In my work at the Medical Center, I have witnessed the ways that policies in place due to the COVID-19 pandemic can have a more negative impact on those who have physical or cognitive disabilities, especially those whose disability may not be immediately obvious on sight.

I recently encountered a patient who was rightfully angry about the way that the policy exceptions had not been applied to her. The policy states that no patients coming to an outpatient visit may bring a visitor or companion except by the discretion of the provider. In addition, there are several standard exceptions in place. According to policy, an exception can be made for “One (1) adult to accompany the patient if physical or cognitive disability impacts their capacity to effectively participate in their medical care.” It goes on specifically to say that those who rely on a caregiver for activities of daily living may bring a caregiver with them.

This patient falls under this category, but had been repeatedly told that her caregiver was not allowed to accompany her. I went to the Medical Center’s website to see how easy it was to find the visitor exceptions and how to proceed if one were to try to get in contact with someone to make sure that they would be allowed to have the assistance that they needed and were entitled to. It takes a series of five clicks to get to the policy from the homepage of the Wexner Medical Center. Here is the visitor policy in its current form if you are interested: https://wexnermedical.osu.edu/features/coronavirus/patient-care/visitor-policy

This policy impacts every patient equally, but not equitably. Some people just want to have someone with them for their visit, and some need someone with them for their visit

Simply having a policy in place doesn’t do much good if those who are enforcing the policy do not have full knowledge of the policy, and if they are not asking the right questions. Sometimes it is very obvious that a person coming for an appointment will need assistance, but other times, it is not. In the case of this woman, I would have no way of knowing what kind of assistance she would need without asking her, and I am glad that she advocated for herself.

People with disabilities deserve to have the assistance they need to keep their healthcare productive. For this patient, this issue was a huge source of stress and anxiety about not being able to get around well enough or participate fully in her visit with the doctor. I would like to see better awareness of the policies and better conversations with patients from those who are enforcing the policies. I would like to see the doctors who care for patients who need assistance giving them the information that they need. I would like the signs and information on the website to be clearer and simpler to navigate, so that people like this woman can be sure of their rights and advocate for themselves or have their caregiver do so if necessary.

It is important for healthcare workers to learn ways to make healthcare more accessible for those who have physical and intellectual disabilities. A lack of equitable access to healthcare is not a new issue for persons with disabilities. In the video posted below, we see one of the ways that healthcare providers are trained to narrow the equity gaps for patients with disabilities.

I like this video because Mark, a man with a disability, is getting to invest in making the system work better and is making his voice heard. I think of de Beauvoir’s definition of the Other. Those with disabilities are too often defined by the ways that they are different from those who don’t have a disability. I would rather see them being defined by their worth as human beings and their equal rights to respectful and effective healthcare. I would like to see more healthcare organizations bringing people with disabilities to the table, to have influence in policies that may impact them more deeply than people in other demographics.

Here is another link that provides information on how COVID-19 is widening the equity gap for those with disabilities seeking healthcare: https://www.sideeffectspublicmedia.org/post/covid-19-makes-life-even-more-challenging-people-disabilities

Reading about Gayatri Chakravorty Spivak, the word that kept coming to mind was “badass.” A more professional description of her would be a founding member of the Institute for Comparative Literature and Society at Columbia University, which is where she currently is a professor. She was born in Calcutta in 1942 and received her MA in 1959 from the University of Calcutta. Spivak proceeded to study at the University of Cambridge and Cornell University, where she earned her Ph.D in 1967.

Her first major work was Of Grammatology, which is an English translation of De la grammatologie, a work by Jacque Derrida, a French deconstructionist philosopher. Deconstruction is an area of philosophical and literary analysis in which false dichotomies in theories are dismantled, not necessarily to destroy them, but to point out the power differential assumed by the interpretations presented. The LA Review of Books, in a 2016 article about Spivak defines the purpose of deconstruction in this way: “to unpack the relationship between text and meaning and critique the hidden biases of the Western intellectual tradition.” When she began this translation she was a young, unknown female scholar from India, pushing through self-described intellectual insecurity in order to complete an ambitious project that she didn’t quite seem qualified for. This translation, along with her translator’s preface became widely read and propelled her career forward. When asked why she chose such a difficult and, at the time, unknown work to translate, she responded, “Well, I didn’t know who Derrida was at all. I was 25 and an assistant professor at the University of Iowa in 1967, and I was trying to keep myself intellectually clued in. So I would order books from the catalog which looked unusual enough that I should read, so that’s how I ordered the book.”

See? Badass! I love that desire to face a challenge head on, not allowing fear to dictate what can be accomplished academically. I love that she knew she had something to offer as a young Asian woman, and just went for it. In her own words, she put it this way, “So I thought, “Well, I’m a smart young foreign woman, and here’s an unknown author. Nobody’s going to give me a contract for a book on him, so why don’t I try to translate him?” And I had heard at a cocktail party that the University of Massachusetts Press was doing translations, so I wrote them a very innocent query letter in late 1967 or early 1968. They told me later that they found my query letter so brave and sweet that they thought they should give me a chance. [Laughs.] It’s really ridiculous, but there it was.” (Paulson)

Her most famous work is the one which we are reading for class, Can the Subaltern Speak? This is an important contribution in the area of postcolonial studies, a movement of which she is considered a founder. She was in the first generation of Indian intellectuals in the post-colonial era, so this is a part of her personal and intellectual heritage. In this piece she focuses on which groups are not heard in the telling of history, and why. She emphasizes the necessity of not just boiling down a group of people based on characteristics that are defined by the Subject, thus always keeping one group defined by the one in power, or the one “with a voice,”

Spivak is not only a respected professor and writer, she also is an activist. She is deeply invested in efforts to bring literacy and democratic principles to rural schools in India, educating both students and teachers. She travels to India for this purpose eight or nine times a year and keeps in contact with the teachers in between visits.

“Deconstruction.” Encyclopædia Britannica, Encyclopædia Britannica, Inc., 12 Dec. 2019, www.britannica.com/topic/deconstruction.

“Gayatri Chakravorty Spivak.” Columbia Global Centers, globalcenters.columbia.edu/content/gayatri-chakravorty-spivak.

“Gayatri Chakravorty Spivak.” Encyclopædia Britannica, Encyclopædia Britannica, Inc., 20 Feb. 2020, www.britannica.com/biography/Gayatri-Spivak.

Mani, B. Venkat. “Gayatri Spivak.” Presidential Lectures: Gayatri Spivak, 2000, prelectur.stanford.edu/lecturers/spivak/.

Paulson, Steve interviews Gayatri Chakravorty “Critical Intimacy: An Interview with Gayatri Chakravorty Spivak.” Los Angeles Review of Books, 29 July 2016, lareviewofbooks.org/article/critical-intimacy-interview-gayatri-chakravorty-spivak/.