The Disease That Shall Not Be Named

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LEPROSY. TUBERCULOSIS. SYPHILIS. CANCER. AIDS. DIARRHEA.

There are some illnesses that we don't like talking about. Today, we are much more open about it, but once, not that long ago really, the names of these illnesses were verboten. You did not mention them. Doctors might not tell the patient what they were suffering from. Media would avoid saying their names. You used a nickname or euphemism if you have to talk about them, avoiding the dreaded name. You just never brought them up. They tended to be illnesses that cannot be cured and/or are transmitted sexually. As medical science has advanced and public attitudes to sex have loosened, they have become more acceptable, but some, most often AIDS, are still treated as Taboo. Another variant are diseases that involve some embarrassing biological function or body part, such as diarrhea on the list above,[1] or pretty much any other ailment involving the backside or groin.

Cancer is a special case. There was a time, back before anesthesia and asepsis, when most cancers were never diagnosed. Doctors could easily recognize breast, cervical, and vaginal cancers from an external examination, but without surgery, X-rays, or medical laboratories, they couldn't detect internal cancers. Because of this, cancer was seen as mainly a woman's disease, and one that could affect any woman: certainly nothing to be ashamed about in any event. By the early 20th century, however, X-rays and surgery had made it possible to diagnose almost any cancer. Unfortunately, it didn't allow them to do anything about those cancers, since patients often didn't see their doctors until the condition was terminal. Cancer therefore became synonymous with "death sentence" and the word gained a sinister reputation. Even now, when half of all cancers can be cured, the word is considered much more malevolent than it would have been in the early 1800s. This is why modern readers of Anthony Trollope's Barsetshire novel Doctor Thorne are often shocked when Trollope steps away from the church politics for a moment to frankly describe a woman dying of breast cancer, described as such. In his time, it wouldn't have been shocking.

Or maybe the artist's just hedging their bets in case they got something wrong. Can't accuse them of portraying X Condition wrong if they never say it's X Condition, right? Similarly it can be used to avoid Science Marches On and lessen the impact of Reed Richards Is Useless in works with the right setting. There's no chance a character's disease will be cured or eradicated after your story is published but before it takes place if you don't state a specific disease.

Almost the inverse of an Incurable Cough of Death, in that there the illness is ill-defined, thus vague. Here it is known, but kept vague.

In some languages, like Dutch, names of diseases make up most of the language's profanity.

See also Never Say "Die", Victorian Novel Disease, Ill Girl, Littlest Cancer Patient, The Scottish Trope.

Examples of The Disease That Shall Not Be Named include:

Straight Examples[edit | hide | hide all]

Anime & Manga[edit | hide]

  • An interesting variation occurs in the Rurouni Kenshin: Seishohen OVA, where Kenshin and later Kaoru suffer from an unknown disease. Fans either call it "Super Tuberculosis" or speculate that it may be syphilis based on the symptoms, but it's likely either a specific unmentionable or one they just made up. In either case what exactly it is never gets brought up, but seeing as it's set in late 1800s Japan this may be justified by the setting.
  • 13th squad captain Jushiro Ukitake from Bleach has a never-named illness that may have cause his hair to lose its color (his eyebrows are black, the rest is white), leads to him laying in bed sick a lot, and occasionally makes him cough up blood. A Fan Nickname of his is "Captain Tuberculosis."
    • Tubercolosis, incidentally, is not known to dye your hair in Real Life.
  • In an SBS of One Piece, Oda Eiichiro was asked if a disease he had mentioned in the series was real. He noted that, yes, it definitely is real, but the name and general idea was tweaked a bit to sound fictional. Apparently, in the manga business, some terms/diseases are frowned upon for being "too real."

Comics[edit | hide]

  • Jack Chick's tract "Wounded Children" contains an odd variant: A Depraved Homosexual speaks of his lover dying of "cancer", which a footnote tells us means "AIDS".
    • Jerkass Has a Point: it wasn't unusual in the 80's for people with HIV to say they had cancer, if they preferred people not ask questions about how they got infected. In most cases, it's technically not even a lie, since Karposi's Sarcoma is an opportunistic skin cancer AIDS victims tend to die from (the infamous black lesions).
  • There's an autobiography (in graphic novel form) called Stitches, about this guy's crapsack childhood. At one point his parents don't tell him that he has and is about to undergo surgery for throat cancer. He finds out by accident a while later, and when he asks why he wasn't told they tell him it's because he "didn't need to know."

