Institutionalization as “Alternative Lifestyle”: Susan Nussbaum’s “Good Kings Bad Kings“

Susan Nussbaum’s first novel, “Good Kings Bad Kings,” portrays abuse endemic to contemporary nursing homes for children and youth with disabilities.

Toni Morrison once wrote that “Sweet Home,” the Kentucky slave plantation depicted in her Pulitzer Prize-winning novel, Beloved, “was named [without] posture(s) of coziness or grandeur or the haughty yearnings of arrivistes and estate builders for the parallel beautifications of the nation they left behind, laying claim to instant history and legend.” In doing so, she makes the point that “Sweet Home” referenced a pastoral place that enclosed fierce instances of violence and brutality toward the slaves who labored and died there. Even the most exemplary slave institutions produced horrors that a novel might effectively expose through its capacity to individuate stories of systemic experiences of violence.

Susan Nussbaum’s first novel, Good Kings Bad Kings, pursues a similar undertaking in detailing the specifics of abuse endemic to contemporary nursing homes for children and youth with disabilities. Such state-sponsored spaces of exclusion did not disappear from the social landscape, but have gone underground, so-to-speak, in the for-profit warehousing of human beings industry. As the novel’s opportunistic institutional physician comments, “He had a product to sell and the product was nursing-home patients.”

For starters, the novel surfaces with a portrayal of institutionalization often mistakenly believed to have died with state-sponsored eugenics (the effort to improve human heredity through reproductive prohibitions on sexuality for deviants). These contemporary lockdown units operate as dumping grounds for those, such as parents of children with disabilities, seeking respite from the exhaustion of caretaking a reviled, under-supported population (i.e. disabled people). Residents of institutions are primarily individuals younger than 22, whose level of disability makes them unsuitable for participation in a competitive labor market with its inflexible commitments to standardization, productivity measures and normative appearance.

Nussbaum’s characters all inhabit the euphemistically titled Illinois Learning and Life Skills Center (ILLC – “Emphasis on “ill”); a modern day “state-of-the-art” facility promoting itself as a “lifestyle alternative” choice for kids with disabilities who would otherwise end up on the street or, worse, dead. It is within this extreme mortality measure criteria that the institution justifies the cause of removing its patients’ liberty as a benign social service. Thus, contemporary institutions continue in our moment, albeit shined up with new diversity rhetoric, as disciplinary sites of exclusion passing as living spaces of choice funded by the state and other private investment interests.

The scenario Nussbaum illustrates is exemplary of neoliberal privatization schemes wherein states get out of the business of running institutions and imprisoning their citizens by outsourcing the distasteful practice. Readers quickly realize the disturbing truth of a contention made some years ago by conservative Alabama Governor George Wallace (turned paraplegic by an assassin’s bullet) that institutions are for the relief of the burden of disability on family and neighbors – but not for the comfort of disabled people themselves (Schweik). Yessenia, a parentally abandoned Puerto Rican-American disabled teen, explains it best when she argues to a reporter during a protest of institutional abuse that, “We got no place else to go, and the least they could do is take care of us and make sure nobody gets beat up or gets raped or left in the shower by mistake and killed” (events that all occur at ILLC by the novel’s conclusion). The bar of what counts for care in these settings is indeed low, but practitioners fall short nevertheless. Ultimately, the novel argues for the recognition that violence proves inherent in institutions organized as punitive places of erasure for the inconvenient fact of human variation.

The supervisor of ILLC, Tim, basks in a conspicuous level of personal wealth based on the profitability of the institutionalization industry. He owns several houses, a large yacht and expansive influence in Big Pharma. While employees of the institution do not live lavishly by most measures, they earn their living based on a willingness to oversee disabled peoples’ exclusion from sociality. To screen the gap between upper management and the lower-labor echelons, Tim employs Machiavellian tactics of control: He throws parties, takes his staff to expensive dinners, and includes his employees in vacations paid for by drug industry captains, where they receive free drug samples as perks. While all of this is going on, the residents’ medications are kept under lock and key where they cannot get to them as needed or supervise their own prescription-taking practices. Yet, prescription control is just one tactic in the contemporary institution’s expansive repertoire of keeping residents from realizing dreams of escape to life on the outside.

