An overwhelmed health care system’s triage may discriminate against people with disabilities

The Atlantic states that people with disabilities may face not only “overt discrimination” in hospitals, but “implicit bias” from a prejudice about their quality of life.

As the philosopher Nietzsche remarks below, in times of stress, an eliminationist attitude residing in some of the mainstream rises to the surface.

Elaine Godfrey:

Daniel Florio … was born with spinal muscular atrophy, a genetic disorder that makes him unable to walk or use his arms. His disability makes him more vulnerable to the virus than most people, and he’s afraid of what will happen if he ends up in the hospital with a serious case. Intubated people cannot speak, and Florio would not be able to use gestures or otherwise communicate with his doctors. Given infection-prevention rules, his caregivers would likely not be allowed to accompany him.

She adds:

But Florio is afraid of something else too: the possibility that, if he contracts the virus, he could be denied lifesaving treatment because of his disability. And like other Americans with disabilities, he worries that could happen not just because of overt discrimination in hospitals, but also because of implicit bias. “People overwhelmingly believe that being disabled implies a worse quality of life than it does,” Florio said. If doctors act on those beliefs—wittingly or not—“what that means in practical terms is that people like us will die.”

In some states’ policies it appears that people with disabilities do not have an equal right to life in comparison with the mainstream:

Washington’s guidelines include considerations about a patient’s “baseline functional status,” which involves factors such as physical ability and cognition. … The Washington health department told me it’s updating its guidelines to make sure “its original intent of nondiscrimination” is “unequivocally clear.”

This bears uneasy resemblance to the presuppositions of eugenics advocates, and of proponents of the Will to Power who said that “in a certain state it is indecent to go on living.” The Antichrist declares, “The weak and ill-constituted shall perish: first principle of our philanthropy. And one shall help them to do so.”

Under the pandemic, a re-evaluation of “disability”

A Facebook post:
Things Covid has proved:

1. The job you were told couldn’t be done remotely can be done remotely 
2. Many disabled workers could have been working from home, but corporations just didn’t want them to 
3. Internet is a utility, not a luxury 
4. Universal healthcare is necessary 
5. Homelessness can be solved when it can affect the rich 
6. Childcare isn’t “doing nothing all day.”
7. Universal Credit is not enough to live on 
8. Wages have nothing to do with skills or value from fruit picker to nurse

Note No. 3

“Thank you for calling me out and giving me this opportunity”

I once went to a local comedy act and the comedian referred to me in front of the audience. I waved him off, feeling very uncomfortable, and the woman with me said, “Don’t be hostile.”

Here’s possibly a better response.

The disabled person could stand up, and say, “I’m glad you called on me, because I’m an advocate for the civil rights of the disabled. We were left out of the civil rights revolution. Hardly anyone thinks we are in a protected class, although we get targeted all the time.

“There’s even a special derogatory catch-phrase for people like me: ‘I don’t care if it harelips the Governor.’ So please remember, we have exactly the same rights as everyone else, even if social events like this don’t act like we do. Sir, thank you for calling me out and giving me this opportunity.”

Was the greatest play of the classical era about a disabled person?

“Nor is that other point to be passed over, that the Sphinx was subdued by a lame man with club feet …” - Sir Francis Bacon, referring to Oedipous (“Swollen Foot”) and the Sphinx.

Oidipous Tyrannos (Oedipus Rex) can reasonably be translated, from Bacon’s perspective, as Clubfoot the Ruler. It then joins such dramas as The Hunchback of Notre Dame and Beauty and the Beast, in which a titular character may be expected to wrestle with their disability in the plot.

Disabled people, as we know, are often treated badly. Oidipous’ parents arranged to have him “exposed,” to die.

A disabled Prince so mistreated might, in royal wrath, take gruesome retribution on those who wronged him. In Sophocles’ tragedy, Oidipous kills his father and entangles his mother in incest.

Aristotle’s pioneering work of literary criticism, The Poetics, treats Oidipous as Everyman, arguing that we undergo his extreme experiences vicariously, as “fear and pity.” We return to our everyday lives purged, a “catharsis” in which our spirits are temporarily uplifted out of their dreary banality.

In this disability tale, things are made better; that which was lost is found.

Sadly, two millennia of mainstream lit crit fail to deal with the great moral fact of the play: Oidipous’ parents tried to kill him when he was a helpless baby.

