Hating the sick; health chauvinism and its cure.

Nothing comes to an individual that he has not summoned.... A person's external circumstances do fit their level of internal spiritual development.

--Eileen Gardner, nominee for special assistant to the Department of Education under the Reagan adminsitration, explaining her theory as to why people become ill or disabled And remember when you're out there trying to heal the sick, That you must always first forgive them.

--Bob Dylan in "Open the Door Homer"

Acouple of years back, I went to see a midnight screening of The Rocky Horror Picture Show. Determined to do my share at this audience-participation event, I threw rice during the marriage scene, squirted water during the rain scene, and shouted the appropriate responses at this or that bit of dialogue.

Near the end of the film, one of the characters, a professorial type in a wheelchair, was confronted by Riff Raff, a hunchback from Transsexual Transylvania armed with a silver ray-gun. A theatergoer behind me--far gone in excitement or intoxication--stood up, shaking his fist, and screamed, "Kill that fucking cripple!" The rest of the audience cheered.

I was stunned. Turning, I saw something on the man's face beyond simple amusement. I saw anger. I saw contempt. I saw hatred.

We live in a health chauvinist society--a culture that often regards the disabled and ill as morally inferior to those who are able-bodied and healthy. Just as our culture often blames rape survivors for their victimization and poor people for their poverty, we all reveive messages, both subtle and overt, that people with disabilities are "different," that sickness and disability are caused by sin, bad karma, or negative emotions.

Consider an article by Catherine Ponder called "Forgiveness Is Healing," which appeared in the winter 1991 issue of Spirit of Change, a New Age journal specializing in features on holistic healing, childhood mystical experiences, Feldenkrais, and so on. The article is an excerpt from Ponder's mid-1960s book The Dynamic Laws of Healing, which, according to the editors of Spirit of Change, demonstrates how "by forgiving the roots of our disease, we regain perfect health." Together with Eileen Gardner's comment, cited above, it is one of the most succinct statements of health chauvinism I've seen.

Ponder's piece begins with a parable in which two people talk about a third person's illness (as is usually the case, at no time is the person with the disability allowed to speak for herself):

A puzzled lady said to a friend, "I cannot understand it. I have the nicest neighbor who is dying of cancer. It seems so unfair, because this is one of the kindest, gentlest people I know."

The friend replied, "She may seem kind and gentle, but if she is dying of cancer, then there is some old negative emotion that is literally consuming the cells of her body. There is probably someone she hates." "Later," Ponder tells us, "the mystery was cleared up. The one in doubt reported: 'You were right. I learned quite by accident that this neighbor has a relative whom she violently hates. They have not spoken in thirty years.'" The article goes on to describe another woman who "discovered a lump on her breast. Instead of frantically rushing out to negatively discuss it with others, she decided to analyze the situation and pray for guidance.... She realized that a hard condition in the body indicates a corresponding hard condition of the mind." The story ends with the women eventually curing her cancer through daily meditation, which presumably softened her mind.

"If you have a problem," Ponder concludes, "you have something to forgive. If you experience pain, you need to forgive."

This notion of disability as a sign of moral failure, a mark of evil, is apparent even in our fairy tales and children's stories, where the villain is often someone with an obvious physical disability or "deformity"--a child-eating dwarf or monster or giant, a Rumpelstilskin or a Captain Hook. Leslie Fiedler, in Freaks: Myths and Images of the Secret Self, points out how "monster is the oldest word in our tongue for human anomalies."

Our contemporary movies and literature continue this theme. Freddy Krueger--the mutilated child molester in the Nightmare on Elm Street slasher series--is a perfect example of this correlation between evil and physical deformity. Not only does he have razor-extended fingernails (an update on Captain Hook) but the layers of scar tissue on his face show us just how evil he really is. Scar tissue, says Susana Kaysen in Girl Interrupted, is not just the natural consequence of trauma to tissue. "It shields and disguises what's beneath. That's why we grow it, we have something to hide." Mainstream magazine, a disability-rights monthly published in San Diego, recently ran a cover story on "the new blackface"--how Hollywood generally hires able-bodied actors and actresses to pretend they're disabled. Most of these characters --from Richard Dreyfuss in Whose Life Is It, Anyway? to Al Pacino in Scent of a Woman--are portrayed as embittered and emotionally stunted, unattractive people who need their able-bodied friends to straighten them out. A recent "Star Trek: Deep Space Nine" episode featured a disabled woman whose maladjusted anger and bitterness were soothed by the ministrations of her nondisabled doctor.

