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Illness and Disability

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Society’s perception of what constitutes illness and disability, along with its treatments of such, have changed throughout the last century. While medical professionals have developed a better understanding of and treatments for both mental and physical illness, many areas of fear and ignorance remain. Many plays written on these themes are attempts to humanize the stories of those afflicted and to promote a better understanding of what afflicts them in order to encourage the general public not to demonize or exploit these people; these plays strive to make us understand the difficulties and pressures they face each day. Other modern dramatists have chosen to use illness as a metaphor for whatever they see as wrong with modern society. Some approach the theme of illness from both perspectives.


Bernard Pomerance’s The Elephant Man is based on the true life story of a nineteenth-century figure, John Merrick, who was known as “the Elephant Man” because of massive deformities caused by his condition. Seeking to direct the audience’s attention to the intellectual and sensitive individual afflicted with these deformities, rather than his illness, Pomerance suggests that the actor playing Merrick use only minimal differences in movement and speech to portray him, and have his deforming growths displayed only through descriptive language and some slide-show images, rather than by makeup or costume. Pomerance guides us to look beyond surfaces, to recognize Merrick for the kind and sensitive soul he was, and, by extension, to see the metaphorical illness existing within many whose outer appearance belies their inner corruption.


Bertolt Brecht was a propounder of “Epic theater,” a kind of intellectual agitprop, which attempts to provoke audiences toward social action. He saw realism as disconcerting, with its tendency to support the status quo in its efforts to present true life. Epic theater intentionally alienates its audience, by empha- sizing its own artifice. This demands that people reexamine what they had previously perceived as reality, employing rational thought rather than unreliable feelings. He expects audiences to recognize the sad state of society once they have been freed from social restraints, and hopes they will then initiate change. Although the title character of Brecht’s Good Woman of Setzuan is in some sense schizophrenic, in that she behaves as two totally separate people, the play is not an exploration of the consequences of mental illness. Brecht uses the suggestion of this illness as a metaphor for his view on how morality fares in the modern world—in his opinion, not very well. The action centers on the desire of Shen Te to be good, and the impossibility of acting in a moral fashion in modern society, given the way in which it operates.


Brecht uses songs and poems to focus attention on specific philosophical issues, such as when Shen Te sings “The Song of the Defenselessness of the Gods and the Good People,” in which she questions why evil exists and why gods, if they are truly powerful, seem incapable of preventing it. The song asks the audience to consider that evil is not an outside force, but one of human origin, the same as goodness, and, therefore, it is up to humans to stem it. Characters in the play frequently speak directly to the audience, sometimes to confront them with social and political messages, but also to tell them what misfortunes to expect, to encourage audiences to go beyond just watching to see what happens, but to consider why and how bad things happen, which would make people better able to stop them from happening in the future.


Tony Kushner’s two-part epic, Angels in America , is made up of two plays that span a period of five months during the mid-1980s, in which he both sympathetically chronicles the spread of the AIDS epidemic during the Reagan years and uses the illness as a metaphor for much of what he believes is wrong with American society. Together the plays relate a vast, sprawling saga comprising eight acts, broken into fifty-six scenes and an epilogue. Kushner mixes fantasy and reality, comedy and anguish, dirty politics and spiritual mysticism, personal dramas and world history, to create a dazzling work full of ingenuity and provocative ideas. The action takes place around New York City and in a heaven that resembles San Francisco after the 1906 earthquake—suggesting an outlook that stretches across America, across a century, and even beyond the bounds of life itself.


Kushner considers illness both in actual terms, as AIDS infects a nation, and in metaphorical terms, as he depicts the sad state into which society has generally fallen. While the motion of the first play, Millennium Approaches , tends toward destruction and breakdown as people grow further apart through ignorance, misunderstanding, fear, or just plain self-absorption, the second play, Perestroika , indicates a reversal of this dynamic. More comic in presentation than the first play, Perestroika depicts characters coming to terms with their lives and one another, learning to forgive and move on. Issues are resolved, growth occurs, people learn to better cope with loss, and the life principle beats back death. Although AIDS still exists, and not everyone has his or her ideal   life and/or partner, a sense of hope and potential love pervades the play. That hope largely rests on the human capacity for change and adaptation, which is highlighted in the play’s epigraph.


