In what ways do popular television programs shape cultural understanding of people with disabilities, particularly with respect to their religious identity, their place in the family and the community, and the significance of their experiences? Depictions of people with disabilities in popular culture often reveal a set of underlying cultural assumptions and practices related to disability. These depictions can be powerful in shaping and disrupting perceptions about disabled identity.1
Ria Cheyne argues, “The narratives circulating in popular culture play a significant role in shaping wider understandings of disability and impairment” (Cheyne 2012, p. 117
). Some portrayals of people with disabilities are deeply problematic, from the trope of the villain’s true nature being revealed in his or her impaired body, to the sentimentalized depiction of the noble person with a disability whose narrative role is to teach others how to suffer uncomplainingly, to the idea of disability as a punishment for wrongdoing and even the seemingly positive but still-distorted trope of the “supercrip.”2
As Paul Longmore argues, these sorts of characterizations are not morally neutral: “Disability has often been used as a melodramatic device not only in popular entertainments, but in literature as well. Among the most persistent is the association of disability with malevolence. Deformity of body symbolizes deformity of soul. Physical handicaps are made the emblems of evil” (Longmore 2003, p. 133
). This use of disabled bodies in popular culture to symbolize evil in turn affects actual people with disabilities.
Other representations of disability in popular culture offer three-dimensional characters or thoughtful analyses of experiences of disability. These depictions include people whose lives are rich and who are socially engaged, whose disabilities are only one dimension of their existence, and who have meaningful relationships with family members and other people in their communities. As Rhonda S. Black and Laura Pretes argue in their analysis of popular films depicting people with disabilities, “The media can play an active role in challenging society’s fear and misunderstanding of disability by consciously seeking to portray characters with disabilities realistically, fairly, and frequently” (Black and Pretes 2007, p. 82
Depictions of people with disabilities can also explicitly disrupt common negative stereotypes, and can extend beyond simple positive representations into thoughtful, nuanced analyses of the lived experiences of people with disabilities and their families. One essential feature of such narratives is that they emerge from the perspective of the person with a disability; as G. Thomas Couser observes when discussing life writing, “Long the objects of classification and examination, disabled people have only recently assumed the initiative in representing themselves; in disability autobiography particularly, disabled people counter their historical subjection by occupying the subject position” (Couser 2006, p. 401
). Subject positions are naturally complex and multifaceted. Narratives that touch on religious identity, race, and social class as features that intersect with disability have particular potential to be meaningful, constructive portrayals.
Two recent television depictions of families responding to disability offer food for thought. Each is substantive and religiously nuanced, and each pushes back against damaging portrayals of people with disabilities. Neither is a perfect model of a disruptive narrative about people with disabilities from their own perspective, but both have something to offer and are positioned within widely viewed programs. First, the BBC television series Call the Midwife
, which often includes plot arcs featuring disability and impairment, offers a particular episode wherein a family, the midwives who provide care, the Anglican nuns who host their clinic, and the British response to disability in the 1950s are all interrogated. The series functions on a number of levels: it is a dramatization of a memoir written by former nurse–midwife Jennifer Worth, narrating her experience as a midwife to a working-class community in London in the 1950s. It also offers modern-day viewers a chance to reflect on and respond to changes in healthcare and in practices around disability over the last sixty years.3
Finally, it provides an ongoing and consistent Anglican religious framework through which all of the characters are viewed.
The second series is the popular American medical drama Grey’s Anatomy, the first in a number of successful programs developed by producer Shonda Rimes. Rimes’s approach to depicting race, wealth, power, and family relationships in this drama, all through the lens of a particular community of doctors and their patients, is innovative and consistently challenges viewers. The narrative arc of Season 11 picks up a number of threads already present in the characters’ backstories and over the course of several episodes weaves them into a powerful commentary on disability, religious beliefs about abortion, and the formation of community around religious practices and beliefs.
Because both programs are explicitly set within the context of a medical community, the disability studies critique of the medical model of disability must be kept in mind as we consider each of the narratives. Tobin Siebers argues, “The medical model situates disability exclusively in individual bodies and strives to cure them by particular treatment, isolating the patient as diseased or defective” (Siebers 2006, p. 173
). One question to consider, then, is whether medical dramas like Call the Midwife
and Grey’s Anatomy
reinforce or disrupt the medical model of disability, and whether any other models of understanding disability are visible in their narratives.
3. Call the Midwife
The popular and highly acclaimed BBC television series Call the Midwife (now in its sixth season) is based on a three-volume memoir written by former nurse–midwife Jennifer Worth. Her alter ego in the memoirs and the television program is Nurse Jenny Lee. The television series, extending beyond the memoir, provides a religiously grounded depiction of mothers and infants, as well as of members of the broader community who come into contact with the midwives. Worth was a nurse–midwife in the late 1950s, living in and working from a convent, which she calls “Nonnatus House,” situated in London’s Poplar neighborhood. At Nonnatus House, some nurse–midwives were nuns and others were laywomen; the laywomen were not necessarily highly religious. However, the Anglican sisters with whom they lived and worked, whose order provided midwifery and other medical care for some of London’s poorest residents, offered an emphatically religious model of care to their patients. They provided prenatal care, delivered babies, and offered antenatal care for both mother and child. In addition, they gave medical care to other residents of Poplar, especially those who were housebound. Care for people with disabilities was a regular part of their work.
