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Transforming the Representation of Disability in Children’s Literature: A Comparative Analysis of What Katy Did and Katy

Health, Literature, and the Literary Artist

The question of the association between human health, both mental and physical, and literary activity, as well as literature itself, as far as the traditional conception of the western canon is concerned, can easily be traced back to Plato and his views that certain types of literary content could inflame what he considered the irrational part of the human mind (Leitch 72). And much literary criticism from that point on has been preoccupied with the value of literature as a moral agent towards shaping an, ideally, virtuous individual.

But beyond the moral edification of the reader, questions have always been asked as to whether literary activity itself might not be symptomatic of mental or physical deviation from a putative norm. “Greeks, conceived of [it] as related to ‘madness’ (to be glossed as the range from neuroticism to psychosis)” (Wellek 81). While later iterations of this tendency, which saw the literary artist as distinct from other members of his community, sought the basis of his ability in disability, of which artistic talents were a compensation: “Pope was a hunchback and a dwarf; Byron had a club foot; Proust was an asthmatic neurotic of partly Jewish descent [sic]; Keats was shorter than other men; Thomas Wolfe, much taller” (81). As the field of psychology developed, so did this tendency. Freud’s assessment of the literary artist’s gift pinned it down to being an “obdurate neurotic” using his art to stave off an actual cure (82). Psychologists, and literary criticism that borrows from their work, have often used works of literature as case studies, attempting to diagnose individual characters and in some instances to ultimately arrive at a sort of conclusion regarding the author’s specific mental state.

Meanwhile, literary artists have often employed disability and/or illness on the one hand as a metaphor, either to showcase moral decay within and divine disapproval of a character, or, on the other hand, as a trial and an opportunity for characters to prove themselves worthy in the face of adversity (Keith).

Medical Humanities and Literary Criticism

With the rise of medical humanities, however, and its privileging of “the patient’s experience and the human condition”, the focus of literary art and criticism has also shifted. Now that a link has been established between storytelling and “all thoughtful caregiving” (198), what is at stake is representation of disease and disability, not as metaphors or symbols that serve the higher purpose of moral instruction, but the development of a culture of inclusivity and understanding.

Taking these insights from research in the medical humanities as a theoretical point of departure, this paper aims to illustrate through close textual analysis the ways in which the aforementioned shift in priorities can be seen in literature, specifically literature aimed at children. The texts selected for this purpose are What Katy Did, a 19th century classic work of children’s literature by Susan Coolidge, and, Katy, a retelling of the same by Jacqueline Wilson, published in 2015.

Much of the scholarly work on What Katy Did includes articles that revisit it either from a feminist perspective, or that of child psychology. Others are more focused on disability and its representation. Elizabeth Hale’s article considers the text from the perspective of disability but focuses on disability as a “crucial stage in the development of talented teenage girls” (Hale 2010) as does the book by Lois Keith, which explores the “symbolic use of physical crippling to represent a girl's passage into womanhood” (Keith 2001). Both are more focused on disability being used as a metaphor than on the transformation of representation over time. A comment by Keith in another article raises an important question, which provided, at least in part, the impetus for this work. She claims, “Modern writers aim for greater realism, but sometimes still find it hard to imagine what kind of life there can be for someone who cannot walk” (Keith 2004). In this regard, Wilson’s Katy has as yet not been considered except in one notable work that looks at how “Wilson has misinterpreted Coolidge's key messages” by not taking into account the feminist undertones of the work (Quillen 2021). This, however, is beyond the scope of the study at hand. The literature review leaves open the possibility of a comparative analysis of the two primary texts to foreground the transformation in the representation of disability in children's literature.

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Stories Retold

The retelling of children’s stories, as a general rule, raises questions with regards to shifting cultural values, the ideological content of the stories themselves, the “attitudes towards the participants and their experiences” that the two or more narratives highlight, as well as “the potential moral impact on the audience” (Stephens ix). These questions form the basis of the research at hand from the standpoint of the concerns of the medical humanities. The analysis will show how the shift in priorities that emerges as a consequence of the growing impact of medical humanities on literary production, is important for academic institutions as far as creating an inclusive environment for the physically impaired is concerned.

