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March 20, 1991

A Lament for Invalids

JAMA. 1991;265(11):1374-1375. doi:10.1001/jama.1991.03460110040011

The invalids have disappeared. And most of us didn't even notice. As best I can determine, I'm the only person who noticed the passing. A sociological event of that magnitude deserves at least some comment.

My Great Aunt Sis was an invalid. She lived with her widowed niece and her bachelor nephew. Aunt Sis was a spinster, a common but by no means necessary condition to be an invalid. She lived until she was 89 years old, then died quietly in her sleep at home.

When I was in medical school in the early 1950s, in the middle of the pathology course, I began to wonder what specific disease had killed each family member. Aunt Sis came to mind.

What dreadful disease could keep a woman in bed for 20 years, yet could remit, even vanish for periods? On most of our visits Aunt Sis would sit in her room