The contemporary British novelist Ian McEwan’s novel Saturday, from the perspective of a neurosurgeon, reflects the status quo of British cities in the 21st century through description of the illness from the perspective of a neurosurgeon. Based on Susan Sontag’s theory of illness as metaphor, this paper interprets the illness as metaphors in Saturday by placing them in the context of a modern western city to explore the social and cultural problems implied by illness. The metaphors of euphoria and Alzheimer’s disease in this novel mirror the problems in the modern urban culture whereas the metaphor of Huntington’s disease signifies “othering”, reflecting the fear of urban people toward those communities as “the other” suffered from such stigmatized disease. McEwan thus presents his solution to problems: empathy is a possible way to cure the maladies of the city whose residents should resist their metaphoric thinking of illness so that they can not only reduce their anxiety, but also communicate with different communities, thereby building a harmonious and healthy city.