From 'Fighting Cancer' to 'Losing The Battle,' We Understand Illness As War. Some Say It's Time For A Change

Words of battle are embedded deeply in our discourse about illness.

In 1971, President Richard Nixon famously declared a "war on cancer.” And people often resolve to be fighters, to do everything they can to avoid losing their battle in the face of a life-threatening diagnosis.

For Dr. Sunita Puri, this language is familiar. But she says that in her experience working with patients, these words can obscure the reality of each person’s experience of disease.

Puri, the director of the hospice and palliative medicine fellowship at the University of Massachusetts and author of the memoir "That Good Night: Life and Medicine in the Eleventh Hour," joined LAist’s public affairs show AirTalk, which airs on 89.3 FM, to discuss how language can affect how we understand our bodies and their limitations.

Why word choice matters

Puri says that these combative phrases are not very meaningful in a medical sense. But, she says, doctors don’t always ask patients what they mean when they use these words, or what, exactly, they are fighting for. Without a frank discussion, these abstract words end up serving as proxies for major medical decisions.

“When I was in my residency, if a patient told me that they were a fighter, then my assumption was that they would want to go through any and all treatments," she says, "no matter what the cost to their dignity and their suffering and their quality of life."

Assuming someone means treatment no matter the repercussion can mean other important conversations — like about the full range of options for care, or about what they want their life to look like — fall to the wayside.

Puri says using fighting words creates a dichotomy of winning and losing and also puts great emphasis on personal strength. Sometimes, patients might feel like they are not fighting hard enough, or that their will to live is not strong enough, if they are too fatigued or in too much pain to get out of bed.

“But strength of spirit is not the same as strength of the body,” Puri says. “So much of what happens with cancer and other illnesses is that your body reaches a limit, and it might be your body that can't fight anymore.”

How to have more compassionate conversation

Puri says it’s important for doctors to help their patients feel comfortable enough to be vulnerable about how they are truly feeling, and what they want out of treatment.

“What I wish we could also talk about is the concepts of suffering and dignity. Because those are things that are absent largely from discussions about what it means to be sick, what it means to be alive,” she says.

And that's where language can make a difference.

“If we reintroduce a softer and more compassionate, humanistic vocabulary to these discussions," she says, "then I think we can actually help people to understand that fighting at all costs, may not actually be what they really mean when they’re telling us that they're fighters.”

Listen to the conversation