Tiny Tim’s Troublesome Tale
By: The Wheelchair Historian
Tags: Illness, Literature, Christmas, History, Disability

Welcome to my special Christmas post. It took me a while to decide what I should write about. I wanted it to be festive, but also be a history post with a disability aspect. As you are probably aware, the history of disability and Christmas cheer don’t really go hand in hand. The only thing I could think of that I could put a positive spin on was Tiny Tim from Charles Dickens’ A Christmas Carol (1843). When I initially looked up Tiny Tim online, I came across the singer by that name. While fascinating, he was not the person I was looking for, so I carried on my search. Anyway, what follows is what I was able to cobble together in an attempt to make a usually bleak subject Christmassy and magical!!

What the Dickens?

I must admit that I know rather little about Charles Dickens. You may remember from my post on Zip the Pinhead, that Dickens was the one who gave Barnum the idea to call Zip, ‘What is it?’. This gave me the impression that Dickens, much like many of his 19th century counterparts did not actually care about disabled people and either feared or pitied them. This may not have been the case. Perhaps the reason that Dickens attended one of Barnum’s exhibits was because he had a keen interest in human illness.

Tiny Tim is possibly the best-known disabled child in the works of Dickens, but he was not the only one. In 1845, Dickens published A Cricket on the Hearth, in which one of the characters, Bertha, is blind. She is the daughter of an employee of a prideful toy merchant. I am starting to think that Dickens liked to repeat the same stories and hoped that nobody would notice. Much like Tiny Tim, Bertha is a happy child, even though she is expected to be miserable due to her disability. It seems as though Dickens is saying being/becoming disabled is not the worst thing in the world, which even today is a common belief about disability.

Perhaps Dickens had a better understanding of disability and illness than he is given credit for. When Dickens was 12, his father was put in debtors’ prison, meaning that young Charles lived in poverty for a while. He also had personal experience of disability and ill health as he had epilepsy and his nephew died of tuberculosis at a young age. This may be where his character of Tiny Tim came from. Dickens was also incredibly skilled at identifying disease. In many of his works, he would accurately describe the symptoms of various illnesses that had not been identified yet. I think it is safe to say that Charles Dickens knew what he was talking about when he included the disabled Tiny Tim in A Christmas Carol.

What was Troubling Tiny Tim?

I know it is a fictional story that is over 150 years old, but it is still interesting to speculate what illness may have been afflicting Tiny Tim. It is important to note that whatever the problem was, his situation dramatically improved once Scrooge had a change of heart after being scared witless by some ghosts. It would have to be an illness that could be improved with money, but would prove fatal if neglected. Ah…. Death, that’s what you want to read about at Christmas time. Here is what we know about his problem. According to the book, Tiny Tim “bore a little crutch, and had his limbs supported by an iron frame.” He is also carried on the back of his father from the Christmas service to his home. Oh…. and he was small in stature, hence the adjective Tiny in his name.

There are several conditions which may explain Tiny Tim’s symptoms. Firstly, there is possibly the most obvious explanation. As A Christmas Carol is a book of fiction, Tiny Tim’s illness may be a metaphor for the ills of society in general. I like this explanation as I am fond of a good metaphor. However, as I am more interested in Tiny Tim’s illness, I will ignore the logical answer. One possible diagnosis is Renal Tubular Acidosis. This is a disease that affects the kidneys. It can lead to restricted growth, bone disease as well as a whole host of other issues. It is incredibly rare, so is an unlikely diagnosis, but was believed to be one of the conditions that Charles II of Spain was cursed with, as discussed a few months ago. Other conditions put forward over the years include polio and cerebral palsy. However, an increase in wealth and a better diet would be unlikely to dramatically change Tiny Tim’s fortunes if either of these were the cause.

Tuberculosis is a more probably explanation, as nearly 50% of children in London at this time had the disease, including the nephew of Charles Dickens as mentioned before. While it may have been difficult to treat back then, an improved diet and more sun exposure, provided by trips to a sanatorium may have helped. Another likely disease was rickets. This could be dealt with easily enough by an improved diet. Some people have pointed out that if a poor diet was the cause, then all the Cratchit children should have had rickets. However, as Tiny Tim was the youngest, his meals would have been the poorest quality. Given the evidence that we have to go on, a combination of rickets and TB is most likely.

Festive Cheer?

Okay. At the start of this post, I said I would try and do three things. 1. Talk about history, which I think I have done. 2. Talk about disability, which I think I have managed by haphazardly trying to diagnose a fictional character. 3. I said I would make it Christmassy, whatever that means. Let’s give that a go, shall we? Since his conception, Tiny Tim has become a poster boy for charities dealing with disability. He is the sweet little kid that makes everyone feel pity for him and empty their pockets, which works well at Christmas because everyone is in a giving mood. Some disabled people don’t like this as they rightly don’t want to be pitied. But hey, if it means people are kinder to each other, I’m all for it!

Fun Fact (I think it’s fun anyway): You may be aware of the phrase ‘Bah humbug’ from A Christmas Carol, but did you know that saying ‘Merry Christmas’ originated from this work as well!

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Next week I will have a New Year special. I just need to work out what it will be.

Merry Christmas!!

The Wheelchair Historian

Further Reading

Chesney, RW. Environmental Factors in Tiny Tim’s Near-Fatal Illness. Arch Pediatr Adolesc Med. 2012;166(3):271–275. doi:10.1001/archpediatrics.2011.852 Accessed: 22nd December, 2020.

Hingston, Kylee-Anne, “A Christmas Carol,” Nineteenth-Century Disability: Cultures & Contexts , https://www.nineteenthcenturydisability.org/items/show/28 Accessed: December 22, 2020.

Kudlick, Catherine, ‘#Disabled People to the Rescue: A Christmas Carol’ https://longmoreinstitute.sfsu.edu/disabled-people-rescue-christmas-carol Accessed: 22nd December, 2020.

Palik, Jennifer, ‘What was wrong with Tiny Tim in ‘A Christmas Carol’?’ Updated Jan 05, 2019; Posted Dec 25, 2011 https://www.pennlive.com/bodyandmind/2011/12/a_big_mystery_surrounding_tiny.html Accessed: 22nd December, 2020.

Soehnlin, Jenn, ‘What Charles Dickens Teaches Us About Disability in His Christmas Novellas’, Sunday, December 15, 2019 https://embracing.life/article/what-charles-dickens-teaches-us-about-disability-in-his-christmas-novellas Accessed: 22nd December, 2020.