What Katy Did (1872) and Katy (2015) 

It should be noted, of course, that there is a gap of nearly a century and a half between the publication of the original What Katy Did in 1872 and the contemporary retelling of the story. Naturally, much has changed in that time and the contemporary retelling adapts its source material liberally in terms of setting and focus to suit the needs of a new audience, while in at least one instance completely alters the relationship between two central characters; however, the beats of the plot and the crisis remain more or less the same. Both novels feature an eleven to twelve-year-old “tomboy”, Katy, who resists, for various reasons, the rules and regulations of authority figures, ending up subsequently in an accident that leaves her physically disabled and unable to walk. It is at this point, where the two authors take on the task of representing a young, disabled person, that the most marked differences in focus become evident.

Soul and Body

The primary claim in this research is that the nature of the shift is a qualitative one that reorients the reader’s attention to the body, which in the original text was limited. That is to say Katy’s injury and her struggle in learning to cope with its consequences are an almost purely spiritual concern in What Katy Did; there are references to her experience of physical pain and the psychological stress at the prospect of an interminable incapacitation, but much of Katy’s process of coping has to do with becoming altruistic, seeming cheerful and hopeful, as much for the sake of others as herself; whereas, in Katy, the protagonist’s struggle, irrespective of its obvious emotional, psychological dimensions, finds its locus in the body and the body’s relationship with its physical and social environment. Indeed, she too must learn to not lash out at others, but again and again the reader is reminded in detail just how alienating the experience of disability can be. Wilson’s account of Katy’s life goes into her time at school as an invalid. This aspect is absent in Coolidge’s novel. Though Coolidge followed What Katy Did, with What Katy Did at School, the protagonist is no longer disabled in that story and is therefore beyond the scope of this paper.

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The Grieving Child

In addition to this is the stark difference in the way both the authors represent Katy’s engagement with her mother’s death. In the original, this aspect of her history rarely crops up, such as the one time when her father “reminded her of the time when her Mamma died, and of how she said, "Katy must be a Mamma to the little ones, when she grows up" (Coolidge 38). In the retelling the absence of her mother is a recurring issue. Katy thinks of her whenever she gets into serious trouble. And to her it appears as if she is always close by. The difference between the two novels in this regard could be explained by the fact that in Wilson’s version Katy’s father remarries, and the character, Izzie, who, in the original story is Katy’s aunt, is in this one cast as her stepmother. A child would, one might assume, plausibly, be more upset by their mother having been replaced by a stepmother than by the presence of an aunt, whose authority she must contend with without feeling resentment that this person has usurped her mother’s position.

Nevertheless, in both narratives Katy has to deal in one way or another with a newfound responsibility as a mother figure to her siblings, all of whom are younger than her and look up to her as a role model. 

The Saintly Invalid

Things come to a head once Katy’s swing breaks, resulting in a fall that injures her so that she can no longer walk. Katy’s suffering and her psychological state of despair are described quite well: “It was not easy, for every motion hurt her, and the sense of being helpless hurt most of all. She couldn't help crying after she was undressed and put into bed. It all seemed so dreadful and strange” (90).

But once Helen returns to talk to Katy, her advice is ideologically biased:

“I should say this: ‘Now, Katy Carr, you wanted to go to school and learn to be wise and useful, and here's a chance for you. God is going to let you go to His school—where He teaches all sorts of beautiful things to people. Perhaps He will only keep you for one term, or perhaps it may be for three or four; but whichever it is, you must make the very most of the chance, because He gives it to you Himself’” (101).

When Katy inquires as to what school this is, Helen responds: “‘It is called The School of Pain,’ replied Cousin Helen, with her sweetest smile” (101). The lessons that one must learn in the School of Pain are of Patience, Cheerfulness, Making the Best of Things, Hopefulness and then finally “the lesson of Neatness. School-rooms must be kept in order, you know. A sick person ought to be as fresh and dainty as a rose” (102).

Institutional Flexibility

Institutional flexibility plays an important role here. Although the rules of the hospital do not allow Dexter to visit the girls’ ward, seeing as how both Dexter and Katy are benefitting from their interaction, the nurse, Jeanine, makes allowances. Her role is supervisory to the extent of ensuring nothing untoward happens, but she is not a prison guard. Her priority are her patients. This particular approach is important both in medical institutions, especially where patients have to stay longterm, but also in academic institutions, where often rules do not take into consideration the individual. In such circumstances, medical staff as well as teachers, who are in contact with individual patients/students, should be given enough room by the institution to use their best judgment. Of course, this is a tricky area that most institutions would rather not leave up to the discretion of their employees for fear of a mishap or a scandal, but this is precisely where too strict an imposition of authority can become dehumanising. Ultimately, for Katy, though her experience at the hospital is a mixed bag, it is an overall positive one: “My family loved me dearly but they didn’t understand.” “I longed to be back in hospital where everyone understood” (314).

