Anne McGuire and Michael Orsini offer a critical analysis of how the business of selling health is influenced by popular images of illness and disability that circulate in the places and spaces where care should be the primary concern.

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Toronto’s Hospital for Sick Children (SickKids) sure knows how to steal the spotlight.

This was clear with last year’s release of the video “Anthem” to kick off SickKids new blockbuster ad campaign. Set to a pulsing rap beat, the video featured a barrage of war imagery from medieval battle scenes, to exploding prosthetics, to a conquered heap of twisted metal wheelchairs. The phrase “SICK ISN’T WEAK” lit up the screen, followed by “WEAK FIGHTS BACK.”

The spot set off a frenzy of media excitement, as well as some push-back. Bowing to critics, the Hospital wrote last October that they were “keenly aware” that “some patients and families have not found the ads released to date as empowering and find the battle metaphor inappropriate.”

Last week, SickKids released a new video, this time to launch a $1.3 billion dollar capital campaign to rebuild the aging hospital infrastructure from the ground up. This black-and-white video – entitled “All In” – ditches the war paint and hyper-masculine violence for a softer aesthetic. However, behind the dulcet tones and jaunty musical score featuring “I’ll do anything” from the musical Oliver! lies a more complex picture.

Black and white image showing five young children using ropes to pull a large truck. There are two children sitting on the roof of the truck, each has one of their arm raised.  Other children are helping by pushing and steering the truck. They are in front of a large brick building with many windows. This is an image from SickKids’ new video “All In.”

The ableist tropes that were difficult to ignore in “Anthem” are replaced by a narrative that weaves uplifting images of children running through dusty streets, working together toward a common goal. As with the earlier video, the children featured in “All In” are not passive patients; instead, they are subjects seemingly brimming with agency, actively participating in building something, in this case, a structure to house state-of-the-art technologies and world-class medical staff. The kids are still fighting back, but this time through teamwork!

While the latest video is not immune to familiar disability-as-tragedy tropes – the slowed down, swell of instrumentals upon the first appearances of children marked as ill or disabled, for example – it nonetheless presents us with some refreshingly varied images of disability and illness. While in “Anthem,” agency is made synonymous with individualized battles, personal strength and one’s capacity to defeat illness and disability, “All In” depicts disability agency through a blend of collaborative building and interdependence.

In stark contrast with earlier images of children ‘conquering’ their personal bodily limitations, the kids featured in “All in” possess a range of embodiments, moving together and moving differently. While we do see more familiar disability scenes where the ‘strong’ or apparently non-impaired kids are helping the ‘weak’, kids marked visibly as sick or disabled (e.g., a group of children stop running to help a fallen kid with a prosthetic leg, an older child carrying a baby with an IV bag), we also see images of sick and disabled kids and their allies variously building, carrying, and supporting one another. What is more, we know that the featured kids are a mix of “real” patients and their siblings and yet we don’t know for certain who is who. In one scene, we see a wheelchair user pushing herself as she carries building materials on her lap. In another, we see a different wheelchair user pushed by a walking comrade: it is together that they carry their load. Taken together, these scenes challenge longstanding assumptions that equate disability with passivity, and affirm that there are many ways to claim agency in the face of illness/disability.

Yet, even as these scenes challenge the equation of disability with passivity, “All in” nonetheless promotes a damaging narrative of ‘good attitudes’ and individual responsibility when it comes to issues of personal health and public healthcare.

Just as “Anthem” depicts kids overcoming their unique health challenges with superhuman strength, “All in” also endows its child subjects with extraordinary powers. The kids are fixated on amassing whatever building materials they can get their hands on, to arrive at their choice destination: an empty lot, the mythical site of the new hospital. They will, it seems, do whatever it takes to erect a new building, a monument, if you will, to medical and scientific progress.

The adaptation of the “poor rascal” aesthetic reminiscent of Oliver also resonates with an invocation to “pull yourself up by your bootstraps”. Seen in this light, perhaps the mud smears of the industrial child labourers are just another iteration of a narrative of conquering, this time with, pluck, determination…and city building! The ableist message of overcoming adversity and fighting the odds remains, but without the offending visual accompaniment.

Killjoys, you say? Why not focus instead on all of the good that will flow from this important fundraising campaign that will directly benefit vulnerable children?

In the spirit of pioneering feminist thinker Sara Ahmed, killjoys are here to disrupt the conversation, with an eye to thinking critically about how the business of selling health is influenced by popular images of illness and disability that circulate in the places and spaces where care should be the primary concern.

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Anne McGuire is Assistant Professor in the Equity Studies Program at the University of Toronto. @anneemcguire

Michael Orsini is Professor in the School of Political Studies at the University of Ottawa. @OrsiniMichael