The nurse–midwives, both nuns and laywomen, represented a powerful religious and medical authority for the people whom they served. Worth writes,
The St Raymund [Nonnatus] midwives worked in the slums of the London Docklands amongst the poorest of the poor and for about half of the nineteenth century they were the only reliable midwives working there. They laboured tirelessly through epidemics of cholera, typhoid, polio, and tuberculosis…In the 1940s, they remained in London and endured the Blitz with its intensive bombing of the docks. They delivered babies in air-raid shelters, dugouts, church crypts and underground stations. This was the tireless, selfless work to which they had pledged their lives, and they were known, respected and admired throughout the Docklands by the people who lived there. Everyone spoke of them with sincere love.
The television series adapts Worth’s original narrative, which depicts her experiences with the advantage of years of hindsight, to add another layer of analysis for modern viewers. The producers intentionally focus on issues of disability in many episodes; plots constructed around the experiences of the nurse–midwives, their patients, and their community invite modern viewers to reflect on what it means to be a mother of a child with disabilities. Like Grey’s Anatomy, the healthcare-focused setting raises the possibility of analyzing disability with a medical model; for the most part, however, the series avoids reducing people to their medical diagnoses. Stories of the people the midwives encounter are typically nuanced, including a review of cultural memory of the individual people and their history, a sometimes sentimental but never patronizing depiction of the neighborhood and its inhabitants, and an ongoing emphasis on the strength and generosity of the Poplar community.
One particular narrative about disability that challenges prevailing social norms comes in Call the Midwife
, episode 4, series 2, (Goldby 2013
), where a mother’s initial response to her newly born infant, diagnosed with severe spina bifida, is an intensification of cultural practices of rejecting and institutionalizing children with disabilities.9
The baby is expected to have a shortened lifespan and significant mobility and other impairments. In telling this story, the episode explores the responses of the midwives and the religious reflection of the nuns, and identifies both a young man with disabilities and the somewhat disreputable father of the new baby as loci of knowledge who create a path for the baby to be raised by his family.
What might a working-class family whose baby was born with spina bifida have encountered in 1950s London? Call the Midwife
depicts the newly born baby being whisked off to a hospital with assurances that medical advances are growing by “leaps and bounds,” although Ruby, the baby’s mother, reports with distress that “Doctor said he’d be lucky to see his sixteenth, and he’ll need all sorts of looking after, so why did they save him?”10
The sound of the nuns singing at prayer immediately follows his birth; while scenes of the midwives at work are juxtaposed with scenes of the nuns at prayer in many episodes, in this episode only the music serves to invoke that sacred ritual.
Later, among themselves, the midwives discuss the baby’s possible complications; Sister Evangeline, whose character is tough and pragmatic, summarizes: he may have problems with bowel control, renal complications, and a drastically reduced lifespan, and he will use a wheelchair (surely a complication for a family living in an urban house with several flights of stairs). Sister Monica Joan, a nurse–midwife and nun whose work with patients has ended because of her age and increasing dementia, reports that when she was first practicing midwifery, the “humane course of treatment was considered to be chloral hydrate”—that is, euthanasia immediately after delivery (Goldby 2013
). The other midwives gasp, shocked by this disclosure.
The final word is given to Sister Julienne, who is in charge of the convent and who functions as the moral center of the series; unfailingly patient and kind, she regularly reminds the young midwives and the nuns alike of the love of God for the people whom they encounter and treat. In this instance, she counsels, “Life is never without hope” (Goldby 2013
). Nurse Lee, the midwife who attends to the family after the baby’s birth and who struggles to support them, repeats this assertion to the parents: Life is never without hope.
This belief that parents should continue to hope eventually prevailed within the medical community as well. Historically, the late 1950s and the 1960s saw a shift in treatment of infants born with spina bifida in Britain and the United States. A review of treatment standards in the journal Pediatrics
In 1967, W. J. W. Sharrard, Robert Zachary, and John Lorber, pediatric surgeons at Children’s Hospital, Sheffield, UK, reviewed the cases of 526 children born between 1955 and 1962 and treated for myelomeningocele. They concluded that there was “no place for the selection of patients for conservative treatment rather than operative treatment on the grounds of paralysis, deformity or hydrocephalus present at birth.” As a result of this and similar studies published in the mid-1960s, most centers in the United Kingdom and United States adopted the practice of operating within 12 to 48 h of birth on all infants who did not have other defects incompatible with life.
The care that Ruby’s baby gets, then, is relatively progressive—he is treated by surgeons immediately and with the expectation that he will survive infancy. However, the response of her neighbors reflects a deeply rooted stigma, perhaps intensified by Ruby’s open pursuit of a higher social class than the one she currently occupies. While she is still struggling to adjust to her son’s situation, a neighbor whom she had previously snubbed sees her on the street and mentions that Ruby and Nurse Lee have temporarily left the baby on the doorstep in his pram: “I do believe you may have left your baby outside, Ruby dear, not that anyone would want to steal a cripple … [Speaking directly to Nurse Lee, she continues:] Not so high and mighty now, is she?” (Goldby 2013
). Plainly, there is tension between Ruby’s aspirations to move her family out of the neighborhood into a higher social class and the birth of a child with visible, significant disabilities. This brings to mind Carrie Sandahl’s observation that “becoming visible” as a person with a disability may be complicated by other marginalization; here, the family’s economic aspirations are seen by their neighbors as deflated by the birth of their disabled son.
