Medicine

There has been a pattern in response that when someone experiences bodily pains, they are conditioned to believe that something is wrong, and they need to fix it. This is why many people wait to experience some kind of serious symptom to approach a medical professional and seek treatment. How do you think this sort of response to pain can be improved and developed from a patient's perspective?

In Disability Studies, this tendency to see disability as a thing to be "fixed" by medicine is often referred to as the "medical model of disability." In the '80s and '90s, the activist move toward the "social model of disability," which emphasizes how spaces, institutions, and cultures are the ones that "disable" people, helped to de-individualize disability and instead put the onus of accessibility on society at large. The easiest example of this is thinking about wheelchair users: if a building doesn't have a ramp or elevators, it is the building that disables the wheelchair user rather than the wheelchair user being "physically incapable." I think healthcare providers need to be thinking about disability more capaciously even if it means challenging their own assumptions about disability as a "problem," "error," or "lack." This often means practicing a patient-centered medicine that takes seriously the lived experiences of those patients who may challenge diagnostic and therapeutic approaches that can only understand disability as undesirable.

How can medical professionals incorporate and learn about crip poetics to be better able to center pain within patients' narratives? 

Where do I begin? I think the rise of narrative medicine in healthcare and healthcare education speaks to a shift happening where medicine is really taking seriously what patient-centered care looks like and that medicine is itself a narrative act. My advice, in this respect, is an easy one: read accounts of disability by and about disabled people and do more listening than speaking. I've so often seen medical professionals dismiss or talk over disabled people about their own experiences, and honestly, if crip poetics creates an opening for a healthcare provider to empathize or even have fleeting access into disabled life, then that's progress. 

How can doctors maintain their role as a person who treats the physical body without ignoring or disregarding these points beyond the physique?

I'm not sure I fully understand this question: my sense is that doctors do this all the time. They are trained to think about patients holistically and with the trend toward "social determinants of health," more physicians are taking seriously how health and disease are not reducible to the body alone. I think the issue is about emphasis and perspective - I'm heartened by the fact that a lot of hospitals are moving toward "healthcare teams" where professionals from different disciplines and training help care for patients as a group. These multiple perspectives, I think, will help keep physicians from being too narrow in their assessment of patients and their needs. 

How should the medical community improve their care for disabled people who live with chronic pain? Would the first steps to improvement be in medical schools? Would you recommend that they read the different perspectives of crip poets and their perspectives on pain? How can we address these issues in a way that is not insensitive or dehumanizing?

Alongside a need for disability studies and health humanities to be a part of the core curriculum in medical education (not a throwaway elective or optional "feelings" class that you skip), I think medical schools need to address the ableism in their own education system that fosters grind culture, burnout, and the avoidance of mental health. If medicine can't address its own systemic problems and ableist practices, it cannot begin to address them for patients. This also means having disabled people practicing medicine! There is a kind of inside joke that it is ridiculous to have a disabled doctor because that would be ironic that someone "unwell" is treating patients. This kind of casual ableism has meant generations of disabled people being kept out of medicine because they are either presumed incompetent or unable to "survive" the ableist challenges of medical school rather than imagining a more inclusive healthcare.

How can cripistemology and the experience of pain be introduced in the medical field in an effective way? 

In my own classroom, it is often in encounters with crip literature and with accounts of disability by disabled people. Rather than emphasize it as a theory, I think it's much more effective to ground it in lived experience, where disabled people aren't some mythological or far-off imagined characters but actual people who have real stakes in how they are understood by society and culture.