• Volume 65 , Number 1
  • Page: 105

Book review

Frist, Tom. Don't Treat Me Like I Have Leprosy! A Guide to Overcoming Prejudice and Segregation. London: International Federation of Anti-Leprosy Associations (ILEP). 1996. Softbound, 174 pp., English. ISBN 0-94754-312-9. Available from ILEP, 234 Blylhe Road, London W14 OH J, U.K.

Tom Frist has written a "Mein Kampf' book on the integration of leprosy patients into society. His views are difficult to understand until the reader grasps the author's basic conception that leprosy is mainly a disorder of society instead of a biomedical entity. The disease itself is dismissed as a virtually noncontagious, easily curable, and rarely deforming disorder which is on the verge of being eradicated in any case. The author's concept is that leprosy patients (or persons affected by leprosy, as the author prefers for those who are not currently in need of treatment to kill the causative organism) are an oppressed minority in the same fashion as African Americans were seen to be in the 1960s, women were seen to be in the 1970s, and homosexuals and AIDS patients are currently seen to be by some. The only politically correct course of action for a "prime mover" is to right these social injustices with all the means at his/ her disposal.

The means to right these wrongs are the tactics of political and social activism pioneered by Gandhi in the campaign for Indian independence, perhaps perfected by Martin Luther King and associates in the U.S. civil rights movement, furthered by Gloria Steinem and others of the feminist movement, and currently pursued by ACT UP and others for gay rights and AIDS patients. The goal is to return a leprosy patient to society so completely that his/her life is exactly the same as it would have been had he/she never contracted the disease.

The logic in the book is internally consistent so long as the reader accepts the basic assumption that leprosy is mainly of consequence to a leprosy patient only because it causes him/her to be discriminated against in society. The courses of action outlined for integrating a leprosy patient into society are logical and well thought out, and are undoubtedly the result of pioneering experience gathered over many years by the author. It is difficult for many with experience as physicians in leprosy work to understand the concept that traditional leprosy services can be dismissed as paternalistic and demeaning to the patient and that all essential medical and rehabilitative services can, and should, be provided by someone in the patient's own home town or village. Indeed, the book targets traditional leprosy organizations for change along the lines outlined for other sources of opposition to the author's fundamental concept of the disease.

The author's logical consistency is perhaps no better illustrated than in a section on page 136 dealing with the proposed abolishment of laws that may grant leprosy patients certain advantages as to pensions, health care, and other benefits. The author advises that leprosy patients band together with "other minority groups" to gather enough strength to repeal these laws and thus rid themselves of the unfair advantages that they, the leprosy patients, hold over those who may be equally deserving but have not had leprosy. Lacking the author's credentials in social matters, this reviewer is unable to refute the likelihood that leprosy patients will follow such a suggestion, but it does seem to run counter to my overall perceptions of human nature.

All in all, the book makes for interesting reading. It goes a long way toward explaining what, to some traditional leprosy workers, are some rather bewildering points of view from "prime movers" who supposedly are working toward the same goals as traditional leprosy workers, i.e., the benefit of patients with leprosy. If all leprosy were indeterminate and were Mitsuda positive, perhaps we would all share the author's points of view. But, if that were the case, I imagine that very few, if any of us would be in full-time leprosy work to begin with. - RCH

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