Setting the Stage: The Status of the Sickly

To begin with then, Katy’s initial attitude towards sickness in What Katy Did might be gleaned from a story she tells her siblings about a fairy that protects the Rosary (a particular bush that the children fancy) but who falls ill and fails to do her job. This ends with a warning to the fairy from Santa Claus “that if she didn't take better care of Rosy Posy he should put some other fairy into her place, and set her to keep guard over a prickly, scratchy, blackberry-bush” (Coolidge 11). The idea of fulfilling one’s responsibilities, regardless of health, is a foreshadowing of the sort of attitude that will become the moral core of the novel.

The more questionable ideas can be traced back to her Cousin Helen’s father. Helen had suffered an accident many years ago that had paralysed her from the waist down. She had given over to despair when her father insisted that “[a] sick woman who isn't neat is a disagreeable object. Do, to please me, send for something pretty, and let me see you looking nice again. I can't bear to have my Helen turn into a slattern” (Coolidge 104). This spurs Helen to become the cheerful, heart-of-the-family type. Her motivation is to satisfy others. Her appearance and her behaviour must not offend others. Although not a bad idea in and of itself, its roots, however, are suspect. Her father’s demand is that since he will have to spend more time with her on account of her illness, she should take care to ensure that she does not look unpleasant to him. The suggestion is not that this is good for her, but a part of her duty to him. The notion that she, on account of her disability is inherently repulsive is echoed by her later in a conversation with Katy. When questioned about her valuable clothes and jewels, she tells Katy that there is no harm in a disabled person dressing up and maintaining a pleasant exterior since “sickness is such a disagreeable thing in itself, that unless sick people take great pains, they soon grow to be eyesores to themselves and everybody about them” (75). While the message that there is no harm in dressing fashionably, and that it doesn’t necessarily imply that one is vain or too “worldly” one would hesitate to approve of the manner of its communication, i.e. via the characterisation of the disabled as eyesores, who must at all times be conscious of their status as eyesores so as to take whatever steps are necessary to avoid offending the aesthetic sense of those around them.

She represents in many ways an ideal disabled person about whom Katy states: “I don't believe Cousin Helen could do anything wicked.” While Dr Carr, Katy’s father, believes “Cousin Helen is half an angel already, and loves other people better than herself” (78, 79), adding that he “couldn't ask anything better than to have my little girls take pattern after her” (79). She happens to be the only person whose charisma can get Aunt Izzie to let loose and play games with her and the children. As such she is the role model for both Katy along with the reader.

The fact that Helen decides not to marry her fiancé after her accident, only encourages the idea that a disabled person ought not to aim for a “normal” life, when it is quite possible to do so.  Her fiancé, Alex, wishes to marry her even after the accident, and her refusal is portrayed as noble and selfless albeit tragic.  Keeping in mind that this book is intended for children, some of whom may well be disabled, one must question the necessity of presenting disability as grounds for disqualifying oneself absolutely from marriage. Again this goes back to the notion that Helen, on account of her disability, is inherently offensive, and must keep herself hidden, either beneath false cheer, fancy attire, or by denying herself a normal social existence.

Helen 2.0

Helen’s character in Wilson’s version suffers from rheumatoid arthritis, but has gone on to become an academic with a PhD. She makes a remark that is most likely a tongue in cheek reference to the original Helen that she is based on: “They thought it such a shame I was practically crippled and expected me to be pathetic and saintly, like the little invalids in Victorian storybooks” (178). Dr Helen is anything but an invalid of the sort she mocks.

Nor is her advice to Katy, after her accident, that she advance her spiritual state. She understands that unlike herself, who has spent most of her life in a wheelchair, and, therefore, identifies the aid as so much part of herself, Katy is completely lost with this development: “You’re thinking right now of all the things you can’t do. But maybe soon you’ll be able to start thinking of all the things you can do. Maybe new, fantastic things you’d never have thought of before” (346). While this assertion sounds overly optimistic, it does not go unchallenged by Katy. And so, Helen recommends that Katy go back to school. Katy, in the original novel opts to be home schooled. Here, Helen insists that Katy goes to the school she had planned to go to irrespective of its lack of facilities for the disabled. In fact, she encourages her to “lobby hard to get them to put in a lift! I think that’s the first step you need to take” (347).