Films -- Live-Action[edit | hide]

  • Even pregnancy can fall to this. In one of the Benji movies, Tiffany (the dog) was referred to as being "ill" when they meant "about to have puppies".
  • In Moulin Rouge, Satine has consumption (tuberculosis), but this is kept from her until near the end of the movie when she dies from it onstage.
  • At the end of Forrest Gump, Jenny tells Forrest that she's "sick". It's never said what she had, only that it's a virus and was terminal. Given the disapproving tone surrounding Jenny's Bohemian lifestyle outside of Forrest's orbit, and that Jenny could be seen as experiencing the "bad side" of decades versus Forrest's hopeful one, it was often assumed the nineties setting meant it would be AIDS. An especially sad case as Jenny was still incredibly unsure of herself when she left Forrest the second time, before Forrest Jr. was born, and a relapse occurred during their life apart. Also leads to some complaints that verge on Reality Is Unrealistic since the fact that neither Forrest nor their son seem to be infected can happen if an infected person is careful.
  • In Mirror Mask, it's never said outright what is afflicting Helena's mother, but the implication is pretty clear that it's a brain tumor (it's also stated explicitly in the companion book).

Literature[edit | hide]

  • The following lines about being gassed from Wilfred Owen's WWI poem Dulce et decorum est were edited by many when first published, often just by removing the word cancer and leaving the poem with a ruined meter.

Come gargling from the froth-corrupted lungs,
Obscene as cancer, bitter as the cud

  • A 19th century French story where (mentioned in passing) an Englishwoman goes and deliberately gets infected so as to sleep with Napoleon and give him the disease. (It doesn't work.) The disease part is very quickly glossed over, but it's pretty obvious what it is they're talking about.
  • Mildred in Of Human Bondage is strongly implied to be a prostitute and dies, almost certainly of syphilis.
  • Digory's mother in The Magician's Nephew, until she is cured by a magic fruit. In Real Life, author C.S. Lewis' mother died of cancer when he was ten years old.
  • The Pearl Diver, by Jeff Talarigo, is a very thoughtful and in-depth discussion about how leprosy (and later AIDS) was this in Japan for ages. You didn't talk about it. If your family member caught leprosy, they got sent off to a different island, and were stricken from the record as if they'd died.
  • At one point in The Tragedy of Y (by Ellery Queen), the York family doctor lets amateur detective Drury Lane read the family medical history, specifically all the parts that talk about the positive Wasserman tests. The book never uses the word "syphilis". Not even when Lane gets access to those medical files by proving to the doctor that he already knew the York children had been born with the disease.
  • Discussed in Two Weeks With the Queen. Colin reflects on the fact that he's never heard anyone other than a doctor refer to his brother's condition as "cancer". When he meets Ted, he first warms to him when Ted openly refers to the disease by name, rather than shying away from it.
  • In the second Flashman book, Royal Flash, a character is described as suffering from a "social disease." To which Flashman immediately responds, "You mean he's got the clap?"
  • Tiny Tim's disease, to modern readers.
    • Researchers say it was most likely a kidney problem or rickets.
  • O-Lan in Pearl S. Buck's The Good Earth became sick later in the book. Her illness was never named, but she described it as "a fire in my vitals," which sounds like cancer.
  • In the Trixie Belden series, Honey's governess, Miss Trask, had an ill sister. Miss Trask looked after her in the hospital when she was chaperoning the B.W.G.s and their friends in New York in Mystery of the Blinking Eye. They never mentioned what the sister had, though.
  • Skorpan in The Brothers Lionheart. He died of tuberculosis but the disease is never named in the book.
  • Subverted in L. M. Montgomery's novel Magic For Marigold, in a chapter called simply "It." "It" is a mysterious disease that the adults around Marigold suspect she has caught, but which no one will tell her what it actually is, driving the girl distracted with all sorts of horrible imaginings of what "It" might be. Until her aunt tells her that "It" is simply head lice.

