🎧 Listen to Sarah read this installment of Cured.
The class is in seminar mode with the students seated around a rectangle of tables, facing each other. I sit on two chairs: most of me on one, my broken foot propped on the other.
We’re discussing Randolph Bourne’s essay “The Handicapped.” It’s not an essay many people read these days. Published in 1911, it’s Bourne’s account of growing up with physical disabilities. His face was misshapen due to a doctor’s error at his birth. At four years old, he contracted tuberculosis of the spine that left him with a hunched back. He writes of the obstacles he faced. Obstacles is putting it mildly. At the time, “Ugly Laws,” as they were known, stated that people with physical disabilities (those referred to as “ugly”) were banned from being on city streets. These laws were intended to discriminate against “hideous monstrosities, which are only half human, begging for alms,” but the stigma transcended class.
Such stigma is evident in the fact that Bourne published the essay anonymously. Though I can’t begin to fathom what Bourne experienced, we have that in common. While I was sick (I’m starting to maybe, possibly, perhaps think about those twenty-five years in the past tense), I published an essay about one of my suicidal episodes. It had seemed like a good idea: writing as therapy, helping others by telling my story. But it was the first piece that came up in a Google search of my name, and I was on the job market. I took my name off the essay, which still reads On Suicidal Ideation by Sarah F. It isn’t me. No one needs to know.
One of my students, a sophomore with dark brown hair and brown eyes, asks rhetorically, “Can you believe these laws ever existed?”
When I tell them that Chicago, our dear city, didn’t repeal its ugly laws until 1974, they’re deeply offended.
After class, as I gather my things, the student who wondered why ugly laws ever existed comes to me. She’s on the list I receive from the Center for Students with Disabilities at the start of each quarter. Though I’m not told the specifics of each student’s disability, few have physical disabilities. Most come to me at some point in the quarter to talk about their accommodations and their diagnoses, which come from psychiatry’s Diagnostic and Statistical Manual of Mental Disorders.
The number of students with diagnoses—some registered with the Center for Students with Disabilities, many not—has grown exponentially in the fifteen years I’ve been teaching at universities. It’s rare to get a student with just one diagnosis. Most have two or three or four. The media talks a lot about stigma and how we need to talk about our mental health. But most of the Gen Zs (and millennials) I’ve encountered have no problem vocalizing their struggles, almost always in terms of their diagnoses being their identities.
The student tells me of her diagnoses, plural. She speaks of them easily, matter-of-factly. Her diagnoses qualify her for certain accommodations for submitting assignments late and not having to attend class. She also can’t give the required presentation.
I nod. It’s not my place to tell her that by avoiding the presentation, she won’t face her anxiety and have the chance to heal from it. I don’t mention that attempting to submit the assignments on time—developing routines and schedules—may help her.
Students deserve whatever accommodations they need but not because they see themselves as a diagnosis and therefore limited.
Young people deserve to have what I didn’t: a true understanding of what diagnoses are and what they aren’t. In a clinical setting, the ideal scenario would go something like this:
Look, we don’t know much about the brain or mental illness or mental conditions, but you need help. The diagnoses we have are designations that we clinicians use. That’s it. Historically, they were meant to give hospital psychiatrists a common language when referring to patients—never for patients to use to diagnose themselves or to think of themselves and others. Here’s the diagnosis I’m using, and this is why. Here’s the treatment I’m suggesting, and this is why. What do you think?
A more in-depth version of I don’t know. If a clinician had said this to me, maybe I would have done everything the same way. Or not. Knowing the truth, I might have seen my diagnoses as place markers, designations my clinician uses to recommend treatment and communicate with other clinicians, not my whole identity.
But I’m not her clinician or her parent, and it isn’t my place to say. Instead, I tell her she can absolutely have those accommodations but not because of a diagnosis but because she asked.
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