Epilepsy: Background information when reading Women and Children First

Epilepsy

This article relates to Women and Children First

In Women and Children First, the debut novel from Alina Grabowski, teenager Lucy Anderson has epilepsy, a neurological disorder involving recurring seizures. Lucy has to deal not only with her distress at experiencing the seizures themselves but also with the stigma associated with the condition.

Epilepsy is one of the most common neurological disorders in the world, affecting around 50 million people globally. According to the Epilepsy Foundation, one in 26 people will develop epilepsy at some point in their lives. The condition can start at any age, but it most often begins in childhood or after age 60. In around 50% of cases, there is no identifiable cause; the other 50% can be due to several factors, including genetics, head trauma, infection, or injury in utero. Epilepsy has no known cure, but around 70% of those with symptoms can become seizure-free through medication. If anti-epileptic drugs aren't successful, some patients can undergo surgery to remove the part of the brain causing seizures or start a high fat/low carbohydrate dietary therapy to reduce seizure frequency.

Although epilepsy can affect anyone, inequality impacts its global spread: the condition is over twice as common in low- and middle-income countries as in high-income countries. This is down to several factors, including the increased risk of diseases like malaria, as well as higher incidences of traffic accidents and birth-related injuries. Not only do these countries see higher rates of epilepsy, but people in them are more likely to be living with the condition untreated: the WHO (World Health Organization) believes that three-quarters of people with epilepsy in low-income countries are not receiving the treatment they need. Access to medication plays a crucial role, and stigma can also be a factor. According to a 2022 article in The Lancet, some Nigerian healthcare workers report they wouldn't employ or marry a person with epilepsy, and children in Guinea have cited embarrassment of seizures as a reason for not attending school.

Of course, stigma surrounding epilepsy is in no way unique to these countries or to contemporary times. Misunderstanding epilepsy has been a feature of the disease since it was first documented thousands of years ago by the ancient Babylonians. For the Greeks, it was the "sacred disease," believed to have divine origins. In Shakespeare's Julius Caesar, the dictator's "falling sickness"—as epilepsy was known in the playwright's time—is not only evidence of his own failing health, but symbolic of Rome's decline as a society. The idea of epilepsy as a treatable brain disorder without moral or supernatural implications only developed from the 17th century onwards; the first medical treatment, potassium bromide, wasn't available until the 1800s.

Today, people with the condition in the United States are twice as likely to experience depression, with stigma and fear of disclosure cited by the Epilepsy Foundation as possible causes. In Women and Children First, Lucy feels that stigma firsthand. One of her classmates films her having a fit, sets the video to EDM (electronic dance music), and starts circulating it online. To what extent this episode plays a part in Lucy's death a few weeks later forms the central mystery of Grabowski's novel.

What is clear, however, is the role a book like Women and Children First plays in normalizing epilepsy in the culture. Lucy's condition isn't shrouded in mystery, nor imbued with myth and meaning. Her epilepsy is just another annoying distraction in the everyday life of a vibrant teenage girl.

Julius Caesar marble statue by Andrea di Pietro di Marco Ferrucci (c. 1512–14), via the Metropolitan Museum of Art

Filed under Medicine, Science and Tech

This article relates to Women and Children First. It first ran in the June 5, 2024 issue of BookBrowse Recommends.