What is a Normal Person Anyway?

A book review of Andrew Solomon’s Far from the Tree

Diversity is not a disease.

What does it mean to be human? What makes one unique? We can categorize ourselves in many ways, but our first role is daughter or son. We are programmed to attach to our caregivers and they us.

But what if we are profoundly different from our parents in away that the entire world can see? What if the difference is imperceptible and we can pass for normal? Is it good to be normal? Or is our bias against those different, the weird and abnormal, just a tyranny of the majority? How can we grow beyond tolerance toward honoring and celebrating diversity?

Andrew Solomon masterfully poses these questions with stunning stories, simplified science, and small servings of statistics in his latest book Far from the Tree. This 700-page tomb is the product of over a decade’s worth of research and hundreds of interviews. Not a word is wasted. The book deserves more than its eleven national book awards. For me, Solomon is the world’s most talented extant English writer.  

In Far from the Tree, Solomon explores two types of identity. A vertical identity is a defining characteristic passed down from one generation to the next, from parent to child, while a horizontal identity is new. For example, in the first chapter he describes how his loving, well-intentioned parents wrought distress by trying to cure him of homosexuality, a horizontal identity once characterized as an illness and illegal activity.

Solomon dedicates a chapter to each of 10 identities that range from admirable, pitiable, to unspeakable.

Tradeoffs dominate the discussion of children born deaf to hearing parents. Children raised with Sign as their primary language are not any more likely to have intellectual or emotional deficits, but as a child becomes increasingly immersed in Deaf culture, families can feel that they have effectively ceded their son or daughter to another community. On the other hand, restricting exposure to Sign language and forcing deaf children to speak and only learn lip-reading is associated with impaired language development, but it can enhance their capacity to integrate into society at large. Solomon fairly frames the ethics of cochlear implantation; since children acquire language early, surgery at a younger age enhances the effectiveness of the intervention, but the child cannot decide for him-/herself. The Deaf community sees cochlear implantation as the harbinger of their extinction; each surgery is the theft of a potential member. I had always thought of being born deaf as inherently bad, but if people can experience rich, fulfilling lives as Deaf, then is it just a benign deviation from normal?

In Solomon’s chapter about dwarfs, he describes an extreme example of parental efforts to normalize their abnormal child. During puberty, a dwarf can undergo “limb-lengthening,” which involves (a) breaking each arm and leg in multiple places, (b) stretching the extremities with a brace, and (c) allowing the bone to heal in; this is repeated multiple times over several years. Afterward, the individual can look like a short “normal” person. The procedure is repugnant to the Dwarf community, but practically everyone who has undergone it is glad they did. I imagine it would be too cognitively dissonant to feel otherwise. During his research for the book, Solomon attended the Little People of America convention; he relays the novel sensation of feeling conscious of his average height, because he was the oddity. Being normal is all relative.

The eugenic implications of prenatal testing are explicitly explored in Solomon’s chapter on Down syndrome. Access to safe abortion now poses a choice. Families describe the mix of joy and challenge brought by their affected son or daughter. The parents with serenity claim that they “wouldn’t have it any other way,” a reverberating theme throughout the book. Solomon writes how a child tested the character of peers by how their potential friend treated their sibling with Down syndrome. In my experience, individuals with Down syndrome tend to be gentle and jolly. A future society without Down syndrome would be markedly deficient.   

The chapter on autism touches the true spectrum of the disorder: from a high-functioning adult who proudly refers to himself as an “Aspy,” to an un-soothable, poop-flinging, head-banging toddler that terrorizes his parents. Solomon succinctly summarizes the theories for what autism is and why its prevalence appears to be increasing dramatically. He also catalogs the most popular forms of rehabilitation/therapy/school programs that mostly appear long on hope and short on evidence. Autism is simultaneously one of the greatest ongoing medical mysteries, a rich source of genius, and a lens into the workings of all human minds.

After a month-long rotation through Psychiatry as a medical student, I can attest to the accuracy of Solomon’s descriptions of schizophrenia. Multiple families share the story of how they lost their child to paranoia and hallucinations, as well as their caregiver fatigue. Parents try to put plans in place for when they pass away. The ethical issues of forced medication and hospitalization of individuals, who may not be an obvious harm to their self or others, is handled deftly by Solomon. To the chagrin of many, he even mentions the “Mad Pride” movement, which consists of psychotic people advocating for their freedom to think differently (medically speaking, pathologically) from the majority of others. Toward the benefits of such divergent ideation, many breakthroughs in science, especially physics, have been brought about by individuals with a strong family history of schizophrenia.

For the chapter on disability, Solomon interviews families of those with multiple severe disability (MSD). More than any other identity in the book, these individuals stretch the concept of humanity, because they often lack features said to set our species apart. Solomon summarizes the leading ethical perspectives on personhood and parenthood. He describes one family’s surprise of the backlash against their use of hormones to prematurely stop the growth of their pubescent child with MSD (wheel-chair bound and speechless) in order to better care for her. Another family shared the tragic story of their son accidentally drowning (due to negligence by a deeply regretful caregiver) at a long-term care facility after they could not meet his needs at home; although, the parents are certain he is more comfortable now. With medical technology advancing, people can be kept alive in increasingly tenuous circumstances. Where do we draw the line? What role should public funding play? I wish that we could hold a mature conversation about these issues, but the recent memory of fear-mongering cries of “death panels” suggest otherwise. I believe a society should be judged by how it cares for and empowers its least fortunate and its pursuit of truth and beauty.