/*****/

A dramatization of this theme, This is the Son of Kings, was published in this blog in 2013.

Two boys with the same disability tried to get help. The rich student got it quickly. The poor student did not.

For many people having disabilities, inaccessibility to necessary services is denial of service. The 1975 Individuals with Disabilities Education Act provides for placement at a private school at public expense if public schools can’t address a learning disability. But obstacles often limit this to wealthy families having above-average resources.

Mike Elsen-Rooney, The Teacher Project: “Two boys with learning disabilities grew up just blocks apart in New York City. Public schools couldn't teach them. So their parents battled to place them in private schools, on the taxpayers' dime.”

For the two dyslexic students below, receiving the revised education they need would enable them to make the contribution to society they were capable of.

For both boys, the struggles at school started in the first grade.
Isaac Rosenthal was a fast talker with a big vocabulary. But when it came time to read, he couldn’t keep up with his classmates. He didn’t pick up on the rhyme scheme in Dr. Seuss books, and often mispronounced words whose meaning he knew (like “Pacific,” for which he’d substitute “the other ocean”).
Landon Rodriguez, four years younger than Isaac, was energetic and talkative at home but quiet and withdrawn at school. When he brought home reading assignments, Landon often confused Bs and Ds, and he labored through even short passages.
By the end of that seminal school year, both of their parents knew that something was wrong. In  second grade, each boy was diagnosed with an unspecified learning disability and started receiving special education services at their public schools. “The teachers had no clue how to teach him,” said Debbie Meyer, Isaac’s mother.
Both families ultimately realized their sons needed support the public schools could not provide, particularly when it came to the all-important task of teaching them to read.

“Who gets private placement? White, wealthy families.”

When Congress passed the landmark Individuals with Disabilities Education Act in 1975, guaranteeing children with learning disabilities a “free and appropriate education” for the first time, it built in the private placement safety net for parents. In some cases, public school officials acknowledge they can’t accommodate a student and agree to pay tuition at a private school. But sometimes families must sue the school district in order to get the tuition covered.

The situation in New York: “Thirty percent of the almost 3,000 students the city recommended for state-approved private schools last year were white, even though white students make up less than 15% of the city’s special education enrollment, state data show.”

Disability forms may not state correctly what qualifies as disability

I have been asked to fill out a “Disability Status Certification” by the 55+ apartment complex where I live. It says “‘Disability’ is defined as a physical or mental impairment that substantially limits one or more of the major life activities of an individual, such as not being able to care for oneself, performing manual tasks, walking, seeing, hearing, speaking, breathing, or learning.”

I added, “or a person who is perceived by others as having such impairment.” HUD.gov*

At the bottom of the one-page form I wrote:
(*) “This document stresses access disability. FHA.gov links to HUD.gov, which includes negative perception — stigma/social bias, which is the operative factor in my case.”

Last September, in Your landlord may not realize that the Fair Housing Act applies to such disabilities as cleft palate, the post notes that the person interviewing candidates for the housing complex appeared not to be aware that supervising Federal agencies such as FHA, HUD, ADA, and DOL regard physical conditions which affect appearance as qualifying disabilities.

Policy towards the stigmatized disabled such as those with Cerebral Palsy or Cleft Palate

[This is an unfinished draft of an email to an official of the 55+ apartment complex where I live, concerning disability discrimination that masquerades as normal social interaction. (As discussed previously in TPOCP, the civil rights revolution has not yet happened for disabled people; mainstream society usually turns a blind eye to disability discrimination; and many in the mainstream are often clever at contriving subtle forms of discrimination that appear to be deniable.)]

Manager:

I am a recent new resident of [your 55+ apartment complex] who has a cleft palate. While you were helping me fill out the application forms I answered the question, Are you disabled according to FHA criteria. An FHA website said people impaired in a major life function, one of which was ’speaking,’ are considered disabled, so I checked ‘disabled.’

A related HUD site used criteria similar to those at ADA.GOV, ‘impaired in a major life function, … or perceived as such,’ (emphasis added) thus including the stigma or prejudice of being perceived as disabled or defective (as in ‘birth defect’) among the criteria.

