Following a discussion on Alas, A Blog (which took many twists and turns), Imfunnytoo wrote a bit about her own differentiation between illness and impairment. I have alluded to my own attitude towards this before when writing about the Social Model of Disability, but this is kind of how it goes for me:
My illness is something which is medically amiss. In my own case, I am ill in quite a classical sense; I get feverish, my lymph nodes swell up, I even have a sore throat very much of the time. But the main constants of my illness are pain and cognitive problems.
These symptoms cause me suffering. My physical existence in often quite unpleasant. It is possible that this suffering could become unbearable. And I willingly take various steps necessary to reduce that suffering; symptomatic relief and management which may create the right conditions for remission to take place. If I could take a magic pill and be well, I would in an instant.
I do not consider my illness part of my identity, any more than the fact I have knobbly knees part of my identity (uh, they are just a bit knobbly). And whilst my illness has been the root cause of all number of experiences and adventures, few of them have been unique to this particular disease, this particular medical event. I'm not giving it any credit for anything, the git.
My impairments are the functional limitations as a result my illness. For example, because of pain, I can only walk a short distance, I need to rest often, there are lots of things I cannot do without some sort of help and some things I cannot do at all.
I do not suffer because of my impairments. They frustrate me very much. However, I can interact with them in a far more positive way; I can find new ways of working around them, even reducing them with careful management.
Often people associate impairments with suffering because practical limitations are far more obvious than internal events. However, many people who have impairments but are not ill, especially when those impairments are congenital (e.g cerebral palsy, autism etc), will insist that there is no suffering associated with their conditions. It’s just the way they are and always have been.
I don't feel that way myself, but I have come to terms to some extent with the limitations I face, as opposed to the experience of illness, which remains an ongoing challenge. I hope that makes sense to someone other than myself.
My impairments are part of my identity, in so far as they dictate a great deal about the sort of life I live. My experiences and interactions with them have inevitably had an influence on the person I am. I share many of these experiences with other people who have various different physical and mental health conditions. Even if I got better tomorrow, these experiences would have a profound effect on the rest of my life.
Disability is the experience I have when my impairments interact with the world in which I live. The most obvious examples are always to do with physical obstacles; I can’t walk very far, I use a wheelchair, and the world has put steps in my way. But of course, it’s much more complicated than that; it is every way in which I face unnecessary social, practical or psychological obstacles.
Disability is the one thing on the list I can actively change, by examining my own attitudes and behaviour, making various practical changes and confronting the attitudes and behaviour of others.
Being disabled is part of my identity. It represents a political and social status which I have had thrust upon me like race or gender. I share this status and many accompanying experiences with all sorts of other disabled people, who have an enormous variety of impairments and life experiences.
I could attempt to deny it or else ignore it, but being the person I am, I attempt to address it, at least in my tiny wee small way.