#Thalidomide caused a massive upswing in certain types of disabilities

[majuuorthrus]

Also, many technological 'cures' would still require regular checkups and cause problems. Like, modern pacemakers are pretty durable, but they may need repairs and adjustments. Metal replacement joints set off metal detectors.

Even in Star Trek, we see Dr Crusher checking on Geordi's implants that make his VISOR work in a couple of episodes. Picard's mechanical heart failing was the inciting incident of Tapestry.

I'd imagine that, for example, if I had an artificial pancreas to treat my type 1 diabetes, it would be less hassle and more freedom, but I would still have to monitor my blood glucose and such because that's the best early diagnostic. And if it failed, I would have to use injected artificial insulin until it could be repaired.

Also, these pseudo-magical treatments might take great skill and specialist equipment to carry out. Even in a society with free at point of use healthcare, this would cause waiting lists. People with such conditions would need treatment, equipment, and accommodations to minimise symptoms and reduce any chance that their condition will get worse whilst waiting.

The treatment also might not be a cure, merely a reversal of damage. If the treatment works and doesn't have excessive risks or side-effects, someone might consider it worth it for relieving their symptoms, but the symptoms will most likely come back years later and require both management and potentially, further applications of that treatment.

There is also secondary disability. For example, my dad is tetraplegic, and has been for about three decades. If someone invented a way of fixing a broken spinal cord, it wouldn't 'cure' him - his muscles are weak from disuse. It might have some benefits, such as making his condition easier to manage and reduce the risk of further complications, but he'd probably still be a wheelchair user for the rest of his life.

There are also people whose bodies are not compatible with certain treatments - allergies, weird metabolism of certain drugs, etc. If there is only one or two formulas for a 'magicure', then anyone whose body is not compatible with that formula will remain disabled.

Finally, if this future setting still has capitalism or similar, there is also the problem of 'what happens when the company making your treatment implant goes bust or gets bought out or stops supporting your implant'. This is already a problem in medical settings - hospitals often keep a few computers running on old OSes so they can use the older version of software for their equipment, which works perfectly fine but newer versions of the software aren't compatible with that model. They can't afford to buy a new, $300k+ MRI machine every decade, when the old one still works but the company making it has decided to not make software for it. Unfortunately this is a data security risk.

Extrapolating from this... I really don't want to risk having my pancreas hacked. I'll stick with my mechanical insulin pens, thank you.

Futuristic Settings and the Erasure of Disabilities

The common theme in a lot of futuristic, sci-fi or not, settings, is the abundance of cure tropes that are thrown in there. Disabled people either don't exist, or aren't actually disabled - they get a magical device that undoes their injury, or get a mech suit that basically does the same thing.

Often the setting is treated like an excuse that can't be rebutted in any way: “but my story is set in the future where medicine is better!”

So: is that true? Does better medicine actually mean less disabled people?

Historical Accuracy

[large text: Historical Accuracy]

In 1900, the life expectancy of a person born with Down syndrome was 9 years. Try putting yourself there and imagining that 2024 is the Future - better medicine, basically sci-fi in comparison to what they had back there. In that future, what is true?

a) There's no people with Down syndrome.

b) People with Down syndrome live to be 60 years old on average.

Answer? B. The only countries with fewer people with Down syndromes are the ones engaging in widespread eugenics, which is a topic I will not be getting into in this post, but I'm mentioning because the only places without disabled people are eugenicist.

The “better medicine” of the future didn't make Down syndrome curable, it made people with it survive longer. 50% of people born with it today will live to be over 60 years old. In the future, there will be retirees with Down syndrome. In the past, 50% of them wouldn't have made it into their teens.

Why does that matter?

[large text: Why does that matter?]

Future medicine won't make disabilities disappear. It will make them more manageable. Less deadly. Easier to survive.

If you base your knowledge and perception of disability throughout the times on sci-fi novels by able-bodied writers, you're going to hate how it actually works in real life.

Have we magically- technologically gotten rid of diabetes? No, 11% of Americans have it. 103 years ago, diabetes were lethal. There aren't fewer diabetics compared to the past. They live longer. You probably know or heard of someone who has diabetes.

You need to expand your understanding on how disability and medicine work, because “future = no disability” is genuine nonsense. It doesn't work like that, and it really frustrates me how writers dead-set on “logic” in their setting fail to see this.

Are paralyzed people walking around in various mechs, or are they using better wheelchairs than those from 100 years ago? Wheelchairs that make it easier to be independent? That help with symptoms of their disabilities by preventing pressure sores, or providing alternative methods of maneuvering?

In the future, why would there suddenly be those futuristic transplant* spines instead of wheelchairs that can be used with one's brain or eyes, for those who can't move their hands, mouth, or head? Why wouldn't there be wheelbeds for those who are currently bed-bound because they can't manage being upright in any way?

*Also, how are all of these magic disability-fixing transplants never actual transplants? Receiving a transplant basically always ends up in being immunocompromised because of the very way the body works. If you're writing about humans, this isn't going to change?

Things like sign language or wheelchairs have been used for thousands of years, they're not going away anytime soon or not-so-soon.

Future = More Disabled People?

[large text: Future = More Disabled People?]

We already discussed that there are presently common disabilities that used to be lethal a century ago or even less. If we use this fact for a futuristic setting, you suddenly have a myriad of new possibilities.

There's vastly better medicine? A lot of people deal with post-rabies syndrome because it's finally survivable, but it leaves people with the effects of the meningitis that rabies cause. There's way more quadriplegic people because the survival rates are much higher. Cancer survivors are more common because people live longer. Physical therapy for people who had prion diseases because they aren't fatal anymore but cause severe disability. Head trauma is more treatable, so there's more people with TBIs and less people dying in vehicular accidents.

The technology is super advanced? People with locked-in syndrome can operate an AAC device with their eyes, fully customize its voice to their liking, and not have to worry about battery life of their powerchair because it has sonar panels. Canes that can fold themselves with the click of a button so that they can fit in one's pocket.

There could be so many more adapted sports! Tools and technology that can adapt a house exactly to one's needs! Wheelchairs that are actually affordable! A portable pocket sized device that makes ableds behave normally around disabled people!

The point of this post isn't to completely shit on sci-fi settings, but instead to urge abled writers to think a bit more and try to be creative in the way they go about speculative fiction. Write something new! There's one billion stories about how impossible it is for disabled people to exist in the future, and it's upsetting at best to read that constantly when you're disabled. As long as there are people, there will be disabled people.

mod Sasza