It’s October, the spookiest time of the year, and also the prime time for a resurgence in harmful stereotypes about disabled people in the media. I love Halloween, and like many people, I’ve been dutifully scaring myself silly this month with new shows like The Haunting of Hill House, and a re-exploration of Stephen King’s back-catalogue. But in nearly all of the terrifying films, books, and TV shows currently dominating our leisure time, it’s impossible to ignore one pervasive trend: the looming spectre of the “Evil Cripple.”

Quite frankly, we disabled people are everywhere right now, but not in the way many of us would like. If we’re not wielding chainsaws and going on murderous rampages, then we’re plotting world domination from our wheelchairs and reveling in a variety of gruesome deaths. The recurring tropes of disability = evil and disfigurement = morally bankrupt are stereotypes as old as culture itself, but what exactly is so scary about us? Well, come with me on a spine-tingling trip through history, that begins thousands of years ago, within the creeping mists of time…

Horror films and books play heavily on the idea that religious texts and arcane tomes are gateways to magic and evil, but the idea of disability as punishment is one found in almost all religious stories. In these parables, sinners are struck down with blindness, leprosy, or paralysis as a punishment for perceived sins, and healing is only offered when they repent and beg for forgiveness. In fact, early Puritan writings suggested that disabled people were innately driven towards evil, and that a child born with a disability was being punished for intrinsic impulses towards immorality.

In folktales and fairytales, too, limping crones lure children to their deaths, and disfigured characters like Rumplestiltskin use their cruelty and cunning to entrap the more moral characters of the story. Often, in these tales, disabled and disfigured people are fueled by jealousy and bitterness, and so turn their hatred onto the pure and blameless members of society. The over-arching message? Disabled people are inherently evil, and as such, we are scary.

Early Puritan writings suggested that disabled people were innately driven towards evil
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Unfortunately, this lazy trope, which positions disability as being caused by, or being the cause of, malicious wrong-doing, is one that repeats itself in popular culture, and feeds into the false idea that disability is inherently a bad thing. In Stephen King’s The Green Mile, callous jailer Percy is punished for his cruelty to the inmates by being rendered catatonic, while the sweet-hearted wife of the prison’s chief warden is saved from her brain tumor because, we’re meant to infer, she deserves to be.

In the Texas Chainsaw Massacre, Leatherface is a disfigured character who tortures people to death and tries to wear their faces, because of course, if you have a facial disfigurement you must be filled with self-loathing, as well as a burning hatred for those who don’t. We know that Freddy Krueger is evil because he’s disfigured; the Phantom of the Opera becomes a villain because he can’t possibly reveal his scars; and Jason Voorhees, with his disfigurement hidden behind a mask, demands your attention with murder.

But it isn’t just physical disabilities that history and, by extension, the entertainment industry, consider frightening.

One of the most famous horror tropes is the mentally ill and therefore murderous antagonist. Often a serial killer, like Hannibal Lecter, or occasionally possessed by demons, like Emily Rose, if there’s one things the horror genre has taught us, it’s that mentally ill people are to be feared. But there’s a particularly sad irony in this stereotype, since throughout history, mentally ill men and women have been the ones most frequently harmed by society.

Take Bethlem Hospital, better known as Bedlam Asylum, for instance. Most of us know that Bedlam was a terrible place, where people were locked away in squalor, without treatment, and routinely abused by their gaolers. What many people don’t realize, however, is that before Bedlam, locking away patients with mental illness was considered to be a humane way of isolating them from their abled peers, for the very simple reason that mental illness was thought to be contagious.

As a result, many people suffering from mental health problems were subject to torture or murder, as it was feared they might infect others. Isolation was considered to be a more compassionate alternative to a variety of so-called therapies, from blood-letting, to starvation diets, to trepanning, an ancient practice in which a portion of the skull is removed. Yet despite this, the horror genre is rife with depictions of psychopaths committing mass murder, or people with multiple personalities slaughtering their families.

