Unmasking Pharmableism

Introduction

In her book Against Technoableism, Ashley Shew interrogates the ways in which society believes that people with disabilities need to be improved or assisted by means of technological intervention. Through an intersectional and cross-disability approach, Shew grapples with tropes of disabled people in literature and media that permeate Western culture. Contemporary characterizations of people with disabilities in the media — as can be seen in the publicization of Amy Purdy on Dancing With The Stars — reinforce widely held social assumptions that people with disabilities need technology to live a fulfilling life. Shew develops the term technoableism to identify this systemic belief, defining it as "the belief in the power of technology that considers the elimination of disability a good thing, something we should strive for."¹ Technoableism is a form of ableism — "bias against disabled people, bias in favor of nondisabled ways of life"² — that relies on technologies to reassert ableist biases, "often under the guise of empowerment."³ This term allows Shew to dive into literature and entertainment with a critical framework to uncover covert forms of ableism within media. Shew's toolbox also provides further evidence against pervasive medical models of disability — models that hold people with disabilities as needing medical intervention or assistance to live a fulfilling life, placing the burden onto individuals with disabilities.

As a theory, I believe technoableism is limited to visible disabilities, effectively excluding those experiences of individuals with invisible disabilities — any impairments that are not readily apparent to the eye but have a large impact on the day to day life of the person, including learning disabilities, chronic pain, sensory impairments, and autoimmune and endocrine disorders. While technoableism as a theory is a helpful launching point for a deep investigation into the harms of medical and social intervention, we must expand the scope of the theory to invisible disabilities.

My work aims to expand the scope of technoableism to effectively contend with the hegemonic role that medicinal chemical technology (pharmaceuticals) has in the intervention of invisible disabilities within the education system. This paper highlights the specific use of pharmaceuticals as a tool used by society to restrict individuals to nondisabled ways of life by looking at the harmful tropes in media, literature and entertainment. Through a critical analysis of the speculative fiction novel Percy Jackson & The Lightning Thief my work pinpoints schools as mechanisms for the reproduction of dominant systems of power, calling out pharmableist intervention as it works to fill in the gaps that ideology cannot.

The Ableist Impact of The Ideal Bodymind on Social Structures

Social models of disability hold that disabilities impair the person predominantly because of the way the physical and social world has been developed and structured. The capacity one has to fully participate in society is dependent on the accessibility of that society physically and socially. For example, a building without an elevator or ramps is inaccessible to a wheelchair user. The user in this situation should not be held responsible for the inability to access the building. Instead, the responsibility is placed on the owners of the building. Under this model "disability is a social phenomenon."⁴ A phenomena that occurs because of social influence, including historical and contemporary societal factors. Of course, there are disabilities that cause physical discomfort or limit certain abilities. However, under social models of disability "problems are not in the bodies or minds of [disabled] people but in the stigmas and barriers erected by society."⁵ The physical, mental, and emotional barriers we face are constructed by the way physical spaces and social institutions have been designed. Thus, social context, social structures and the built environment cause dis-ease for certain individuals and access for others.

Following the logic of a social model of disability — society is built for a very specific way of being (white, male, cis, abled, rich) — one might posit that when the cultures' believed ideal "way of being" changes, so too will the believed non-ideal "way of being" change.

When I say 'way of being' I am speaking to our existence as beings in the world, and how we experience such an existence within certain societal structures. In this work I will express 'way of being' as bodymind.

Bodymind, originally coined by Margaret Price, is often used in disability studies to refer to the "enmeshment of the mind and body."⁶ As a theoretical tool, bodymind challenges a Cartesian dualism of the mind/body split within Western Philosophy and has been adopted by many intersectional cross-disability scholars such as Sami Schalk or Ashley Shew to engage with Black feminist philosophy, speculative fiction, and modern-day experiences of oppression. In current disability scholarship, the term bodymind has been successful in producing a theoretical analysis of the ways that "experiences and histories of oppression impact us mentally, physically, and even on a cellular level," as well as revealing the relationship between psychic stress and overall wellbeing. For my use, bodymind as a term is reflective of the evolving relationship between all that there is within our bodymind (physical and spiritual) and our relationship with the world beyond our bodyminds. In other words, the term bodymind reflects the real human experience unique to each individual based on their physical, mental, emotional, and spiritual relationship to the world around them through time and space.

Just as there is a real bodymind, there too is a symbolic bodymind. The symbolic and imaginary bodymind, or the ideal bodymind as I will be referring to it, is the idealized mediating image of the bodymind that operates within the cultural imaginary. The ideal bodymind is an idea or concept. It cannot be fully achieved by a real human. However, despite an inability to be achieved, the ideal bodymind is what a culture will value and what individuals within a culture will be told to strive for.

