THE ETHICAL, HUMANISTIC, AND
SCIENTIFIC SPECTRUM OF AUTISM
Thomas James III, MD
S
he was worried. Her four year old son
was clinging to her and avoiding me
altogether. My patient was a young,
artistic woman who had moved to town from
a rural community where she had been labeled
as “different.” So often magical thinking provides people in discomfort the solace that a
new environment will change the underlying
problems; but on coming to town she had
found herself more isolated. She was much better able to communicate with others by writing, and did that so well that she won local
honors for her work. That writing skill allowed her the ability to
communicate with others on the internet. But she still had anxiety
in talking with groups or individuals. Even being in crowds like the
supermarket made her feel uncomfortable, as though she stood out,
and people looked too long at her. So she found work in doing jobs
that others would not do. Ultimately her old boyfriend moved to
the city, and they had a child — the one before me, who was now
completely avoiding me. Through emails to me, my patient had
recounted how preschool workers had arranged for social service
workers and for psychological testing for the young boy. My patient
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LOUISVILLE MEDICINE
was against all this. She worried that her child would have a label
attached to him, a diagnosis that would become a barrier for him,
in the way being labeled as “different” had been for her.
Having a medical or a behavioral health diagnosis may assist the
clinician in developing a treatment pathway, but for the patient it is
the label by which he or she is known, and can become the person’s
new identity. She had heard the social workers and psychologists
use the word “Autism” and this was a word that seemed to her to
box in, to imprison, to diminish a person. She had read more about
Autism Spectrum Disorder (ASD) and so she began to put that label
on herself. But is this word “Autistic” reflective of the stereotype
that both clinicians and society use to establish their approach
to an individual? Or is it a banner that an individual can use for
identif Z[