I want to make my character seriously ill. What with?
August 13, 2019 7:18 AM   Subscribe

For a scene to work in my story, a character needs to have an injury/condition that is physically but not cognitively disabling - the mind/personality is as it always was, but they are unable to speak as before (maybe can only make sounds) or have full independent movement, and may be mistaken in that condition for someone who is also intellectually impaired. What circumstances would make this a likely outcome for the patient?

I want to get this right, so details of cases/memoirs would be doubly good.

The character needs to not always have been in these circumstances, and it's even better if the condition could be mistaken for something where people assume (wrongly or rightly) the sufferer is not at full mental capacity and may treat them in a patronising or offensive manner.

The character will have the same cognitive/intellectual ability as before, but be unable to properly express themselves or fully act (being able to move in a chair is fine - specifically I mean fighting off a home intruder) - and preferably this came from an injury that has divided their life into 'normal' and 'sick/injured'. Could someone be left alone for any length of time in these circumstances? It is NOT important if they are or are able to recover.

I don't want to be wrong on the details or inadvertedly write something horribly offensive (and I hope I haven't been here) so thought I'd pick your brains!
posted by mippy to Writing & Language (18 answers total) 2 users marked this as a favorite
ALS. It rarely causes cognitive issues but people will often still talk to people with ALS like they are little kids.
posted by amro at 7:19 AM on August 13, 2019 [8 favorites]

I would research stroke or cerebral palsy. I have a very casual acquaintance who developed cerebral palsy as an adult after a mountain-biking accident, so I know it's possible. And of course some people with both stroke and cerebral palsy have cognitive impairments also.
posted by If only I had a penguin... at 7:20 AM on August 13, 2019 [2 favorites]

Stroke can have varying effects depending how how severe and where in the brain it happens
posted by supercres at 7:21 AM on August 13, 2019 [1 favorite]

Thanks so far - I didn't know that about cerebral palsy but from knowing someone with it as a teen I think people would make the kind of assumptions I mean.
posted by mippy at 7:34 AM on August 13, 2019

Do you want the new condition to be something that is steady state, i.e. they will continue to be just this way the rest of their lives? Or do you want it to be something progressive, i.e. they will get worse over time and maybe even die from it.

ALS is progressive.

Multiple Sclerosis (MS) could potentially have the affects you want.

Cerebral Palsy appear in early childhood (usually by conditions of birth) so I don't think that fits your criteria.

You could probably get the effects you're looking for from some sort of traumatic brain injury. Those can affect cognition, but they could affect motor control without affecting cognition. Ditto for stroke.

Spinal cord injury can completely immobilize people. I'm not sure if quadriplegia (wheelchair plus unable to move arms/hands) would work for your purpose.
posted by Winnie the Proust at 7:34 AM on August 13, 2019 [1 favorite]

A brain injury or stroke leading to aphasia could do this. You should research specifically Broca’s aphasia; it renders the sufferer unable to communicate with words, but leaves their intelligence intact.
posted by chainsofreedom at 7:37 AM on August 13, 2019 [2 favorites]

My mom had a stroke about a decade back. She has some difficulty speaking and loss of dexterity in her left hand, but no cognitive impairment at all. Drives her crazy when she can't get the right word out. Sometimes people mistake that for mental disability.
posted by InfidelZombie at 7:41 AM on August 13, 2019 [1 favorite]

Cerebral Palsy appear in early childhood (usually by conditions of birth) so I don't think that fits your criteria.

Hmmm...so I googled my casual acquaintance and according to her wikipedia page, she has "hemiparesis". I could have sworn it was cerebral palsy that I read she had in another article about her, because I remember being surprised that you could get that from an accident. Anyway, I guess that article was wrong. I don't want to violate her privacy by posting her name or anything like that here, but because she has a lot of difficulty speaking (or rather she sounds like she does), I think it would be easy to assume cognitive impairment.