This ideal bodymind is inextricably linked to the social and cultural institutions of a society. Thus, what is considered an ideal bodymind will reflect the given biases of such institutions. Within the settler-colonial U.S. the ideal bodymind is informed by a deeply racist, classist, cis-gendered, and ableist history. In the U.S. the ideal bodymind informs the way one's real bodymind should look, move, emote, speak, and overall exist in the world. Often such normative statements mediating a peoples are more nuanced and commonly reflect cultural pockets within the larger culture.

The ideal bodymind in the settler-colonial United States of America is informed by ableist normative claims of how a bodymind should look, behave, move, and more. Ableism at its core is the idea of perfection, a striving for the ideal bodymind, that privileges nondisabled ways of being. Talia A. Lewis describes ableism as a "system that places value on people's bodies and minds based on societally constructed ideas of normality, intelligence, excellence, desirability, and productivity."⁷ To be ableist then is to place one's worth upon how closely they coincide with the ideal bodymind or to devalue a person because they do not coincide with said ideals. In my work ableism does not occur only to disabled communities. Ableism can occur to anyone at any time based on presumed in-ability to know, act, speak, learn, etc. to the standards held by the one making the judgement. One might read through a Black feminist discourse my conception of ableism to be applicable not only to the disabled community but all marginalized communities. They would be correct. Ableism at a most basic sense is about ability of which many have argued that within Western cultures in-ability has been wrongly assigned to anyone who is not White, male, and cis-gendered. Within contemporary Western culture ableist assumptions are supported by scientific claims and the medical model of disability, privileging nondisabled bodyminds.

What our current society deems as disabilities — such as a limb difference, Deafness, or attention deficit hyperactivity disorder (ADHD) to name a few — are diagnosed through 'scientific' assessments that measure disabled bodyminds against the ideal bodymind. Care or treatment of disabilities are set up to aim for the ideal bodymind. The development of such assessments is historically rooted in racial and gender biases and privileges one type of bodymind in particular, the ideal bodymind. If one falls far enough away in their assessment from the ideal bodymind then they are deemed disabled.

Value judgements and assessments on ability are not exclusively made by physicians. Everyone, be it teachers, bosses, parents, coworkers, peers, friends, family, even strangers perform ability-assessments, whether consciously or unconsciously, all the time. We have been taught through the production and reproduction of ideology to assess the ability of ourselves and others through comparison to the ideal bodymind. Subliminal and overt messaging about the ideal bodymind are inescapable, especially in the age of advanced technology.

Technoableism → Pharmableism

Shew's work is mainly concerned with disability as it is visible to others. Technology then is ableist in that it has been understood to make disability less visible. Where Shew's concept of technoableism fails is in its interaction with already invisible disabilities, such as ADHD. Inspired by the work done by Shew on technoableism, I have developed the term pharmableism to identify the dominant ideology perpetuated in contemporary Western cultures that operates from a medical model of disability: the belief that the disability creates barriers for the disabled individual and medical intervention can aid in "overcoming" the disability. Medical models of disability suggest that the disabled individual needs to change and pharmaceutical intervention can help them do that. Thus, pharmableism is the belief that pharmaceutical intervention "fixes" what is wrong with the disabled person and should be used to do that.

I am very concerned with the impact that pharmableism has on neurodivergent people. Pharmableism affecting neurodivergent people instantiates the belief that the eradication of neurodivergence is a good thing and should be strived for. What's more, it aids in the invisibilizing of learning disabilities. This message promotes the belief that pharmaceutical intervention will 'fix' the issue and make the person 'normal.' This comes from assumptions about the quality of life of the disabled person being worse off because of their disability. It aims to fix the person and not the society around them.

In my experience, moving through the world is difficult without pharmaceutical intervention. As someone who has been medicated for over half their life I have directly experienced the effective nature of pharmaceutical intervention in making life easier. Even though pharmaceutical intervention works to ease discomfort it places the burden on me to advocate, seek out, and afford such intervention, all in the hopes of relief. It has also created a relationship of dependence on pharmaceutical intervention to be able to tolerate or find academic, personal, and financial success in the world. Such a relationship is not an addiction but must be understood as an internalized reliance or dependence based on external messaging. In other words, when one is told that they need to be 'normal' and pharmaceutical intervention will make them 'normal,' they will begin to depend on medicine to obtain 'normality.'

The use of medication as a tool that aids in the comfort of one's day to day functioning or relieves pain is not what I aim to criticize. In fact, I do not wish to criticize anyone who takes medication for any reason at all. I take medication for ADHD and anxiety, and I am not looking to go off of them any time soon.

