Thus disability is a complex phenomenon, reflecting an interaction between features of a person’s body and features of the society in which he or she lives.
This statement rang all sorts of crazy bells in my head, causing me to go off on a mad search that resulted in me finding in my Sent mail folder an eerily similar statement I made almost ten years ago about mental disorders:
A mental disorder is a complex beast, known only through a person's interactions with the expectations of the society in which they live.
I find this statement incredibly topical to a lot of my thought patterns of late. Jay's post dealt with the emotional management dimension of his physical disorder. I've been dealing lately with the physical effects dimension of a mental disorder, and how it interacts with my diabetes. What both of us share (albeit in very different scales) is a winnowing, a shortening of choices in our lives.
Any person in this situation has to deal with limitations, some lessor (like my own), some much greater. But every choice holds more consequence, and some choices are simply not available to us. What for a normal person might be "another option" can either kill us outright, or take years off of our lives. And perhaps more importantly, as Jay deals with very well and very extensively in his post about coming to terms with disability, we are no longer have the option of blissful ignorance. We can't just ignore the cricket on our shoulder and worry about it tomorrow. That ship has sailed far too long ago.
For my own part, the option to continue dealing with my ADHD untreated is no longer available to me. It was clear and obvious that my sugar and caffeine self-treatment for ADHD took too much of a toll on my body. I was pissing away years of my life, rather than take a drug which would help balance out my hyperactivity. Even with a perfect diet, diabetics don't live long lives. Failing to take control would drastically shorten it, or make the final years much less enjoyable.
Jay and others face consequences much more direct. I suspect that recovered alcoholics and drug addicts have very similar limitations. It's not a matter of "don't drink", it's a very serious engagement with yourself and your choices that fully healthy people do not experience. (I do know from experience that athletes experience a similar winnowing of choices, but they engage deliberately on this path and slippage on the path are not usually fatal for them.)
However, I think that the physical and mental interact far more directly than through our choices. I am actually sitting in an interesting situation, dealing with a physical disorder (genetic diabetes) and a mental disorder (ADHD) and observing the clear line of interaction between the two. I observe as a change in diabetic drugs affects my mental state, and a change in the ADHD drugs causes a sharp change in my body's handling of sugar. However, I am unable to get either specialist to acknowledge the other or even to review with the differences in blood tests before and after changes medicine proposed by the other doctor. I am left to manage the balance on my own.
I have been seriously debating with a number of people how physical and mental interactions are far more related than modern practitioners seem willing to acknowledge. I believe that to fully truly treat the human body well we are going to have to bring the mental and physical care together. Likewise, as friends and neighbors of people with mental or physical limitations (whether we are also afflicted or not) we need to have sympathy for these interrelationships. We need to understand how the disabilities limit their choices, and have respect for the sustained impact these limitations have upon the other every day.