Epileptics at Work

For 13 years, a lean Oklahoman named Paul Cadwell languished in Los Angeles' Veterans Administration Hospital, prisoner of the epilepsy that got him bounced out of the Navy. His self-confidence shaken, Cadwell could not face returning to the outside world. Now Cadwell is not only out of the hospital but enjoying a normal life. He earns $1.70 an hour in a small Los Angeles plant, has married an ex-WAC from Texas, lives in a middle-class bungalow, bowls on weekends.

His rejuvenation is the work of a unique movement called Epi-Hab, short for "epileptic rehabilitation." Epi-Hab has opened four miniature factories in which epileptics prove to themselves and to industry that they can man an assembly line. Says Epi-Hab's founder, Los Angeles Psychologist Frank Risch: "Epileptics are not human junk."

Superstition's Stigma. Although history's epileptics feature such notables as Mohammed and Napoleon Bonaparte, the vast majority have been stigmatized by superstitions that attribute the disease to demons. The actual cause is unknown, but seems to be related to a disturbance in the cerebral cortex. A patch of the cerebral cortex--the brain's command post --gets irritated, and sends out waves of involuntary impulses. On the receiving end, the body muscles respond with spasmodic convulsions--the epileptic seizure. In the average victim, the seizure passes within five minutes. Drugs, among them Dilantin and phenobarbital, eliminate seizures in 50% of cases, reduce them in another 30%.

Yet, for the U.S.'s 1,500,000 epileptics, life is still full of persecutions. Owing to a belief that epilepsy is inherited--actually, so far as is known, only a "predisposition" can be inherited--in ten states epileptics cannot marry, in 18 they can be sterilized. Federal law bars epileptic immigrants. Nowhere is the stigma felt more painfully than in job hunting, despite progress in recent years. The civil service, for example, will hire epileptics "provided that their seizures are adequately controlled and their placements selective." In a recent survey, 73% of Arizona manufacturing firms said they would not hire epileptics. Reason: fear that they are accident-prone.

Cot in the Corner. Epi-Hab began in 1949, when Dr. Risch, a Ph.D. from the University of Southern California, joined the staff of the Los Angeles Veterans Administration Hospital. He set up a machine shop on the grounds, manned it with ten epileptics. In one corner Risch placed a cot. When a worker suffered a seizure, he was helped to the cot and cared for. When the seizure passed, he was encouraged to march right back to his machine. In 1956, with a small grant from the U.S. Government, Risch opened his first Epi-Hab plant in downtown Los Angeles, independent of the VA. Later, he inaugurated a second. In 1958, citizens adopting Risch's techniques started Epi-Habs in Jamaica, N.Y., and Phoenix, Ariz.

Epi-Habs have employed, for varying periods, a total of about 800 epileptics, have permanently placed about 100 in private industry. Safety records equal or top those of any efficiently managed plant. "I was concerned myself when I started," says Risch. "We put padding and plastic shields on all our equipment. Then we saw it wasn't necessary." One reason for the low accident rate: most epileptics receive an "aura" or mental warning, from one day to ten seconds before a seizure, enabling them to get clear of machines. In the last five years, Risch's Los Angeles Epi-Habs have had only 30 mishaps attributable to seizures--none of them perilous to life, limb or machine. The plants even won a 20% cut in workmen's insurance rates.

A "Sheltered Workshop?" In spite of Epi-Hab's accomplishments, it has its critics. The program director of the United Epilepsy Association, Dr. Harry Sands of New York, contends that efforts should be aimed at placing the epileptic directly in private industry rather than in a "sheltered workshop." To this Risch replies that industry resistance is strong, and that "by building up actual work records and work experience, Epi-Hab can build up the sort of confidence among industrial firms that is necessary to get an epileptic a secure job." But on one fundamental premise Sands and Risch are in complete agreement. Though no one knows why, epileptics who are working suffer far fewer seizures than those who are idle.

Last week, in the pink stucco Los Angeles plant, ex-Recluse Paul Cadwell sat hunched over his bench, expertly soldering wires to an electronic subassembly that the plant is turning out for Hughes Aircraft Co. Once racked by grand mal (severe) seizures thrice weekly, Cadwell is now hit only once or twice a month. Near by, a grizzled man with a cigarette dangling from pursed lips was drilling holes in aircraft aileron assemblies. At the downtown shop, the pace was being set by 21-year-old Jam's Newhouse, whose blonde ponytail popped like a whip as she slapped cardboard sheets over a metal matrix to form boxes. She used to have seizures every few days, now has them only every two or three weeks.

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