Posted by: Hourglass PJ20 FEB 2013
Following on from my piece about Charles Dickens (PJ 2012; 283:155), an article by a professor of medicine at Tel Aviv University about Dickens’s portrayal of disabled people caught my eye. Avi Ohry points out that social discrimination against people who are physically disabled and mentally ill were key themes in Dickens’s works.
In the literature of the 19th century, physical deformities were often interpreted as “outward manifestations of inner depravity” or “punishment for moral failings”. Although Dickens does portray some of his disabled characters in this way, such as the greedy and ruthless Smallweed in ‘Bleak house’, many of his portrayals of disabled characters are sympathetic. These include Tiny Tim in ‘A Christmas carol’ and Phil Squod, a loyal servant in ‘Bleak house’, both of whom are “crippled”.
Considering the era’s social prejudices towards disabled people, these sympathetic character portrayals show a surprisingly progressive attitude, says Professor Ohry. Dickens also took care to differentiate between physical handicaps and mental illnesses, another distinguishing feature of his work.
Although attitudes towards disabled people have shifted since Dickens was born in 1812, his message still has resonance in modern times since prejudice remains common. Perhaps as pharmacists we need to think about our attitudes not only to disabled people but also to customers and patients who are obese, for whom the stigma seems to be increasing, even among health professionals.
In this context, the US Yale Rudd Centre for Food Policy and Obesity has a range of scales used to test “weight bias” in clinical practice. You can find it here. We might all like to think about how we score.