9th May 2009

Empowerment for the young, fit, rich, and beautiful…

posted in Injuries, Politics, Pop Culture |

A few months ago, yet another TED talk came across my radar.  This one was given by Aimee Mullins, a young lady who was born with missing fibula bones and had her legs amputated at age one.  Mullins went on from there to become a super-achiever–she received a full scholarship from the Department of Defense to attend Georgetown University, and became a record-winning athlete in Georgetown’s track team.  She competed in the paralympics, received modeling contracts, has acted in motion pictures, and is a motivational speaker.

At the TED talk, she spoke of disability being a chance to be “more”:

I came away from this video excited, thrilled, wondering “what’s next?!”

At the same, time, however, in the midst of all the gosh-gee-golly-wow that I felt, there was also an overwhelming feeling that this woman’s excitement for the future of prosthetics and the possibilities they open up for her and other was…well…a function of a position of privilege.

See, she’s young, she’s beautiful, she’s obviously wildly intelligent and vividly motivated.  She has people falling all over themselves to show her their latest-and-greatest prosthetic advances so that she can be a spokesman–albeit tangentially–for their new product.

Let’s look at a different amputee, shall we?

Let’s talk about D.  D. came down with diabetes–severely–in his thirties.  It could have been due to his addiction to Dr Pepper (doubtful, but it was a serious addiction!); one version is that his diabetes was caused by a severe blow to his abdomen from his on-again, off-again common-law wife and mother of his children, which deposited him in the hospital with trauma to (among other things) his pancreas.  But diabetes definitely runs in his family; his father had Type II, his grandmother had Type II, his cousin developed it in his forties, and no doubt there will be others.

Although the doctors were–as I understand it–overwhelming in their insistence that he needed to care for himself as a severe diabetic, including watching his blood sugar with an eagle eye, D. lived in denial, continuing his Dr Pepper addiction and sort of waving the diabetes away.  In his forties, he began getting severe foot infections.  He didn’t take care of one, and didn’t go to the doctor for a long time, and then there was a question of whether his doctor was a quack (one point of view) or whether he just wasn’t following doctor’s instructions very well (another point of view).  Anyway, as is common among diabetics, the infection in his toe turned gangrenous, it had to be amputated, and then things didn’t heal, so he had to have the foot amputated.

A year or so later, the other foot had to come off too.

D. was on Medicaid (I believe).  The insurers were reluctant to purchase prosthetics that were any good; oh, they’d buy the cheapest of the lot, but those (as I understand it) didn’t fit very well, were hard to walk with, and, what with one thing or another, D. ended up wheelchair-bound.

D. was not young.  He was not attractive–not ugly, but not attractive.  He was definitely intelligent, but rather than being a go-getter, he was the kind of guy who was always looking out for ways to “get around”, “get by”.  (This was, I must say, a severe frustration for the remainder of his family.)  He was the kind of guy who was irritated by other people trying to make him do things, like, say, the cops; but when someone else trespassed on his turf, he was indignant when the cops didn’t do anything.  Nobody was pounding on his doors offering him bigger-better-faster-more prosthetics.  And his insurance certainly wouldn’t offer anything but the basic.  In the end, his being wheelchair-bound cost him his life; his house was set on fire, he was upstairs and unable to escape, and he died.

There are 80,000 to 84,000 foot amputations each year in the U.S. due to diabetes.  A basic leg prosthesis starts at $2,000, with additional costs from physicians and prosthetic specialists raising the cost up to $10,000.  As someone commented on a Digg posting about Mullins’ TED talk, “most of her prostheses are likely already on the market (all except the arty ones, which appear to be custom designed). no prosthesis is “mass produced” they all have to be individually fitted and cast, sometimes more than once… below the knee prostheses average $8,000 - $16,000. the ones that are for running start at around $22,500. prosthetic limbs are horrendously expensive. an above the knee prosthesis can cost as much as $32,000. it is a huge problem facing the disabled community because health insurance almost never fully covers it or repairs, alot of coverage is as low as a $1,500 annual limit for prosthetics, which in most cases doesn’t even cover repairs.”  Steve, at My New Leg, takes you through the process of (a) getting a new prosthesis, (b) the complications, (c) dealing with insurance; his process starts here.  All the comments I read from either amputees with prosthetics or health professionals who deal with them made it very clear that it’s very expensive to get good prosthetics and it’s very difficult to get insurance to actually cover it.

