mrissa: (intense)
[personal profile] mrissa
One of my friends has posted a bit under friendslock about dealing with a health-related thing that is also a work-related thing; you can see why this would be understandably private and not the sort of thing I would be poking this friend to unlock. So I wanted to pull what I was thinking out here where I can poke at it and not poke at my friend's private issues as well.

The thing is, I think we are, as a culture, sort of in love with the broken leg model of illness, injury, and disability.

Here's what makes the Hollywood broken leg model so shiny.

With a broken leg, you:
*know what has happened.
*know when it happened AND
*know it right away.
*know what to do to fix it.
*know about how long it will take to heal.
*know that it will not suddenly get less healed for awhile in the middle and then jump back to more healed again.
*can easily predict which things will stress the injury.
*know that it will be completely fixed when treatment is done.
*have at least some theory of where the person experiencing it falls on the continuum of sinner ("What were you doing on top of that water tower at 3 a.m. anyway? You're lucky it wasn't your neck!") to saint ("Hit by a drunk driver while helping an elderly nun across the crosswalk? Let me fluff that pillow for you, you poor baby!").
*do not have any doubt as a casual passerby whether there is something wrong, or what.

Of course, not all of this is actually true of broken legs, even! (I have edited in a few spots to add "Hollywood," because I want it to be absolutely clear that I know that my friends' leg injuries to not come with these magical advantages.) It's just the assumption from people who don't have the said broken legs. But it is a mighty convenient set of traits for an illness, injury, or disability to have. And the farther from this model your actual illness, injury, or disability goes, the more frustration you are likely to face from other people, because their questions are likely to be centered around the broken leg model.

Why didn't you go in sooner? they will snap. Sometimes they don't even notice that they are snapping, and if you point out that they're snapping, you need to stop being defensive. But see: if you break your leg, there are bits of broken leg sticking out, and you are an idiot for not going right in, right now! But what if you wake up just exhausted one morning? Should you go to the doctor that morning? "How long have you been exhausted?" the doctor will say. "Since this morning," you say. Wrong answer. Get more sleep, or less sleep. Get more exercise, or less exercise. Eat differently. Change something up. What if you feel a little dizzy? If you're female, does this correlate with your menstrual cycle? Well, if you've only had it for one day, you can't really say, can you? Why didn't you go in sooner? Because some things are not a broken leg. And if you get a history of going in and mentioning things that have not really been a problem very long, if you're not very lucky, you get a doctor who writes down "hypochondriac" or "drug-seeking," and then when it's still a problem later, you've got that to deal with. The cardiac surgeon's memoir I read recently acted as though women could go in with fatigue and find out whether they'd had a heart attack every time they had fatigue, since fatigue is the main symptom of heart disease in women, and I laughed and laughed. It is not some feminine perversity that makes that not happen. Really, really not.

Why don't you take meds for that? they will ask. Because naturally there are meds for that in existence. And they work for you. And they don't interact badly with anything else you have to take. It's just spite that makes you not take them, or spite that makes you take them wrong so that they don't work perfectly. This is the twenty-first century! They can fix things! Who can? You know--They! They can! Them! They would have already if you had only gone in sooner! What these people mostly want is for you to have a big plaster cast on your kidney, your endocrine system, your ears, or whatever else is not working--in some cases your actual broken leg that was not perfectly fixed by divine fiat somehow, because the world does not magically work like that--so it can fix the thing, they can sign it, and then in a few weeks somebody can come along and saw the thing off and everybody can go skipping merrily along. Most of us want this too. It just doesn't happen to work that way.

I'm pretty sure I do this to people, because one thing I've learned in the last few years is that we are all really terrible at spotting the ins and outs of illnesses, injuries, and disabilities not our own, so one of my new self-checks before I open my mouth is going to be, "Am I trying to treat this like a Hollywood movie of a broken leg again?" Too many of the formal things we have set up for employment and compensation are working on the broken leg assumption. The least we can do is not perpetuate them when we have the option.

Date: 2010-06-10 10:13 pm (UTC)
From: [identity profile] coraa.livejournal.com
Yes. Yes!

I particularly notice this with a type of cause-seeking (or, to put it less charitably, blaming) that sort of makes sense with a broken leg model but not so much with other things. For most people, leg bones don't just fracture on their own: even if someone has a predisposition to more-fragile bones, there's usually some physical trauma that casued a particular breakage. So it's reasonable (possibly overly-nosy, but reasonable) to ask how a break happened, because there's usually an answer like, "Skiing accident" or "car accident" or "tripped on the cat" or "slipped on the ice" or "attempted to create my own backyard high-wire act" or something.

(I won't say always, because there may very well be disorders that cause spontaneous bone breaks, but for most broken bones, there's a fairly clear proximate cause for the break.)

