Autism, Disability, and the Obligation to Get Well, Part One

I’ve recently begun reading Robert Murphy’s The Body Silent, one of the great books on the social and cultural context of disability.  Murphy, a professor of anthropology at Columbia, became a quadriplegic in his fifties as the result of a benign tumor on his spinal cord.  He wrote The Body Silent from the perspective of an anthropologist observing himself as a disabled person in the context of late 20th-century America.

His writing immediately spoke to me, in part because I’ve lived my life from the perspective of an anthropologist in a foreign culture, and in part because I recognize so many of my own experiences in his words.  I am not very far into the book, but what I’ve read so far has sent my thinking in all kinds of new directions.  I am being careful not to read too much at a time without articulating my thoughts on it; the book is so rich that I could lose track of all its implications if I didn’t pause to reflect.

Among the many passages that I’ve found powerful is the following, which describes the social role of a person who becomes ill:

“A person’s ordinary social roles — mother, father, lawyer, baker, student, and so forth — all become temporarily suspended when he or she falls ill.  The individual becomes a ‘sick person,’ which relieves him or her of some or all of the ordinary obligations, depending on the severity of the illness.

The suspension of his other duties does not mean that the person playing the sick role has none at all.  Quite the contrary; he is saddled with one big obligation:  He must make every effort to get well again.  In our own doctor-ridden culture, this means that he must seek medical advice; he must take his medicine and follow the doctor’s orders.  This expectation mandates the proper role of the sick as one of passivity.  The sick person is excused from work or school, household duties are suspended or at least limited, and connubial relations may be put on ice.  But in return, he must devote full time to getting better.” (Murphy, 19)

The temporary suspension of numerous social roles in favor of a single imperative to “get well” is a trap that is well-known to many of us.  Sometimes, this suspension of other obligations is necessary and welcome.  For instance, when I had surgery to remove a degenerative disk in my neck a few years ago, I spent several weeks recovering my strength before I was able to get back to “normal.”  And I well remember the feeling that my only role was to heal.  At the time, I felt great comfort in knowing that others would take care of business while I recovered.

But the situation becomes much more complicated and troubling when a person moves beyond a short-term illness into a chronic condition.  A couple of years ago, I went through a particularly low period with being autistic.  During my 50 years of ignorance about my condition, I had pushed myself unmercifully — physically, psychologically, and emotionally — to the point of burnout.  At the same time, I had been prescribed benzodiazepines, medication that was wreaking complete havoc with my sensory and emotional life.  For awhile, I needed assistance with basic tasks, such as food shopping, housecleaning, and cooking.  It was painfully difficult to ask for this help, and my self-esteem suffered significantly.

Two years later, I take much better care of myself.  I have adapted to my disability, I have gotten off the benzodiazepines, and I have healed from the burnout.  As a result, I no longer need such assistance.  But the legacy of having once required it has cast a pall over my life that I have never completely dispelled.

Until now, I’d never known why.  I’m beginning to understand, though.

With a condition such as autism, Down Syndrome, or multiple sclerosis, there is no “getting well” in the conventional sense.  There can be therapies, accommodations, and the amelioration of certain symptoms, but there is no pill, no surgery, and no treatment that will remove the condition and render the person “normal.”  Having any of these conditions, therefore, automatically puts one into the category of “sick” people (think “autism epidemic”), with a concomitant obligation to “get well.”  But if you have a condition from which you can not “get well” according to the standards of the larger culture, you are completely unable to fulfill the one social imperative that the world gives you.  And if you fail at that one obligation, then the quality of all the other social roles that you might have — father, mother, husband, wife, friend — immediately becomes suspect.

Thus, you end up with the widely held belief that the partners of disabled people are heroic for sticking around, and that they do so only out of pity, as though disabled people are not full and equal participants in the process of their own lives.  And you get a great deal of talk about the numerous (and very real) challenges that the parents of disabled children face, to the exclusion of talk about the numerous (and very real) delights that such parents find in their disabled children.

You get T-shirts, mugs, and tote bags that say, “I love someone with autism.”  You don’t get T-shirts, mugs, and tote bags that say, “Someone with autism loves me.”  I’ve considered making up some items with that message on them, but I think it would only depress me to find out how few I would sell.

Of course, defining us as “sick” generates a great deal of money, energy, and emotion in the race for a “cure.”  After all, if our one imperative is to “get well,” the culture is going to make damned sure that we do it.  And, inevitably, the only way to get other people to join the search for a cure is to generate FUDD (fear, uncertainty, doubt, and dread) about living with a disability.  In the autism world, Autism Speaks is masterful at this form of gamesmanship, which has the net effect of making the parents of autistic children absolutely terrified of what might happen to their children without all the latest treatments, without 40-60 hours per week of expensive therapy, and without that elusive “cure.”

The fact that there are millions of disabled adults who have created happy and fulfilling lives, without full-time treatment and without a cure, seems to matter not at all.  We are ignored, and why?  We have broken the obligation of being a “sick” person.  We have not remained passive.  We have not lived our lives in a quest to “get well.”  We have lived our lives in a quest to live well as the people we are.

Continue to Part Two

Rachel Cohen-Rottenberg blogs at Journeys with Autism.

Autism, Disability, and the Obligation to Get Well appears here by permission.

Rachel Cohen-Rottenberg’s Memoir is The Uncharted Path.

[image via Flickr/Creative Commons]

on 05/13/11 in featured, Society | No Comments | Read More

Leave a Reply