One strategy sometimes chosen by parents in this context was institutionalization; this became increasingly common in the early to mid-twentieth century. “Parents who needed care for children with disabilities, especially if they were working class or lived in urban areas without extended families, increasingly found institutionalization their only option…Many doctors pressured parents to relinquish disabled children to the state just after birth” (Rose and Michel 2012
). This began to change in the 1950s and 1960s because of exposure of abuse in many institutions, the growing disability rights movement that advocated for independent living, and the cost of institutionalization (Rose and Michel 2012
). In the setting of Call the Midwife
, Ruby and her family are living under circumstances where institutionalization might well have been recommended: they are working-class, they live in an urban setting, and Ruby’s husband laments that both of their mothers have died, leaving them without family support.
Indeed, Ruby and her husband Douglas explore the possibility of placing their son at St. Gideon’s Home, described by one of the midwives as an asylum for “mental cases as well as incurables” (Goldby 2013
). Douglas is opposed to placing the baby outside the family, but Ruby finds herself unable to take over his care. She tells Nurse Lee, “Douglas told me to stop working, but I carried on, lifting them baskets. I used to rest them on my bump when I was loading up, what if that hurt his back?…He came out of me, like that. Or was it God? He punishes people, dinn’t he? Vanity is one of the deadly sins, they say. Maybe it was Dougie’s gambling. Doesn’t Jesus hate all that? We did something. One of them things, made him like that. What did we do?” (S2E4). She explains that she cannot bring herself to pick the baby up and hold him: “If I hold him, I think I might die of the sadness” (Goldby 2013
). Thus the family considers institutionalization.
The discourse of the midwives provides a nuanced counter narrative to Ruby’s concerns about the cause of the baby’s disability. She thinks God is punishing her, her husband, or both of them for some infraction, though she cannot identify it precisely.11
The aging Sister Monica Joan suggests that green potatoes might be the cause, but the more recently trained Nurse Miller tells her that potatoes are not the issue although no one knows, at that point, what is. While there is not an extended religious discourse about the reason for spina bifida, the midwives take for granted that medical conditions have medical, and not theological, causes, and they never suggest that Ruby or her husband is somehow responsible for the baby’s disability. Their religious authority does not directly address Ruby’s questions, but the viewer is reminded that the baby’s birth is not a punishment. This reminder reflects “concern that disability is uncritically associated with evil” (Yong 2009, p. 57
). While Ruby seems to consider this possibility, the midwives dismiss it out of hand.
As the family explores the possibility of institutionalizing the baby, two characters emerge, one a current resident of St. Gideon’s and one a former resident. The two serve to some extent as proxies for Ruby and Douglas’s baby, speaking to the quality of life within St. Gideon’s but emphasizing the very high cost of broken family relationships. Both of these characters are adults with disabilities, one with cerebral palsy and one with an early diagnosis of mental illness. These scenes are not only important to advance the plot of the episode, but key to avoiding a narrative where the baby is made into an object lesson for others’ growth or spiritual reflection.
While visiting St. Gideon’s, Douglas meets the director, a capable woman who—the narrative emphasizes—ensures that no abuse takes place there.12
She tells him, “We would ask that the parents visit as often as possible; the bond needn’t be broken just because the baby is at St. Gideon’s” (Goldby 2013
). Douglas turns to Jacob, a young man with cerebral palsy who is a St. Gideon’s resident. Jacob has brought him tea, and he sees Douglas’s discomfort with the movements of his impaired body as he brings the cup across the room. He jokes that the tea is not poisoned.13
Jacob has been affectionately described earlier to Nurse Lee by the director of St. Gideon’s as “bright as a button and cheeky as a monkey” (Goldby 2013
). Clearly Jacob is witty and intelligent, and he reliably performs everyday tasks; he was born with his disability and is portrayed as having the social authority to speak to the experience of institutionalization.
His experiences serve the viewer, and the baby’s father, as a projection forward in time: what will happen to the baby if he is left here? Douglas asks him, “What’s it like here?” and Jacob answers, “There’s a biscuit factory next door; we get the broken ones” (Goldby 2013
). This wry observation illustrates that the institution gets adequate but second-rate support, and while “we get the broken ones” seems at first blush to be a reference to the residents’ bodies, the word “broken,” coming immediately after the reminder that children’s relationships to their parents need not be broken, suggests that it is the relationships, not the bodies, that are damaged. The broken ones, then, are those whose families have chosen to place them outside the home in an institution, and perhaps have to be reminded to maintain contact.14
As the facility’s director tells Nurse Lee, “This is a home by name only. It is not home. If the child can stay with its family, I suggest that you do everything in your power to make that happen” (Goldby 2013
Jacob recognizes that the institution where he lives embodies a harmful construct of disability as requiring segregation; the social practice of removing people with disabilities from their homes is breaking the relationships and causing damage to the residents. Even this particular institution, which attempts to maintain family ties, does not provide a real home for the residents who have been displaced from their homes. Instead, they live in brokenness. As Sandahl argues, this testimony from a person who has been institutionalized about what his life is like is subversive: the most disregarded people with disabilities are “those who are completely socially marginalized, stigmatized and hidden away in institutions (residential, prisons, etc.) What they know, how they know, and why it matters is most threatening to the status quo” (McRuer and Johnson 2014, p. 157
Jacob’s sorrow is echoed by Jane Sutton, a medical orderly and recent addition to Nonnatus House who was raised at St. Gideon’s. As she explains to Nurse Lee, “I was a patient, and then I became a trustee. I met Sister Julienne here; she’s been very kind to me” (Goldby 2013
). Nurse Lee assures her that she will not tell anyone, underscoring the stigma placed on institutionalized people. Later, Jane tells another character, with whom she has been struggling to establish a friendship and perhaps a romantic relationship, that she was placed at St. Gideon’s because her behaviors related to her mental health were too much for her parents: “They say I used to sit bolt upright in bed and scream. My parents sent me away. I don’t blame them. But for a long time, I was…away…I still struggle. Life, for me, is full of fear” (Goldby 2013
),Her difficulty in forming relationships is tied narratively to this early rejection; insofar as she can speak for the possible future of Ruby and Douglas’s baby, the act of placing him in even an above-average institution will cause significant harm.