Disabled and Dihumanized

The experience of feeling dehumanised is addressed in Wilson’s text in different situations. From receiving embarrassing comments about her body from a nurse, to being stared at by the public at large. A particularly egregious incident occurs when she tries to get on a bus in her wheelchair and the bus driver refuses to let her board because there are several prams in the bus: “But that’s ridiculous. Can’t the buggies be folded up? Surely my daughter takes priority here?” insists Izzie but the driver refuses (374). In essence he considers Katy an object without feelings.

Similarly, at school, an application from a student’s mother puts a stop to Katy participating in sports with other students. It was the one thing that had allowed her to feel like she was her old self again, but she is informed that her wheelchair makes her too dangerous a physical presence among the able-bodied. She tries to reason with the principal, Mrs. Mathews: “But anyone can get knocked over by anyone else. Look at rugby! Or you can get whacked about the legs playing hockey. It’s so unfair! Everybody else can join in and take a risk. Why can’t I?” (432) This is a fair point. Sports are inherently risky, especially when there is contact involved. The institution, however, chooses not to indulge her and invite a potential lawsuit from a fussy parent.

Her sports teacher, Mr Myers, tries to get her to opt for basketball for the disabled, which she could play off campus at a health club. But the idea of being in such a team makes her dread having to accept that she really is disabled. Of course, her attitude changes once she watches the aforementioned DVD that Helen sends her as a Christmas gift featuring the Paralympic Games, eliciting the following response from her: “This wasn’t softie sport – this was the real thing! I’d had no idea that people with all kinds of disabilities could achieve so much” (471). 

Finally, another aspect that Wilson’s account takes on is the impact of Katy’s injury on her family, specifically her father. Dr Carr, who, although a medical doctor, is not a specialist in spinal injuries. And yet, according to Izzie, he “stays up half the night poring over medical stuff about spinal injuries on the internet” looking for a cure that does not exist (301). The desperation of the father stuck in a situation where he feels helpless at being unable to help is quite moving. The fact that he does not mince words and straight away tells Katy when she’s still in the hospital that she would never be able to walk again, much to her dismay, exemplifies the conflicting space he occupies as a doctor, who must be factual, and a parent, who must give his child hope: “Oh Katy, I got it all wrong. Call myself a doctor! I should be gently reassuring you, trying to help you be as optimistic as possible – and yet there I was, dashing all your hopes” (279). Of course, this puts Katy in the awkward situation of having to comfort her father: “Dad seemed desperate for reassurance, so I gave him a hug” (337).

A serious physical injury, necessarily demands a recalibration of relationships. An ideal situation where such a development could be passed over unremarked seems impossible. As Katy’s relationship with herself and her physical environment changes, so does the environment’s relationship with her. Some, like Clover, Izzie, and Cecy, will be more protective towards her, perhaps to the point where she feels her autonomy compromised. Others, like Eva, will try to take advantage of her vulnerability. Still others, strangers, often motivated by good intentions, make it difficult for her to feel “normal”. A particular bus driver, who in an attempt to be friendly and accommodating, makes too big a deal of her presence on the bus, singling her out, making her feel ridiculous. On spotting another individual in a wheelchair, he is unable to keep himself from suggesting that she race him, as if all disabled people know each other and enjoy nothing better than a good race.


Compared to What Katy Did, Katy offers a far more realistic and multidimensional representation of a physically disabled person. The detail with which the reader gets a sense of what it means to function from with a wheelchair paints a tough picture. It requires a lot of effort and the development of certain muscles. The process changes a person physically, though it does not straiten the nose or turn black eyes blue. Simple acts like dressing yourself or going to the washroom become a challenge. Katy’s experience at school also highlights the importance of installing ramps, lifts, toilets with wheelchair access, and classroom doors that swing both ways. Having to open a door by pulling towards yourself while in a wheelchair, as we see in the account, is quite cumbersome. Her experience with other people also highlights the importance of some level of institutional flexibility in medical and academic institutions. It also underscores the importance of a support group, of positive interactions with people who share the disabled person’s experience. This could be essential for people who have not been disabled since birth and have just begun navigating this development. Katy’s interactions with Dexter allow her to be able to make light of and laugh at her predicament, perhaps an important step towards acceptance. Having positive role models, who can help the afflicted see possibilities of personal growth seems more useful than a self-abnegating approach of the House of Pain variety, which suggests that a good enough character might miraculously restore lost bodily functions. 