Hollywood's image of disability mirrors what the religious community has been telling us for millennia. Eileen Gardner's statement didn't come out of a vacuum; she identified herself as a born-again Christian, and her sentiments place her in the mainstream of fundamentalist Christian thought. For every message in the Bible that tells us the rain falls on the just and the unjust alike, there are multiple stories of illness and disability--especially mental illness or disability-being caused by demonic possession and cast out by the righteous and godly (and nondisabled). Jesus may tell us in John 9:1 that blindness is not caused by sin, but he also cures mental illness by casting "unclean spirits" out of the sufferer and into a herd of swine. And Fiedler points out that, although dwarfs, for example, were sometimes elevated to high office in the Roman Catholic church, there was also an injunction in Leviticus forbidding them to serve at the altar.

"In biblical times," writes Kathi Wolfe in "The Bible and Disabilities: From 'Healing' to the 'Burning Bush'" (Disability Rag, September/October 1993), "many thought that disabilities were caused by sin. People with disabilities were outcasts, ignored by their families and neighbors--often left alone to beg. The Bible was influenced by this context in its portrayal of disabled people."

"We all know that sin is evil," writes R. Randolph Cooper, in "Healing: The Visible Sign of a Whole Ministry." Cooper is a contributor to Sharing: A Journal of Christian Healing, published by the Order of St. Luke the Physician, which describes itself as an "interdenominational, international" organization "dedicated to Christian healing." "Likewise, sickness is evil, and our deliverance from sickness is as real and necessary to our salvation as is our deliverance from sin." Cooper first qualifies this by saying that "sickness is mrely a manifestation of evil (not my evil, but the presence of evil at work in the world)." In the next sentence, however, he emphasizes that "to be forgiven and to be healed are exactly the same--healing brings forgiveness and forgiveness brings healing." And so the Christian Cooper reaches exactly the same conclusion as the New Age Ponder.

Conversely, some fundamentalist Christians see the alleged powers of faithhealers as proof of a direct hotline to divinity. Take as an example erstwhile presidential candidate Pat Robertson. When he isn't railing about feminists trying to turn women into lesbians, child murderers, and witches, he's bestowing his spiritual largesse on (generally anonymous) people with disabilities. These quotes are taken from one of his "700 Club" broadcasts: "We come up against cancer and declare it gone in the name of Jesus! High blood pressure, give way.... The sinus cavities must be opened up...."

"Sickness," writes the Reverend Mark A. Pearson of the Order of St. Luke, "comes from a misuse of human free will as expressed in sin.... If I abuse my body, which is the Temple of God; if I harbor bitterness or anger, if I refuse to forgive, some kind of sickness will likely occur." The Reverend Rufus J. Womble, also of the Order, writes of the ill and disabled "surrendering to illness and defeat, without realizing in the slightest degree that they have yielded to evil."

This condemnation of people with disabilities is by no means limited to Christians or to Western cultures. James I. Charlton, in "Religion and Disability: A World View" (Disability Rag, September/October 1993), quotes disability activists from Zimbabwe, Malaysia, and Indonesia as saying that their religious traditions also regard disability as "divine punishment." Upon his retirement, the head of the Spastic Society of Britain was asked if he could envision the day when a person with spasticity would head that charity. "That'd be like putting dogs and cats in charge of the Humane Society," he quipped.

--as quoted in the November/December 1993 issue of Mouth: The Voice of Disability Rights

The social and individual acceptance of health chauvinism serves a number of purposes. First, it mitigates any responsibility those of us who aren't ill or disabled might feel toward those who are. Not only are the disabled different, but they are to blame for that difference, and they have thus placed themselves outside the circle of our compassion. We need not worry about discriminating against them in the workplace, or slashing funds for Medicaid or rehabilitation or independent-living services. If we do decide to help "the less fortunate," health chauvinism allows us to adopt a stance of moral superiority--of pity, charity, and "forgiveness."