Both of these positions reflect a social, rather than a medical, model of disability. It is neither Jacob’s cerebral palsy nor Jane’s unspecified mental illness that has been harmful; rather, the problem has been the fracturing of relationships, reinforced by misguided religious beliefs like Ruby’s and stigma in the community. Jacob speaks to this fact. The choice of an actor with a disability to play Jacob helps underscore the importance of recognizing people with disabilities as authorities on their own lives. Sandahl observes, “Disabled artists not only tell our stories, but critique both mainstream and alternative communities, show variety in the human form itself, and model how variety necessitates change to structures of all kinds” (McRuer and Johnson 2014, p. 157
). Jacob’s reply to Douglas shapes the family’s choice, gives them a sense of what might be possible with their child, and confirms Douglas’s reservations about putting his son in an institution.
Contemporary medical research gradually recognized that there was good reason not to give up on infants with disabilities: “Acknowledging the unrealized potential of children with myelomeningocele [the most serious form of spina bifida], Zachary maintained that ‘extreme disability is not synonymous with unhappiness and we are only at the beginning of finding ways of developing the capabilities of these patients’” (Pruitt 2012
). Within the storyline of Call the Midwife
, Ruby and Douglas reach a similar conclusion.
While Douglas, after assessing the institution, feigns willingness to leave his son there, he is gambling on Ruby’s deep attachment to their child and her as-yet-unspoken regard for him as a valuable human being. Returning from his visit, he packs the baby’s things in a suitcase and tells her, “I’ll take this; you grab it,” as he reaches into the as-yet-unnamed baby’s bassinet to remove a presumably unnecessary stuffed toy. She responds, suddenly and fiercely: “He’s not it. He’s a baby. He’s my baby boy. How could you even think to send him away?” She lifts the baby and holds him for the first time, and then calls down the stairs to Nurse Lee, waiting to help transport the baby to St. Gideon’s: “Douglas Junior is going nowhere. He’s staying right here, with us.” The voiceover, from Nurse Lee reminiscing later in her life, says: “It had been the biggest gamble of Douglas Roberts’s life. The stakes had been high. But the dividends paid were permanent, and beautiful…Sometimes in life, one has to take a chance. Without risk, there’s no possibility. Without potential loss, no prize. The Roberts’s baby defied all odds and thrived and was cherished always” (Goldby 2013
). The family’s embrace of their child reflects Worth’s admiration for the family stability and strong social fabric of Poplar. While she does not shy from describing the significant poverty, the realities of living in a rough area, and the sometimes desperate living conditions, she recognizes the deep love that the members of the community had for each other.
Ruby’s choice to name her son, and to use pronouns that affirm his identity as a human being and not an object, represent the family’s shift away from some cultural expectations, such as placing their son in St. Gideon’s and seeing him as a “cripple,” and toward others, namely those modeled by the midwives: remaining hopeful about the baby’s future, affirming his identity as a child of God—reinforced by the sacred music played following his birth—raising him at home, and presenting him to the community as proudly as any parents would.
4. Grey’s Anatomy
In Grey’s Anatomy
, the religious dilemma embedded in a story arc in season 11 about a baby diagnosed with a disability was proposed by Sarah Drew, the actor playing Dr. April Kepner. In the episode, entitled “All I Could Do Was Cry,” April discovers in the second trimester of her pregnancy that her son has osteogenesis imperfecta (OI), sometimes called brittle bone disease. OI is a “genetic bone disorder characterized by fragile bones that break easily” (Osteogenesis Imperfecta Foundation 2015
). Deeply religious, April hopes throughout the experience that God will intervene and provide her child with a miraculous recovery. As is typical for the structure of Grey’s Anatomy
episodes, stories about other characters and various medical situations are interwoven with this plotline; in this episode, a man whose eyesight has been impaired has his sight restored, and a woman who had believed she could not get pregnant discovers while in labor that she is expecting a child. While miraculous stories that mimic biblical narratives unfold around her, April does not receive the intervention she had hoped for.