Having to pass tests to use the elevators independently or step outside into the institution’s defoliated courtyard effectively diminishes the ability of all residents to live on their own over time. In other words, institutionalization fits one only for life in an institution, thus fulfilling a deterministic prophecy of the ill-fitted nature of residents to pursue non-institutional life options. By creating a population of institutionalized subjects, the institution effectively guarantees its own continuation into the future. As one of the ILLC administrator’s comments, “We’re one of the few businesses for which there will always be a need. We’re like funeral directors.”

In addition to administering prescriptions and testing regimes for banal tasks of living, the institution oversees an expanding repertoire of disciplinary practices. Time-out rooms, food withholding, inept caretakers, arbitrary rules of restriction, and petty tyrannies of aversion to non-normative bodies abound; as a result, the residents take turns experiencing their self-esteem destroyed as a routine outcome of institutional life. Even a tokenistic effort to hire one disabled employee, Joanne Madsen, results in suspicions of her loyalty to the able-bodied cause of keeping disabled youth under permanent lockdown. While Yessenia’s schizophrenia surfaces in what her fellow resident Cheri Smith describes as “seeing patterns on the wall,” Joanne begins to recognize systemic patterns of abuse as she enters data from neglected patient medical files. Out of 82 residents, 32 full admissions to the hospital have been recorded in one seven-month period; as Ricky Hernandez, the Puerto Rican driver and reluctant bouncer, explains to Joanne: “Petri dishes. It’s like that. The place is crawling with bugs.”

The bacterial cesspool of large group home living proves to be not only detrimental to resident health, but also beneficial to institution physicians. Dr. Caviolini, whose medical imperialism is captured in his insistence to “call me Roman,” turns his medical practice into a Ponzi scheme. He and a group of participating doctors charge huge costs to Medicaid and Medicare by ordering unnecessary X-rays, scans, and chemistries on their disabled patients who don’t always need a trip to St. Theresa’s, the ghost town of a hospital set aside especially for institutionalized residents. Both hospital and institution occupy buildings long ago abandoned by the state, only to be resurrected by private insurers and service providers as an enormously important resource to the uncontrolled amassing of profits.

Toward the end of the novel, a group of residents follow the lead of Yessenia, who belts herself and her wheelchair to a sapling at the building’s front entry in protest; sympathetic journalists looking for a spectacle to report superficially identify the problem as the result of staff cutbacks and cost-saving measures. Perhaps, but Good Kings Bad Kings provides no pre-cost saving optimal time of support where the institution was productively fulfilling its public mandate of caretaking. Scandals abound throughout the institution’s history and much of the time is spent in meetings figuring out how to strategically implement “damage control.” The menacing nature of institutional caretakers’ approach to assistance haunts resident Mia Oviedo’s dreams in the image of a large bird with claws roosting on the top of her closet door.

In the tradition of other socially engaged social justice fiction such as Michelle Cliff’s If I Could Write This in Fire, I Would Write it in Fire, Carolyn Chute’s The Beans of Egypt, Maine or Barbara Kingsolver’s The Poisonwood Bible, Nussbaum’s Good Kings Bad Kings captures the creativity and folk wisdom of those who are subject – in this case, disabled youth seeking to navigate the labyrinthine nature of today’s carceral institutions. Awash in the invasive bureaucratic chartings of diagnostic pathologies and records of minor infractions portrayed as criminal regarding the institution’s unevenly applied rules of engagement, ILLC arrives as an important example of what educational sociologist Henry Giroux identifies as the “new culture of cruelty” emerging in the United States in Disposable Youth: Racialized Memories and the Culture of Cruelty:

At the heart of this corporate-driven market rationality is an egocentric philosophy and culture of cruelty that sell off public goods and services to the corporate and private sectors while simultaneously dismantling those public spheres, social protections, and institutions serving the public good. As economic power increasingly frees itself from traditional government regulations, a new global financial class asserts the prerogatives of capital and proceeds to destroy systematically those public spheres advocating for social equality, along with the educated citizenry required for a viable democracy.