Health chauvinism also undercuts any critique of a social system that oppresses people with disabilities, who commonly report that it is society's reaction to their disability--in the form of attitudinal barriers, job and school and housing discrimination, and lack of accessible transportation and public facilities--rather than the disability itself, that is their greatest problem. "The problem with blindness or mobility impairment or hearing impairment is every bit as much what society as a whole refuses to accommodate," Dr. Irving Zola, chair of sociology at Brandeis University, told the Boston Globe in April 1993. "If you individualize it, if it's only my personal character, my God, we don't have to do anything. We don't have to make ramps to make buildings accessible. We don't have to change. It's not our attitudes--it's that he's so screwed up."

It's also worth noting here that blaming cancer or other illnesses on bad feelings lets other possible culprits off the hook--for instance, the nuclear power industry, chemical pollutants in our food and our environment, and so on. Again, health chauvinism works to prop up the status quo, to undermine voices for radical change.

Second, health chauvinism serves to protect the temporarily well and able-bodied from the fear of the unknown or unmanageable. Since we cannot predict, with any certainty, who will develop leukemia or liver cancer or multiple sclerosis, none of us knows if and when we or a loved one might be stricken. Not to worry: Eileen Gardner, Pat Robertson, Spirit of Change, and the Order of St. Luke all have the answer. If cancer is caused by bad feelings, or by being bad, we all can avoid it by following the right rules. Thus, a collateral benefit for the healthy is that health chauvinism allows them to feel good about themselves. After all, if illness or disability are caused by sin or bad thoughts or wrong living, then the fact that I'm healthy must mean I'm a pretty swell person. This works fine and goes a long way toward helping you keep your peace of mind--until the day you come down with cancer.

This isn't to say that there is no link between attitude or emotions and health, or that certain behaviors--cigarette smoking, for example, or heavy drug or alcohol use--aren't selfdestructive. But such behaviors aren't sinful, nor are they purely questions of attitude; nor do they explain the majority of illnesses and disabilities.

Finally, health chauvinism serves to divide the disabled from other disenfranchised groups, as the comments of Norfolk County District Attorney William Delahunt make clear. Last year, a 76-year-old Quincy, Massachusetts, woman--a resident of a public-housing project for elders and people with disabilities--was raped in her apartment. Though the police had no suspect and no evidence whatsoever that anyone living in the building had committed the crime, the DA nevertheless concluded that the assailant was a mentally ill resident and that "you just can't mix" the mentally ill with the elderly. Quincy Public Housing Director Jake Comer went even further, calling for a cap on the number of disabled people in elderly/disabled housing, and telling the press that the elderly have to live in fear of the mentally disabled. All of this, even though, according to Stephen E. Collins at the Alliance for the Mentally Ill of Massachusetts, "study after study has shown that the population of persons with mental illness is less violent than the general population. In fact, the mentally ill are more likely to be victims of crime than perpetrators."

It's no coincidence that the two examples in Ponder's article on how "negative emotions" and "hard feelings" cause illness are women. Women are generally more likely than men to be blamed for their own illness or disability. We can trace this at least as far back as the creation myth of Adam and Eve, where the pain of childbirth--and the death that often resulted from it--were blamed on women's sinfulness, on their status as "daughters of Eve." Health chauvinism and sexism go hand in hand, from the contempt with which the medical profession has traditionally treated "women's problems" (such as menstruation and menopause) to the use of diagnoses such as "hysteria" and "depression" to brush off any malady or disability the male-dominated medical profession cannot immediately explain or treat.

"There's a tradition in psychiatry," says Dr. Miriam Greenspan, author of A New Approach to Women and Therapy, "of diagnosing women with any kind of physical complaint as having 'hysteria.' Recently it's been changed to 'depression.'"

Here's what the thirteenth edition of the Merck Manual, the bible of medical definitions, says about "hysteria": For the hysterical patient, the sickness role is a preferable alternative to ordinary life. The role of the invalid includes social permission to be dependent, and immature personalities who cannot satisfy their dependency needs in adult relationships may seek the special attention and compassion given to a sick person. How far is this, really, from the Order of St. Luke's Reverend Rufus J. Womble when he writes: One question the sick should face is: do you really want to be well--regardless of how desperately ill you may be? Do you really want to give up your grumbling and other poisonous sins? Do you want to come out into the world and accept your full responsibility or do you want to continue your sheltered life?