After the initial diagnosis of OI in episode 10, April engages in research and diagnostic evaluation of her own ultrasound images. She recites what she has learned to her husband Jackson Avery, a plastic surgeon, giving basic information about OI: “There are four types of OI, ranging from a manageable disability to completely fatal. Types II and III are the most severe. I studied my ultrasounds. Best case: our kid gets surgery after surgery; worst case, our kid lives only minutes after birth” (Wilson 2015
The OI Foundation, a useful but by no means comprehensive resource for people with OI and their families, lists six types of OI, but confirms that Types II and III are most severe and describes people with the other types as having a longer lifespan and needing less medical intervention. However, the foundation emphasizes that “understanding the individual’s OI Type provides a starting point for understanding the person’s health care needs. But due to all of the variable features, care for each person needs to be individualized” (Osteogenesis Imperfecta Foundation 2015
). Thus, while a few episodes of Grey’s Anatomy
may familiarize viewers with OI, that information might not be applicable to individual people living with OI; the depth and accuracy of medical information provided by the program is, unsurprisingly, limited.
Why is this baby’s diagnosis framed as a crisis? As the OI Foundation explains, “With good medical management and supportive care, the majority of people who have OI will lead healthy, productive lives and can expect an average life span” (Osteogenesis Imperfecta Foundation 2015
). This reality is somewhat unevenly presented in Grey’s Anatomy
, though April and Jackson’s obstetrician, Arizona Robbins, tells them that babies with Type III (and, as she implies but does not make explicit, other types as well) can have a “very, very happy life” (Wilson 2015
). This reminder is brief but is reinforced to some degree by the identity of the speaker. Long-time viewers will recall, although this episode does not discuss it in much depth, that Robbins, who has recently ended her marriage to another female doctor, uses a prosthetic leg after being injured in a plane crash and having part of her leg amputated. Her identity is multiply marginalized. In a subtle way, then, she represents for viewers an adult with a disability whose voice is authoritative on the subject of quality of life for people with disabilities.
Robbins’s narrative role as a stand-in for their infant is not perfect, however; she does not have OI, she did not grow up with a disability, and her disability is not a focus of these episodes. The fit between Robbins and April’s baby is not as clear as the analogy between Jacob and Ruby’s baby; no adult with OI is provided to viewers or the characters as authoritative, and there is very little evidence of the reality that many people with OI lead rich, ordinary lives. Similarly, the obstetric surgeon from whom the parents seek a consultation, Nicole Herman, is herself in the midst of a diagnostic process for a brain tumor, the removal of which will make her blind, but her situation is not framed at this point in the season as a disability experience.
The tension between the medical model of disability, which sees people with disabilities primarily as patients in need of medical intervention, and a model of providing care that recognizes the patient and his family as whole people is depicted in the conflicting language that Robbins and Herman use when discussing prospective candidates for fetal surgery. Herman is reviewing files and tells Robbins, “I have found us the most incredible surgeries…I have hunted down the most screwed up, medically compromised fetuses I could find” in order to schedule interesting procedures. They sort the files into three categories: impossible, possible, and maybe. Robbins argues that engaging with families whose babies are already born is easier: “Their kid is right there, and you can hold them and hope for the best…This feels so theoretical.” While the unborn infants are still patients needing medical care, the contrast between babies who have already arrived, who can be held and comforted, and files classified as “impossible” is clear (Underwood 2015
Religious language and practice are used throughout the story line to establish the value of individual people aside from any medical diagnosis, but this process is not straightforward. April’s character is from a white farming family in Iowa, and she is devoutly Christian; her conservative religious beliefs have been featured in previous seasons. Her husband was raised by his black mother and is biracial. Jackson is not religious, and the disparity between the married couple’s beliefs has previously been a source of conflict. April’s mother-in-law, surgeon Catherine Avery, proves to be a greater source of support than April’s religious family, and Catherine proposes a path forward for April that honors her religious beliefs and emphasizes the baby’s personhood. While April’s mother advocates prayer, whisks her off to church, and hopes for a miracle, April’s mother-in-law suggests induction and baptism for the baby.
Like the character April, actor Sarah Drew is a conservative evangelical Christian.15
Drew says that although the idea for the storyline was hers,
I pitched it accidentally. In an episode in Season 10, Catherine Avery makes an assumption about April being pro-life and what her attitude would be as a person who is pro-life. In discussing it with the writers, I had offered a not-so-black-and-white look at how a person of faith might deal with that. That came in the form of a story that happened to my mom’s friend, who was pro-life and they had a baby with O.I. Type 2. They ended up inducing and baptizing [their] baby. Everything that happened on our show happened to my parents’ friends.
Thus, Drew’s suggestion of the story line where a religious woman, married to a nonreligious man, responds to a serious medical diagnosis of her unborn child and must consider her strongly held beliefs against abortion emerges from her own family’s social circle. Here the knowledge about a disability experience is the parents’ knowledge rather than the firsthand subject experience of a person with a disability. As an evangelical Christian, Drew expressed a desire to portray a family’s deep religious beliefs in the midst of making a very difficult set of choices about their child. The other themes present in these episodes emerge as the writers have embroidered on that original pitch: the possibilities for a person born with OI, the religious resources of April’s mother-in-law, the inadequacy of April’s family’s religious teachings in this crisis, the markers with which parents might recognize the personhood of a very medically fragile baby.