Perhaps, you might think, that these stereotypes are no big deal. But the fact is that the horror genre is the only genre in which disabled people are regularly represented at all. In 2015, a report by the Media, Diversity, and Social Change Initiative found that of the top 100 movies that year, only 2.4% of disabled characters spoke or had names, despite the fact that 1 in 5 people around the world are disabled.

The entertainment industry, in particular, regularly comes under fire for allowing abled actors to “crip up” and play disabled roles, thereby denying disabled actors the opportunity. The problem has become so bad, that the Ruderman Foundation recently reported that an incredible 95% of disabled characters on television are played by able-bodied actors.

The fact is that the horror genre is the only genre in which disabled people are regularly represented at all.
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Similarly, while most horror films depict mentally ill people as violent, cold-blooded killers, the reality is that they are far more likely to be the victims than the perpetrators of violent crime. The stigma around mental health issues also makes recovery harder, and according to the Mental Health Foundation, nine out of ten people with mental health problems believe the stigma around them has a negative impact on their lives.

While Halloween is a great excuse to terrify ourselves and indulge in dark stories, it’s worth remembering that while horror entertainment frequently depicts disabled people negatively, there’s essentially no other popular media to counter-act these depictions. While there are countless disabled and disfigured people portrayed as killers and villains, we rarely ever get to be the heroes, and frequent negative representation breeds ongoing stigma and prejudice.

Stories of disability as a moral punishment, in particular, feed into the idea that disabled people deserve suffering, or even that the lives of disabled people are nothing but suffering, and so we are either to be pitied or punished. Neither of these things is true, and isn’t it about time we stopped using disabled bodies as a short-cut to cheap scares? The chances are we’re probably not going to murder you or wear your face as a mask, but we are pretty tired of always being the bad guy. Really, the only thing frightening about disability is the archaic attitude the entertainment industry still has towards it – in both its depiction of us, and its refusal to offer us a chance at employment.

What if you could get a medical diagnosis for free? No confusing copays, no being put on hold trying to argue an unexpected bill with your insurance company. A first, and second, and third opinion, all at once. Do we have the government to thank? Nope, just TV. TNT has announced it’s prepping for M.D. Live, a show where patients can apply to get their illnesses diagnosed by a panel of doctors—and a live audience.

During an episode, a panel of doctors will reportedly discuss the patient’s symptoms and possible diagnoses, before “crowdsourcing” with the audience, which seems perfectly healthy. Speaking to the Hollywood Reporter, Michael Bloom, TNT’s Senior VP of unscripted and live programming, said, “We want this show to inspire action and give hope to real people struggling with medical problems to get answers, proper treatment, and ultimately, improve their quality of life.” But responses from disabled and chronically ill people online suggest that this new breed of entertainment is hiding a far darker reality.

Chronic illness affects approximately 133 million Americans, and an estimated 30 million sufferers remain undiagnosed. It takes an average of 7.6 years to diagnose a rare disease in the U.S., and undiagnosed illnesses are associated with higher mortality rates, and lower quality of life for the people affected.

But because of the high costs involved in accessing care, many patients are forced to abandon their search for answers for years at a time. Last year, The Guardian reported that medical expenses were the most popular category of fundraising on crowdfunding site YouCaring, and that medical fundraisers on GoFundMe had increased from $6 million in 2012, to $147 million in 2014.

Unsurprisingly, women, particularly black women, and people living in poverty, face additional barriers to diagnosis. In Maya Dusenberry’s ground-breaking book, Doing Harm, she reveals that of the 100 million Americans who live with chronic pain, the majority are women. Yet research released in the study Women With Pain shows that women with chronic pain are more likely to be wrongly diagnosed with mental health conditions than men, and are frequently prescribed antidepressants and psychotropic drugs instead of pain relief.

Similarly, a study by the British Heart Foundation found that women have a 50% higher chance of receiving a false diagnosis following a heart attack, because the severity of our symptoms is not immediately believed, and we are more likely to be told we are having a panic attack.

