Opinions, Preclinical
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Abnormal is the New Normal


Approaching the end of my first year in medical school, a recurrent theme I have found threaded into the foundation of our learning is the idea of normalcy. Given that we are in a profession that aims to prevent harm, treat ailments and promote healthy living, the concept of an ideal body seems to be embedded in our work. The problem with the idea of normalcy, however, is that it is an ill-defined and very subjective idea that varies among each individual. It can be dangerous for us as physicians to treat patients with the aim of getting them to a societal norm, because that takes the personalized aspect out of treatment.

In the past, a woman’s body was given value based on the ability to produce children. In an almost mechanical sense, the capacity for childbirth was the focus of a woman’s role in society. This idea is still deeply embedded in social norms and to this day remains part of our culture when we think of womanhood. Unfortunately, it is easy to associate these norms with an ideal body. Just because a body can or cannot do what is socially desired does not mean a body should be seen as any lesser or abnormal compared to another.

I currently see examples of this thinking in clinic, where I work with children who have cognitive disorders like autism or ADHD. When medical professionals think about treatment goals for these children, they often focus on making these kids “employable.” This idea of an employable body is rooted in the association of productivity with value to society. This is dangerous because it assumes the patient wants to be a working, “normal” adult. Instead, we should focus on quality of life treatment driven by a conversation with the patient and their family about desired outcomes.

A similar situation presents itself with disabled patients. Instead of “fixing” them and trying to make them as normal as possible, we should recognize that they are living in a different body that might require accommodation to accomplish what the patients want. I took a medical humanities course on disability this past spring with Dr. Emily Rapp Black that helped shed an enormous amount of light on the topic of disability, which can sometimes feel like a taboo in the medical profession. When we discussed things that we as future doctors could do to best serve disabled patients, some of the best advice was to simply ask, “What would you like your day or life to be like?” This does not ask specifically about a goal, which inherently contains a context of achievement and productivity, but rather about how the patient would like to live their life.

By genuinely listening to a patient and respecting their desires, we as physicians can recognize the usefulness of a disabled body and provide resources and accommodation as best as possible. It is important to acknowledge that the disabled patient’s body is different and listen to their experiences in a world constructed for able-bodied individuals. The focus of our care, however, should be on providing ways for patients to best use their bodies in the ways that they desire.

As history progresses, socially desirable norms will come and go, but there will always be a desired “normal” body. It is important for current and future medical providers to realize that every body has aspects of abnormality. Abnormal is the new normal, and we should treat every patient on the basis of their desired role in society. Simply asking a patient how they are doing and how they would like their life to be can allow us to guide professional treatment on a course that aligns with personalized desire.