Instead, I take issue with the harm caused by the pharmaceutical industry and its auxiliaries (e.g., medical practitioners or the education system) and the effect it has on people's mental, physical, emotional, and economic well-being. The pharmaceutical industry is harmful when it a) privileges the ideal bodymind when developing pharmaceuticals for the disabled bodymind, b) ignores the input or needs of disabled bodyminds during production, c) costs thousands of dollars, even after insurance (or is not covered by insurance), d) is used to push the narrative that taking medication will bring you closer to the ideal bodymind, e) prioritizes that disabled people conform to the ideal, as opposed to the world making changes to be better suited for all bodyminds. Essentially, I take issue with pharmableist social structures.

Pharmableism promotes the erasure of disability through pharmaceuticals. It can do so because of the way pharmaceuticals work. Pharmaceutical intervention is often invisible since pharmaceuticals work from within the body. While pharmaceuticals are sold as a way to help reduce or fix a medical condition. Ideologically they operate to placate the difficulties that arise for the individual from the ableist systemic and physical structures with promises of bodyminds fixed with pharmaceuticals. While it might seem like pharmaceuticals aim to help the individual — and they can — on a larger scale pharmaceutical intervention continues harming the individual while upholding the current ableist structures. The message bodyminds fixed with pharmaceuticals when heard repeatedly engenders a certain self-belief that one is 'broken' or 'failing' without pharmaceutical intervention.

For instance, when I was seven, I was diagnosed with ADHD and the only treatment I received was pharmaceutical intervention. In the following years I developed coping mechanisms while on pharmaceuticals, but when I went off of pharmaceuticals over the summer or missed a dose, these coping mechanisms were ineffective. While unmedicated, others commented on my behavior being irregular or atypical. Peers and adults found me over-energetic, over-talkative, and consistently perceived me as being 'too much.' By reacting to and engaging with me in the way they did, I became inadvertently hyper aware of how others received my actions, emotions, and energy levels on and off medication. Pharmaceuticals became a crutch that enabled me to appeal to the standards of my peers and the adults in my life. Social acceptance, and lack thereof, had a strong influence on the emotional and physical reliance I had on the pharmaceutical intervention I was receiving.

Speculative Fiction Exposing Technoableism

In Western cultures, such as the settler-colonial United State of America, disabled people are portrayed as one-dimensional characters. Casted into very specific tropes.

In the chapter "Scripts and Crips," Shew breaks down the different archetypes and tropes in media, entertainment, news, and memes that appear in stories about disabled people. One trope often used to support the manufacturing and advertisement of assistive technology is the "Inspirational Trope" that highlights a disabled persons journey to "overcome" their disability with the help of prosthetics or advanced technology. In season 18 of Dancing With the Stars, Amy Purdy, a double leg amputee, was paired with pro Derek Hough. Before the show even began airing, Hough interviewed with multiple news outlets about how inspirational his dancing partner, Amy Purdy's, story was. As the season aired, focus was placed on how strong and inspiring Purdy was to be dancing with not one, but two leg prosthetics. Much of her identity besides her disability was overlooked as she was cast into the inspirational disabled person trope.

Another trope is the "Super-Crip," where a disabled person has superhuman abilities either overshadowing their disability or being a direct result of their disability. Charles Xavier (aka Professor X) from the X-Men series is an example of the "super-crip" trope. The disabled villain trope frames disabled characters as immoral and evil, as can be seen with Freddy Krueger in Nightmare on Elm Street and Captain Hook from Peter Pan. The movie Avatar (the one with the blue people) is emblematic of the jaded disabled person trope. Anyone who has seen this movie might remember a jaded Jake Sully — paralyzed from the waist down — waking up in his avatar body for the first time.

Jake was sent to Pandora to replace his deceased twin brother in the Avatar Program. After learning that he was a perfect match for the avatar body designed for his late brother, scientists recruited Jake to take his place in their program. The process of transmitting Jake's consciousness into the Avatar body for the first time required a team of doctors and multiple tests to make sure everything was operating smoothly. Waking up groggy and disoriented, Jake began testing his dexterity. The camera focuses on him wiggling his toes; there is a visible pause in Avatar Jake as he realizes he is no longer paralyzed from the waist down. He clumsily jumps up and breaks out of the medical unit ignoring the warnings from the team of physicians around him. Jake is elated as he tests out his new legs while running a muck through the program's campus on Pandora. As the story progresses Jake makes the decision to stay in his Avatar body forever, abandoning his disabled human body for good.

Shew intended to identify these tropes in Chapter 3 to help "people do better by disabled people"⁸ urging others to create multidimensional disabled characters. It is here that Shew falls short in her philosophical analysis. By stopping at the identification of such tropes Shew fails to question the larger institutions and structures that such tropes are upholding. The examples of tropes that I have given are different from those given in Shew's book. Those I listed all function to support medical models of disability and moral models of disability.

