Illness as a Metaphor

Song Meaning

The song opens with a stark, almost ritualistic repetition of "Oh, Andrew Jackson," establishing a sense of unease before a spoken exchange introduces Rachel and a central conflict. Rachel immediately quotes a "wise woman" asserting "illness is not metaphor," yet she immediately questions her own physical reaction to someone, "So why do I feel sick when I look at you?" This sets up a tension between the literal reality of sickness and the overwhelming emotional responses it can trigger. The core of the song lies in the narrator's (presumably Jackson) struggle to articulate intense feelings, particularly love and desire, by mapping them onto physical ailments. He needs to "get it out," and when he "bleed[s]," the band clarifies, "It's not blood / It's a metaphor for love." This is a desperate attempt to reframe visceral, potentially painful emotions into something understandable, even artistic, by equating them with illness. The fever "isn't real" but "represents how I feel," and the urge to "throw up" becomes a proxy for longing. The most striking aspect is the direct confrontation with Susan Sontag's famous assertion that illness should not be treated as a metaphor. The lyrics acknowledge Sontag's death and the implication that her own cancer was, in fact, not metaphorical. This moment of self-awareness, marked by a blunt "Sorry," casts a shadow over the preceding attempts to romanticize or artisticize sickness. It suggests a dawning realization that while emotions can feel like illness, the literal reality of disease is profound and cannot simply be transmuted into a poetic device. This lyrical approach is effective because it uses the very concept of illness as a metaphor to explore the difficulty of expressing overwhelming emotions. The contrast between Rachel's initial, almost academic, statement about illness and the narrator's subsequent, deeply personal, and ultimately self-aware use of it creates a compelling narrative arc. The repeated refrains from the band, insisting on the metaphorical nature of blood, veins, and fever, highlight the narrator's persistent, almost willful, reinterpretation of his internal state, making the final, brief apology all the more resonant.