Solomon dedicates a chapter to musical prodigies and their parents. He describes toddlers that imitate everything they hear on the radio. He reports another kid that recovers from a day at kindergarten by playing the piano for hours. The talent for playing and the need to play are difficult to untangle. Some parents push too hard. In other instances, the personal aspirations of the parent are often pitted against the goals for their gifted child. There is a battle between realizing a child’s musical potential and the development of emotional maturity and the freedom of self-direction. The nature of time dictates that practicing is time not spent doing normal kid stuff. It was surprisingly to learn how having, and being, a prodigy is both a blessing and a curse. 

I responded viscerally to the chapter devoted to children born as a consequence of rape. The usual secrecy surrounding this identity sets it apart. Mothers who loved their child would cringe at their touch because of whom (and what) they represented. Knowing where it was going, I would brace myself as each woman’s story began. I wanted to personally retribute the violence. Somehow, both sides of the abortion debate employed rape as justification for their position. Giving birth to children consequent of rape also raises the issue of perpetuating genes that could predispose one toward sexual assault. Solomon ends the chapter by noting how rape has long been used as a weapon of war, as was the case during the Rwandan genocide of 1994 (especially since many perpetrators had HIV); those conceived through this violence are known as “children of hate.” The extreme tragedy is hard to fathom. Nevertheless, it is imperative to explore, study, and implement strategies to reduce the prevalence of rape. Universities are now bastions of these efforts.

Solomon also interviews criminals and their parents. Some parents are repeatedly harmed by their child’s deceit and destructive behavior; others take steps to protect themselves while maintaining a slimmer of hope. Evidence points to strong peer influence on juvenile criminal behavior; the vast majority of crime committed by youth is in groups, while adults are more likely to be caught solo. Solomon studies the issue at a juvenile detention center that has recidivism rates lower than average, because of their comprehensive programming for family members, education, job-training, and emotionally expressive activities like theater. More importantly, the employees seem to care. The confluence of physical abuse, sexual abuse, and drug abuse among this population quickly rolls into a chicken-or-the-egg discussion. The cycle must be stopped. The details of conditions at some other sites can only be described as inhumane. Given the cost to society of repeat offenders, Solomon’s research begs the question of why the majority of youth detention centers (and our adult prisons) remain more focused on punishment than rehabilitation.

Transgender children comprise the final group identity profiled in Far from the Tree. Parents describe early signs of non-normative gender behavior, like their little girl disliking dolls and dresses and preferring short hair. Many children were depressed, acting out frequently, and poorly performing in school prior to transitioning. In hindsight, the solution was staring parents straight in the face; they just needed to listen to their child. One parent realized that she could either have a dead son or a joyful daughter; about 1 in 3 transgender persons have attempted suicide. The parent of the child’s biological sex tended to struggle more with the adjustment, e.g., a dad accepting that his son felt like more like a girl. Sibling reactions were full spectrum. The institutional barriers faced by these families demonstrate how gender variation remains a major civil rights issue in our society. When Hannah and I are expecting, I imagine responding to people’s question about whether the child will be a boy or girl with; “We know its genitals, but not its gender.” Or is that annoyingly politically correct?

The final chapter describes Solomon’s personal journey into parenthood. His tale is far from traditional, including in vitro fertilization, surrogate mothers/friends, and joint-parenting agreements. His research made him acutely aware of the inherent eugenics throughout the decision-making process. I feel joy for him and his family. I have no doubts that he is an excellent father. His book will make me a better one.

Several noteworthy themes emerged. First, many of the parents interviewed found themselves as activists by merely demanding the best for their child. When faced with the impossibility of molding their child into the norm, they bent the world toward their child.

Second, many parents exhibited mystifying ambivalence. They loved their child and were grateful, but they also acknowledged that they missed their old life, that they had to mourn the child that never was, and that their life would be infinitely easier without their unique child. Far from the Tree implores you to abandon the preference for clean categories and embrace the messy, gray-scale reality of life.

To be honest, I used to dread the possibility of having a disabled child. Maybe I thought that it would somehow reflect poorly on me. Now, I realize that reproduction is not about creating someone in your image; parenting is about loving your child unconditionally and helping them to blossom into their best self. The mother of a prodigy describes parenting as art, where you have the material and you deal with it as lovingly and creatively as you can. These families’ stories taught me that what I once thought would be unbearable actually isn’t. I now imagine being a fierce advocate for my future child, whoever they happen to be.

Solomon’s book shows us how an intolerant society creates self-loathing people who confuse their identity with disease. We do not need to pathologize all anomalies. Biology is based on variation; it’s how evolution works. We must work toward embracing the differences between us: physical, cognitive, and otherwise. Diversity is not a disease. His work also teaches that at the beginning of life, like the end, just because we can treat something, it does not follow that we should.

We must do better to prevent rape. Love, forgiveness, and hope are the most useful tools for steering people with a criminal history toward a pro-social future. Nearly 1 in 100 Americans is behind bars.

The question is never “is it nature or is it nurture?” Everything alive is a product of genes interacting with the environment. Life is more a matter of nurturing your nature. We could exert less effort on getting others to fit in and dedicate that time and energy toward listening to their story and finding a way to meet their needs.

We must learn to toe the fine line between serenity and complacency.

One cannot be both exceptional and normal. This mindset lets me lean into my weird.

Let grace be both the cause and consequence of your happiness. Because we can’t be someone else, but we can each be better.