Medical models of disability are the operating models in Western culture, characterizing disabilities as "a physical, sensory, or mental impairment — a disease, injury, or ailment affecting a person's body or mind — that needs to be addressed by professionals (e.g., in medical fields or within disability service organizations). To address a person's functional limitations, professionals determine appropriate medical treatments, rehabilitation, and accommodations to existing physical environments, practices, and services."⁹ Under such a model Amy Purdy can overcome her disability with the help of prosthetics, Professor X can overcome his with the use of a wheelchair and his superpowers, and Jake Sully can overcome his disability through advanced futuristic technology that gives him a whole new body.

Moral models of disability are used less frequently due to the work of disabled activists, but can still be seen in older tropes such as the disabled villain or the jaded disabled person. Captain Hook's villain-hood is inextricably tied to his disability. Like many disney characters, Captain Hook has been flawlessly iconified, reduced to the image of a hook.

As individual stories their impact on our collective consciousness might not seem as large. But as tropes often used as plot devices and character archetypes, one-dimensional disabled characters casted into one of these tropes helps to support the larger social structures and social barriers at play. These models overshadow work done by social models of disability that question the social structures in play that limit disabled individuals from full participation in society.

Withholding from a philosophical exploration of the ways in which such tropes uphold the medical and moral models of disability, Shew forgoes a deeper understanding of invisible disabilities and the tropes, or failed tropes, of such invisible disabilities.

Focusing on the visible is helpful in Shews critique of technoableism when investigating the ways disabled people are encouraged by media and social norms to hide or normate their disabilities with technology. Shew tracks the desire to use prosthetics for the comfort of the looker back to social narratives of what the ideal bodymind looks like. But she fails to account for the social narratives around what the ideal bodymind should act like. As a result, Shew's work on technoableism cannot wholly account for all disabled experiences.

Using pharmableism in place of technoableism when looking at contemporary portrayals of disability in social media and entertainment might help us uncover invisible disabilities.

Not only was I informed by interpersonal reactions to being medicated, I too was informed by the media I was consuming. Growing up I often felt as though I was the only student in my classes with ADHD — which was not the case. Most of the shows I watched did not have characters with disabilities, nor did they show the daily ins and outs of pharmaceutical intervention. The shows that did have characters with ADHD often focused on the "drug dealer trope" that harmfully portrays those taking medication as dealers hoping to sell their ADHD medication for money. Such tropes cause distributive and retributive injustice. While I was never accused of selling my medication, I was always fearful that someone would assume I was selling my medication. Thus, if I ran out early I would go through withdrawal instead of letting my practitioner know because I feared being accused of selling my medication. This trope also made people think it was okay to ask me to give them my medication because they didn't think I needed it. They operated from the logic that if someone is willing to sell it they must not need it, thus anyone taking it must not need it. Distributive injustice has increased as shortages and stricter regulations on ADHD medication have become more common in response to tropes perpetuating the misuse of controlled substances. While there are individuals out there who misuse controlled substances, oftentimes these are not the same individuals who would be prescribed this medication. The disproportionate lack of representation of invisible disabilities in literature and entertainment is something Shew overlooks because of the limitations of technoableism as a theoretical tool. Pharmableism amends this oversight by acknowledging the invisible. Invisible disabilities, while not portrayed as often as visible disabilities in literature and entertainment, provide the unique ability to be reimagined within speculative fiction because of their invisible qualities.

Speculative fiction has been a site for theoretical analysis in many diasporic traditions, including the Africana diaspora, the queer diaspora, and the disabled diaspora. In Bodyminds Reimagined, Sami Schalk uses speculative fiction among these three diasporas to contend with bodyminds beyond what is normative in western contemporary thought. Schalk deems speculative fiction as "any creative writing in which the rules of reality do not fully apply, including magical realism, utopian and dystopian literature, fantasy, science fiction, voodoo, ghost stories, and hybrid genres."¹⁰ Within speculative fiction one finds the "rules of reality" — the rules that construct a culture and society's experience of space, time and embodiment — to bend or completely disregard the physical world the reader currently inhabits.

Schalk gives the example of air travel as we know it today, i.e., airplane or helicopter. In the Middle Ages air travel was not a rule of reality for people and "yet it is an accepted possibility today even for those who have never experienced this type of travel themselves."¹¹ As technology and aviation advanced, our "rules of reality" shifted to include the concept of defying gravity with technology. Speculative fiction written today might bend our current "rules" by normalizing teleportation or a mutation that allowed all humans to grow wings.

