“Memories are not history. They are fragments of things and feelings that were tainted and sifted through varying prisms of present time and disposition” (Dayan, 1985, p. 1). This reflection by Yoel Dayan, the daughter of the revered Israeli patriot and statesman, offers a helpful perspective on our most treasured memories. We must keep in mind that the events and people we remember have likely been altered over the many times we have recalled them. With that caution expressed and forgiveness asked in advance, the senior author of this article shares a memory.
A Memory From Dr. Goldberg
During my doctoral studies at Teachers College, Columbia University, I was blessed with having professors who were not only scholars with great knowledge, but also people of impressive character and deep compassion. One of my mentors was Ignacy Goldberg. As all great teachers do, he often shared with his students stories from his own life. One of his stories that I have frequently recalled, and perhaps altered or embellished, was of his experience working in a Midwest institution for persons with mental retardation.
Professor Goldberg remembered that during his first days at the institution an experienced staff member explained to him that there were actually three populations of residents living there. The three groups he described were the “retarded retarded,” the “normal retarded,” and the “minimally gifted.” The retarded retarded were those people who needed constant care and attention. They could not survive without the help that was given to them by other people (often including help from the normal retarded and the minimally gifted). The normal retarded were those people who constituted the mainstream population of the institution. They cared for themselves for the most part and functioned in a relatively independent fashion within the institutional culture. They were also subject to being given the most basic and unpleasant chores to do. Their work was often supervised by the minimally gifted, who made sure that things ran smoothly in the wards of the institution and who occupied the upper echelon of the residential population. The minimally gifted were commonly rewarded by the institution staff for doing the things the staff was actually being paid to do. Their rewards varied from cigarettes, to special privileges, to money, and other favors. The quality of life and the standard of care for many of the other residents often depended on the abilities, sensibilities, and compassion of the minimally gifted. Dr. Goldberg discussed the degrading nature of the words used to describe the residents, particularly the sarcasm of the designation “minimally gifted.” The idea behind the descriptions, however, he had found to be valid. There were distinctly different populations of people in institutions that were designed and operated for the retarded, a supposedly monolithic group.
I often thought of Dr. Goldberg's story as I visited residential facilities early in my own career. I believe that I have seen it played out a number of times. Recalling his descriptions of the hierarchies and population differences in institutions helped me understand some of the social dynamics and individual behavior that I observed.
“Told in the Drooling Ward”
A striking confirmation of Dr. Goldberg's recollection came to us recently when we stumbled onto a short story by Jack London. It was written from the perspective of a resident in a state mental retardation institution in the early 20th century. London was an admirer of eugenics, and his philosophy included the assumption of innate human limitations of both racial and social class origins (Labor & Reesman, 1994). London's character in the story, Tom, repeats several times that the institution is the right place for him to be, and he implies that the outside world is too complex and competitive for him. On the other hand, London has Tom explain the ways in which he is superior to others within his institutional world and how they rely on his abilities for their well-being. Tom's description of the differences among the people in the institution make the story, “Told in the Drooling Ward,” a compelling reading experience for anyone interested in the sociology of institutionalization.
Me? I'm not a drooler. I'm the assistant. I don't know what Miss Jones or Miss Kelsey could do without me. There are fifty-five low-grade droolers in this ward, and how could they ever all be fed if I wasn't around? I like to feed the droolers. They don't make much trouble. They can't. Something's wrong with most of their legs and arms and they can't talk. They are very low-grade. I can walk, and talk, and do things. You must be careful with the droolers and not feed them too fast.. . . Miss Jones says I'm an expert. When a new nurse comes I show her how to do it. It's funny watching a new nurse try to feed them. She goes at it so slow and careful that suppertime would be around before she finished shoving down their breakfast. Then I show her, because I'm an expert. Dr. Dalrymple says I am, and he ought to know. (London, 1916, p. 87)
Tom goes into further detail about his special place in the hierarchy of the institution. He also divulges the fact that there are people in the institution who have been placed there because of epilepsy, and he does not like them. He clearly thinks that they do not belong in what he calls “the Home.”
But I am a high-grade feeb. Dr. Dalrymple says I am too smart to be in the Home, but I never let on. It's a pretty good place. And I don't throw fits like lots of the feebs. You see that house up there through the trees? The high-grade epilecs all live in it by themselves. They're stuck up because they ain't ordinary feebs. They call it the club house, and they say they're just as good as anyone outside, only they're sick. I don't like them much. They laugh at me, when they ain't busy throwing fits. But I don't care.. . . low-grade epilecs are disgusting and high-grade epilecs put on airs. I'm glad I ain't an epilec. There ain't anything to them. They just talk big, that's all. (London, 1916, p. 88)
Tom also describes several of his fellow residents according to the etiology of their retardation. His description of the characteristics and prognosis associated with each diagnosis is interesting and, in some cases, moving.