The Elephant Man begins in 1884, in the London Hospital at which John Merrick will later find refuge, where we meet Dr. Frederick Treves being welcomed as the new lecturer in anatomy. Discovering Merrick in a storefront sideshow, Treves brings him to the hospital for examination. The public, outraged at the apparent exploitation of Merrick in the sideshow, close the operation, forcing him and his manager, Ross, to flee to Belgium. There, they are again restricted from setting up show, and Ross sends Merrick back to England in disgust. Attacked on his arrival, Merrick is brought back to Treves by the police. The hospital takes him in permanently, although the doctor has trouble employing anyone to tend him because his appearance is so frightful. Treves tries to give Merrick the more normal life he desires, introducing him to women and society, including the actress, Mrs. Kendal, whose compassion benefits Merrick more than the doctor’s restrictive ministration. Ross tries to reclaim Merrick now that he is a social success, but Merrick refuses to work with him again. Treves guiltily wonders how far he has been complicit in a similar, though well-meaning form of exploitation. On completing the church model he has been building, Merrick dies in his sleep, and we learn of his obituary.


Placed in a workhouse when he was only three by a mother who could not look at him, Merrick has developed a huge head with massive growths front and back that deform his mouth, obliterate his nose, and almost cover one eye. His condition is not elephantiasis, as his nickname suggests, but rather stems from a fungal growth that also smells terrible unless he bathes frequently. His limbs, except for one delicate hand and arm, are also deformed, and he is lame from a hip disease he contracted as a boy, and must use a cane to walk. The workhouse made him scrub floors and he was routinely beaten until Ross took him away, but only to use him as a sideshow display.


In his pitch Ross declares, “To live with his physical hideousness, incapacitating deformities and unremitting pain is trial enough, but to be exposed to the cruelly lacerating expressions of horror and disgust by all who behold him—is even more difficult to bear” (3). But Ross is the one exposing him to such ridicule. He abuses Merrick, calling him a “bloody donkey” (4), and steals Merrick’s share of their take, abandoning him when he fails to be profitable. When he tries to get Merrick back, he clearly views him as property rather than a person. Merrick may be deformed on the outside, but, in his inner life he is as beautiful as the church he builds, unlike many around him whose outer appearances disguise inner ugliness. But as Merrick knows, like Romeo, people refuse to look beneath the surface and judge by outer appearances alone. Ross, we learn, is full of internal sickness, indicative of the truly degenerate character he is—just as the smooth-talking surface of Lord John, one of the society people   to whom Treves introduces Merrick through the assistance of actress Mrs. Kendal, hides a profligate who squanders other people’s money. Later, Treves shares his vision of the entire upper class as inwardly deformed by privilege and wealth into ruthless, dissipated, and ignorant people—everything that Merrick is not.


Because of his grotesque appearance and inability to speak clearly, Merrick is seen as less than human by most people he meets. The police regard him as an imbecile and ignore his requests for justice, not taking the trouble to decipher his speech. He is mocked, patronized, and treated as if he had done something wicked to bring this illness on himself, yet he takes all in stride, and never complains. He amazes the Bishop with his religious knowledge and outlook, believing firmly that he will be saved by Christ, and does not resent his afflictions. Merrick generously forgives Ross for stealing his money and abusing him. He displays genuine sympathy for others, such as the “Pinheads,” and Porter, who gets fired for sneaking in to gawk at Merrick. By contrast, supposed humanitarians like Treves seem incapable of feeling, yet Treves advises Merrick to be less sympathetic if he wants to be like other people. However, Merrick knows Porter was treated too harshly, and refuses to be so limited in his mercy and understanding, refusing to accept the rules by which Treves lives, which finally leads Treves to question those rules himself.


Social reaction toward Merrick is indicative of an ambivalent attitude toward disease, from which many people shy away. They do not see the act of putting Merrick on display as indecent, but Merrick himself as indecent in his outward appearance. Their outrage at his being on display is meant to save him, yet it leads to him being beaten and having his only means of support taken away. Later the public sends in sufficient donations to the hospital to support him for life, but this is the same public who nearly dismembered him on his return from Brussels. Treves points out that Merrick’s callers use him as a mirror to reflect back their obsessions, and do not actually see him at all, but Treves is as guilty of this as the rest. His intentions may have been more honorable than Ross’s, but they turn out to be little less exploitative, as Treves uses Merrick to advance his own career.