Applying a speculative fiction analysis to the movie Avatar might assist in exposing limitations of technoableism within disability discourse. The movie Avatar is meant to critique the violent and exploitative aspects of colonialism through the story of Jake siding with and overtaking the RDA (the militant operation running the Avatar program) the rules of reality within the world are pro-colonialism, pro-scientific discovery, and ableist. But to what extent does the message of the movie align with the ableist rule of reality within the movie? Jake Sully is introduced as a person with paraplegia and a wheelchair user. As a marine veteran, Jake's jaded personality while in his human body makes for a stark difference when he is in his Avatar body. In his Avatar body, Jake is portrayed as having a new lease on life and is 'able' to gain a moral compass when he learns that the Avatar program has been violently taking land, resources, and lives from the Na'vi, the native Avatar people on Pandora. The contrast of his personality while in these different bodily forms affects his disabled body as lacking morals and being inept, while granting his able body with moral faculties and greater physical capacities.

Within the rules of reality of Avatar, not only does technology pose the chance for a cure to physical disability, but also creates the reality of moving a person's consciousness from one body to another. Such rules of reality conflate the body to a mere vessel for the human consciousness that can and should be overcome with the help of technology. Seemingly supporting transhumanist thought, which in itself is inherently ableist.

Early on the audience learns that one of the reasons Jake is participating is because he wants to find a cure for his paralysis. However, instead of finding a cure for his original body, the writers remove Jake from his original body entirely. Discarding it in a traditional Na'vi burial at the end of the movie. In doing so, the writers are inadvertently sending the message that the disabled body is something to be abandoned or discarded. The body is to be changed, not the world. But what would happen if the disability was not in the body but in the mind? Does the removal of one's consciousness from the body remove learning disabilities or mental health conditions? To what extent are the body and the mind separable within the Avatar world? All of these questions relate to the invisible, the disabilities that technoableism cannot account for.

Speculative Fiction Exposing Pharmableism

This section focuses on a more positive representation of invisible disabilities within contemporary popular entertainment and literature. Framing it as a speculative fiction can help expose pharmableist assumptions within our everyday social institutions.

Percy Jackson & the Olympians, by Rick Riordan, is a novel series in which the main protagonist, Percy, is an adolescent boy who over the course of the first book comes to learn that he is the demigod son of Poseidon. Unique to the genre at the time, 2005, Percy has ADHD and struggles to fit into the human world. Under Schalk's definition, Riordan's novel series is considered speculative fiction because it is a novel in which our rules of reality do not apply, unless you believe that we walk amongst demi-gods.

In the fantasy world of Percy Jackson & the Olympians, what is considered a normal bodymind within the human culture Percy was raised in differs greatly from that which is considered normal to the demigods he meets at Camp Half Blood. Upon meeting Annabeth, demigod daughter to Athena goddess of wisdom and warcraft, and one of the protagonists close confidants, Percy comes to know his learning disabilities (dyslexia and ADHD) to be impairing only within the human world. Annabeth re-conceptualizes for Percy that which has been preventing him from full participation in the human world:

Taken together, it's almost a sure sign. The letters float off the page when you read, right? That's because your mind is hardwired for ancient Greek. And the ADHD—you're impulsive, can't sit still in the classroom. That's your battlefield reflexes. In a real fight, they'd keep you alive. As for the attention problems, that's because you see too much, Percy, not too little. Your senses are better than a regular mortal's. Of course the teachers want you medicated. Most of them are monsters. They don't want you seeing them for what they are.¹²

Percy is limited to his participation in human schools because of the language used in the classroom, the physical spaces confining Percy, and the speed at which society moves: all of which are socially constructed "rules of reality." In other words, the language we use, spaces we create, and the speed at which we operate are constructed by humans and can be deconstructed by humans. What constitutes a "real" disability in the human world Percy grew up in is very different from that which is considered disabling in the demigod world.

By juxtaposing the "rules of reality" of two different worlds within Percy Jackson & The Olympians, Riordan unintentionally provides us with evidence supporting social models of disability. Aside from ADHD and dyslexia, Riordan introduces a variety of characters that are considered disabled in the human world but not so in the demi-god world. Percy's best friend, Grover, is a satyr (half human-half goat). In the human world, to disguise his unique gate due to his lower goat extremities, Grover uses crutches. Passing as a person with a mobility disability. Percy's mentor Chiron, a centaur, uses an enchanted wheelchair in the human world to disguise his lower horse-half. The beauty of Riordan's novel series is that as speculative fiction, it challenges the rules of reality held by readers in a way that allows us to suspend our disbelief and become comfortable with disabled bodyminds. Providing imaginative frameworks for what the bodymind can be.