Aimee Mullins is excited by the possibilities in prosthetics.  She has twelve pairs of legs; she can switch between any pair any day she wants.  (Which sort of reminds me of Princess Langwidere from Ozma of Oz (chapter here), who was able to switch heads depending on what she wanted to look like each morning–Langwidere wanted Dorothy’s head for her collection…)  Mullins is passionate about the future, about how people who need prosthetics can pick and choose what their new abilities are going to be.  But in her talk, she glosses over–actually, she leaves out entirely–the fact that her situation is far from the norm; she, by virtue of her go-getter personality and good looks, has a much better prognosis, prosthetics-wise, than, oh, 98% of the amputees out there.  My brother D. was one of those 98% who live in the real world.

Other commenters on the issue

Reminds me

There are currently 6 responses to “Empowerment for the young, fit, rich, and beautiful…”

  1. 1 On May 9th, 2009, Jo said:

    I’m so sorry you have this story to tell but this was an amazing post.

  2. 2 On May 10th, 2009, Johnny said:

    Amen!

    When I see commentators on TV who spout just K-razy stuff on the air. I ask myself, “If you weren’t very attractive, could you spout these incendiary diatribes? If you were UGLY, would we skip to the next channel?”

    Sorry about D, but that is the real world as you say.

  3. 3 On May 10th, 2009, carosgram said:

    I am so glad you posted this. For families like yours who deal with the real world in prosthetics it has to be so psinful to watch the ‘feel good” stories on the morning tv news shows about amputees with arms that actually work because they have been connected to the brain, legs that enable them to walk nearly pain free, and restored facial features which are unnoticeable to casual eyes. I am glad for everyone of those lucky few who are taken up by some sponsor and given a prosthesis which is top of the line. I wish as a country we did not find body disfigurements so repellent that we don’t want them displayed in public, nor are we willing to acknowledge how common they are. We are not willing to insist that insurance companies pay for prosthetics nor are we willing to pay for the very soldiers we send into harms way to have top of the line prosthetics when we ‘boot them out’ of service for the injuries suffered on our behalf. I am sorry about your brother, D. He sounds human, just like most of our brothers and sisters. Not a saint and not a wastral - just a brother who lived a hard life and died too young. Thinking of you and wishing you the best.

  4. 4 On May 10th, 2009, Jean said:

    A really great post. One I would hope more people would see.
    D had Stim amputations which left him with his heel bones and managed to still get around with a cane, but painfully. He’d have agreed with your description of him and the problems of so many amputees. We must do better for all of them now, not in some starry future, but it will cost more in taxes, fees and research costs not only on prostheses but on regeneration of tissues.Again thank you.

  5. 5 On May 10th, 2009, Sister Carrie said:

    Interesting point. I think the same could be said of many technological advances — how likely is it that regular people will benefit from stem-cell research, for example? But what I will remember about this post is D’s story. Thanks for sharing it.

  6. 6 On May 11th, 2009, lisa said:

    I’m very sorry about D.

    But I feel that you are conflating different experiences. Those of us who were born with limb differences-1 in 4000 births, though some are more noticeable (my former boss had a digital difference that only I knew about)-most of us,like my cousin and I, benefited from the services of Shriner’s Children’s Hospitals. We didn’t need to be rich or beautiful, and we didn’t even need to be indigent-thanks to the fundraising efforts of Shriner members worldwide, we received free services, including prosthetics. Many children now receive their first prosthetic from Shriner’s as toddlers, simply to ensure that their development is balanced on both sides of the body. There are also a few charitable foundations whose mission is to provide prosthetics (my professional organization just gave an award to one). I think the main difference between someone who is born this way, and someone whose circumstances change due to disease is expectations, what you describe as “go getter.” Yes, Aimee is beyond the age for Shriner’s services, but she was raised with the expectation that opportunities would exist for her.
    At the same time, I declined prosthetics, and my cousin couldn’t benefit from them. He walks as if on stilts, and has two fused fingers per hand. Yet we both have very happy successful lives, and I am looking forward to dancing at his wedding in a few months.
    The prices you mention, are about the equivalent of IA-something many of us never thought we could afford, yet managed in the “hour of need.”
    Again, I am very sorry about D. But I’m not comfortable with equating Aimee’s experience with privilege. ~lmc

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