Along with an article on the failure of other primates to develop a system of communication comparable to human language, the January 12 Science Times in the NYT has a letter from William J. vanden Heuvel (founder and chairman emeritus of the Franklin & Eleanor Roosevelt Institute), following up on a January 5 article about the spot over FDR’s left eyebrow. The letter begins:
Your article perpetuates the idea that there was a concerted effort to conceal how sick President Franklin D. Roosevelt was, using as an example the fact that he had had polio at age 39, which caused him to be disabled to the extent that he could never stand or walk without assistance.
To F.D.R., this was not “a sickness” — one of the reasons he is an icon for people with disabilties. He educated Americans to understand that disability is not illness and that we can master the limitations caused by disability.
Some Republicans used the fact that he could not walk unaided in political attacks, even to the point of maintaining that “a cripple” should not be elected president. He did not conceal his physical limitation except to prevent his opponents from making political capital out of it.
The linguistically interesting point here is the contrast between illness/sickness/disease and disability. The two states are sometimes confounded, because people may be inclined to take disability as a sign of disease. In Roosevelt’s case, his disability was a consequence of an earlier illness (disabilities can, of course, arise in a number of other ways), so there was a connection between the two, but his disability was not itself a sickness.
In addition, some people are inclined to treat both disability and illness as sources of stigma, and that’s something that can’t be addressed by distinguishing the two.
(The topic is of special interest to me, since my right hand and arm are somewhat disabled, ultimately as a consequence of disease, namely necrotizing fasciitis. The event intervening between the illness and the disability was a series of surgeries in which my ulnar nerve was damaged. So I’m now disabled, but not now suffering from NF.)
Just two days before vanden Heuvel’s letter, the NYT Magazine had a fascinating piece on the vocabulary of disease: “The Americanization of Mental Illness”, by Ethan Watters. Watters notes the Western drive to conceptualize mental disorders as just another kind of disease (“mental illness”) and details some counterintuitive and not necessarily welcome consequences:
For more than a generation now, we in the West have aggressively spread our modern knowledge of mental illness around the world. We have done this in the name of science, believing that our approaches reveal the biological basis of psychic suffering and dispel prescientific myths and harmful stigma. There is now good evidence to suggest that in the process of teaching the rest of the world to think like us, we’ve been exporting our Western “symptom repertoire” as well. That is, we’ve been changing not only the treatments but also the expression of mental illness in other cultures. Indeed, a handful of mental-health disorders — depression, post-traumatic stress disorder and anorexia among them — now appear to be spreading across cultures with the speed of contagious diseases. These symptom clusters are becoming the lingua franca of human suffering, replacing indigenous forms of mental illness.
… at the same time that Western mental-health professionals have been convincing the world to think and talk about mental illnesses in biomedical terms, we have been simultaneously losing the war against stigma at home and abroad. Studies of attitudes in the United States from 1950 to 1996 have shown that the perception of dangerousness surrounding people with schizophrenia has steadily increased over this time. Similarly, a study in Germany found that the public’s desire to maintain distance from those with a diagnosis of schizophrenia increased from 1990 to 2001.