To be sure, the "rules of reality" within the demigod world are not perfect. Much like the social organization of the human world, the social structures and physical design within Camp Half Blood reflect a social hierarchy operating below the surface. Disproportionate social organization can be seen in how Camp Half Blood organizes and operates its cabins, with the cabins of the big three (Zeus, Poseidon, and Haites) having the highest status, and the Hermes (messenger god) cabin being the catch-all for any unclaimed demigods and his many off-spring from his illustrious travels. If you are not the child of the god, you are not granted constant access to any cabin other than your own. What's more, Camp Half Blood itself, while considered a safe-harbor for any demigod, choses to only home human demigod children. Until the second book in the series, The Sea of Monsters, when readers are introduced to Percy's half-brother Tyson. As a cyclops, Tyson is relegated to the bottom of the social hierarchy and is gawked at when he arrives at Camp alongside Percy. The "constructed notions of what constitutes a 'real' disability, gender, race, and so on"¹³ within the "rules of reality" in the demigod world construct race not as tied to skin color but instead parentage (child of Poseidon and a nymph). Within theogony, cyclops are skilled blacksmiths known to serve gods and human demigods. In the novel series, cyclops are encouraged by social norms to obscure their one eye with the Mist — a magical veil that disguises all otherworldly things from the eyes of humans. Because Percy is half-human, he fails to see Tyson's true nature until they arrive at Camp Half Blood and the rest of the campers — more accustomed to seeing beyond the Mist — treat Tyson as a second-class citizen. Percy, unsure what to make of Tysons' change in appearance, begins to treat Tyson not as another demigod, but as a monster. Such treatment informs Tyson to continue masking his true nature until the end of the book when Percy comes to accept Tyson for who he is and the strengths of his character.

The beauty of a book like Percy Jackson & The Olympians is that it provides neurodivergent children representation within a positive context that allows them to dream beyond the restrictive reality they might live in. However, such representations are only partial and often are unaware of the other norms they are reproducing. Riordan set out to provide his son with ADHD representation, and while he partially did so, he also reproduced other oppressive systemic structures operating in the real world. Thus, as much as these partial representations help, they also hurt.

The reason that Percy Jackson is a partial representation of ADHD is because it is informed by the collective conception of ADHD held within Western culture. The conception of ADHD that we hold in our collective pool of knowledge is male-centric and white. Western society is heavily influenced by frameworks backed by science. Such science, although marked as subjective, often carries with it the biases of the producers of knowledge. Most of the research that has been done on ADHD, especially before 2005, was done on male participants. Many clinical trials testing out the effects and efficacy of ADHD pharmaceuticals were also administered only on white male participants. Both of these contribute to the stereotypes around Dyslexia and ADHD that Riordan is listing in his novel: letters floating off the page, impulsivity, and inattention. Although he is trying to provide a reimagining where one's learning disability is a strength, he loses sight of the patriarchal and racist norms that formulate these stereotypes.

In spite of its shortcomings, Percy Jackson & The Olympians pushes back against the medical model of disability and encourages young readers to see their invisible disabilities as empowering. However, we must proceed with caution in regards to the framing of said disabilities. The "super-crip" trope is when a character's superpower gives them a disability. In the book Percy's ADHD is a result of his being a demi-god. At face value it would seem that Riordan has fallen into the tropeing of disabled characters, casting Percy as a "super-crip." Yet, through a speculative fiction reading where the rules of reality are taken into account, it becomes less clear if Percy is a "supercrip" or if Riordan is rejecting moral and medical models of disability by reconstructing the rules of reality. In so far that the world Percy should be living in (the demi-god world) is structured for him and the world he was forced to live in (human world) was not structured for him. We come to find out that the traits he has inherited from his god side impacts his seamless existence in the human world, but that too can be said about his human traits in the god world. Within such a reading Percy is not meant for the human or the god world, but the demi-god world. Highlighting the impact that world structures have on the ability to participate fully.

In the context of pharmableism, Riordan pushes back against the use of pharmaceutical intervention to fix neurodivergence. Annabeth exclaims, "Your senses are better than a regular mortal's. Of course the teachers want you medicated. Most of them are monsters. They don't want you seeing them for what they are."¹⁴ Of course, in the rules of reality prescribed to the physical world, those who encourage pharmaceutical intervention are not actually mythological monsters in the literal sense. Despite this, many children reading Percy Jackson can relate to feeling like their teachers and other adults are against them.

Readers also can relate to Percy's feelings, prior to discovering his true parentage, that something was wrong with him. For Percy, the world around him has fed him the message that something is wrong with him that is making it so hard to participate successfully in society. Pharmaceuticals are discussed as an aid to help him 'overcome' his shortcomings. What the reader and Percy come to find out together is that his medication was meant to obscure the systems of power that were harming him. When reimagined by Annabeth though, Percy comes to realize that pharmaceuticals have been inhibiting him from using his demigod traits to see the systems working against him. What's more, he comes to know the world as the cause of friction and not his innate behavior. He comes to realize that he does not need to change, the world does. The villains in Percy Jackson's life rely on pharmableism to ensure that he cannot break the system by medicating him into submission.

