Disability versus Sickness

Sick or disabled?

Carl is a paraplegic. That’s definitely a disability, not a sickness. Right?

But then Carl’s paraplegia means that rather than mobilise using his legs, he mobilises using his shoulders, arms and wheels. He is putting strain on his upper body and on his heart, that are causing pain and other problems with a greater risk of heart attack. His back goes into spasm occasionally, and this is happening increasingly often. The strain on his body makes him mentally tired as well as physically tired. He used to be fully continent, but he has since lost this control.

Heart attack, incontinence, pain and weakness. That’s illness, surely?

Bethany is Deaf. She has a small amount of residual hearing which she augments with hearing aids. Her first language is British Sign Language and most of her friends are also Deaf, although because they live scattered over a wide area she can’t meet up very often. Although she prefers BSL, when communication with hearing people she combines the use of her hearing aid with lip-reading. This is draining so she cannot keep it up for long, particularly as English is not her first language. Trying too hard or for too long leaves her with migraines as well as fatigue.

Migraine and fatigue. That’s sickness, right?

Dinah is autistic. I’m not even going to go there.

I have ME. There are many things that I am not able to do. Some of them are partly because of the environment. I can only access one side of my local train station, so trips on the train require me to start in the wrong direction or finish by overshooting my station to change at the next accessible one. I can’t go on most of my local public footpaths to walk my dog because I can’t get my scooter through the gates or over the stiles; my nearest accessible footpath is a mile away and by the time I’m halfway there on my scooter I’m ready to come home.

Most of my inability to do things is because of a combination of physical fatigue, mental fatigue and pain. I have a physical and mental condition that limits my ability to move and carry out activities. According to the Oxford English Dictionary, I am disabled. I am disabled because it is my physical or mental condition that limits by abilities.

Interestingly what I have may turn out not to be a sickness, but a disability (if we continue to attempt this spurious disability/sickness dichotomy). I may actually have a genetic condition called Ehlers-Danlos Syndrome, which basically means that all my connective tissue is a bit lax, hence all my difficulties. Suddenly, without change of symptoms or abilities, I’ve jumped from sick to disabled.

Bethany is Deaf – a disability – but she can’t work full-time because of her fatigue and migraines.

I have ME – a sickness – but I can’t work full-time because of my fatigue and pain. I may be disabled, but it is still the fatigue and pain, not the name, that affects my ability to function.

This entire dichotomy and attempt to build a dichotomy is spurious and specious (I love both those words). It is invalid and, whilst superficially plausible, it is wrong (for those who can’t remember the definitions of spurious and specious). People are not either disabled or sick; not either impaired or ill. We’re a mix of abilities for a mix of reasons, ranging from severely disabled to Olympic Mensans. Trying to restrict ‘disability’ to a narrow range of conditions is to attempt a distinction that doesn’t exist.

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