Treves comes to recognize Merrick’s humanity, and sees the man of intelligence, sensitivity, and imagination beneath the deformity, although it is not until after he analyzes his revealing response on seeing Mrs. Kendal naked in front of Merrick. Treves had brought in Mrs. Kendal, thinking that an actress would better be able to mask her horror and allow Merrick to meet a woman socially for the first time. Her question about Merrick’s penis, and the fact it looks normal, indicates that she sees something in Merrick that Treves still resists knowing, that he truly is normal in many ways and has the same desires as other men. She tries to alleviate his acute loneliness, becoming his friend, introducing him to high society, and showing him her naked body. Treves’s admonition to Merrick at this point, “Are you not ashamed? Do you know what you are? Don’t you know what is forbidden?” (42), shows that for all he  has told himself and Merrick, he does not see Merrick as normal and he becomes ashamed of his own calling as a doctor.


Treves begins to question the strict rules by which he lives and limits his compassion. He recognizes that his need to assert authority has often superseded any seeming acts of charity he has performed. He realizes that he needs to see his patients as real human beings rather than case studies, and begins to have nightmares in which he guiltily imagines a vengeful Merrick. But Merrick has nothing but words of gratitude for what little Treves has done for him. Merrick’s meticulous construction of the church model, which he began when taking up residence at the hospital, acts as a metaphor for the way in which Merrick reconstructs himself in the eyes of both society and himself. He recreates himself in order to become better accepted by a society that remains blind to his true worth to the end, judging him finally by his deformity, as indicated by the hospital director’s obituary. Merrick’s one desire had been to be normal, a desire that finally kills him, but that he feels was worth the cost. By sleeping in a “normal” position, he essentially commits suicide, as the weight of his head crushes his windpipe. We are left to ponder if that was a fair price for such a noble soul to have to pay.


In The Good Woman of Setzuan , the gods seek a good person to try to end the poverty and drought that plague the province. Since the prostitute, Shen Te, offers them shelter after they have been turned away by all the wealthy people, they reward her for her goodness with one thousand silver dollars. Rejecting her former profession and opening a tobacco shop, Shen Te attempts to do the good works the gods expect of her, only to discover that to survive she must create an alternative and more ruthless self, her cousin Shui Ta, to protect her interests. Throughout the play she alternates between these two roles, getting into constant trouble as people take advantage of Shen Te, then having to bring in Shui Ta to sort things out. Shen Te falls in love with Yang Sun, giving him money that she needs, only to discover that he is using her and refuses to marry her without more money. Still loving Yang Sun, she turns down offers by the wealthy barber, Shu Fu, finds that she is pregnant, and becomes Shui Ta for an extended period to launch a successful tobacco factory to provide for her future child. Unable to find Shen Te, Shui Ta is arrested for her murder. The gods come to serve as judges, Shen Te confesses what she has done, and the gods depart, delighted that she is still alive, but without offering any solution to her dilemma. This task is left to the audience in the epilogue that follows.


Brecht’s suggestion that people must become akin to being schizophrenic in order to ensure their survival suggests an illness in society itself. It is impossible to escape the evils of the modern world without becoming psychotic. In the modern world, Brecht insists that there is no chance to maintain a positive value structure without you or it being destroyed. The evil of society is evident from the start, which is why the gods had such a hard time finding anyone tooffer them shelter. In Setzuan, all the residents are selfishly out for themselves, regardless of the harm they do to others. The area’s drought is indicative of the paucity of goodness the province contains.


Shen Te is the epitome of goodness in a Christian sense, in her regard for others and her desire to assist others, even at a cost to herself. A gentle, motherly figure, she exudes love and compassion for all; she is willing to give everything she has to help others. But the Christian ethic, in its purest sense, which insists that a person give all and never take, proves impossible to uphold in a world of “give and take.” To survive, which she must if she is to continue to do good, Shen Te finds that she must create the epitome of capitalism in Shui Ta. Each time he helps her surmount her problem and she thinks she can dispense with him, her difficulties mount. First she is in danger of losing a night’s business, then her shop, then the shop of someone else, and, finally the future of her child. Each time the solution comes down to cold-hearted business tactics rather than compassion or fair play.