Where do we see this occurring most? For Percy, it is his school teachers, admin, and his mother that encourage the use of pharmaceuticals. In Percy's world, external push to take pharmaceuticals comes from those that need him to conform to the human world. The push from his mother comes from a place of fear and protection. The school admin encourages him to medicate for his academic success. However, the literal mythological monsters posing as his teachers need him to medicate so he cannot see them for what they truly are: harmful. While teachers in our world are not monsters, this exaggerated metaphor in Percy Jackson turns suspicion back onto the systems in place that encourage people with disabilities to change their bodyminds through pharmaceutical intervention. If we want to understand the pervasiveness of pharmableism on a deeper level, we must look to the main site of its reproduction, schools.

School

While these fictional worlds provide representation as a site for a reimagination of disability, what they really are doing is putting a mirror up to Western culture. However, this does nothing if we cannot transcend the mirror image we are exposing. In order to change our rules of reality we must look at the site of reproduction. In this case we must look towards schools as ideological state apparatuses.

Within Marxist scholarship, state apparatuses are the institutions and structures used by the ruling class to maintain its power and control over society. In Ideology and Ideological State Apparatuses, Louis Althusser makes a theoretical amendment to the classical definition of the State as State Apparatus given in Marxist theory. Distinguishing between the two operating branches of the state apparatus:

In order to advance the theory of the State it is indispensable to take into account not only the distinction between state power and state apparatus, but also another reality which is clearly on the side of the (repressive) state apparatus, but must not be confused with it. I shall call this reality by its concept: the Ideological State Apparatus.¹⁵

In doing so, Althusser amends our understanding of how state apparatuses function and the sites in which repressive or ideological control is being reproduced. The two branches are the Repressive State Apparatus (RSA) and the Ideological State Apparatus (ISA). Unlike RSA's — such as the Government, the Army, or the Police — ISA's "present themselves to the immediate observer in the form of distinct and specialized institutions" like schools or churches.¹⁶ While ISA's stand out to Althusser as capable of being plural and private, the main difference between RSA's and ISA's noted by Althusser is the way in which the two function. "The Repressive State Apparatus functions 'by violence', whereas the ideological State Apparatuses function 'by ideology.'"¹⁷ While both State Apparatuses can function with both violence and ideology, the differentiating feature is that RSA's function "predominantly by repression (including physical repression), while functioning secondarily by ideology."¹⁸ In doing so, RSA's are able to ensure the cohesion and reproductions of labour power. ISA's function predominantly by use of ideology and only through suitable methods of punishment do they function by repression.¹⁹

Among the empirical list of ISA institutions given by Althusser is the educational institution; "the system of the different public and private 'schools.'"²⁰ It is here that my focus is drawn.

Following that the "ruling ideology is active in the Ideological State Apparatuses insofar as it is ultimately the ruling ideology which is realized in the Ideological State Apparatuses" I am interested in examining how pharmableism functions within schools to reproduce labour power.²¹ Under Marxist theories, wages are utilized to ensure the reproduction of labour power by giving laborers material means to reproduce themselves.²² However, Althusser concerns himself with the ways in which competent labourers can be reproduced. He suggests that this is achieved "outside of production: by the capitalist education system, and other instances and institutions."²³ Thus arguing that the production of means of production and the production of means of consumption are dependent on ISA's to reproduce diversely skilled and competent labourers. He goes on to suggest that schools are the main locations in which the state apparatuses can control the successful production of future producers, and this is done through ideological reproduction.

However, I do not think that schools can be understood as predominantly ISA's. I posit that "know-how" and "good behaviour" taught in schools can not be enough to ensure the reproduction of a competent labour power in all individuals. I believe that the school system functions with equal amounts of repression and ideology in order to remain the primary site for the production of future workers. Althusser overlooked the violence experienced in schools because of his social location as a 20th century male French philosopher. As a result, he might not have been aware of the acts of violence that occur in schools for the sake of maintaining dominant power structures. Oftentimes, such repressive violence is felt in the margins of the education system. University of Illinois Chicago professor and activist, David Stovall, might be read as in agreement with my amendment.

