When You’re the One With AIDS, It’s a Different Fight : AIDS AND ITS METAPHORS <i> by Susan Sontag (Farrar, Straus & Giroux: $14.95; 95 pp.) </i> : MORTAL EMBRACE : Living With AIDS <i> by Emmanuel Dreuilhe, translated by Linda Coverdale (Hill & Wang: $15.95; 162 pp.; 0-8090-7019-7) </i>

“Twelve years ago, when I became a cancer patient, what particularly enraged me--and distracted me from my own terror and despair at my doctors’ gloomy prognosis--was seeing how much the very reputation of this illness added to the suffering of those who have it.” So Susan Sontag explains the reason she wrote her influential “Illness as Metaphor”: “I didn’t think it would be useful--and I wanted to be useful--to tell yet one more story in the first person of how someone learned that she or he had cancer, wept, struggled, was comforted, suffered, took courage . . . though mine was also that story. A narrative, it seemed to me, would be less useful than an idea.” The idea was that the dread metaphors of cancer degrade the experience of the patient, inhibit help seeking for early detection and contribute to a demoralization that undercuts the effort to get competent treatment. Worse still, they blame the victim.

Now Sontag turns to the terrifying new disease that has replaced cancer as the most feared, as the epitome of evil. Applying metaphors to AIDS--an invasion, a pollution, an alienating, repulsive taint of deadly sin--intensifies the victims’ deep fears of degrading pain. At the same time, these cultural messages spread panic, encourage hatred and offer a “rhetorical opportunity” to fulminate against sufferers as blameworthy and deserving of punishment. AIDS fosters authoritarian political ideologies that promote fear in order to tighten social control. Thus, AIDS becomes one of the subverting, apocalyptic catastrophies--uncontrollable pollution, unstoppable migration, unserviceable debt, plagues of crime and drugs, genetic mutations, conspiracy--that recrudesce as the millennium nears.

Ultimately, fear of sexuality and of plague-ridden communities strengthen the commercial culture of self-interest. Capitalism commodifies the body through preventive practices, prophylactic disciplines. The ancient idea of miasma resurfaces as Sontag’s old bete noire, psychosomatic tropes that hold the patient responsible for suffering. A survivalist mentality erects walls around white, heterosexual, middle-class Americans: We fail to see the increasingly highest-risk populations: African and Caribbean men and women; poor people of color in America’s inner cities.

The logical culmination of this symbolic vision is that there is a struggle for the “rhetorical ownership of AIDS”; therapeutics and prevention should be extended into the realm of meanings to remove those that inflict stigma. Of all the metaphors of AIDS, the one she selects for retirement is the military trope of viral “invasions” and immunological “defenses” and “aggressive” medicine, which Sontag, wrongly as it turns out, associates with the rise of modern medical thinking around the germ theory of disease and the search for antibiotics and other magic bullets. For the wartime imagery, she avers, inevitably leads from the demonizing of illness to the stigmatizing and blaming of patients.

The upshot is sparkling writing, quirky and tendentious and yet impressive and useful, in an analysis of cultural meanings: an intellectualist account of the “idea” of AIDS. But all serious illnesses embody a dialectic between shared (if contested) cultural signification and the always particular meaning of the lived experience of suffering for patients, their family and friends, and their professional care givers.

AIDS, like cancer and heart disease and diabetes, is not only an idea: It is cramping pain, the disturbing sounds and difficult-to-take sights and smells of basic bodily processes gone terribly awry, the sting and choke of deep despair, especially the isolation and loneliness that come from near-total preoccupation with survival. This most personally unique, therefore most human, meaning of illness begins with the loss of a world--leaving behind the country of the healthy--extends through a limbo of enervating uncertainty and waiting, and terminates in the preparation for death, when, as if their faces were pressed against the terminal window, the sick look backward toward receding corridors of biography and ahead toward ultimate meaning.

