar is outworn; but that grammar lives and generates worlds because there is a wager on God.” Meaning is possible because of the actual presence of God: an outrageous claim in our age of science and progress, skepticism, and cynicism. If meaning is arbitrary and the human is whatever we choose, care is optional. But, if a human being truly is a bearer of God’s image, we really are our brother and sister’s keeper.
If meaning is arbitrary and the human is whatever we choose, care is optional. But, if a human being truly is a bearer of God’s image, we really are our brother and sister’s keeper.
I don’t see how it is possible to practice that trust, as Wiman says we must, without God somehow being part of the equation. The stakes are way too high for me to simply shrug it off and say, “Truth is illusory; meaning is arbitrary,” because the consequences of our speaking and living are very real: just ask the ex-wife of the man who has gone and changed his mind on “forsaking all others / till death do us part.” Words matter, and meaning matters, because life matters, but that depends entirely on the presence of God and truth. Absent the Almighty, the whole enterprise is so weak because it is strung together in such arbitrary ways. I don’t know about you, but I need something stronger than eeny-meeny-miny-moe to make sense of meaning. Go ahead and recount for me, in as much detail as you think necessary, all the historical blemishes, missteps, and failures of Christianity, but I bind myself to that broken tale anyway. I throw my lot in with the transcendent, with the tale of a Creator hard at work, brooding over all that has been made like a mother hen with her chicks. I bind my words and flesh to the Word made flesh, and I believe in order to understand because that polite, feeble consolation of pick-a-path meaning, you’ve-got-yours-and-I’ve-got-mine tears like a sheet of wet paper in the brutality or paralyzing, numbing boredom of life. I need something stronger than skepticism and doubt.
The Christian account of human origins, that we bear the image of an all-powerful God, and that our being is a miracle of Christ, the Word made flesh, are all completely strange ideas, unlikely, and difficult to believe, I know, but I find the rendering far more compelling, generous, rich, kind, and beautiful than the alternative immediately at hand. Like Puddleglum says to the Witch in C.S. Lewis’s The Silver Chair, “Suppose we have only dreamed, or made up, all those things. . . . Suppose we have. Then all I can say is that, in that case, the made-up things seem a good deal more important than the real ones.” Drawing together word and flesh—and Word and flesh—is poetic and metaphorically rich, but so much more as well. Because sometimes our words can be a matter of life—and death.