Discussing her character’s hope for a miracle, Drew continues: “Moving forward, I actually think that in some ways in going through this, she has this miracle happen to her…I felt the sense of, ‘God is covering April and holding her and he’s walking beside her. He has not abandoned her and he’s not evil, bad and cruel. He’s with her.’…Having a tragedy like that happen and then feeling God show up for you is something that impacts someone tremendously and actually strengthens her faith” (Abrams 2015
). One drawback of this framing is that Drew’s description instrumentalizes the baby’s life as an opportunity for April’s religious growth; he is not, in this account, portrayed as a person in his own right.
The episode as written and acted is somewhat more nuanced than Drew’s description. When April expresses a belief that God has deserted her, the rest of the characters provide significant support, suggesting that instead of abandoning April, God is present within the community of people seeking to support the couple. She exclaims, “This isn’t fair; this isn’t just. I have spent my life believing in a God who is just. He gave me a calling and I followed it…and then to be handed this? It’s cruel and I feel like God is laughing at me.” This expression of grief eventually meets with some comforting, but the beliefs of April’s family of origin and her somewhat narrow view of God’s love and protection as transactional are upended. April is raising questions about the nature of God that her religious beliefs cannot answer.
Invited to visit by April, April’s mother tells the couple, “There’s really no point in even getting those [test] results. God gives what he wants to give. No test is going to change that…It’s not good for the baby; focus on loving that sweet little baby; that’s all that matters…It’s hard to understand how his plan will unfold. He never gives us more than we can handle” (Wilson 2015
). This reassurance proves insufficient for April, who learns in the next episode that the diagnosis is OI II, and she translates this into nonmedical language for viewers, “My baby’s bones are breaking inside my belly? He can feel it, right? So he’s in pain” (Underwood 2015
). Her mother’s absolute rejection of abortion on religious grounds, framed to Jackson as “something [April] knows in her heart and soul she does not want to do,” leaves April without options for responding to her son’s situation: he will likely survive only briefly if she carries the pregnancy to term, and even in the second trimester he is experiencing pain in utero (Wilson 2015
At this point the religious dynamics of the episode shift subtly to suggest that the religious knowledge and practices handed down from Jackson’s mother are necessary for the family to embrace their child’s existence. While Jackson is clearly depicted as nonreligious, the explicit religious views of his mother Catherine Avery are unclear. However, she provides a plan for the baby using language that emerges from the African-American Christian tradition.
April tells Catherine, “There’s no way for me to do what I need to do and what I believe that I should do.” Catherine replies, “There is always a way. Here’s what we’ll do. You will choose a day, soon. Set it aside and arrange to be induced. You will give birth to your beautiful little boy, and have him baptized right then and there. Then you’re going to get to hold that baby, and you’ll pray for him and sing to him. You’re gonna look at him and memorize every little detail of his face, and you will do that as long as he lives, you will do that until God takes him” (Underwood 2015
This phrase, “There is always a way,” offered in response to April’s despairing statement that “there is no way” for her to respond to her son’s medical situation while remaining faithful to her religious beliefs, is an echo of the saying “God will make a way out of no way.” Although Catherine does not invoke religious authority in her phrasing of the aphorism, she goes on to offer April an affirmation of her son’s dignity, the certainty of the opportunity to baptize him, and an acknowledgment of the power of God. Her use of the phrase “here’s what we’ll do” shifts the decision from April alone and instead suggests a shared family recognition of the baby. Wolfgang Mieder writes of this proverb, “It grew out of the African American experience of searching to carve out a life of equality and dignity.” (Mieder 2010, p. 181
What does this mean in context? This framing of the baby’s life not only gives April a pragmatic plan that honors her child as beloved and is compatible with her religious beliefs, it also envelops him in the black church tradition. Catherine Avery is drawing from her own cultural and religious experience to comfort and counsel her son and daughter-in-law, and by extension she is recognizing the place her grandchild will hold in her family and as a participant in that experience. Notably, when the baby Samuel is born, he is named (his middle name, Norbert, is after one of Jackson’s uncles) and then baptized immediately in the hospital by an African-American pastor. His life and death proceed as Catherine Avery has described; the couple hold him until he dies. Neither April’s mother nor Jackson’s mother is present, but Jackson’s family ethos has prevailed.
What of April’s anguished complaint that God is not just? Yong raises the issue of traditional theodicy as subject to critique from a disability perspective. He argues, “Disability advocates caution against the traditional association of freedom and evil…This is because as traditionally articulated [theodicies emphasizing free will] have been called on to either justify why disabilities happen to people with them (i.e., because of their sin, carelessness, or irresponsibility), or to enable a sort of resigned posture in the face of human evils” (Yong 2009, p. 164
). April’s mother offers an account of God that emphasizes God’s sovereignty and God’s goodness, which leaves very little room to explain why April’s baby is dying; April can only speculate that God is torturing her and rejecting her obedience and diligence in following God’s call. In contrast, the religious perspective that Catherine offers, formed in a tradition well versed in reflection on suffering, does not insist on God’s sovereignty, although it affirms that God is the actor who will end the baby’s life; she says instead, “There is always a way.” In this case she provides a means for April to remain in relationship with God while also making choices that conflict with what April has long believed God requires. The issue of whether God is just is set aside; as Jack Halberstam argues, not knowing is a mode of cripistemology (McRuer and Johnson 2014, p. 152
The ongoing visual image of candles, lit in the hospital chapel in recognition of the baby’s birth and his parents’ struggle, emphasizes religious themes. Near the beginning of the episode, several colleagues are discussing what to do to show support for April and Jackson, and another surgeon, Amelia Shepherd, says, “I lit a candle in the chapel. You can all just give them privacy. That’s all they are gonna want” (Underwood 2015
). The episode closes with Amelia in the chapel, disclosing to a friend that she also lost a baby shortly after birth. Thus, her suggestion is framed as empathetic and authoritative.
