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Coping With Physical Impairment: Assertiveness Versus Reticence

by J.

Lying beside me on my desk are my elegant half-frame reading-glasses made in Italy. They compensate for my longsightedness, and they do so comfortably and conveniently, but they don't disguise my disability: on the contrary they draw attention to it, and to themselves by the excellence of their design.

One of my friends prefers contact lenses. He seems to have constant problems with them: soreness of the eyes, cloudy tears, blurred vision; but against the discomfort and inconvenience he balances the benefit of disguising his disability.

My solution is assertive and comfortable, his reticent and uncomfortable.

It is only recently that people have felt free to cope with defective eyesight assertively. At the beginning of the century, in one of the Father Brown stories, G. K. Chesterton wrote :

... Some apology may be made for Father Brown; for he himself would have been sincerely apologetic. It must be remembered that he had never seen America before and more especially that he had never seen that sort of tortoise-shell spectacles before; for the fashion at this time had not spread to England. His first sensation was that of gazing at some goggling sea-monster with a faint suggestion of a diver's helmet. Otherwise the man was exquisitely dressed; and to Brown, in his innocence, the spectacles seemed the queerest disfigurement for a dandy.

For Chesterton, who wore rimless pince-nez, the assertive strategy came as a shock, but nowadays many people prefer glasses to contact lenses, and choose frames designed to be elegant as well as efficient.

In dealing with other physical disabilities the assertive approach is seldom considered, and this limits the options for designers of aids to circumvent them.

A series of quotations follows, all from accounts by amputees; as it happens, all of them women, who have chosen the assertive strategy preferring, at least some of the time, to use crutches rather than prostheses. (I have emphasised certain passages in the quotations by setting them in italics.)

1.

. ... We decided to go for a walk on the boardwalk ... This was no ordinary walk. I was outdoors on crutches for the first time in fourteen years... .

The day was so pleasant it seemed silly to be afraid. I was soon feeling so much more confident that I began walking faster. In fact, I was walking so fast that for the first time ever my husband asked me to slow down.

... I was on cloud nine when we got home. I'd let everyone see me without my prosthesis, and no one had made a big deal out of it... I'd been accepted. I felt really good even though the long walk made me so tired I couldn't use crutches again for a couple of days. When I could use them again, I even went swimming... . Imagine that: I went out in a bathing suit only two days after my first public walk on crutches since 1975! I could hardly believe it was me.

... Looking back over my experience I realize that my learning to walk again was not the most important or difficult part of my rehabilitation, even though it was all I was taught. Important as walking is, it's a minor skill compared to the ability to accept and be comfortable with myself, which I had to learn the hard way over so many years. ... No one helped us accept my new body image. They just helped us cover my image with a prosthesis.

... It would help a lot if hospital and rehabilitation staff would just act as if we didn't have something to be ashamed of. Perhaps they think we wouldn't buy artificial limbs if we thought we were acceptable emotionally. Well, perhaps some of us wouldn't although I doubt it but I think it would be better if the prosthetists lost a few sales than it is for amputees to spend years with an emotional dependence on something which is only a mobility tool.'

2.

'It took me eight years to get the courage to go out without my prosthesis, other than on the ski slopes. Actually, I didn't have much of a choice. I had plans with a friend to vacation in Florida for a week. The airline and hotel reservations were already made, and the day before our flight ... I found it difficult walking with the prosthesis and I was worried that it might get worse. My prosthetist took a look at it and said that I'd have to leave it and that it would take a few days to fix. So I went on vacation without it, and used crutches instead.

It was to be a blessing in disguise. That week, I walked along the beach barefoot for the first time in eight years. I can't describe in words how emotional it was for me to feel the wet sand between my toes again! My crutches sunk a bit in the sand as I cried silent tears of joy. It's the little things in life that mean so much, I thought... . I absolutely love to travel. If I travel alone, ... I wear my prosthesis because while using crutches I can't manage to carry even the smallest items. If I'm traveling with a companion, I'd rather leave my leg at home and use my crutches. It's so much more comfortable sitting in an airplane seat without the cramped feeling I get when wearing my prosthesis. I can also walk much faster with crutches than I can with my leg on, and I feel much less clumsy.'

3.

'Aren't modern prosthetics wonderful? NO! I wear a leg during the day, but I prefer to use crutches. I have gotten quite good with underarm crutches and can carry things in both hands for short distances. I still can't walk on one crutch. If my prosthesis ever needs replacing, I probably will just give up on it. The biggest problem is the relationship between the top of the stump and the socket. The body changes size and the socket doesn't. There is a lot of wear on the skin in the crotch area and for both genders that is uncomfortable.'

4.

'I had developed a cyst that required surgery that prevented me from wearing the limb ... I decided I was not going to be a recluse just on account of some damn leg. I got out on crutches and came back to life in a bigger way than ever before. It's been great ... I learned I could get around okay on my crutches. Maybe a little faster and better than with the limb... . It doesn't mean the end of the world to use crutches. It isn't fattening, immoral, or against the law. Each day I feel a little better about myself.'

5.

'... why don't you wear a leg?

'Well I did for the first year. But it never did fit me right. It hurt to walk with it, and I was always falling down.'

6.

'I got a prosthesis while I was in hospital. I wore it for a year, mostly to please my family. It killed me to wear it, it was so painful. Finally I put it in a corner and I've been crutching my way through life ever since.'

It seems that prostheses may be even less fun than contact lenses. The assertive solution, the use of crutches, is not expensive and it is efficient because it uses the remaining limbs within their natural potentialities to compensate for the missing member. Because the gait can be efficient it can be beautiful. Notice how many of the quotations contain positive statements about the speed and the ease of locomotion with crutches. By comparison the use of a conventional prosthesis is slow and cumbersome and can be painful as well. The use of a simple peg can also replace much of the missing function, and also free the hands; this too can be efficient and relatively cheap. A hi-tech prosthesis designed solely to replace the function of a missing limb would probably not look much like a leg with a natural knee and foot, but it could be beautiful in a way that a cosmetic prosthesis cannot, because its form would be united with its function. By contrast, a conventional prosthesis is a lie: its appearance implies that it is composed of flesh and bone, while in fact it is made of coloured plastic and metal. Mechanical systems are different from natural ones: aeroplanes fly, but not like birds that flap their wings, so why should a mechanical prosthesis have to look like a limb, and appear to work like a limb when it cannot be powered or controlled like one?

These are all implications of transferring the assertive stategy of coping with defective eyesight to coping with missing limbs. There is no reason why someone should not be uniquely elegant, in the assertive fashion, walking with a pair of Calvin Klein crutches, or driving an Armani wheelchair. Such things might not exist at the moment, but if people demand them the market will supply them.

I have argued elsewhere that there is nothing shameful about physical impairment, and therefore there really is no need to hide it away. (I look no worse when I'm wearing my glasses, and my wife looks gorgeous in hers.) So why isn't the assertive option available to people with other disabilities?


Note

Quotations 1 to 3 are taken from A stroll on the boardwalk by Pat Hackett.

Quotations 4 to 6 from material published in Fascination.

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