Unfortunately, Good Kings Bad Kings shows us that the “culture of cruelty” is thriving at ILLC even among the most well-intentioned overseers. Resident experiences of cruelty deepen and their living conditions degrade from uninhabitable to animalistic over the course of the novel. The institution realizes the degradation involved in treating people “with pre-existing conditions,” in conservative pundit Mike Huckabees’s words, “like houses that have already burned down,” as quoted in Disposable Youth. The gutting of social services and state funding of institutions coincides with anthropologist Susan Koshy’s argument that the decimation of social services comes in the midst of a populist rhetoric of lavish public expenditures that create “a simulacrum of inclusiveness, even as it advances a political culture of market individualism that has legitimized the gutting of social services to disadvantaged minorities in the name of the necessities of the global economy.” Such an irony of expenditures, while implementing cutbacks, often pits racial and ethnic minority communities as antagonists toward each other and disability subpopulations within.

However, this is largely not the case in Nussbaum’s novel, where disabled people of color enter into alliances with racialized care workers and transgender staff. Those who experience social devaluation on the basis of bodily deviations from white, able-bodied norms, share affinities for managing reduced opportunities and the necessity of piloting alternative lives. While the novel does not collapse experiences of oppression into each other to claim similarity of marginalization, it does expose how losses precipitated by social neglect and poverty create foundations of identification. For instance, Ricky analyzes the victimization mentality of institutional care workers who, in a perversion of psychological reversals, often see themselves as abused within institutional power structures by residents: “The kids ain’t the victim. No. The grownup is the victim . . . You gotta do some deep self-deluded backflips in your brain to see yourself as the victim when you’re the pig at the truncheon beating some guy’s head in. It’s a whole psychology they got, some of these people.” Or when Jimmy Kendrick, a transgender institutional body care worker who leads an “all lesbian band” springs Yessenia from the institution one night to attend one of her performances, the goal of which is to expose the disabled teen to the celebration of bodily difference available within queer women’s subculture: “I told her what the scene was gonna be too – like, just women. All types of women, who are all types of lesbians.” These moments represent ways in which insights into human variation lead to the creation of usable ethical maps for navigating social disenfranchisement.

Good Kings Bad Kings asks us to consider some of the most difficult questions regarding the treatment of people with disabilities in the deepest underbelly of social banishment. While Joanne argues for the necessity of analyzing a system that coerces people into perpetuating violence on others, Jimmy believes such an approach obscures personal responsibility: “It would be a whole lot easier if you would stop saying ‘System’ because you use the word as if it’s something people can see, and it’s not.’ I say. ‘It’s not like you go into a building and it says SYSTEM on the door.’ ” Nussbaum allows the novel to expose systemic violence by offering readers a multi-perspectival reading experience that nuances the kinds of exploitation disabled people may encounter. Thus, she offers a more saavy, less passive version of disability – a new culture of disability responsible for its own insights into worlds largely neglected by earlier theories of social exclusion. As one staffer sinisterly explains to resident Teddy Dobbs, after locking him in the time-out room: “I can be a good king or I can be a bad king,” demonstrating the ease with which staff can knowingly swing between extremes of care management depending upon the arbitrary dictates of the moment. Ultimately, Good Kings Bad Kings shows us that no such dichotomy is allowable when power over the liberties of others is at stake.

Works Cited:

Koshy, Susan. “Morphing Race into Ethnicity: Asian Americans and Critical Transformations of Whiteness,” boundary 2 28.1 (2001): 153-194.

Morrison, Toni. “Unspeakable Things Unspoken: The African American Presence inAmerican Literature.” Michigan Quarterly Review 28.1 (2000): 1-34.

Giroux, Henry A. Disposable Youth: Racialized Memories and the Culture of Cruelty. New York: Routledge, 2012.

Schweik, Susan. Unpublished presentation for Keynote Panel commemorating the 50th anniversary of the publication of Erving Goffman’s Stigma: Notes on the Management of a Spoiled Identity. Society for Disability Studies: Orlando, Florida, June 2013.