Live-Action TV[edit | hide]

  • In a Monty Python's Flying Circus animation sequence, we have an enchanted prince who gets a spot on his face, ignores it and dies of cancer, but the word "gangrene" was very obviously dubbed over "cancer" in a very different (as in, male as opposed to female) voice. It can be heard as intended in And Now for Something Completely Different.
  • Good Times was the first time STD (then called VD) was mentioned in a (US) fiction TV show, but they never really said what it was or how it was spread, just that JJ's ex had VD and he should get tested, along with Anvilicious speeches about VD (given the time frame, they almost certainly meant gonorrhea).
    • During the final season, Willona wants to protect little Penny from the facts of life, suggesting to her adopted daughter that her 12-year-old pregnant friend had simply contracted the "Stomach Mumps." Terms related to teen pregnancy are freely exchanged between Wilnona and Florida, as the two bitterly argue about whether to tell Penny the truth (Willona is forced to when Penny is nearly sexually assaulted in the hallway).
  • Another STD example on Dr. Quinn, Medicine Woman, paired with Getting Crap Past the Radar, seeing as how this was a family show airing at 8PM. In the series first episode, prostitute Myra comes to see Dr. Mike about a "female problem". Later, Dr. Mike tells Hank, owner of the local brothel, that Myra needs to be "chaste" for several weeks. When he complains about the loss of revenue, she warns him that he'll lose a lot more if she has to treat his customers as well. In a later episode, Hank asks why Dr. Mike has been oblivious to the fact that her sister Marjorie is ill--"That husband of hers left her with more that anyone suspects". Mike realizes what the problem is and gently tells her sister, "It's not your fault, he gave it to you", then offers to give her an injection of silver nitrate in order to clear up the infection. Given the treatment mentioned, it's obvious that Marjorie's unfaithful husband has given her gonorrhea.
  • The Hogan Family: The first use of the word "condom" and what it's for on a (US) fiction TV show was in a Very Special Episode during the series' second season (episode titled "Bad Timing," when Valerie told David to use a condom if he had sex with his girlfriend. The episode aired with a content warning.
    • Unlike many other sitcoms, The Hogan Family also unashamedly addressed AIDS in one of the last episodes of the series, where David's best buddy Rich contracts AIDS. The episode shared Rich's last days and ends with his death.
  • On Happy Days when Chachi asked for Mrs. Cunningham's blessing for he and Joanie to get married he said he "had to" marry her, so Mrs. C thought he and Joanie were "in trouble"—that he had knocked her up. But no, he "had to" because he loved her so much.
  • On the House episode "Wilson", Wilson notices that a patient's girlfriend has a cold sore, and so prescribes him acyclovir. The word herpes is never mentioned. In a medical drama. Particularly odd since they had mentioned it in at least one previous episode ("House vs. God"), where it turned out to be the patient's condition. Most likely because neither of them had what the average viewer would think of as herpes—she had a cold sore, he had myelitis, but it's not at all like House (the show or the character) to downplay the dramatic impact of a disease...
  • Non-disease example: on Sex and the City, Charlotte mentions that her Jewish boyfriend has relatives who died in the Holocaust, a word she says at least 20 decibels lower than the rest of the sentence. She may have also done the same about Samantha's cancer.

Music[edit | hide]

  • Prince used "A big disease with a little name" to describe HIV/AIDS in Sign o' The Times.
  • Amateur Transplants hilariously parody the practice in their Dorsal Horn Concerto song.
  • TLC's song "Waterfalls" features this. It's a series of morality plays, and the second one is about a man who sleeps around, and it gives us this gem:

His health is fadin and he doesn't know why
Three letters[2] took him to his final resting place

Puppet Shows[edit | hide]

  • In Meet the Feebles, the doctor ominously tells Harry he's caught "The Big One". This trope is averted when we find out near the end of the movie that he meant myxomatosis.
    • Though, for a rabbit, myxomatosis is a Big One indeed.