That isn't true, for the most part, of things like heart disease, or cancer, or depression, or autism, or whatever, but people insist on treating it that way. Did you eat the wrong foods, or did you not eat enough of the right foods? Were you too sedentary, or did you do the wrong kind of exercise? Were you stressed, or did you fail to have sufficient life goals to motivate you? And so on, and so on. That there must be a clear cause: you got X because you did Y, or you failed to do Z, or possibly because someone else did Q or failed to do R around you at the right, or wrong, time.

While I see this with other health issues I have, one of the simplest to explain is the fact that I have terrible teeth despite having great dental hygiene. I spent years brushing three times a day and flossing religiously and using all manner of fluoride supplement and avoiding soda and so on, and still having everyone from the dentist on down assume that there wasn't any possible way that I just had bad teeth: I must have done something bad to them, or failed to do something good to them. Until finally I found the dentist that I have clung to ever since, who noted quite reasonably that there's a genetic component to dental health, and some people just get unlucky. But the idea that All Mouths Start Off Perfect So You Must Have Done Something To Screw This One Up was so prevalent that it took years to get there.

Date: 2010-06-10 10:21 pm (UTC)
From: [identity profile] mrissa.livejournal.com
One of the most common ways of expressing health concern is not the neutral, "What happened?" but the accusatory, "What did you do?" This is often even skewed in its intonation: "WHAT did YOU DO?"

And one of the things it means is, "What did you do that I can avoid doing so that I can dodge this thing that happened to you?"

"What did you screw up that I can get right so that I can be okay where you are not okay?"

Even, "What happened?" assumes that there is an event, something you can point at. Even if it's that a bolt of lightning or a meteorite hit you while you were sitting innocently in your living room reading, something happened, and there is before, and there is after. Whereas with, say, food allergies, or depression, or many other things people I know deal with, there is less the bolt from the blue--even if we stipulate that it is the blameless bolt--and more the gradual awareness that not all is well, or at least not as well as it could be.

Story-seeking is a very human urge. It's just not always a very useful or appropriate one.

Date: 2010-06-10 11:05 pm (UTC)
From: [identity profile] haddayr.livejournal.com
My particular favorite is the accusatory: "Do you think stress brought this on?"

Because, of course, I purposefully had a time-consuming child, and I purposefully like to worry about money all the time because it's so fun for me, and I purposefully have family-of-origin issues, and I just ran out and courted sleep-deprivation brought on my slumlords and and and . . .

Date: 2010-06-10 11:51 pm (UTC)
From: [identity profile] orbitalmechanic.livejournal.com
My mother worked in a fertility clinic for years (in the 1980s), and every one of her patients was constantly hearing, "Oh, just relax, it's stress." She to me once, "That's why no one gets pregnant during wars! or during an economic depression! or in horrible relationships! Thank goodness someone noticed!"

Date: 2010-06-11 12:02 am (UTC)
From: [identity profile] mrissa.livejournal.com
That is some quality field research those folks are doing. For Science.

Date: 2010-06-11 11:47 am (UTC)
From: [identity profile] dichroic.livejournal.com
I know one person who actually did get pregnant after years of infertility, just a year or two after adopting a child. I think the only thing worse than "you should just relax! or adopt a baby, then you'll get pregnant!" would be hearing, "See, it worked!"

Particularly if the phrase "real daughter" is used somewhere in there.

Date: 2010-06-11 07:25 pm (UTC)
From: [identity profile] mrissa.livejournal.com
Yah, people who use "real daughter/son/child" are really invited to depart the premises. Honestly.

Date: 2010-06-16 08:48 pm (UTC)
From: [identity profile] marydell.livejournal.com
I get told a lot that I'll have no problem getting pregnant since adopting my son, apparently because infertility is just a form of hysteria.

Date: 2010-06-11 12:01 am (UTC)
From: [identity profile] mrissa.livejournal.com
YES, the stress of having to LISTEN TO QUESTIONS LIKE THAT ONE NEXT PLEASE.

Date: 2010-06-11 11:18 pm (UTC)
From: [identity profile] swan-tower.livejournal.com
Corollary: "What did I do?" In my case, why -- despite years of reasonable physical activity and almost never wearing high heels -- am I the one who gets a torn ligament and plantar fascitis and collapsing arches and all the rest of it, while these other women swan around in their stilettos without problems?

Which is false in so many ways, because a) I have no idea what problems any given woman may have or not have, and b) I know that swanning around in stilettos frequently leads to a great many problems, most of which I don't have. But it feels so bloody unfair.

Date: 2010-06-12 12:10 am (UTC)
From: [identity profile] mrissa.livejournal.com
There is a House episode I think has a completely brilliant moment, in which a patient who has spent the episode trying to convince the doctors that one particular habit is not to blame for his health problem--even though they associate that habit very strongly with the type of problems he's having--is diagnosed with lung cancer, and he blurts out, "But I don't smoke."

It is so very human.

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