Comment: On the Borderland of Medical and Disability History

Beth Linker’s essay, “On the Borderland of Medical and Disability History: A Survey of the Fields,” raises important issues about the ways the history of medicine and disability history have interacted and should interact in the future. Rather than adopting the metaphors of “rival siblings” or “conjoined twins,” she suggests that each field pursue its own course but recognize “family resemblances” and a need occasionally to come together for the mutual benefit of the family. Let me say at the outset that I generally endorse her argument that both the history of medicine and disability history can benefit from a mutually respectful relationship.

As Linker notes, many of the early historians writing disability history strongly rejected the medical model of disability, and implicitly at least the history of medicine. Instead, they adopted a social model of disability, in which disability is constructed and imposed by society, and wrote a distinct disability history. Just as contemporary disability activists demanded that people with disabilities decide and speak for themselves, so disability historians created a new approach independent of the history of medicine, which many regarded as giving insufficient attention to the history of people with disabilities. These disability histories privilege the individual with a disability and treat medical professionals as less central to the story. In these ways, disability history, as Linker suggests, replicated the development of other minority histories such as women’s history and African American history. Now that its legitimacy seems ensured, with its own organization, several book series, and numerous publications over the past twenty years, Linker rightly looks to ways in which the two histories (medicine and disability) can cooperate in their mutual interest.

I am struck when I teach the history of medicine how much of that history is distinct from disability history. The history of the medical profession, of its institutions such as dispensaries, hospitals, and medical schools, of discovering the causes of diseases and how to prevent or cure them, and of public health, often stands apart from the history of disability. To be sure, disability history intersects with various aspects of history of medicine, for example with the development of asylums and rehabilitation facilities to care for individuals with disabilities. A full history of asylums and rehabilitation hospitals needs to take into account the goals and practices of the professionals running them and the needs, desires, and experiences of the patients who were treated there. Furthermore, the history of rehabilitation is not complete without also understanding what happened to individuals when they were released from care and treatment.

Similarly, much of what comes under the heading of disability history has little connection with medicine or its history. Disability historians have explored the various social, cultural, economic, and legal stigmas attached to disability in general and to particular disabilities. The origins of these stigma often lie in social and cultural attitudes that may have little to do with the history of medicine. Many individuals living and working with a disability do so with only slight contact with the realm of medicine. For example, many polio survivors went decades after being discharged from rehabilitation before they saw a doctor for polio-related symptoms. Only when the fatigue, weakness, and pain of postpolio syndrome became intolerable did they return to the care of a physician. Disability activism may have little to do with medicine, except when directed against medical institutions. Linker also notes other issues, such as the healthy disabled and a disability hierarchy, that have more to do with cultural and social attitudes about disability than about medicine.

If disability history and the history of medicine have distinct realms of expertise, there are also sites where the two fields productively intersect. It is often necessary for disability historians to know and understand the disease or medical intervention that gave rise to a particular disability. My work on the polio survivors would have been incomplete had I not explored the history of polio, the acute disease, and the goals and practices of the rehabilitation professionals who treated those paralyzed by the disease. Yes, I was primarily interested in the...