Shui Ta’s pragmatism is not attractive, but it is acceptable given the way the world operates. Shen Te recognizes the terrible practicality of her alter ego, even as they stand opposed on nearly every point. He works the system, making friends with the local police, getting rid of those leeching off Shen Te without giving anything in return, cheating others who would cheat her if they could, and making better deals with a tough business approach that does not allow itself to be swayed by compassion. In Shui Ta’s tobacco factory, even the duplicitous Yang Sun can rise, by being equally ruthless and brutal. But Shen Te’s pseudoschizophrenia is self-destructive in that it will not allow her to act naturally, even while it is the only way for her to survive. Indeed, it nearly destroys her, and the locals may be right in thinking her murdered, as she weeps in her back room for sorrow at what Shui Ta is forced to do, while she is hardly ever seen.


Because of her love for Yang Sun, who is worthless and uncaring in return, Shen Te destroys the old couple who lend her money and then need it repaid when the man falls ill. This allows us to question even her goodness, and wonder how much the gods might be to blame by sullying her with money in the first place. They forced her to become part of a capitalist system in which she must constantly struggle to keep her head above water, frequently resorting to the nefarious practices of her alter ego, and at times having to sacrifice others to stay afloat herself. Brecht wishes us to recognize that when the good are so easily destroyed in this manner, we have come to accommodate evil within the social system, and the humanitarian response should be to seek better justice in the world and make crucial changes.


The gods begin the play looking well-fed and decently dressed, especially in comparison to the residents of Setzuan, but they become more haggard and ragged as the play proceeds, as their contact with human beings wears them down. They are only too eager to leave at the close and return to the shelter of heaven. They are truly incapable of helping with human problems, indicating that it is useless to look to any gods for help, and problems need to be solved by the people who cause them. The gods’ unhelpful resolution insists that to live is to suffer, and they expect Shen Te to accept this and carry on. Brecht would ask that the world be changed so Shen Te can be offered a better option. By this he questions the rightness of Christian principle, being a determined believer in Marxism, which considers Christianity the “opium of the masses,” and unsuitable as a workable social system.


Angels in America, Part One: Millennium Approaches begins at the funeral of Louis Ironson’s grandmother, and the scent of death increases as Prior Walter tells his lover, Louis, he has AIDS. Unscrupulous Jewish Republican lawyer Roy Cohn tries to recruit Joe Pitt, a young, Mormon law clerk, to join the Justice Department so he can use his influence. Louis tries to support Prior, but finds it too intense, and guiltily walks out. Joe asks his agoraphobic wife, Harper, about Roy’s offer, and she refuses to move to Washington. When Joe sees Louis crying, he comforts him, leading to the discovery that he is a repressed homosexual. Roy learns he has AIDS, but since the accompanying label of “homosexual” will weaken his political influence, he refuses to be called homosexual, even though he sleeps with men; instead, he announces that he has liver cancer. Harper tells Joe to take the job and she will leave him, but he wants to hold their marriage together, even against Roy’s advice, and decides his conscience cannot allow him to take Roy’s job. Drunk, he phones his mother, Hannah, to confess his homosexuality. She leaves Utah, coming to New York. Prior, who has been in and out of the hospital, hears voices and is visited by ancestors who prepare him for the coming of the angel. As Roy’s condition worsens, the ghost of Ethel Rosenberg, whose execution he facilitated, sits watching. Louis and Joe meet and decide to have sex, as the Angel appears to Prior.


In Part Two: Perestroika , the Angel tells Prior to insist that people stop changing. Prior decides he cannot do this, and wrestles the Angel to get into heaven to return the book of prophecy. Louis and Joe spend time together, and while Joe says he loves Louis, Louis cannot condone Joe’s manipulative legal practices and connection to Roy Cohn. Both try to rekindle their original partnerships, but Prior and Harper reject them, having moved on and become independent. Roy gets AZT, but dies in agony with Ethel Rosenberg watching. Although intensely disliked by all around him, they show him grudging respect, and even Ethel assists in saying Kaddish over his body. Hannah rescues Harper, and looks after her until Harper realizes the pointlessness of life with Joe, and discovers a new outlook. Hannah also helps Prior return to the hospital, face his angel, and reject his mission. The epilogue, set four years later, shows us Prior still alive, intending to hold on to life as long as possible.