In order to participate in the life of the [apartment complex] community, I participated in a small group which plays Scrabble in the Community Room on Thursdays. Another group, which as I recall plays Pinochle, also uses the CR at the same time. In one of the games after Thanksgiving, I remarked on a couple of Scrabble linguistic peculiarities, something like ‘gript’ for ‘gripped,’ and not allowing other common inflections such as ’ing’ or ‘ed.’ The game finished. Suddenly the person who sets up the board and and puts it away left, saying they would come back after checking their pet, and close up.

Everyone else left, so I stayed, covering for the leader. After waiting quite a while I asked the Pinochle people, who were still playing, if the Scrabble game went on a certain shelf. By this time I was feeling embarrassed. Obviously something unusual had happened, and it focused negative attention on a resident who has a stigmatizing disability.

Before the next scheduled game I realized that it looked like I had been discredited and probably couldn’t continue participating in the game, so I haven’t.

My disability has its own defamatory tag line, ‘I don’t care if it [h-words] the governor.’ If the governor, after a lifetime in the mainstream, improbably woke up one morning with a cleft palate, they would find that repeatedly, what masquerades as normal social action turns out to marginalize, exclude, and disenfranchise them from the social groups that constitute our lives: the family, the classroom, the workplace, and the diversions of retirement.

Your landlord may not realize that the Fair Housing Act applies to such disabilities as cleft palate

Recently I, assisted by my oldest son, was applying for an apartment in a 55-and-older complex which provides both subsidized and marketplace rate housing. In one of the many documents was a checkbox, Qualified as disabled under the Fair Housing Act (which applies to "federally-assisted housing programs and activities"). I asked the person administering the application process if people with cleft palate qualified as disabled under the FHA. They said they thought those with a cleft weren't. I asked, Do you mind if we look it up?

We found that the following section of the Fair Housing Act clearly includes cleft palate among the recognized disabilities - 1. “speech and hearing impairments”; 2. “Federal nondiscrimination laws define a person with a disability to include any (1) individual with a physical or mental impairment that substantially limits one or more major life activities … Major life activities include … speaking … or … (3) individual who is regarded as having such an impairment.” [(3) covers the stigma of cleft palate, discriminatory presuppositions about birth defects, or responding to a visible disability by attempting to demean, degrade, or intimidate the person who has a disability.]

An earlier post, The Rights the Disabled Have under Section 504 of the Rehabilitation Act of 1973, notes that in most cases if the local or state government program you are using (such as a public university, or public transit) receives Federal money in any of its activities, it is required to follow Federal civil rights rules regarding the disabled.

An important decision overturned was a case where the Court interpreted Section 504 as meaning that only clients of the departments of an entity which actually received federal funds had protection from disability discrimination. Under current law, because of the CRRA, protection applies to the entire agency. If a college's engineering department receives federal funds, students in the English department are also protected.

FHA Main:

Federal nondiscrimination laws provide housing protections for individuals with disabilities. These protections apply in most private housing, state and local government housing, public housing and any other federally-assisted housing programs and activities. The Fair Housing Act prohibits discrimination in housing and housing-related transactions because of disability. Section 504 of the Rehabilitation Act prohibits discrimination on the basis of disability in any program or activity receiving federal financial assistance. Titles II and III of the Americans with Disabilities Act prohibit discrimination on the basis of disability in all programs, services, and activities of public entities and by private entities that own, operate, or lease places of public accommodation.

The applicable passage:

Federal nondiscrimination laws define a person with a disability to include any (1) individual with a physical or mental impairment that substantially limits one or more major life activities; (2) individual with a record of such impairment; or (3) individual who is regarded as having such an impairment.

In general, a physical or mental impairment includes, but is not limited to, examples of conditions such as orthopedic, visual, speech and hearing impairments, cerebral palsy, autism, epilepsy, muscular dystrophy, multiple sclerosis, cancer, heart disease, diabetes, Human Immunodeficiency Virus (HIV), developmental disabilities, mental illness, drug addiction, and alcoholism.

Some impairments are readily observable, while others may be invisible. Observable impairments may include, but are not limited to, blindness or low vision, deafness or being hard of hearing, mobility limitations, and other types of impairments with observable symptoms or effects, such as intellectual impairments (including some types of autism), neurological impairments (e.g., stroke, Parkinson’s disease, cerebral palsy, epilepsy, or brain injury), mental illness, or other diseases or conditions that affect major life activities or bodily functions.

The term “major life activities” includes those activities that are important to daily life. Major life activities include, for example, walking, speaking, hearing, seeing, breathing, working, learning, performing manual tasks, and caring for oneself.