As the episode progresses and April and Jackson struggle to proceed with the induction, the number of lit candles increases as various friends and coworkers visit the chapel. In another nod to the religious depth of the black church tradition, the only characters who seem to know how to pray, apart from Amelia, who is white, are a black physician, Miranda Bailey, and a black resident, Stephanie Edwards. Both are interrupted by white women while at prayer, and while people flow in and out of the chapel, most express some discomfort at their own lack of expertise in a religious setting. Notably, in other scenes during this episode Bailey helps to deliver the unexpected, “miraculous” baby born to the woman who believed she was infertile, and Edwards assists with the procedure that restores a patient’s sight. Neither echoes April’s belief in miracles, and both model a religious identity compatible with the scientific method and modern medicine.
Together, Catherine Avery, Bailey, and Edwards embody Jennifer Nash’s description of the intersection between race, feminism, and disability: “Black feminism has revealed the epistemic advantages that emerge from marginality. In so doing, black feminism validates embodied forms of knowing, legitimizes experiential knowledge, and endorses forms of knowledge too often dismissed by the academy” (McRuer and Johnson 2014, p. 151
). Like Arizona Robbins, both Bailey and Edwards have a back story of disability, not highlighted in this episode but familiar to long-time viewers: Bailey was diagnosed with obsessive–compulsive disorder after a traumatic event, and Edwards was frequently hospitalized as a child with sickle-cell disease, which has in previous episodes emerged as a source of empathy and has been portrayed as a valuable addition to her capacity as a physician.
What do these television programs provide us, and the broad range of people who view them, that is constructive for reflecting on the intersections of disability, religious identity, race, and class, and for developing a disability-influenced religious epistemology? Each of the narratives is culturally influential and each offers explicitly religious framings for stories of families responding to a diagnosis of disability in a much-wanted baby son, but is this significant to religious engagement with disability?
First, we must identify the limitations that emerge from a close reading of these narratives. Yong reminds his readers of the disability rights slogan “Nothing about us without us!” and emphasizes that it applies to religious discourse as much as anything else (Yong 2009, p. 70
). One problem is that each of these stories is a retelling of the experiences of a person with a disability by an able-bodied person. Although nurse–midwife Jennifer Worth and actor Sarah Drew provide detailed, thoughtful accounts of events they have witnessed for adaptation into television shows, both women are recounting someone else’s life story. That both of the narratives selected for analysis are about infants makes this problem somewhat inevitable; even an adult with a disability would be hard-pressed to recount the story of her own infancy with much accuracy.
Call the Midwife
has a more effective strategy than Grey’s Anatomy
for mitigating this problem of narrative authority, and it more successfully deploys adult characters, Jacob and Jane, to speak on behalf of the infant Douglas than do the writers of Grey’s Anatomy
for the infant Samuel. Jacob’s and Jane’s descriptions of St. Gideon’s are historically improbable, however. The reality of institutions created to, as one of the midwives says, house the “mental cases as well as incurables” (S2E3) is glossed over. Such institutions arose out of eugenicist policies designed to cull people with significant disabilities, the so-called “feebleminded,” from the reproductively active population and to permanently segregate them; while deaf and blind children were removed from their homes to be housed and educated rather than to be permanently segregated, the rationale made to their families was the same: they were a burden (Rose and Michel 2012, p. 242
). Call the Midwife
offers the gentlest possible depiction of such an institution, although it is clearly critiqued.
Although some adults with disabilities on Grey’s Anatomy help shape the narrative around the baby Samuel, a viewer who had not kept track of the character development of many different characters over the course of eleven seasons would not necessarily remember the disability narratives of Robbins, Bailey, and Edwards. Furthermore, none of those women speaks on behalf of Samuel. This eliding of adults with disabilities, not to mention adults with OI, makes the story less complex and accurate than it could have been, and the program fails to give voice to the experience of a person of any age living with OI.
The unfolding narrative in Call the Midwife also lacks a discussion of the prospects for Douglas Junior as he grows into childhood and perhaps adulthood. His family’s home has stairs; both of his parents have jobs. As his mother notes, he will need care. The degree of accessibility his world will have to offer is unclear, and although Nurse Lee’s voiceover affirms the goodness of his life very clearly and strongly, the viewer is left to wonder what happens to Douglas Junior and his family as he outgrows his pram and gets his first wheelchair: Will the family move as they had hoped? Will the new home have stairs? Can he go to school? While the newly created British public health system provides for his medical care, will his parents’ love and determination be sufficient to meet his other needs? Nurse Lee is reassuring, but details that might provide context for a political analysis of access are thin on the ground.
these stories add to a religious epistemology of disability? Again, our use of these programs for analysis of the bodily experience of people with disabilities is limited in part because each television episode is focused on an infant. While infants are constantly having new bodily opportunities, it is difficult to capture their firsthand reflections on these experiences. However, there are some important moments. Both narratives portray the acts of holding the baby and naming the baby as significant. This intimate exploration of the babies’ naming and their embodied contact with their parents recalls “the situated i of my disability” that Kivisild writes about (McRuer and Johnson 2014, p. 151
). Each child is situated within his family, his racial and class context, and his religious community.
