Invalidism

“ From these and many another supporting observation, easily and everywhere to be had, it is perfectly legitimate to conclude, beyond reasonable doubt, that mental pain and its resulting invalidism is quite naturally the necessary outcome of a great variety of causes, which may be contributed to, usually, by almost every influence that either bad heredity, accident, disease, wrong education, personal over-stress, or failure, or future uncertainty, may happen to afford. ”

“ If it affects the bread-winner of the family, how long will he or she be disabled, and how completely; what are the hopes of ultimate and complete recovery; will chronic invalidism follow; is it worth while in this particular disease to spend a great deal of money and time in trying to achieve a complete cure, or is cure so improbable and at best so incomplete that our resources can be expended more wisely in other directions? ”

“ THE FREEDOM OF ILL-HEALTH One of the greatest advantages of invalidism is that it frees us from petty obligations, unworthy pleasures, and meaningless conventions. The blessed freedom of ill-health is something few people appreciate ”

“ Then, if invalidism is to be accepted, meet it bravely and serenely as may be; and if death, then approach it loftily, for no one dies with his work undone, and no just-minded person can wish to survive his service. ”

“ After twenty years of invalidism, I have been restored to perfect health of body and mind, and wholly by a strict obedience to the laws of health and happiness, which I now commend to your especial attention, with the hope and prayer that by obedience to them you may save yourselves and households from unspeakable future miseries. ”

“ A certain mineral extract, added to an ordinary dose of Schlafstrank, quietly and painlessly disposes of our physical existence, and sends the spirit on its way, rejoicing in its new found freedom.”
“You mean that what we call chronic invalidism does not exist among you, simply because your people are in the habit of killing themselves as soon as health leaves them. It is one way of escaping earthly troubles. ”

“ When such expensive remedies are out of the question, it seems better that patients, even seemingly very feeble, should take to their ordinary avocations in life again, and fight down the tendency to invalidism. But of course, the decision on such a point must rest with the tact and judgment of the practitioner in each individual case, for there are, doubtless, instances in which the attempt to carry out such a plan, even moderately, would break down the remaining strength, and make matters worse than they were before. ”

“ But if society understands and readjusts these barriers, making it possible for its citizens—women as well as men—to approximate the natural instinctive bent, it will not only save itself much unrest but will also go far toward preventing the spread of nervous invalidism. ”

“ All the moral uses of rest and isolation and change of habits are not obtained by merely insisting on the physical conditions needed to effect these ends. If the physician has the force of character required to secure the confidence and respect of his patients, he has also much more in his power, and should have the tact to seize the proper occasions to direct the thoughts of his patients to the lapse from duties to others, and to the selfishness which a life of invalidism is apt to bring about. ”

“ It is easy to laugh at such trifles—easy to the invalid himself at times; but if any healthy person will recal his feelings during convalescence from any former illness, he will{135} remember the sort of painful sympathy with which he saw the servants going about their work—how his frame ached at hearing of a long walk, or even at seeing his friends sitting upright upon chairs. If he considers what it must be to have this set of feelings for life, he will think the particularity of the invalid not only worth indulging, but less absurd than in the eye of reason it appears ”

“ Just as in the case of physical illness, we need to know not merely that the patient is sick, but also why he is sick, what organs are involved, what course the illness will run, and what physical work the patient can safely undertake, so in the case of a retarded child, we need to know the exact degree of intellectual deficiency, what mental functions are chiefly concerned in the defect, whether the deficiency is due to innate endowment, to physical illness, or to faults of education, and what lines of mental activity the child will be able to pursue with reasonable hope of success. ”

“ She has made an admirable start toward a differential diagnosis of special defects in number work, language ability and other mental activities. The degree of special deficiency which results in social failure could be placed upon an objective basis, but the rarity of special deficiencies as compared with general deficiency will make this a slow task. In the meantime we may rely upon the mutual dependence of the organic processes as a point of view which emphasizes the common spread of deficiency to many activities. ”

“ The fascinations of your present life are too overwhelming; when an invalid once begins to enjoy the contemplation of his own woes, as you appear to do, it is all over with him. Besides, you urge, and perhaps justly, that your case has already gone too far, for so rough a tonic. What, then, can I do for you? Medicine I cannot offer; for even your respectable family-physician occasionally hints that you need something different from that. ”

“ A diagnosis of deficiency should not be made until the examiner is able to estimate whether the removal of training or health handicaps would bring the individual above the borderline. So far as known temporary handicaps affect the standard of the test results with groups they should, of course, also be taken into account. On the other hand, it is clear that the borderline which predicts social failure should not be shifted to allow for differences in permanent handicaps whether those be of race, sex or social position. ”

“ The most that we know of health has been learned through a study of the misadjustments that bring about disease. What has been done educationally to assist the defective, the handicapped and the dependent has thrown a flood of light upon the training of the normal child. Through work undertaken in the first instance for the benefit of the exceptions, the minority, the whole community has benefited.
In this connection no one will deny that immigrants, both men and women, have their handicaps. ”