Commentary: Under the FHA, the community in, for example, a retirement community, is not allowed to reject a person having a stigmatizing disability, such as a birth defect, on the basis of that birth defect, any more than that same community would be allowed to reject a person of color, on the basis of dislike of people of color. Public sentiment is not a sufficient reason to deny any person the Fourteenth Amendment’s guarantee of equal protection of the laws.

This all-too-common disability incident responded to because of viral video

This, it seems, is how the story starts. Joshua Bote:
“"At this point, it is believed that the victim was invited out by some girls who are so-called 'friends' who are eventually the offenders in these disgusting incidents," [Jose] Jara said.”

What did the mainstream offenders instigate?
“"There were some things going on that these young ladies wanted her to do that she didn't," said police superintendent Eddie Johnson in a news conference before trailing off. "We'll leave it at that for right now."”

How did it actually get noticed?
USA TODAY: “Chicago police are investigating an assault after a video claiming to show a brutal attack on a teenage girl with disabilities went viral.”

What action was taken?
“Police spokesman Anthony Guglielmi told USA TODAY Thursday that two of the suspects are charged with aggravated battery, a felony. One was charged with mob action. The girls, who remain unidentified, are 13, 14 and 15.”

A common story. Mainstream people see a person with a disability, and because that person has a real or perceived disadvantage, somehow feel entitled to take liberties. If the “misfit” doesn't cooperate in being publicly degraded and humiliated, they are a bad sport. Can't take a joke. Offends the community and deserves to be punished.

Only difference, this time: Viral video, police can't dismiss it, and with the public eye on them, investigate.

America's largest minority, according to the Department of Labor and the ADA.

Still doesn't have its Brown v. Board of Education, its own landmark civil rights case.

Still doesn't know, when its members go about their daily business, if this is one of the days when there will be an incident.

A Partial List of the Disabled Among Us

(See analysis of social attitudes toward disabled characters at end.)

Stephen Hawking, first rank physicist, Amyotrophic lateral sclerosis (Lou Gehrig's disease).

Oidipous Tyrannos, mythical star of the greatest drama (Oedipus Rex) of classical antiquity, talipes equinovarus (club foot).

"Nor is that other point to be passed over, that the Sphinx was subdued by a lame man with club feet …" - Sir Francis Bacon, Novum Organum

A reasonable translation of "Oidipous Tyrannos," following Bacon’s interpretation, is "Clubfoot the Ruler." When a drama has a name of this form, as with "The Hunchback of Notre Dame" or even "Beauty and the Beast," there is a certain hint as to how the plot will go.

Franklin Delano Roosevelt, the 32nd President. A polio survivor, he adroitly concealed that he could barely walk.

Michael J. Fox, who continued his acting career after he developed Parkinson's.

Michael Kinsley, founder of Slate Magazine, Parkinson's.

Helen Keller, blind and deaf.

John Nash, mathematician, schizophrenia.

See movie, A Beautiful Mind

Christy Brown, author, Cerebral Palsy.

See movie, My Left Foot

Demosthenes, classical era orator, stammer.

Vincent Van Gogh, painter, psychiatric illness.

Beethoven, composer, deaf.

Ray Charles, singer, blind.

Stevie Wonder, singer, blind.

Marlee Matlin, actress, deaf.

Peter Dinklage, actor, dwarfism.

Joaquin Phoenix, actor, cleft palate.

Jürgen Habermas, philosopher, cleft palate.

Stacy Keach, actor, cleft palate.

Flanner O’Connor, author, lupus.

Robert Pirsig, author, schizophrenia.

Sartre, philosopher, strabismus (exotropia).

Saul of Tarsus (the Biblical Saint Paul), had a “thorn in the flesh,” which was not described.

Sherman Alexie, author, hydrocephalus

Implied fictional disabled characters (other than Oidipous):

Beauty and the Beast

Boo Radley of To Kill a Mockingbird, psychiatric illness.

Of Mice and Men (Lenny Small, limited intelligence)

The Hunchback of Notre Dame

Tiresias in Oidipous, blind.

Forrest Gump (Crooked spine, I.Q 75)

Cyclops ("Circle Eye," i.e., One Eye)

Captain Hook (Missing hand)

Tiny Tim (possibly renal tubular acidosis (type 1), or rickets)

... And many more.