But hidden biases in the medical system don’t stop there. Obese men and women are more likely to suffer with undiagnosed conditions, often because doctors blame their symptoms erroneously on their weight. This leads to a lack of diagnostic testing, and frequent fat-shaming may mean that sick patients stop going to the doctor altogether.

And these problems are compounded for black women, who often experience implicit racism in medical settings. Black women are three to four times more likely than white women to die from pregnancy-related complications, as illustrated recently when Serena Williams had to fight for medical intervention following the birth of her daughter. Black women also face a significantly higher risk of delayed breast cancer diagnosis than white women, and are frequently under-diagnosed generally.

It takes an average of 7.6 years to diagnose a rare disease in the U.S., and undiagnosed illnesses are associated with higher mortality rates, and lower quality of life for the people affected.
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Under a medical system that so often struggles to provide equal, affordable treatment to its patients, it’s no wonder that those with undiagnosed chronic illnesses might be tempted to prostrate themselves across our TV screens, in the hope of finding answers. But the trend of producing television that depicts suffering as entertainment, is one that does real-world harm to disabled and chronically ill people worldwide.

Most recently, Netflix came under fire for its show Afflicted. Billed as a documentary portraying “baffling symptoms and controversial diagnoses,” it was alleged in an article by the LA Times that producers edited the footage unethically, to falsely suggest that the participants’ medical conditions were psychosomatic in origin.

In a joint post on Medium, entitled ‘The Truth Behind Netflix’s ‘Afflicted,’ participants in the show say they were told they would be taking part in a project that would show their lives and struggles through a “compassionate lens.” Instead, they say, footage of their concrete diagnoses and tests results was excluded, and conventional medical doctors were either not consulted during filming, or their interviews were left on the cutting room floor.

The result of this was that many of the participants were harassed online, and some were even sent death threats by viewers who believed they were either faking it, or mentally ill. But such poor depictions on screen aren’t just damaging for the patients involved. They also have a far-reaching negative impact on the millions of other people struggling just like them.

Netflix reaches 300 million viewers worldwide. When a program with that kind of impact misrepresents medical conditions that are already under-funded and under-studied, it has a direct effect on whether patients facing similar problems can access appropriate care, or whether governments choose to support research funding.

And this is the core of the problem with M.D. Live.

The trend of producing television that depicts suffering as entertainment is one that does real-world harm to disabled and chronically ill people worldwide.
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It’s likely that many undiagnosed patients will be from social groups that already experience prejudice from the medical profession, and these prejudices may be replicated by the producers, unknowingly, on-screen. It’s easy to imagine a panel of doctors telling a fat white woman she just needs to lose weight to solve her problems, or insist that a black woman’s pain can’t be as bad as she says it is. While it’s easy to see why desperate patients might approach the show to help them when they’ve exhausted all other options, it’s also all too easy to see how exploitative this could become.

Disabled and chronically ill patients often experience harmful advice from the medical profession, as well as from friends, family, and the public, if a simple cause for their symptoms isn’t easily identified. It’s difficult to see how a show in which doctors discuss potential diagnoses, before “throwing live to the crowd for additional feedback”, will do anything other than encourage dangerous speculation from unqualified viewers, and lead to damaging, pseudo-scientific suggestions in the pursuit of interactive entertainment.

Michael Bloom says TNT’s “professional team of studio and field crews will lead our charge crowdsourcing hope to help our patients solve the medical mysteries we present in the series,” but even more so than a documentary like Afflicted, as live entertainment, it’s unlikely that TNT will succeed in helping patients long-term.

M.D. Live is the direct result of a government that considers medical care as a product, not as a basic right. In a show which allows a live audience to share their opinions, while people with undiagnosed illnesses are forced to waive their right to privacy in the hope that television will succeed where their doctors have not, the potential for misrepresentation and exploitation is staggering. TNT claims to be “crowdsourcing hope,” but I don’t find much hope in a world that relies on television to heal the wounds that the medical system leaves gaping open.