He writes that 'school' reproduces the ruling ideology, quoting Mwalimu J. Shujaa: "Schooling is a process intended to perpetuate and maintain the society's existing power relations and the institutional structures that support those arrangements."²⁴ Similar to Althusser, Stovall understands 'school' to be a location in which dominant ideology is re-produced through relations of power and the dissemination of "assumed beliefs and cultural values" of the ideal bodymind ("White, Western European, protestant, heterosexual, able-bodied cis-gendered males"²⁵). However, while Althusser understands schools to be an Ideological State Apparatus, only secondarily functioning by repression, Stovall pushes forward the understanding of 'school' as a school-to-prison pipeline, reframing it as a dynamic school-prison nexus:

The school operates as a jail, hence a nexus between school and prison. If you think about a place where students are punished if they do not walk on demarcated lines in the floor, are required to remain silent during lunch, required to wear uniforms (including clear backpacks), subject to random searches, and are fined for being out of uniform, this place is not "leading" you to prison. Instead, we should understand this space as an operative prison, with the main difference being that you are allowed to go home every afternoon.²⁶

With this I want to reframe 'school' as a location where both repressive and ideological control is not mutually exclusive and ranges based on one's locality to the ideal bodymind.

With this reframing the monsters disguised as teachers in Percy Jackson reveal the role that teachers play as exploiters' auxiliaries, to put in terms of Althusser. These auxiliaries are the managers within the ideological state apparatuses. As such, they manage the production and reproduction of ideology within the mechanism of school. But with Stovall's addition, they are also the prison guards, ensuring their students 'good behavior' both through ideology and violence. Such violence is not always overtly abusive. Much of the violence that occurs in schools at the hands of auxiliaries is invisible or obscure. Isolation, degradation, and pharmaceutical intervention all function as repressive violence with the goal to control power relations. Similar to solitary confinement, isolation in schools occurs as a punishment to 'bad behavior' through the removal of one from the classroom environment. Isolation can be impermanent or temporary — being sent out of the class, suspension, detention, and other forms of physical removal. It can also be permanent: expulsion, special education courses, and boarding schools. Degradation in prisons at the hand of prison guards starts from the moment they are entered into the system as numbers — effectively dehumanizing the person — and continues as their individuality and voice is silenced. In schools, degradation occurs in discursive practices at the hands of auxiliaries in many different ways. For instance, shaming students for talking out of turn. Pharmableism undergirds the degradation of people with disabilities, especially learning disabilities, by shaming students for their behavior or challenges in the classroom and encouraging them to medicate in order to be a more "successful" student. Pharmaceutical intervention is needed within the school system because ideology on its own is not effective for the exploitation of all students.

Schools function through the transmission of dominant knowledge from the exploiters' auxiliaries (teachers and admin) to the exploited (students). The dissemination of dominant knowledge has been codified by government intervention and cultural practices into a dominant pedagogy that favors a certain type of student, the nondisabled straight white cis-male student. It is designed with that specific student in mind to maximize the learning of "know-how" and "good behavior" over the course of a student's time in the education system. As a result, few students find success early on in their academic career without external intervention from the repressive side of school. The farther one is away from the ideal student the system was based on, the less likely they are to be permeable to the ideology being dispensed. The less permeable one is to ideology, the more likely they are to experience violence. As such, violence is concentrated at the margins.

Since it has become less common for overt violence within school systems — no longer can teachers get away with using a ruler as a physical form of punishment — alternative measures must be promoted to encourage a students permeability to the ideology being reproduced in school. It would seem that the alternative measure that has taken hold within the 21st century is the use of pharmaceutical intervention coupled with degradation and isolation to maximize a students productivity, efficiency, concentration, and prudence. The results of such intervention is not only a malleable student for exploitation, but the increase in invisible violence occurring economically and at the level of embodiment (i.e., lack of self-confidence, reliance on finite resources that cause withdrawal when unavailable, monthly costs for prescription, etc).

As we begin to look at school not as a place of education but as the location for the reproduction of ideology by means of pharmaceutical intervention, we must conduct epistemic investigations into how pharmableism is impacting the epistemic agency of those within the margins.

Conclusion

While my work focuses only on the aspects of Shew's work that fall short, it does not aim to ignore the importance of addressing the role of technoableism in the reproduction of dominant systems of power. It should be understood that pharmableism is an off-shoot of technoableism, and that both are necessary in the production and reproduction of ableist structures. Thus both must be accounted for in a critical investigation of ableism in disability studies.

My work was intended to closely look at pharmaceuticals as forms of medicinal chemical technology that work to make the exploited permeable to hegemony. Specifically looking at the use of tropes within literature and entertainment proved how pervasive pharmableist ideology is within Western culture. What's more, the focus on literature and entertainment exposed the need of pharmableist ideology within the education system to maintain the mechanism that is the educational ideological state apparatus.

My hope is that readers leave with a new found understanding of disability as a result of oppressive social and cultural power systems. My hope is that those taking medication for their disability come to see pharmaceutical intervention as a tool that allows them to survive in a world that was built against them. Not as something that can 'fix' them. You do not need to be fixed. Finally, I hope that this work encourages all who might read it to pay more attention to schools.