-*--

Apposite comments from the National Council of Teachers of English:
Are disabled people “pitiable, helpless, evil, super human, magically cured at the end, or dead?” Or are they complex individuals who enjoy their lives and have the same values, hopes, and aspirations as the mainstream?

Patricia Dunn:

Whether students are disabled or non-disabled themselves, they absorb impressions about characters like or unlike themselves from the books they read for school. So when they read books that feature characters with disabilities, what messages are they getting about disability? Does the story reinforce negative stereotypes (that disabled people are pitiable, helpless, evil, super human, magically cured at the end, or dead)?  Or does the text challenge negative stereotypes in its depiction of characters with impairments by showing that they are complex individuals, that they enjoy their lives and are as “normal” as non-disabled people, and that they have agency and voice?

She adds:

Works such  Johnson’s Accidents of Nature, Orr’s Peeling the Onion, and Alexie’s True Diary, written by authors with disabilities similar to those of their protagonists, depict these characters as fully developed individuals with agency, voice, and a critical attitude toward  their ableist societies.

Disabled people are America's largest minority, according to the Department of Labor and the website of the Americans with Disabilities Act. As well, a significant number of mainstream people will be disabled in later years, such as former President George H. W. Bush, wheelchair-bound in his last years. Disabled people are widely distributed among us; are powerful symbolic themes in some of our greatest works of literature; and are, in the final analysis, us.

Online hate against disabled people rising in England

Amy Walker, today, writes:

The charity [Leonard Cheshire, a health and welfare charity] called on global media companies, including Facebook, to take online disability hate crime more seriously and to protect users. It supported recommendations from MPs for government and social media companies to directly consult disabled people on digital strategies and hate crime law.

According to the report, online offenses are increasing, are under-reported, and disabled people are sometimes reluctant to speak out. Those who are targeted do not get social support; and those who discriminate against disabled people suffer no social consequences:

Neil Heslop, the chief executive, said: “Police are increasingly recording online offences, but we know it remains an under-reported area and that disabled people may have reservations about speaking out.

“We suspect many crimes remain under the radar, with survivors never getting support and perpetrators facing no consequences.”

The effect, Heslop said, can cause disabled people to experience stress and isolation. Mocking remarks and hurtful comments demean, degrade, and humiliate people with disabilities, lower their quality of life, and cause them to have “reduced life chances.”

Hate crimes against disabled people could lead to long-term fear, anxiety and isolation.

Janine Howard, who was supported by the charity’s advocacy services after experiencing online abuse, said: “People I don’t know take my photograph when I am out and about, they post it on social media for others to comment on.

“The comments are nasty, hurtful and leave me feeling frightened and angry. There is no escaping this online abuse if I want to use social media.”

A casebook on disability: Facial disfiguration

The first selection notes that in discussions of those whose civil rights are commonly violated, disabled people or often left out.
Jonathan Allen, on the deep divisions exposed by the fight over Rep. Ilhan Omar, in the form of “the list of groups targeted by hatred”: “Rep. Doug Collins, R-Ga., [noted] that Wiccans, Mormons and disabled people had been left out.” (Emphasis added)

Neil Steinberg, on the human discomfort occasioned by disfigured faces:

Disfigured faces can provoke a fear reaction, leading to bullying and other social tyranny:

Fear of people with facial disfigurements is a common phobia, yet, unlike other fears -- of height, of water, of the dark -- it is seldom discussed, perhaps because so much popular culture, from The Iliad to Saw V, pivots upon this fear. Perhaps it is assumed: of course you are afraid of the man without a face. Who wouldn't be?

Or perhaps because, unlike fear of high places, water or the dark, teratophobia -- fear of disfigured people or of giving birth to a disfigured baby, literally 'fear of monsters' -- has a living object: the injured, burnt, unusual-looking people themselves. Drawing attention to the flinching reaction they often receive, the stares and mockery that are a routine part of their daily lives, can seem an additional cruelty, the sort of vileness enjoyed by schoolyard bullies.

Identifying friend and foe has been a survival skill. A disfigured face, perhaps not seeming human at all, can trigger an instinctive fear:

Why are distorted faces so frightening? Freud classified certain objects as 'unheimlich,' a difficult-to-translate word akin to 'uncanny': strange, weird, unfamiliar. Waxwork dummies, dolls, mannequins can frighten us because we aren't immediately sure what we're looking at, whether it's human or not, and that causes anxiety. A surprisingly large part of the human brain is used to process faces. Identifying friend from foe at a distance was an essential survival skill on the savannah, and a damaged face is thought to somehow rattle this system. ...