Sontag starts from Aristotle’s definition of metaphor. Emmanuel Dreuilhe starts from a different place. Like American soldiers in the killing fields of the Pacific War, who thanked God for the Atomic Bomb, which for them brought the deadly ordeal at last to an end, Dreuilhe’s remarkable narrative of a personal battle with AIDS, which is written as a military allegory of the experience of a soldier in combat, clarifies that what is at stake in the experience of AIDS patients is survival under immensely threatening and all-too-often inhuman circumstances. This victim’s vision, like the soldier’s perspective on Hiroshima, may be too particularistic and biased by the practical demands of survival to sustain a viable ethical position, but it does infuse a powerful vitality into the narrative. Dreuilhe has no time for commentators on AIDS:

“This plague has attracted the inevitable swarm of AIDS researchers, officials, businessmen and journalists, and they are the ones who have monopolized the media. We people with AIDS, who devote each waking moment to our own survival, have been unable to prevent those loquacious experts from stealing our thunder and robbing us of the only thing we have left: our illness . . . (they) have accumulated a considerable store of information and conclusions about our genes and our mores, our mode of socialization and our myths, but in so doing, they’ve lost sight of our humanity.”

“I can’t stand it when civilians talk about AIDS. What do they know about it? How can they claim any authority when they’re completely untouched by it, without a simple wound or symptom?”

Dreuilhe adopts the very metaphor Sontag is repelled by:

“My personal war began two years ago when I was mobilized by AIDS. . . . On this same corporal survey map, I could also indicate the organs once believed lost to the enemy retaken after bitter fighting, backed up by an artillery barrage of antiviral and sulfa drugs, chemical weapons in that trench warfare which has kept me pinned down for almost two years now.”

He begins his letters to friends with “News From the Front.” What Sontag regards as the abuse of metaphor and medicine, for Dreuilhe is the source of carrying on against the odds. During psychotherapy, of all places, he discovered that a military myth sustained him and gave encouraging meaning to an otherwise futile battle. He refuses, like some AIDS patients, to give up without a fight, believing they are receiving a deserved punishment; Dreuilhe goes beyond cultural message to speak with great eloquence about menacing interior meaning: “Even more than our immunity, it’s our confidence that the virus has destroyed. We no longer believe in ourselves or in all those who have betrayed and deceived us. . . . For me, AIDS was first of all the experience of solitude. . . . That’s the state to which AIDS patients should aspire: to throw themselves so deeply into the struggle in which they are embroiled that peace and fear melt away, allowing better instincts to prevail over panic and despair. Fight, not flight.”

“Death,” Dreuilhe recognizes, “--the incongruity of its presence in our still young lives--is the height of absurdity: It makes a mockery of all my efforts to continue to live normally despite its constant threat.”

“Woe to the vanquished. That’s the ultimate fate of people with AIDS, to be losers in a society obsessed with winning. From the moment someone is stricken with AIDS, all his previous accomplishments are retroactively annulled.”

Sontag, fighting a rear-guard action against the psychologizing of moral experience, which she seems to believe trivializes life and alienates the sufferer, must have been astounded to read Dreuilhe’s entirely different view of the matter: “For AIDS is perhaps above all a mental illness, not so much because the virus may affect our brain as because it forces upon us such isolation and anguish that it drives us mad.”

In the acknowledgements to Dreuilhe’s book, placed, untypically, at the back, one reads with some surprise that “this American edition is the result of the kind and patient efforts of Susan Sontag, Richard Howard, and Steve Wasserman.” Perhaps because of the side of her cancer experience that she chose not to tell, Sontag must have recognized the difference between the idea and the experience of AIDS.

“Even if I wind up dying of AIDS like all the others,” Dreuilhe writes, “I’m no longer afraid of it because these pages have purified me, given meaning--at least for me--to these last three years of care, grief, and mourning, a meaning that is intensely personal.”

And that is the very essence of the difference. Read Sontag and ponder the symbolic coherence of AIDS as literary allusion and intellectual conundrum and thereby consider, what are metaphors for? Read Dreuilhe to tell you how particular to the sick person’s biography and world life with AIDS is, and thereby bear witness with him of human suffering and consider, what is life for?