Theater[edit | hide]

  • In Cat on a Hot Tin Roof, the doctors never tell Big Daddy or his wife that he has cancer, telling them instead that he has a spastic colon.
  • Henrik Ibsen 's Ghosts was incredibly controversial in its time merely for referring to congenital syphilis, even though the disease was never named outright.
  • Angels in America uses the aforementioned Roy Cohn inversion. Prior occasionally plays the trope straight by saying that he's "sick" and "diseased". While he is able to admit to his boyfriend what he has, he does fuss around before spitting it out.
  • In Neil Simon's Brighton Beach Memoirs, the mother mentioned that someone had tuberculosis, but said in in a quiet, hushed tone.
  • In Passion by Stephen Sondheim & James Lapine, nobody, not even the doctor, explains what Fosca's disease is.

Video Games[edit | hide]

  • In Persona4, it's fairly clear that Hisano's husband suffered from dementia, largely through her story harshly averting Easy Amnesia.

Real Life[edit | hide]

  • When Terry Pratchett gave the 2010 Dimbleby Lecture, he mentioned that Richard Dimbleby (after whom the lectures are named) broke a taboo by admitting he was dying of cancer (almost invoking this trope by name). He went on to say that Alzheimer's and Dementia is now in the same category.
  • When doctors diagnose a person with scabies, it is named with the technical name of scabiosis. Rather obvious in English, but not so in other languages (Spanish "sarna" vs. "escabiosis").
  • Isaac Asimov contracted AIDS during heart surgery from tainted blood, but the stigma associated with the disease caused him to hide the condition throughout the rest of his life. It wasn't until ten years after he died from AIDS-related complications that his family revealed the truth in a biography.
    • According to his wife Janet, Isaac Asimov wanted to go public during his lifetime but was persuaded not to by his doctors for the sake of his family and friends, as it was quite likely they would suffer from anti-AIDS prejudice that was prevalent at the time.
  • Most newspaper obituaries will read that a person died "after a long illness," which usually means one of these.

Exceptions and Aversions[edit | hide]

Anime & Manga[edit | hide]

  • In Black Jack's back story, he broke this taboo to straightforwardly tell a fellow medical student she had ovarian cancer. Overall, Black Jack tends to be very blunt about the patient's chances.

Films -- Live-Action[edit | hide]

  • Averted in The Shootist, where John Wayne's character is explicitly said to have cancer.
    • This may have something to do with the fact that John Wayne himself was dying of the disease—this would be his last film.
  • From Team America: World Police, "Everyone has AIDS!!"

Literature[edit | hide]

  • A female character in the Anthony Trollope novel Doctor Thorne has been diagnosed with breast cancer. The condition is treated matter-of-factly, as it would have been in Trollope's time in Real Life. However, the idea that cancer was not shameful was so shocking to early 20th century readers that some believed Trollope instead meant to show the patient as a pathetic malingerer who claimed to have cancer so she could get the doctor to feel her breasts.
  • Rebecca was revealed to be dying of a tumor in her ovaries, which mean that she couldn't have children.

Puppet Shows[edit | hide]

  • Refreshingly averted in the South African Sesame Street, which features Kami, an HIV positive Muppet.

Theater[edit | hide]

  • Averted hard in Rent, where characters that have AIDS are pretty frank about it. In the film version, however, Roger and Mimi recognize each others' affliction through the medication without mentioning the name of the disease - though it's still averted in the case of Angel and Collins, who speak about it frankly and by name.
  • Eugene Brieux's problem play Damaged Goods, though now forgotten, caused quite a stir in its time by referring to syphilis by name.

Western Animation[edit | hide]

  • Averted in South Park when Scott tells Terrence and Phillip that he hopes they both get cancer with special emphasis on "Can-saa!"
    • AIDS especially is often joked about. With the episode "Jared Has Aides", it was noted that only South Park could do an episode that consists almost entirely of an AIDS pun and end up getting in trouble for something else.
    • And then there's the episode where Cartman got AIDS:

Cartman: We're not just sure, we're HIV positive!

Real Life[edit | hide]

  • In the 1960s, John Wayne went public with the fact that he'd had lung cancer—and through surgery had "licked the Big C". He remained in remission for several years before developing stomach cancer; he died in 1979.
  1. although it also kills thousands of people each year, despite being treatable even in the worst case for under a dollar
  2. HIV