“ The woman in the situation I have described has probably a variety of symptoms on which her condition causes her to dwell. A great many of them are of little practical moment. If she is irresolute and weak, she yields where she should not, and finds for inactivity or for fears ample excuses in the state of her own feelings. An unwholesome crop of disabilities grows out of these conditions. It then becomes the business of her physician to tell her what is real, what is unreal, what must be respected, what must be overcome or fought. She has acquired within herself a host of enemies. ”

“ There are those, also, of all ages, who are incapacitated for self-support and for service by disease, or by physical or mental defects such as bodily deformities, blindness, or feeble- mindedness. In addition, there are some who, though physically able to perform service, deliberately prey upon the community in one manner or another without giving anything in return. ”

“ Under usual conditions, eighteen per cent of our working population has a definite physical defect or chronic disease. Of our war handicapped, it is believed that some eighty per cent can be placed, by careful selection of jobs, in work where they can be happy and just as productive in that particular job as they would be without the handicap. Another twelve or thirteen per cent will need rehabilitation before such placement can be made. ”

“ The Court noted that although an individual may have an impairment that does not in fact substantially limit a major life activity, the reactions of others may prove just as disabling. "Such an impairment might not diminish a person's physical or mental capabilities, but could nevertheless substantially limit that person's ability to work as a result of the negative reactions of others to the impairment." ”

“ Some such disharmony will, by adequate investigation, be found in a large number of cases to exist in the early states of the illness and will be appreciated by the patient before there occur any obvious signs, any outward manifestations of disability.
But in any disharmony which may occur it must be recognized that the mental mechanisms affected are those with which the patient was originally endowed, which he has gradually trained throughout his past experience and which he has employed more or less successfully up to the time the illness commenced. ”

“ Only those who go through such an experience are able to understand what it means to lose the use of any part of the body and be disabled after many years of perfect health. To be deprived of my ability to walk and the use of my body as of old, words are not adequate to describe the dreadful change, knowing that in all the coming years of my life I would have this burden. ”

“ Considering the important part played by uncorrected physical defects in causing permanent physical disability among adults, do you think in the long run it is cheaper or more expensive for a community to spend money in protecting the health of school children? Discuss the particular needs of convalescent and of chronic patients. Explain the effect of activity upon recovery, and explain why it is desirable for invalids to have occupation. ”

“ By command of the court, all invalids disabled by no visible and well-known disorder, were forced to rise from their couches, to drag themselves about in the blazing sunlight, and even to resume their former occupations. Some of them, however, succeeded in simulating well-known disorders of the limbs so cleverly, that they were considered, even by skilled investigators, to be victims of chronic disease, and were mercifully left alone. ”

“ The barriers facing the handicapped are not so much their own disabilities, but the attitudes of the non-handicapped toward their disabilities.
Those of us who are not handicapped think of what we could not do if we lost an arm or a leg, lost our sight or our voice, or were disabled in some other way. We often forget that the handicapped are thinking of what they can do.
We must learn to think like them-positively ! We must look not at what they cannot do, but at what they can do. We must look beyond the disability to the positive ability. ”

“ The number of persons, more or less absolutely lost to the working force through physical disability, of the lame, sick, and debilitated, which constituted such a burden on the able-bodied in your day, now that all live under conditions of health and comfort, has shrunk to scarcely perceptible proportions, and with every generation is becoming more completely eliminated. ”

“ The primary motivation for the inclusion of misperceptions of disabilities in the statutory definition was that "society's accumulated myths and fears about disability and diseases are as handicapping as are the physical limitations that flow from actual impairment." ”

“ Under the regulations applying to children, a person under 18 will be considered disabled if suffering from a Part A impairment listed for adults or its equivalent, as long as the disease's processes have a similar effect on adults and younger persons. ”

“ This day-a wonderful, vigorous celebration of the progress and possibilities for equal opportunity-must also include an equally vigorous commitment to continue the fight. Now is the time to act on our understanding that having a physical or mental disability is a part of the human experience. ”

“ Life on hard conditions is their lot; and as no chastening in immediate endurance is otherwise than grievous, these dear invalids have the tenderest claims on our ready help and affection. If they are precluded from all activity of either mind or body, the greater responsibility is laid on those around them who possess the blessing of health to cheer and lighten as much as possible the burden of their affliction. ”

“ Recall to mind the rich men and women whom you have known; are not most of them invalids? A person of that class whose physical disabilities do not oblige him to take a periodical course of hygienic and medical treatment is as rare as is an invalid among the laboring classes. ”

“ I have directed the Health and Human Services Department to make clear to every health care facility in the United States that the Rehabilitation Act of 1973 protects all handicapped persons against discrimination based on handicaps, including infants. ”

“ Seeing the mischief which the system of disabilities is accomplishing, is it not time that there should be at least an end of it? Or is there any good it can possibly do to make up for the harm it has already wrought and is still working? ”

“ For purposes of subparagraph (A) , an individual shall be determined to be under a disability only if his physical or mental impairment or impairments are of such severity that he is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy. ”

“ There is no reference to nonmedical factors in this definition and no references to specific consequences that an impairment must or should produce. Furthermore, neither "comparable," "severity," nor the two words together are there or elsewhere defined in the Act, and their meaning is anything but clear. The severity of an impairment that disables an adult is measured by its effects on the ability to engage in gainful employment. ”