I think I’m on safe ground saying shows about people with ugly and/or embarrassing medical conditions, are a modern freak-show.  Especially reality television that deals with disfigurement. Such programmes often have fuck-all to do with the people they purport to document – I’m not being callous - it’s just that disfigured people are cheaper than actors and the make-up is better.  Quite often they get paid peanuts in the process. The documenting comes second to the sights and sounds. But…

If people can be desensitised to disfigurement, is it a good thing for disfigured people?  If viewers become desensitised to disfigurement, in real-life they will stare less, and, maybe, be less afraid.  Which would be a good thing.  However, given the tenuous and complex links between violent television and violent behaviour, it’s probably difficult to say that desentisation will lead to better treatment of disfigured people.  In the same way that it can’t be said violent television is ever the primary factor contributing to violence. I don’t think freak-shows, aside from supplying an income to the performers, improved the lot of disfigured people.  Still, I’m an optimist, I hope that there are positive side-effects to the modern freak-show.

A seriously negative side-effect of this, could be that in order to maintain viewers, medical reality TV will perpetually search for more extreme medical conditions.   In order to maintain shock value.  Like soap operas adding an explosion or violence.  Reality TV will  have to go to poor countries to find people shocking enough. Poor people with extreme medical conditions, on our screen, for titillation. Which, if it generates awareness of medical conditions in poor countries, isn’t such a bad thing.  The next thing is people may empathise. Tourist destinations may be shamed into action.  But..

It could still just be about titillation. I don’t, for a second, think that the majority of medical reality television is made for any altruistic reason at all.  I don’t think it’s immoral and I’m not even sure it’s all that harmful, but I do think it amoral, in that it boils-down to viewing figures, and best commercial practice.   Change will be in response to a changing audience.  I hope people become so desensitised to disfigurement John Merrick could walk down the street naked and people would be more shocked by his penis than his elephantiasis.