Stigma:
1) The recognition of difference based on some distinguishing characteristic or mark;
2) A consequent devaluation of the person
Quiggles: A made-up term (by famous sociologist, Erving Goffman) to identify all of the variations and differences of the human body which occur either from birth, daily wear and tear, accident, or illness which can be, and will be stigmatized.
Something I swore I would never allow in my life has begun to happen - I've started to think about "the good old days" way too often. Shocked at this development and determined not to morph into either of my parents who talked relentlessly about this very topic in the autumn of their lives, I've been searching my soul to try to understand what it is I really miss, because surely it can't be the pork tenderloins at the local RBS (root beer stand) where I grew up.
What I discovered, after considerable thought, is that what I am missing is something I refer to as a "social contract" - those binding agreements we make with absolute strangers and do so without discussion, or even contemplation, when we enter into society. Slowly many of them seem to be disappearing from the American landscape, "social contracts" such as giving up your seat on a train or bus to a pregnant woman or elderly man with a disability, or yielding the right of way to a pedestrian at any time, let alone during a torrential rainstorm.
Although I am not yet relentlessly talking about the good old days (hopefully I'll save that for several decades into the future) I do think of yesterday often, especially when I observe something such as a car struggling to exit a parking lot onto a busy street and not one driver motions it into the traffic stream. That visual is all it takes for my mind to flash back to autumn weekends in my hometown of 16,000 when the entire town showed up to attend high school football games. After every game the school parking lot would empty in a matter of minutes, all without the help of a police officer directing traffic (at taxpayers' cost) because everyone automatically took turns exiting the row in which they had parked.
That I have believed in the importance of "social contracts" is probably evidenced by the fact that I have been known to even make them across species. For instance this winter, which has been exceptionally brutal in the Midwest, I've entered into one with "someone" in my garden. In addition to keeping a heated water dish going 24/7, I've started just after dark every evening to leave out food. I haven't yet seen who has agreed to eat it, perhaps a possum, skunk, raccoon or some other exotic critter. What I do know is they hold up their end of the "contract" arriving at the same time every night to collect the food and entertain the love of my life, a bored Siamese who never has enough play time from her human.
What does this all have to do with defeating stigma in healthcare? The thing is that there are no good old days of "social contracts" relating to people who are stigmatized whether because of health conditions or disabilities. This is not to say that there weren't unspoken agreements that our society entered into (like finding it acceptable to confine people who are developmentally disabled in institutions or constructing churches with more barriers to mobility than the no-man's-land between two enemy lines), but it is difficult to look back at these "social contracts" without fondness and wish for the good old days.
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