If you want a clear before-and-after moment, I think you need to go with some kind of brain injury (traumatic or non) because most other conditions (e.g. ALS) would likely come on gradually.
posted by If only I had a penguin... at 8:19 AM on August 13, 2019

Um. I don't have suggestions for a specific condition, but if you're going to write a disabled character, you need to fully commit to it. I can tell you're doing your very best to be respectful, but this comes off as you just wanting your character to be disabled for a plot point, which is something disabled people are really pretty sick of. If you want to do this well, especially because the disability is a critical plot point, you are going to have to do a ton of research, not just memoirs and autobiographies but theory and critical writing from advocates to make sure you aren't further stigmatizing disabled people. I can tell you already one thing you don't want to do is call anyone "the patient," that's super weird if you're not their doctor. Disabled people aren't "patients" in their day-to-day lives.

Here's some resources on writing disabled characters, there's lots more to be found via a quick Google search.

The Dos and Don'ts of Writing About the Disabled
A Guide to Writing Disabled Characters
Cripple Characters (blog about writing disabled characters)
Writing Tips: How Not To Write Disabled People

If you want to lean into it, you can do this well--but I think it would also be reasonable to consider how central this scene is, and if it needs to hinge on disability.
posted by brook horse at 8:21 AM on August 13, 2019 [19 favorites]

Parkinson's Disease impairs language even while cognition functions normally.
posted by Elsie at 8:41 AM on August 13, 2019

Locked in syndrome.
posted by St. Peepsburg at 8:52 AM on August 13, 2019

Strongly seconding brook horse's words of caution. Maybe this is a case of poor phrasing (which in any case supports what I'm saying), but I have definitely known people who would be offended at the idea of dividing their life into "normal" and "sick/injured". Even if it is poor phrasing just the general idea of using a person's disability as a literary device is something that I think would be very hard to do in good taste.
posted by ToddBurson at 9:05 AM on August 13, 2019 [1 favorite]

Rheumatoid Arthritis. I'm just at the edge of this abyss and just this morning I had the thought, "I remember when I didn't hurt every damn day."
posted by heathergirl at 12:03 PM on August 13, 2019

Multiple Sclerosis can have a variety of effects depending on the seriousness of the attack. Loss of speech can be temporary, weakness may recede. Recovery is rarely 100%, and each attack leaves some damage. This has been the experience of a friend of mine, but you will need to do some proper research if you don't want to irritate your more knowledgeable readers.
posted by Enid Lareg at 12:38 PM on August 13, 2019

brookhorse - I used 'patient' because I was thinking about illness and didn't want to use 'sufferer' though it did sound weird when I wrote it...

The character is a teenager which is why I used the idea of dividing - someone who might feel that they were 'normal' and now aren't? (I have a mental health disability so perhaps this is just me thinking about when I felt self-pitying about it) I can see already though that it might be difficult to do well. I did have the 'plot point' worry...
posted by mippy at 1:58 PM on August 13, 2019

Just read your first link and it illustrates a lot of the issues with this I was thi king about. So thank you.

I just remember when I read an otherwise good novel with a character in with the same condition I have, and it was so weirdly written (not offensive, just...unrealistic) that it ruined the book for me.
posted by mippy at 2:05 PM on August 13, 2019

A brain injury and/or stroke leading to paralysis and aphasia would fit with your description.

Aphasia, in particular, affects the way that people perceive your intellect, because the way most people judge people's intelligence is by how they communicate, and aphasia directly attacks your ability to communicate. The irony is that the part of the brain (the language centre) that is damaged in someone with aphasia has nothing to do with your ability to think or problem solve; that's another part of the brain. So, in a case of damage to only a specific part of the brain (as in a stroke), someone with aphasia almost certainly has their full cognitive abilities, but can't express them.

Aphasia has different forms, depending on the nature and extent of the brain damage. Aphasia can affect your ability to produce language ("productive aphasia") or to understand it ("receptive aphasia") or (more often) both to one degree or another. For some people, they retain speech but lose the ability to read and/or write; for others, writing may be easier. Some people have no ability to do either.

/ speaking from personal experience - a close family member has aphasia

As aphasia affects your ability to communicate, there aren't many memoirs. But here's a list from Goodreads (mix of memoir and fiction), and an annotated list along with other resources from UMass Amherst which lists what seems like several good memoirs and books. Also, an article I found: When the words stopped (Guardian article)
posted by jb at 2:17 PM on August 13, 2019 [1 favorite]

You're perfectly describing the effects of some brain tumours I've encountered up close.
posted by bonobothegreat at 8:46 PM on August 13, 2019

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