I have very strong opinions about Million Dollar Baby and the messages it sends. Like watching the movie, writing this piece was both pleasing and painful. Your experience may be similar.

The pleasure comes from watching a well-written, well-directed, and well-acted film that, from an artistic standpoint, deserves all the awards it received. Clint Eastwood and Morgan Freeman, both veteran actors, give performances so strong they seem to overshadow even the best roles of their recent past. Hilary Swank draws viewers into a life only a few can imagine—both as a skilled boxer and as an injured one. The storyline is crisp and quick-moving, providing several moments of laughter as well as many scenes that bring tears. Heck, even the music, written by Eastwood, is wonderful. The movie is full of dramatic mood swings that add to its depth. I can see why movie critics have given it “two thumbs up.”

My pain stems from reflections on my own life experiences evoked by what critics call the “film’s tragic ending.” I was reminded how, in 1978, I was the subject of active discussions about living out my life in a nursing home. Embedded in the movie are the attitudes and practices I experienced nearly 30 years ago. Diagnosed with a progressive neurological disorder, all the messages focused on what I could no longer do, how things would get worse. When I tried to look into the future, all I was shown was a blank slate. While it was called “rehab,” the services provided to me then were palliative care at best. Like most—if not all—of my contemporaries, there were times when I contemplated suicide. Those thoughts vanished forever when my then 7-year-old son reminded me of a promise I had made to him and gave me a reason to fight back.

Most of the dark projections made in 1978 have come true, along with some no one thought of at the time. I now know that my future will likely include some form of respiratory assistance and that what little functionality I have left in my hands will gradually slip away. But I will continue to make and keep my promises to never give in and never give up.

Well beyond my personal flashbacks, though, I am deeply pained by the fact that the majority of the people watching the movie were probably thinking the same thoughts “Maggie” was thinking as she begged for help to end her life. Her desire to die was based on the fact that, with the exception of one brief mention of attending college, no one ever made an active effort to give her reasons to live; reasons not to give in to her disability; reasons not to give up on herself. In her mind, the only end she could envision was the one the family dog had years ago—going for a drive in the country and not coming back.

Maggie gave up and audiences sympathize with her. My guess is that a majority of the people in America equate severe disability with death—or perhaps something worse than death. I felt this directly when, as I left the theater, people actively looked away from me, turned their back to me, and grabbed friends out of the way. One person put his hand on my shoulder (as if he knew me) and proclaimed, “I can see you are a man of great courage. I don’t think I could go on in your condition.” Restraining my gag reflex (and my desire to scream at or hit him), I politely rolled away but his words still ring in my head.

From a personal standpoint, public reaction to Million Dollar Baby is frightening. But those in the HME and rehabilitation world should be more outraged than I am! The movie exposes the fact that most of our society remains in the dark about rehab technology, HME, and home care. Too many are totally unaware of the technological advances and the new services available that make it possible to live a rich and full life despite having a disability—especially severe disabilities. As difficult and as painful as my life can be or might be, I would not trade a minute of it for anything.

Despite titles, fancy offices, and occasional obsession with appearances and power, members of Congress and the Administration represent the thinking of the people who elect them. The probability that officials in Washington and the various state capitals share the view that disability is worse than death is more than chilling. It is a call to action for people with disabilities and all those who work with them.

It is critically important that people in the home care and rehab industry hear the clarion call. Government is always erecting barriers that keep HME and rehab providers from meeting the needs of their customers. The challenges will only increase if the idea that disability is worse than death becomes more pervasive. We, consumers and providers, must join hands and respond to the call by working together to educate policymakers at every level. Through word and example, we must show them the quality, the richness, the fullness of life that can be achieved with HME, rehab technology, and other assistance.

The nursing home setting of the film’s final scenes made me wonder: “How much has changed in the past 30 years?” My encounters in the theater lobby told me “not much.” Consumer or provider, it is impossible to see this movie and not come away with a gut feeling that there is still so much to do. Together, we must role up our sleeves. Together, we can’t afford to give in to the attitudes portrayed in this film. Together, we must never give up!

David T. Williams is a freelance journalist, poet, consultant, and author. His first book, Battling the Beast Within, was recently released by the Cleveland Clinic Press. Williams can be reached via email: davidtwilliams@comcast.net or by visiting his Web site: www.battlingthebeastwithin.com.