On the Nature of Handicaps

“If one is physically disabled, one cannot afford to be *psychologically* disabled as well.”
― Stephen Hawking

In the past I spoke about a young woman who had been paralyzed below the waist by an automobile accident.  Despite her devastating injury, and the fact that it was traumatic (therefore potentially avoidable), she managed to retain a positive outlook on life and became very successful.

Everyone likes these stories, and the comments I received reflect the prevailing view.  For good reasons we admire people who overcome these very difficult moments.  I think that we tend to put ourselves in the same position these courageous souls are in, and we make a subconscious estimate of how we would react had we been placed in a similar dilemma.  I recall many times in my career that I’ve told my patients “I don’t know how you do it.”

We call these people “handicapped.”  We divide their handicaps into “physical” and “mental.”  I know many of us will deny this, but in general we tend to treat these individuals different from other human beings.  We don’t feel comfortable being around them.  In the old days we assigned names, such as “crippled,” to them.

Years ago I became friends with one of my patients who was confined to a wheelchair.  Eight Sundays a year we met at the Dome to watch the Rams play.  The conversation ranged from family to jobs to life in general.  One day we talked about the adjustments that he had to make in order to attend the game, and he made it clear that it would have been impossible for him to attend if Congress hadn’t passed the ADA law (Note: remind myself to bring this up whenever one of my friends complains about “big government” overreaching).

Then he went on to discuss how much work remained to be done.  He asked me to stand behind him when he went up to the concession stand to order a beer and a hot dog.  He bet me a dollar that the attendant would look at me and ask me what he wanted, the assumption being that because he was in a wheelchair he’d be incapable to think for himself.

He got my dollar.

Therein lies the rub.  We process sensory images and we tend to make associations that are often inaccurate.  If we see a bald woman or child we assume “chemotherapy.”  A wheelchair means mentally incapable; slurred speech translates into drunk or intoxicated.  Thousands of years ago we needed to make these neural connections fast if we wanted to survive (animal in stripes means hungry tiger).  These days we need to readjust our reflexes.  We should make an effort to treat everyone with the assumption that they are vibrant and fulfilled entities.  If we don’t we will add to the burden that they already carry.

One last note on who’s handicapped or not (I’m sure I’ll get in trouble for this, but it’s worth some musing).  It’s a difficult world out there, and our parents sometimes don’t prepare us well to deal with it.  I think the young woman that I helped years ago was exquisitely well prepared to deal with her misfortune.  Other people are not.  They become surly; dependent; even institutionalized.   Many times their disability is minor; their disease easily manageable.  We resent these people.  We make mental notes whenever we are forced to deal with them, as to how they could learn something from the courageous souls that we’ve met in the past.

I try very hard (I’m not saying that I succeed all the time) to think of these human beings as having a deeper handicap that the inability to move about freely.  They have locked themselves into a room that they cannot leave, mostly because they cannot see the exit sign.  Because of their upbringing, or lack of education, or the way their brain is wired, they cannot lose the extra fifty pounds, or do the stretches the therapist recommended, or avoid still another destructive relationship.

My first reaction when I run into these problems is anger.  Over the years I have learned to recognize this as a reflex that needs to be controlled.  I try very hard to switch to “compassion mode,” to convince myself that these people who’re doing such a good job of aggravating me have their own deeper problem that they can’t help: they can’t see the way out, and not because people haven’t tried to show it to them.  They just can’t see it.

How society deals with these individuals is the most challenging issue we face.  Whether it will involve medication, psychotherapy, prison, or a combination of these remains to be seen.  Hang on: it will be a rough ride.