The psychologist Irvin Rock demonstrated this in his landmark 1974 paper 'The perception of disoriented figures.' Rock showed that even photos of familiar faces -- famous people like Franklin D Roosevelt, for instance -- will look unsettling when flipped upside down. Just as, if you tip a square enough it stops being a square and starts becoming a diamond, so rotating a face makes it seem less like a face. The mind can't make immediate sense of the inverted features, and reacts with alarm. A bigger change, such as taking away the nose, transforms the face severely enough that it teeters on no longer seeming a human face at all, but something else.

The author himself, who thought he was prepared, experiences “horror”:

That isn't a theoretical example picked out of the air. On another visit to the Craniofacial Center, I enter Seelaus's examination room to be introduced to a patient. He turns in the chair, and is missing the middle part of his face. There are four magnetic posts where his nose will go, and below it, a void revealing smooth yellow plastic. My eyes lock on his eyes, I shake his hand and say some words.

A half-hour later, standing on the elevated train platform, I still feel ... what? 'Harrowed' is the word that eventually comes to mind. Why? There was no surprise. I'm no longer a child but an adult, a newspaper reporter who has spent hours watching autopsies, operations, dissections in gross pathology labs. I was expecting this; it's what I came here for. What about his face was so unsettling?

Maybe seeing injured faces compels an observer to confront the random cruelty of life in a raw form. Maybe it's like peeling back the skin and seeing the skull underneath. Like glimpsing death. Maybe it touches some nameless atavistic horror. ...

Randall H James was born in Ohio in 1956. His first surgeries were done over the next couple of years at Cincinnati Children's Hospital by Dr Jacob Longacre, a pioneer in modern plastic surgery.

The teachers assumed I must be stupid.

Randy James, doctor

Our instincts often betray us into making an “automatic connection between inner person and outer appearance”:  “A disfigured person is a retard”:

"He was like a second father to me because I saw him so much," says James, who didn't celebrate a Christmas at home between the ages of 3 and 13. School holidays were for operations. Summers too.

When little Randy began school, his teachers in the city of Hamilton made a common mistake, the sort of automatic connection between inner person and outer appearance that has been the default assumption since history began.

"The teachers assumed I must be stupid," says James, who was put in a class with children who had learning disabilities -- until teachers realized that he was actually very bright, only shy, and missing an ear, which made it harder for him to hear. He was allowed to sit in the front of the room, where he could hear the teacher, and his grades soared. ...

The disability version of the Heckler's Veto: “You might make the students nervous”:

As a student at the University of Kentucky, James applied to be a residence hall adviser, someone who assists other students in navigating dorm life. The supervisor who rejected him candidly told him that his odd-looking ear could put others off.

"'You might make the students nervous,'" James recalls him saying, then paused, the pain still obvious after 40 years. "These were my classmates."

In the past, disfigured people were often subject to genocide: “A couple hundred years ago, people born with craniofacial conditions, they were just putting them in a bucket of water”:

We are a society where people thrive or fail -- in part, in large part -- because of appearance. The arrangement of your features goes far in deciding who you are attractive to, what jobs you get. Study after study shows that people associate good looks with good qualities, and impugn those who aren't attractive. Even babies do this, favoring large eyes, full lips, smooth skin. Billions of dollars are spent on plastic surgery by people who are in no way disfigured, just for that little extra boost they feel it gives to them, gilding the lilies of their attractiveness.

How do people with unusual appearances fit into such a world? For most of recorded history, children born with disfigurements were wonders, portents or punishments. If they were allowed to live. "A couple hundred years ago, people born with craniofacial conditions, they were just putting them in a bucket of water," said Dr David Reisberg, an oral plastic surgeon at the Craniofacial Center.

“Those that we call monsters are not so to God”:

But even then, astute observers saw beyond externalities. Michel de Montaigne in 1595 encountered a child conjoined to the half-torso, arms and legs of an undeveloped twin (what we would now call a parasitic twin), displayed by its father for money. Montaigne noted: "Those that we call monsters are not so to God, who sees in the immensity of His work the infinite forms that He has comprehended therein."

“With malice toward none, with charity for all,” said our kindest president.