The disabled, which include the blind and the crippled and other infirmities, are usually understood as deviant in that they are more or less distasteful to ordinary society because they are not part of those who are able bodied, and so the disabled are a scourge to society just because they are unfamiliar with normal society. That also happens to criminals and drug addicts and sex perverts, who also are all degrees of deviance. Normal people just feel various degrees of apprehension and disgust for the deviants, rather than there being distinct differences in kind, as if there were different feelings to people who are, let us say, of low caste rather than disfigured. People look away at disabilities of the disfigured just as they abhor associating with loudmouths. President Trump thinks it depressing to see wounded war veterans on display. The various kinds of the disabled share the fact that they are “master statuses” in that disability is a constant companion that must be managed along with a person’s other roles. You can forget to lock your front door but, if you are using braces and crutches, you cannot forget to lock your knees when you rush to get to your cab.
Disabled people are also subject to stratification and which also apply to such other stratifications as social class or the age ranking whereby Freshman move up to Seniors and old people over time have relatively enhanced or lessened prestige than do younger ones. Old sages can be chiefs and shamans and young people can be hip when Frank Sinatra dominated youth culture. Types of disability, for its part, can be ranked according to the extent to which the disabled depart from “normality”, that being the term for the level of physical condition for which society has inevitably already made its adaptations so people can cope with their biological natures. There are institutions for the raising of the young because the physical and social dependency of the young is so long expanded. So schools have lower drinking fountains and are excused for child hijinks. There are breaks for normal people of various ages to have breaks for sleep and eating and it is acceptable for people to excuse themselves to go to bathrooms. But disabilities create additional burdens for the management of life and the extent of these burdens can be ranked. The ranking is not a matter of prestige but of self-sufficiency: to what extent can a person with one or another kind of disability manage to accomplish the way of life practiced by the normal? People with dental cavities can do so and people with temporary illnesses, however life threatening, can be restored to normality after a time in a sick role. Disabled people, however, are all prisoners of the society in which they might hope and demand that the society will try to accommodate what might be their very different existential needs.
An objective ranking of kinds of disabilities as these disabilities descend from normality are the following:
Limb impairment (leg or arm amputation or paralysis)
Organic impairment (cancer, colostomies)
Sense impairment (blindness, deafness)
Terminal illness (tuberculosis, Coronavirus)
Impairment of self (psychosis, vegetative states)
Disfigurement
The significance of this ranking lies in its identification of relationships that are not otherwise apparent. There are, for example, fates worse than death, which is a poetic but exact way of saying that dying is less distressing than being some kinds of crazy. The ranking also gives rise to a hypothesis concerning the politics of disability: the closer to normality, the more the disabled will try to integrate themselves into the world of the normal, which also means that the farther from normality will try to segregate themselves from the normal world. The crippled are merely an aggregate of people that hard not to become differently from an ordinary way of life; the organ impaired do have a way of life they nevertheless may wish not to make themselves into a special community; and the sensory impaired do create communities for their segregated residences; while the terminally ill are part of a community of the near dead, in hospitals and nursing homes and the disfigured are an aggregate which would risk death to become acceptable enough to have a way to avoid isolation, this clearly the figure in “The Elephant Man”.
There are any number of ethnographies, biographies,cultural and political crises to document the situations of various forms of disability. Most searchingly and the most pivotal is Erving Goffman’s “Stigma”, which elaborates and classifies kinds of spoiled identity. Goffman regards the crippled as suffering from visible stigmas. Management requires the crippled person to call attention to the fact so that the normal able bodied are made less uncomfortable. They joke about their wheelchairs as having good brakes. The paradox is that people who are the victims are the ones who have to be more mature than the normal person who is otherwise tongue tied or embarrassed. Pointing out the disability makes the disability the whole of their person. The crippled person needs help to get up or down a curb but is more than a curb problem.The mass media cooperate in making the crippled normal, as only contingently crippled, by showing them in athletic contests such as wheelchair basketball, so that they have overcome their handicap by engaging in their sports events. Crippled people are normal for all practical purposes because, purportedly, only a few practicalities stand between themselves and normality even though being most of the time in a wheelchair is a permanent and irrevocable capacity.
Veterans who suffer from limb impairment are particularly subject to normalization. They have been injured due to circumstances which could have caught up with anyone in that age bracket. The young are drafted or volunteered and so honorable while young people who are killed or wounded by mild altering drugs are part of the youth culture and so the victim is responsible for his own grief, while ordinary fatalities are coincidental in that a cancer victim will or will not turn up and so a victim, smoking taken as itself an addiction that also made the cancer patient as a victim. Wounded veterans are in that sense victims of disaster, akin to flood victims, and so have a call on common sympathy, while drug addicts and murderers are individually at fault for their villainies, even if social contexts explain why there are higher or lower rates of murder and addiction between different classes and ethnic groups. Crime is an essential rather than a contingent quality of the poor because the poor have been politicized as different from the rest of us and so unsympathetic for their disabilities.
Motion pictures focus on crippled war veterans as ones, therefore, who should shed their stigmatization. “The Best Years of Their Lives” features a young man who has lost his arms in World War II and was replaced with hooks. His family finds it difficult to deal with people staring at them and has to explain just how dependent he is when she has off his braces that support his hooks. As James Agee put it, men are infantilized by their women, as is also the case in “The Men”, where a Teresa Wright has wedding night distress when she sees that the wheelchair bound Marlen Brando has occasional tremors in his legs, and she has to adjust to that.