In Call the Midwife, Ruby and Douglas’s baby remains nameless as they struggle to understand his diagnosis, as Ruby finds herself unable to respond to him emotionally, and while they consider placing him at St. Gideon’s. When she finally is required to pick the baby up, she reacts to his physical presence in her arms by refusing to take him down to the waiting car, by naming him loudly and deliberately after his father, and by naming him explicitly as her son. Although there is no scene of a baptism, the voiceover from Nurse Lee reassures the viewer that the baby was cherished “always,” suggesting that his parents’ love for him covered his life and his death, and hinting at their expectation of an afterlife. The family’s social class makes them vulnerable to the social system of institutionalization but also provides a community model of deep attachment to family. Sister Evangeline provides a maxim that the family is able to live out: Life is never without hope.
In Grey’s Anatomy,
April and Jackson discuss names as they prepare for the baby’s induction, and April decides to move forward with the procedure that will lead to the baby’s birth and death only after selecting a name for him. While the baptism is depicted with background music rather than dialogue, the two scenes together signify that the baby has been named and has been explicitly, ritually recognized as a child of God. After the birth, April tells Jackson as she is holding the baby, “He squeezed my finger…And then he let go” (Underwood 2015
). This very limited physical movement signifies some agency on the infant’s part during his short life; he sought connection and then released himself from it.
These depictions of physical touch between parents and children emphasize that although infants cannot speak for themselves, physical engagement can signify deep emotional bonds. In narratives where the infants are vulnerable to separation from their families (in one case by being placed in an institution, in the other by death), the image of a mother holding the baby close serves to stabilize his place in the family and in the community. Given the harm done by isolating people with disabilities geographically, socially, educationally, religiously, and in other ways, the strong refusal of that practice—holding the baby close and creating a place for him in the family—is a powerful one. Each mother has asked what role God has played in her situation, and the resolution of that question is connection: God has given this baby.
The naming scenes also remind the viewer that the act of selecting a name for one’s child is an affirmation of that bond and of the baby’s inherent value as a human being. While the idea that names are important and represent connection to family is hardly a disability-particular concept, within each story here, the personhood of the infant, somewhat tenuous at least in the case of Douglas Junior, is firmly and intentionally recognized by the parents. What does it mean to have a name and to be baptized? It means that a person is seen as both an individual and as part of a family. Each child is given a name that connects him to his father, and in each case this serves to underscore his identity.
Grey’s Anatomy also offers a complex depiction of the African-American Christian tradition as flexible, deeply spiritual, and practical; without sacrificing the notion of God who is all-powerful, Catherine provides a means for April to both affirm the God she believes in and take necessary steps to end the life of the child she loves. The plot arc both demonstrates the tensions between some Christian doctrines and the experience of disability and offers an account of faith that suffices for the situation, fosters community, and permits recognition of Samuel as beloved.
Both series also push against a concept of God as all-powerful and punishing. Both Yong and Halberstam explore the problems of seeking to fully understand the actions or nature of God. Yong cautions against too strong a doctrine of divine sovereignty that asserts that God is personally directing each event in a person’s life: “The problem arises…when people with disabilities are told by the nondisabled that their disabilities are part of God’s plan for their lives. It is one thing for an individual to come to accept his or her own disability as the result of God’s intentions, and embrace this as his or her own confession; it is quite another for others to be told by well-meaning and able-bodied people that God has basically chosen to inflict their disabilities for God’s own reasons” (Yong 2009, p. 58
). Halberstam, describing how disability shapes epistemology, uses language often invoked in religious discourse: he says a cripistemology “should identify modes of not knowing, unknowing, and failing to know.” He continues, “If conventional epistemologies always presume a subject who can know, a cripistemology will surely begin and end with a subject who knows merely that his or her ability is limited and that the body guarantees only the most fragile, temporary access to knowledge, to speech, to memory, and to connection” (McRuer and Johnson 2014, p. 152
). Surely the bodies of infants are capable of communicating this knowledge.
Each of these narratives presents an experience that also pushes viewers in the direction of unknowing: What will happen to Douglas Junior, and why was he born as he was? His family and his midwives do not know, but in the not knowing about his biology there is knowing about his identity. Why was Samuel born with OI? Why did April’s expected exchange with God, having faith in return for God’s blessing, go awry? She cannot know God in the way she thought she could. Samuel’s life and connection to his family are brief, and his inner experiences cannot be known. In this unknowing April names and baptizes and holds him.
Television is certainly not the only, and likely not the best, means to access disability-specific knowledge, about God or anything else. It is, however, a potentially disruptive locus for asking questions, telling stories, offering accounts of lives, real and imagined, that are overlooked or regarded as inconsequential elsewhere. Insofar as people with disabilities and their families, friends, classmates, and coworkers watch television—and they do (U.S. Department of Labor 2017
)—television programs offer the chance to think about, discuss, critique, and meditate on the lives of others and their particular experiences and insights. They are often, as in these two cases, worth our consideration.