There is no doubt that What Katy Did is a beautifully written, and frankly, quite charming tale. All the characters are individualised and memorable. The world it evokes is of childhood innocence and nostalgia. In many ways Katy’s interactions with her father in that text are deeply moving. He comes across as a wise and gentle person who understands his children and gives them room to grow, compared to the conflicted and confrontational, perhaps more human version we find in Wilson’s text. But where What Katy Did lacks is in its 19th century understanding of disability and its forced marriage with religious ideals. Jacqueline Wilson’s text is a fine retelling that not only questions its predecessor but raises other newer questions relevant to medical and academic practices in the 21st century.

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Disability and Divine Judgement

In themselves these are arguably positive traits everyone should hope to acquire. But to invest accidents with divine will can be problematic. Susan Sontag's essay Illness as Metaphor theorises that in the Christian tradition, “[t]he idea of disease as punishment yielded the idea that a disease could be particularly appropriate and just punishment” (48). Katy, however, is never portrayed as such an awful twelve-year old that God should desire for her to suffer so, nor for that matter is Helen. But the fact that Katy does ultimately regain her ability to walk after four years, implies that having mastered her lessons at the School of Pain she has graduated and is finally free. Does this suggest that disabled readers, who might never recover, deserve to stay disabled on account of a flaw in their character? Were they not neat or cheerful enough? Again, while there is nothing inherently wrong with aspiring to be patient, neat or cheerful, one must question the representation of disability as a means to a better overall personality. Disability is not a metaphor for the state of one’s moral being, nor is it a gauge of one’s spiritual account. In any case, a doctor cannot discriminate between patients or draw conclusions about them on the basis of their religious views or lack thereof.

It is obvious that the narrative in Coolidge’s version of Katy’s life is heavily influenced by a particular form of religious belief. In addition to that though there is a surprising lack of understanding of biology, considering Coolidge had herself served as a nurse. Some of which can be attributed to the state of medical science in the 19th century: Cousin Helen is taking a four day water cure for her health. Water cures were a popular innovation of the time. But some references to human physiology are more likely the author’s own invention. For instance, the narrator at one point, while discussing Katy’s generally rough and tumble personality, mentions how “[h]er eyes, which were black, were to turn blue; her nose was to lengthen and straighten, and her mouth, quite too large at present to suit the part of a heroine, was to be made over into a sort of rosy button” (8). It seems as if the narrator has taken the transformational metaphor of the butterfly too far. For black eyes do not turn blue, even from a debilitating spinal injury. The point here is that there is a sense in which physical transformation from an arbitrarily unattractive to an attractive state is symbolic of the soul’s nearness to the divine. And this is precisely what happens when Katy, in a dream, while attempting to read an indecipherable book cries out for help, and is aided by somebody with “a great beautiful Face”, whom she recognises as the one Cousin Helen had informed her was always by her side: God (109).

Katy 2.0

In Wilson’s account of Katy’s life, the shift is significant. First of all, Katy is a first person narrative, as opposed to the third person omniscient perspective adopted in What Katy Did. This lends a sense of immediacy and authenticity to the experience Katy describes. The reader is given access to her thoughts in her own words. In this account, Izzie is not Dr Carr’s sister but his second wife, and apart from Katy and Clover, the rest of the children are from the second marriage. This explains not only the friction between Izzie and Katy, but Katy and Elsie as well, who is Izzie’s daughter from her previous marriage. Wilson dwells on Katy’s feelings about her mother’s death, a subject mostly untouched by Coolidge. For instance, Katy feels that her mother should have been buried, against her wishes (she had asked to be cremated), so that she might have been able to visit her grave. She also feels resentment towards Izzie for having “snapped him up quick as a wink” (Wilson 74). In any case, to use the opportunity to shed light on how a child might deal with losing a parent:

“When we were taken to visit her she didn’t seem like our mum any more. She’d lost all her lovely long hair and she looked pale and pinched, and she didn’t even smell all sweet and rosy like our mum. But when she put her arms round me and hugged me tight I knew she was still our own dear mum inside” (153).