The constant overlap and shifting dynamic of the plays’ characters echo Harper’s vision of the dead souls networking to protect the earth, only these are predominantly living souls whose changing interrelations, although often   messy, also indicate human mutability. Kushner reinforces his emblem of human connection with split-focus scenes, in which different events play out concurrently, with sufficient common ground to suggest simultaneity. Connection is further emphasized by the way disparate characters appear in each other’s dreams and visions, and how everyone becomes linked by various relationships. The characters’ fears, desires, losses, and achievements frequently echo each other, indicating how similar human beings are regardless of gender, race, age, or sexual preference, to which end, Kushner would suggest, people should have no difficulty eventually uniting. The true illness in society is not AIDS, as much as people’s selfishness, which makes them incapable of forgiving and embracing others.


The plays teach us much about the process of AIDS and how it affects people physically and psychologically. Both Prior and Roy have AIDS, and while Roy dies in incredible pain, Prior remains alive after nearly five years and is determined to keep going. We see the stress under which Prior’s partner is placed, wondering if he has the disease and whether he has the strength to stand by his lover. We also see the fears of abandonment and readjustment of self-image Prior must face, alongside the ups and downs of the effects of the disease as Prior and Roy switch between home and hospital. We learn of the potential breakthrough with AZT medications, but how they are kept for the privileged few. The epigraph to Millennium Approaches suggests that when we live in unpleasant times, pain becomes our means of knowing we are still alive and should be accepted, and this doubles as an apt metaphor for living with AIDS.


Prior tells the story of an ancestor in a leaking boat who randomly drowned passengers to stay afloat, seeing it as a metaphor for modern life, particularly living with AIDS. Everyone is in such a boat, “waiting, terrified, while implacable, unsmiling men irresistibly strong, seize … maybe the person next to you, maybe you, and with no warning at all, with time only for a quick intake of air, you are pitched into freezing, turbulent water and salt and darkness to drown” ( Millennium , 42). The modern world has become filled with people like the Reagan family, whom Louis describes as having no connection or love between them, as everyone avoids such responsibilities. Roy insists that this is the only way to be—you can either be nice or effective—and it is better to live alone so one can be more ruthless. But such isolation exacts a cost on the soul.


Prior is openly homosexual, whereas Roy refuses to be so labeled for he sees that as announcing oneself as a loser. Roy buys his way with stolen money and threats into the best drug programs, but they do him little good. Although we may admire his spirit and vitality, as do many other characters, his basic selfishness tells us he is rotten within, full of the selfish values Kushner wants to expose, and deserves to die, unlike Prior, who is told by Harper that, “Deep inside you, there’s a part of you … entirely free of disease” ( Millennium , 34). But Roy is at least unlike Joe, who sees homosexuality as sinful, and ruins his own and Harper’s life by trying to repress it. Joe admits he married Harper because she seemed so messed up that next to her he was bound to look good— hardly a solid basis for any relationship. Although Joe rejects Roy’s job, he accepts his philosophy, which is why Louis eventually rejects him as poisoned.


The play’s central image is that of the Angel—perfect, but dangerous—for perfection implies stasis, and the Angel’s disgust with change and evolution makes her the enemy of humankind and a symbol of the death principle opposed to that of life. To survive, society must embrace progress and change because that is what life is all about, just as the AIDS community needs to resist the Angel’s call to nostalgia and passivity if it wishes to survive. Roy is a man of action who demands, and therefore receives, power; by contrast, Louis, despite his political liberalism, seems ineffectual, by which Kushner prepares us for the truth that change is never easy. The struggle between principles of life and death is found throughout the play, and in a sense it is the struggle itself that denotes life, supported by Kushner’s close association of life with sex. Harper, despite the apocalyptic fears against which she constantly struggles, still desires life, indicated by her desire to become pregnant. Prior, though living with AIDS, refuses to be diminished by it, and though sick, desires life, because all life is sacred, regardless of the quality of that life. The play ends with his words of hope: “This disease will be the end of many of us, but not nearly all, and the dead will be commemorated and will struggle on with the living” ( Perestroika , 146).

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