Degrees of Disability

“The fault, dear Brutis, is not in our stars”

This blog may not be indicative of my true thoughts and feelings on the subject, exactly, as I’m currently disadvantaged in my abilities to articulate myself fully — that is through research, referencing, editing etc… So I guess this is a minor disclaimer rendering any errors in logic or processing null and void (at least temporarily; I will come back an edit when(if) I’m better).

So, more to the point: would you all agree that there are differences in disability? I’ve written many essays and articles about the subjectivity of suffering; I’ve read many books ranging from psychology texts to novels (The Tin Drum, Man’s Search For Meaning) on this subject. I also qualify as one who ‘suffers’, at least by my standards (which I have articulated previously in other posts). So that in mind, I think that I have, at least to my own knowledge on the subject, a fairly firm grasp on what suffering is. I should also say that the infirmities and fallacies I note I have more than my fair share of experience with (both committing and receiving; I still catch myself, often); however, as I’ve become more ill, I’ve learned things are always much more complicated than we make them out to be.

I’m going to go ahead and concede that there are degrees of suffering and disability; that one person can objectively be in more pain, or is more disabled (physically, mentally: cognitively or emotionally) is apparent to me — and I think most people would agree… for the most part. I’m mostly concerned with the least part; because that’s what I find the most interesting and at the same time the most startlingly complicated part.

If someone is suffering, how can we tell? First you have to establish trust. You have to agree that the person in question is not lying or attention seeking. Once you rule out fictitious disorders, you can evaluate the situation in a more precise manner. The quickest way is simply to ask them; what are their daily limitations (self-care scores), how much pain they’re in (McGill pain questionnaire) etc. However, these simply gather information from respondents. Evaluating is the tricky part, and probably responsible for how we view others in pain, verses how we view ourselves (whether we offer internal vs. external attributions to explain their suffering (fundamental attributional error).

Even in the most skilled hands, data results can be skewed. That’s why statisticians must always operate objectively, keeping emotions away from their methodology.

So, where are we? We’ve ascertained the respondent is trustworthy. We’ve collected data (something we all do, although when we think of ‘data collection’ images of a classroom or a boring laboratory, or a university come to mind (availability heuristics). And, finally, we’ve evaluated the data. There’s a problem here, though. Because in some way or another, everyone is ‘suffering’. Whether that’s a troubling financial situation, illness in the family, or in the self, mental disorders; a whole slue of potential factors can be thought up. And secondly, the evaluations are made by untrained laymen who are either related to the respondent, or are acquaintences or friends (at least for my purposes). That means when they evaluate the data, they skew it with their own personal problems.

Back to the initial question then: are there degrees of disability, and if so, are there degrees of suffering. And, if yes, how do we treat those people? Do we have an ethical responsibility to downplay our problems in their presence? Do they deserve respect and praise as compensation for their inspiration?

What I’ve found being sick (and I’m actually substantially disabled and sick), is that most people would answer yes to all of those questions, but practice as if it were a no. They know that its ‘right’ to do all of those things listed above, and so publicly acquiesce, while they privately disagree.

I’ll speak towards pain more directly now. Lets establish a rating scale (1-12; all the major articulating joints (individually, of course). So that’s: shoulders, knees, ankles, elbows, wrists, and hips. And we’ll offer one point for each joint. Much like hospitals will triage using a 10 point rating scale of pain, we will too… its just slightly more modified for our purposes. Pain, for our purposes, can be theorized as involving tissue damage to the surrounding structures (ligaments, tendons, muscles) as well as the joint itself (cartilage, bone). If your pain in that joint is above a 5 on the 10 point ‘hospital triage’ scale, you get one point for that joint. Although, you must explain why its a 5 or above (the whole evaluation process listed above must be carried out). So, for instance, I rank a 9 out of the twelve, and the average pain is an 8.5 in each joint.

I think that this gives us a better picture of exactly what a persons suffering is, by explaining and including the ‘why’s’ and the ‘how’s’. I also think that credit is deserving when credit is due. I mean, even if you disagree, if you experienced certain scenarios which demonstrate this phenomena, you may change your mind.  For instance, say someone has locked in syndrome (stroke resulting in total paralysis excluding movement of the eyes), and a person who hangs out with them regularly complains a pulled muscle in their shoulder (even something more serious like a congenitally dislocating hip). They may go on and on about how horrible it is and how much they’re suffering. Wouldn’t you think that’s wrong? Wouldn’t you say, ‘hey, maybe she or he should talk to someone else about that, someone who either has the same problem (or similar) or is equal to their own suffering in some objective way’? I think you would. Not only do I think you would, I think you should.

I’ve come to learn not to obsess over how bad things are for me. Because they could (and probably will) get worse. Others who have it worse and bear it with a bold face inspire me; they inspire me to be like them.

The great Spidey deontological principle ‘with great power comes great responsibility’, can be converted to ‘with great ability comes great responsibility’.

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