by Reid Fitzsimons

From 1986 to 2001 I worked for the NY State Office of Mental Retardation and Developmental Disabilities (OMRDD) as a medical practitioner (PA). This was at one of a number residential institutions scattered throughout NY, located in a fairly rural area as was common for such facilities. We had an in-house population of around 300, with people ranging from profoundly retarded requiring total care and often with severe medical co-morbidities, to mildly retarded, who were generally were able to talk, walk, and take care of their basic needs with supervision. It was a job to feel good about: society taking care of people who truly couldn’t take care of themselves.

With a few exceptions, the employees who interacted daily with our population were caring and competent, this being especially the direct care aides and the nurses; it can be a tough job, both physically and emotionally. Ultimately the facility was controlled by bureaucrats, and with all bureaucracies there were petty people lusting for petty power and involved in petty intrigue, but at the direct care level it wasn’t too hard to remain oblivious to such nonsense, at least for most of my time there.

Bureaucracies typically create their own jargon and euphemisms, which frequently change depending on the whims of rarely seen bureaucrats. When I first started in 1986 the people in our care were not called the historical name of “inmate,” nor were they called patients, but the designated word was “client.” I always thought this was a little silly because it implies a cognizant two-way relationship, but assumedly someone deemed it a humane, non-pejorative title, which was okay. Nevertheless. people with important positions felt compelled to change the wording, so over the years we used “individual we serve,” “service recipient,” “consumer,” and after I was gone I heard “colleague” was in vogue. To me the simple word “resident” would have been both accurate and polite, but it never entered the lexicon.