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Designing for Disability

April 16, 2015

Three years ago, Liz Jackson, a thirty-three-year-old Harlem resident, noticed that her feet had begun doing something she describes as “plopping”: the front of her foot would hit the ground before her heel when she walked. In the beginning, it was subtle, a quirk she couldn’t reliably reproduce. One evening, about a month after the plopping first started, she and her partner were walking home from dinner when she noticed that it was happening with every step. They recorded a video to show Jackson’s parents and doctor. The following morning, when Jackson tried to get out of bed, she collapsed on the floor. After a visit to the emergency room, she was diagnosed with idiopathic neuropathy—nerve damage with no known cause. She learned that she would need eyeglasses to ease the frequent migraines that attend the damage and a cane to lean on for balance.

The cane soon became a source of self-consciousness. “My eyeglasses would get compliments,” she told me, “but my cane would get a funny tilt of the head from people, as if they were thinking, ‘What’s wrong with you?’ ” For months, she was despondent. One thing that helped her recovery was finding a purple cane, while browsing online, to replace her drab, hospital-issued one. “I went from walking hunched down, wanting to hide, to actually being proud of it,” she said. Sometime afterward, she was shopping at J.Crew, her favorite store, and it occurred to her that her cane would look beautiful with the brand’s Kelly-green T-shirts. That led her to begin asking J.Crew, through e-mails, blog posts, and open letters published on Facebook and Twitter, if it would sell a fashionable cane—to broaden its customer reach and to help ease the stigma attached to assistive devices.

There are a few brands, such as Top & Derby and Sabi,* that design sleek, colorful canes with style in mind. And J.Crew has a history of working with smaller brands; over the past few years, it has collaborated with more than a hundred companies, on products ranging from jeans to notebooks to jewelry. (The retailer is barraged with packages from companies hoping to make the list.) J.Crew’s Web site currently lists dozens of such partnerships in its “In Good Company” section.

Still, it’s particularly difficult to design a good cane. It has to distribute a person’s weight properly and hold up to constant use. It can’t slip or skitter across the ground. Because engineers focus on function, aesthetics are often overlooked. Alicia Contreras, who worked as an assistive-technology educator in Oakland, California, helping people learn to use devices such as canes and crutches, told me that her clients are constantly wishing for something more stylish. “It’s a brave step to recognize that you have to use a cane,” she said. “The image that immediately comes to mind is that you are an old person.” Like Liz Jackson, her clients want canes that they won’t feel ashamed of. Many of them have foregone traditional canes and have turned instead to hiking sticks. Unlike a cane, a hiking stick lends the impression of vigorousness, as if the person carrying it to the grocery store is merely warming up for a weekend trek. “They were proud of them,” Contreras said. “They felt like, ‘I am active, I am safe.’ ”

Patty Ruppelt, an assistive-technology practitioner in Watsonville, California, who has been a physical therapist for twenty years, told me that in recent years, wheelchairs have been getting makeovers, with lightweight carbon-fibre bodies, but there has been less incentive to reinvent canes, since people often pay for them out of pocket instead of sending the bill to Medicare. “Reimbursement drives research and design for a lot of medical supplies,” she said. “There’s room for improvement in terms of people’s options.”

Yet, in the twenty-five years since the Americans with Disabilities Act became law, rehabilitation has shifted from a medical model, in which patients play a largely passive role, to a disability-rights orientation, in which those in need of assistive devices act as educated consumers who demand more choices. “People are out and about more, not trying to ‘pass’ as much. I think that’s at the heart of the purple-cane issue,” Ruppelt said, alluding to Jackson’s J.Crew campaign. “Here’s somebody who’s saying, ‘This is my life now, and I’m not going to hide it.’ That’s the great thing about what she’s doing.”

Ruppelt also mentioned that wearable technologies, from Bluetooth earpieces to smart glasses, are leading to a merger of human and bionic forms. As these accessories have become commonplace, there has been a parallel shift in prosthetic limbs, away from flesh-toned simulacrums of human body parts. More people are showing off their prosthetics’ intricate mechanisms or, indeed, treating them as a fashion statement, adding slip-on covers with designs of wood grain or lace. Viktoria Modesta, a Latvian-born model and singer who bills herself as “the world’s first bionic pop artist,” wears a number of stylized prosthetic legs in the video for her song “Prototype”—one lights up, one is covered with Swarovski crystals, and one resembles a shimmering black ice pick. (Modesta chose to have her left leg amputated below the knee at age twenty, following fifteen surgeries.) The video has been viewed on YouTube more than six million times.

During New York Fashion Week in February, a number of models with disabilities appeared on the runways, leading some to conclude that the industry is becoming more inclusive—yet the emphasis on an appearance that is unattainable for most remains. “It’s exciting when people can challenge mainstream ideas and defy the oppressive standard of what passes for a beautiful body,” Jennifer Kern, a lawyer and disability-rights advocate in Berkeley, California, said. “But I’m much more interested in images of people with disabilities just living their lives, dropping their kids off at school or making dinner with friends. If something is feeding distance between people, even if that is, ‘Look at those amazing fashion models,’ then it’s not really moving everybody closer together. Fear is fed by an absence of images and by our failure to get to know each other.”

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