Do you know what a micro is? It's the kind with the little heads no bigger than your fist. They're usually droolers, and they live a long time. The hydros don't drool. They have the big heads, and they're smarter. But they never grow up. They always die. I never look at one without thinking he's going to die. Sometimes, when I'm feeling lazy, or the nurse is mad at me, I wish I was a drooler with nothing to do and someone to feed me. But I guess I'd sooner talk and be what I am. (London, 1916, p. 90)
Tom was once taken from the institution by a family who wanted to adopt him. He soon discovered, however, that the family was primarily interested in him for free labor. He was worked hard, was physically abused, and after a few months he ran away from his new home and back to the institution. Upon returning to his ward, Tom was most concerned about a particular “drooler” whom he had missed while he was away:
I walked right into the ward. There was a new nurse feeding little Albert. “Hold on,” I said. “That ain't the way. Don't you see how he is twisting that left eye? Let me show you.” Mebbe she thought I was a new doctor, for she just gave me the spoon, and I guess I filled little Albert up with the most comfortable meal he'd had since I went away. Droolers ain't bad when you understand them. I heard Miss Jones tell Miss Kelsey once that I had an amazing gift in handling droolers. (London, 1916, p. 102)
Tom fantasizes about how his life could be improved if the staff of the institution openly recognized his abilities. He believes that if he were treated fairly he could have a “normal” life in the Home.
Some day mebbe, I am going to talk with Doctor Darlymple and get him to give me a declaration that I ain't a feeb. Then I'll get him to make me a real assistant in the drooling ward, with forty dollars a month and my board. And then I'll marry Miss Jones and live right on here. And if she won't have me, I'll marry Miss Kelsey or some other nurse. There's lots of them that want to get married. And I won't care if my wife gets mad and calls me a feeb. What's the good? And I guess when one's learned to put up with droolers a wife won't be much worse. (London, 1916, p. 103)
At the end of the story, however, London's character admits that he knows that his life in the institution will not change. He also knows that he could never leave the community that needs him because he is a “high-grade” and not a drooler. He has developed relationships, especially with little Albert, that give meaning to his life. He admits that even if his dream of running away and finding work in a gold mine were to come true, he would miss the friendships and roles he has established in the Home.
Next time I run away, I am going right over that mountain. But I ain't going to take epilecs along. They ain't never cured, and when they get scared or excited they throw fits to beat the band. But I'll take little Albert. Somehow I can't get along without him. And anyway, I ain't going to run away. The drooling ward's a better snap than gold mines, and I hear there's a new nurse coming. Besides, little Albert's bigger than I am now, and I could never carry him over a mountain. (London, 1916, p. 107)
The Typology of Mental Retardation
Typological thinking is the belief that complex individual variations can be reduced to underlying human types or essences. Gelb (1997) has found that definitions of mental retardation, regardless of their particulars, are grounded in typological thought. The core of mental retardation as a field is the assumption that somehow there is a “mental retardation essence” that eclipses all of the differences that characterize people described by the term. Ignacy Goldberg's story of people who are retarded retarded, normal retarded, and minimally gifted contradicts this sense of a single essence of retardation. Tom's description of droolers, feebs, epilecs, micros, and hydros also illustrates how people with varying disabilities or life conditions have been both literally and figuratively aggregated under the same term, the mentally retarded.
Even a brief glance at the panoply of etiologies associated with mental retardation illustrates the allure and power of typological thinking. In 1992, the American Association on Mental Retardation listed more than 350 conditions in which mental retardation occurs (Luckasson et al., 1992). This list of causes does not, of course, take into account the varying degrees of mental retardation or other disabilities associated with each of the etiologies. When those variables are considered, the universe of human conditions subsumed under the term mental retardation is staggering. The only “glue” that holds mental retardation together as a category is the typological notion that there is some underlying and shared essence to the characteristics and needs of the people identified by the term. Clearly, mental retardation is an aggregate of human conditions.
Mental Retardation: Redefining or Disaggregating?
Perhaps it is time to abandon mental retardation as a classification, rather than continuing the quest for a more humane or more scientific definition of the term. Mental retardation and its various definitions are, in fact, manifestations of the typological thinking that inevitably creates a simplistic and misleading aggregation of people with very diverse needs and characteristics.
There must be alternatives for conceptualizing the needs of the people currently referred to as having mental retardation. It may be helpful to ask ourselves questions about what the abandonment of the term and the definitions associated with it could mean in the lives of individuals and families. We must also ask ourselves what abandoning mental retardation as a classification might mean for resource allocations and the provisions of services to people who need them. Finally, we must consider the impact of the deconstruction of mental retardation in terms of need versus stigma. In other words, is the aggregation of people into this diagnostic category truly necessary to meet their needs? Are services in the name of mental retardation justified given the risk of stigma associated with the label? How can we achieve a balance between the need for assistance and the risk of diminished individuality? These are questions that seem to be critical in giving thought to the dismantling of the concept.
The time is overdue, however, for a fundamental questioning of the terms and practices associated with mental retardation. The millions of people with developmental disabilities who have been subsumed under that classification deserve a careful analysis of its impact on the manner in which they are regarded and treated. A careful consideration of the feasibility of disassembling the aggregation that mental retardation has become may enhance our vision of what it should be.
Authors:J. David Smith, EdD, Dean and Professor, and Alison L. Mitchell, BS, Graduate Assistant, School of Education and Human Services, Longwood College, 201 High St., Farmville, VA 23909.