Language Identity and Space 

The idea being that although current social standards exist because the able bodied are a vast majority, staying at home, wallowing in self pity, and not demanding that the disabled be accommodated is not the way forward for her. Katy would have to be there in person for the school administration to understand the necessity of making the required changes to their campus. She also helps Katy accept that the word ‘disabled’ is not an insult. Katy finds the word horrible: “I don’t want to be it!” (346)

‘But you are, sweetheart. And it’s not necessarily a bad thing. I’m proud to be the way I am” (346). Her point here is that though there certainly are words that are meant to hurt, others are merely adjectives that describe reality. Instead of trying to shy away from a word, Katy must accept the reality it describes. With this acceptance she might move on to better things instead of fussing about a particular word.

Helen, while being just as beloved to the children as she was in the original text, is also more realistic when it comes to helping Katy understand that she should not undervalue her own relationship with her siblings. When Katy despairs over how good Helen is with the children in stark contrast to herself, Helen remarks: ‘It’s easy for me. I’m the novelty. But I’m not sure I could be Miss Sweetness and Charm if I had to cope with all of them every day,” (352).

She is thus able to present her character as an attainable one to Katy, rather than the nearly impossible ideal in Coolidge’s version.

Katy also tries to explain how difficult she finds that her stepmother is so “nicey nice” to her since her accident (344). The sense of obligation she feels to be grateful to her is a trial in itself. Helen is able to share in this with her, letting Katy know that she is not alone in feeling this way: “Oh yes. I understand that. It’s the great trial of the disabled: having to be bloody grateful when we can’t help ourselves and have to get people to do things for us,” (344). Wilson’s Helen thus subverts most of the advice a young person might have drawn from Coolidge’s Helen. Wilson’s Helen is realistic. She is more than a one dimensional, saintly ideal.

Perhaps the most important gesture that Helen makes is sending Katy a Christmas gift. It is a DVD of the Paralympic Games. Initially, Katy finds the idea of such a gift somewhat dreadful, but realises how inspiring it is once she puts the video on. As an aspiring sportsman herself, she feels extremely encouraged by the display of talent and ability in the video. Helen understands how important it is that Katy gets to see others, who are in a similar physical state, achieving excellence. This opens her up to what she had initially hinted at, i.e. to think of what she can do instead of what she cannot.

A crucial point in which Wilson’s version of the story differs from Coolidge’s is how it focuses on Katy’s lengthy stay at the hospital, with all the difficulties of being in an unfamiliar environment immediately after a debilitating injury and the endless tests, operations, the loss of hope, and the painful process of acceptance. This section of the novel highlights the alienating impact of the medical facility on the patient, while also pointing out what in that environment works. 

One of the most important aspects of her condition, completely overlooked in the original account, is the sense of humiliation a disabled person will feel at the prospect of needing assistance for even the most personal bodily requirements:

“Sometimes the nurses had to do terrible things to us. Terrible for them as well as us. None of us could go to the loo properly. I had to have a catheter for my wee, with an awful little bag, which was bad enough. The nurses had to cope with my bowels. I hated the first session so much that I resolved never to eat again and then I wouldn’t need to go” (243). 

Katy goes on a hunger-strike to spare herself the shame of needing assistance, resulting in even more physical weakness. At this point, it is a particular member of the nursing staff, Jasmine, who manages to get Katy back to eating. She is not an indifferent professional but someone who has worked hard to develop a bond with Katy that transcends the physical aspect of her job description to include emotional caregiving. This is the lowest point in Katy’s life, where she no longer sees any point in being alive. Jasmine’s ability to care for Katy without being overly saccharine requires a fine balance. When Katy refers to herself as a “cripple”, and then justifies the usage by claiming that surely she can say whatever she likes about herself so long as her words are not directed at another, Jasmine is quick to discredit her line of reasoning: “You can rail all you like against fate – and you wouldn’t be human if you weren’t very angry – but no swearing and no inaccurate, unpleasant words. Do I make myself understood?” (246) Her point of course must be distinguished from Helen’s point earlier. For in this case, the word does not describe a reality, but a mindset that reflects a sharp decline in Katy’s self esteem. It is crucial that she does not think of herself as useless, lest the self-deprecation become a self-fulfilling prophecy.

 Having others in the ward, who share her condition, and especially being allowed to visit Dexter in the boys’ ward, helps Katy deal with not just that she is away from home, but also, and more crucially, that her family, her siblings (especially Clover) and her friend behave differently with her than how they used to. It is of course only natural that now that they see her differently, they are concerned and cautious. But the difference in treatment makes her feel alienated from them. Under such circumstances, being around people who can relate with her is helpful. To watch them deal with the same problems, the ups and downs associated with the process of coping, normalises for her how she feels, making it easier to adjust.  


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