The key point of the crippled is that they are close enough to normals so that their condition is so circumstantial. Accessible entryways, elevators and oversize bathroom stalls make it possible for them to navigate the streets and subways on their own. They try to avoid as small favors as possible to let them manage themselves. Goffman, in his book “The Presentation of Self in Everyday Life” uses the idea of “backstage work” to describe the various ways in which people arrange to do in private that show them as competent. Backstage work includes homework (for everyone at school),putting on makeup (for most women), and going to the bathroom, also for everyone. Crippled people have more and special backstage work to make them able to function. The idea is to make it still possible to put together a presentation of the crippled which seem to be normal life, however much they may need mechanical support, special arrangements or painkillers.
Goffman argued that those who are not visibly impaired, which is not the case with the crippled, manage their stigmas by hiding them. The discreditable avoid being disclosed and so appear to be and so remain normal, and so people who are in pain from organic disease do the best to hide their miseries. People with colostomies work hard to be normal in public, restricting travels to times limited enough so they can safely change their bags. People with AIDS used makeup to hide the symptoms of Kaposi Sarcoma for as long as possible. People with cancer will admit only to intimates that they have one or another of these diseases.
Diseases which involve organic deterioration can feature recurrent episodes that may or may not mark continued deterioration. If these episodes are well enough spaced then the person can treat even the medical management of the disease in public because the disease may be temporary enough so that is only a displacement of normality. So diabetics can manage their insulin even if the very long case can hurt organic well being. A slowly deteriorating disease can call suffer a low grade malfunction which the organically disabled work hard to make appear only that. Camille makes her consumption only a continual cough until it becomes too much for her to feign having a minor inconvenience. Those who recovered from cancer come together in groups to prepare for their remissions and so is also an example of another protracted illness.
The organically impaired who suffer intermittently are an aggregate, just like cripples. They suffer separately from the same kinds of circumstances, even if they use special interest groups to advocate for their needs. Hemophilia was an intermittent organic impairment that required considerable care from a young age so that the disease became part of life rather than the only condition of a life. Excruciating intermittent pain, however, will mark the personality, even as a sufferer is merely sensible rather than obsessed about his condition.
The organically impaired who suffer continuously cannot fake at being cripples. They are a group since they have a specialized way of life which provides a sense of personal identity. Women, for example, had such a way of life in that they managed menstruation and child bearing, and were treated for so long as a secret society that it was impermissible to discuss their infirmities and there were elaborated customs to deal with their sequestration. As Susan Sontag observed, organic disabilities such as consumption, cancer and venereal disease each had particular metaphors for the human condition and achieved a secondary gain, so some said, of enhanced character, or at least so “The Magic Mountain” said. Even intense pain can be treated as a kind of spiritual grace, though not to my lights..
The blind and the deaf sufficiently transform their lives so that the people with those disabilities have selves that are significantly different than the people they have if they were able bodied, and feel so much so that to reacquaint hearing or sight might seem a disadvantage or a shock on their own senses of self, and so preserve to see themselves for some as a community with differently abled people rather than just as handicapped ones. The deaf and the blind create a personal identity that creates a life rather than just extend an agony. They are not an aggregate or a group but a community, people organized around the way of life which they have been burdened, and so negotiate collectively for their interests. So the deaf can disparage Cochlear implants which present a somewhat like speaking and hearing but require the deaf to exclusively try to learn through that device and so do not engage in the supposedly fluent American Sign Language, even if it is restricted mostly to only the people within the deaf community. Young men going to schools of the blind, according to the writer Ved Mehta, discuss the relative advantages and disadvantages of marrying sighted and unsighted girls. That sounds much like immigrants who wonder whether an “American” girl will be too domineering and make them feel guilty for what they are even though they will make it easier to manage life and are a considerable trophy for what might seem a disadvantaged young man.
Those who are mentally severely decapacitated or are seriously disfigured have an option that is very different from the crippled, who are so close to normality. They posit as a preferable way of life to be segregated and institutionalized, whether for Down’s Syndrome, or for long term residence in a tuberculosis sanatorium, or for very long year recovery from poliomyelitis, or for residential mental hospitals. There remains a lively controversy. From the Sixties through the Nineties, there was large scale deinstitutionalization. People could live in halfway houses with some supervision because mentally ill people would have psychotropics that could manage their lives so that a fairly normal life could be maintained. The trouble was that insufficient supervision and the side effects of the psychotropic drugs made many mentally ill patients reluctant to take their medications. So the numbers of people who had to be institutionalized was severely reduced, it does not make residential segregation an unnecessary stratagem.
The curious thing about the elderly, which is an age status, is that they deal with all of the dynamics of the disabled. The elderly need minor accommodations so as to be normal. They need hearing aids and elevators and low rise steps. The elderly hide their infirmities as they can or reveal what they try not to reveal, as are losing a bit of quick memory or proper nouns that take a moment to recall. Sometimes they think that the elderly think that a residential community which segregates the elderly from younger people seems to be an advantage. Retirement communities sprung up in Arizona and Florida when the Baby Boomers got old that did not allow people over fifty five or so to buy a home, thinking that life would be more serene without noisy children and grandchildren and with spas and other services to satisfy the elderly, though people do seem to have reversed themselves and so prefer deinstitutionalization for the present elderly, there not being an appropriate lifestyle for the elderly, a cultural commonality, in that people are about politics or music or whatever they were interested in when they were younger. Illnesses of the aged are managed as if they had nothing to do with themselves rather than as a new kind of identity, practical difficulties that interrupt or restrain abilities only for practical matters. And old people I have known just recognize that they have worn down enough that it will not be longer before they die, and there is nothing to do about it and there is too little energy to much resist, the accumulation of debility becoming, perhaps, worse than death, though I suspect it is to me still in the future in that I cannot think of it to be anything palatable.