Sickness as cultural performance: drama, trajectory, and pilgrimage root metaphors and the making social of disease.

This paper examines the use of root metaphors in the description of social activity and especially the performance of sickness. It starts with a critical account of Susan Sontag's examination of the use of illness as metaphor in literature. There then follows a brief analysis of another account of society based on the discussion of creative literature-Kenneth Burke's "Dramatism," itself acknowledged as a source by Erving Goffman. Goffman's own expressed reservations about his supposed use of a dramatic metaphor are then extended to suggest that Goffman was more concerned with "performance" in a broader sense. The discussion of performative metaphors is then shifted by a critical consideration of Anselm Strauss and colleagues' view of sickness as manifold performances of work rather than drama, expressed in their metaphor of "trajectory." Sickness as a process compounded of many performances is further explored using ideas developed by the anthropologist Victor Turner toward the end of his life, in collaboration with his wife, Edith Turner. It is finally suggested that sickness as cultural performance enables us to understand the dialectical relationships between expressive and instrumental activities surrounding sickness. This in turn leaves room for the nonreductionist understanding, within a sociological framework, of individual idiosyncrasy, biological accident, and the discourse of healing.