Womble's notion that people with disabilities lead "sheltered" lives is far off the mark. John Winske, director of the Massachusetts Coalition of Citizens with Disabilities, cites a national unemployment rate of 65 to 70 percent for people with disabilities seeking work. He points out that housing, job, and social discrimination against people with disabilities has been so prevalent that federal legislation was required to address the problem. (Indeed, at one time a Chicago city ordinance made it illegal for anyone who was "in any way deformed so as to be an unsightly or disgusting object" to appear in public.) And Dr. Sandra Cole in Disability, Sexuality, and Abuse points out that the incidence of physical and sexual abuse of disabled people is apparently far higher than that of the general public.

Health chauvinism, like other prejudices, generally gets worse with hard economic times, and that certainly seems to be the case today. In Germany, skinheads are targeting people with disabilities as well as Auslanders. "Violence Against Disabled People in Germany," a report prepared in 1993 by German disability-rights advocate Ottmar Miles-Paul and Dinah Radtke, documents how a blind man was beaten to death in Siegen, how deaf students were attacked and beaten in Halle, and how a wheelchair user in Hannover committed suicide after he'd been spat upon by school children and then pushed down the stairs of a subway station. During these attacks, the assailants were heard to say, "Under Hitler you would have been gassed." The reference is to the Nazis' T-4 program, under which tens of thousands of severely disabled and mentally ill Germans were murdered in the early 1940s through lethal injections or in gas vans and gas chambers. According to Hannah Arendt in Eichmann in Jerusalem, some of the techniques developed in this war of extermination against what Hitler called "useless eaters" were later used during the Final Solution.

Closer to home, Barbara Faye Waxman, project director for ADA training for the Los Angeles Regional Family Planning Council, has written on hatred as the "unacknowledged dimension in violence against disabled people." Waxman has recommended that the federal government begin tracking hate crimes against people with disabilities. In an article in the fall 1991 issue of Sexuality and Disability, she cites the case of Cary Dickenson, whom she believes was targeted by his assailants because of his multiple disabilities, murdered, and then stuffed into the trash at a southern California library. James Lundvall, a Denver man with paraplegia, was hospitalized in a coma after vandals set fire to the wheelchair ramp to his house--twice within 48 hours. Two-and-a-half-year-old Eric Bernstein was shot to death by his mother when he wouldn't respond to treatment for his multiple disabilities. "It has not yet occurred to the authorities," Waxman writes, "that these overt acts were hate crimes."

The traditional explanation of why people with disabilities are so often the victims of abuse has been that they are more vulnerable than the general population and, thus, easier targets. Waxman believes otherwise:

While it is certainly true that society places disabled people in highly vulnerable situations, the contention that vulnerability is the primary explanation for disability-related violence is too superficial. Rather, hatred is the primary cause, and vulnerability only provides an opportunity for offenders to express their hatred. Indeed, people who are respected and considered an equal are not generally abused. {emphasis added}

Our collective response to AIDS is ample indication that health chauvinism can have devastating consequences--and not only for the currently disabled. Pat Buchanan, speaking for homophobes everywhere, declared the epidemic to be "nature's" response to homosexuality, as if the epidemic was some divine retribution for the "sin" of being gay. That sentiments like these are linked in fundamental ways to the oppression of people with disabilities has been acknowledged by members of both the disability and the HIV/AIDS communities. The founding of the HIV/Disability Alliance in Boston is a recognition that the two groups have common interests and in many ways share a common oppression.

To end health chauvinism, we must first recognize it for what it is: a form of bigotry, a category of hate. Giving up this prejudice will be difficult, because it means coming to terms with our own fragility, our own mortality. It means recognizing that disability and illness are an inevitable part of the human experience. We are all only one accident, one virus, one bacteria cell away from being ill or disabled ourselves. The true test of our morality is how we treat each other in the face of this unalterable reality.