Somatic metaphors raise many questions as to the nature of personhood, and whether, within the Western cultural and scientific traditions, we have got an adequate framework for understanding persons and their diseases. Because we actually discover somatic metaphors through the correlations of the manifestations of physical diseases with patients’ meanings conveyed through speech and language, an exploration of language-making in relation to meaning-full disease is crucial to an examination of the nature of personhood. Let’s begin with a short story:

A woman, aged thirty four, complains of eight years of nasal congestion, facial soreness, and puffy eyes, all beginning when her mother was diagnosed with scleroderma, a very serious disease that causes both skin and internal organ damage. I could not find an allergic cause for the daughter’s symptoms. Discussing her mother, the woman says: “I will always grieve.”

38A key element of this rather simple story is the congruence between the daughter’s long-standing physical symptoms of tears, congested nose, and puffy eyes, and her language of grief. I see this sort of congruence every day in my clinic, if I listen carefully to my patients. The connections appear so self-evident that we might wonder why anyone would question them. But things are not that easy. If, having discerned congruence of mind and body manifestations in the patient’s presentation, I go on to openly formulate an understanding of the patient’s disease as emerging within and because of the patient’s languaged story, some patients will become unsettled, even very upset. Even though we can say that it is their language that prompted me to make the connections, my underscoring of those connections may not be at all welcome.