ASPERGER'S VIGNETTES

 

COMEDIES and TRAGEDIES – Chapter 1

 

These papers are devoted to descriptive anecdotes from the histories of some of the 300 + patients affected by Asperger's Disorder (AD) I have treated during the course of my nearly 40 years of practice as a child, adolescent, and adult psychiatrist.  I hope these stories will be entertaining as well as informative, and assist readers' understanding of the wide variety and depth of the symptoms AD individuals experience.  All patients' names and areas of residence have been changed to safeguard their privacy.

 

ADAM (14) an 8th grade student at a public middle school forgot to bring payment for a CPR course being taught in his last period P.E. Class.  He was told to sit on the gym floor, and while seated there wrote “Expect what is coming” on the pinewood floor.  His P.E. Teacher saw him writing on the floor, and upon reading these words reacted in horror and hauled Adam straight to the dean's office.  He was suspended pending an expulsion hearing to be held three weeks later by a committee of the School Board, since the school administration concluded he was covertly threatening to blow up the school.

 

When I evaluated him a week before the hearing he insisted he had NOT been thinking about  anything like blowing up the school.  He was hungry and thinking about a TV program he had watched the night before (he was “fixated” on this show) in which cartoon characters ran around and constantly encountered “Expect what is coming” written on walls, desks, whiteboards, etc.  I documented the dynamics of the incident in my report to the school board committee, with the following phrase centered in bold print:

 

Adam was thinking about Sponge Bob Square Pants and his friends seeing

that phrase and discovering an Ice Cream Sundae was coming in a show he watched

the prior evening.

 

He was tired and hungry at the end of the school day and was craving a tasty snack.  He thought about Sponge Bob all day, every day, and did not realize anyone would interpret his writing as suggestive of a threat.  After a few moments of snickering, the committee chairperson moved to dismiss the complaint, and all committee members agreed.  Adam was also unaware he wrote this phrase three days prior to the 1st anniversary of the Columbine School incident.  Bad timing! 

 

Several stories I will relate later in this paper describe similar preposterous incidents.  See stories about Jack, Joe, Colin, and Nate.

 

TOM (14) always interpreted essentially everything his parents or teachers or peers said absolutely literally.  I use a list of common idioms as an assessment tool when I evaluate older children and adolescents.  Tom failed every item, such as “Grandpa Luke kicked the bucket” and “Suzie is too nosy”.  He earned the distinction of being the only AD teenager I have ever seen who looked out my office window and said “There are no cats and dogs out there” when he and his mother arrived late for an appointment and his mother used this common idiom to describe how hard it was raining.

 

Quite remarkably, despite this severe impairment, Tom was diligent and thorough completing all his homework.  When last seen at age 16, he was taking regular classes in a public high school and receiving C+ - B grades.

 

MICHAEL (10) was incredibly fixated on a particular video game, and upon arrival for a routine appointment with me he was very angry his mother had not stopped at a store and purchased another video game in that series for him.  He expressed his frustration with an incredibly long and convoluted “explanation” of why it was so crucial his mother promise to go to the store right away and buy the game for him.  Neither I nor his Mom could comprehend his reasoning.  His mother said “Michael, that is as clear as mud!”  Michael's response was “Mud isn't clear.” 

 

*** Readers can easily imagine how completely “lost” AD children and adolescents are in the idiom-riddled dialogue and banter on a school playground or lunch area.  When these comprehension problems are coupled with social / interactional misperceptions and awkwardness these children are frequently teased and bullied.  This situation is brilliantly described in the book titled Perfect Targets . 

 

GREGORY (55) was the mayor of a medium-sized Arizona city.  He was described as “a huge pain in the a..” by his wife, and although he was thoroughly disliked by most residents of his city he won elections again and again due to his wealth and real estate connections.  Gregory interpreted all or almost all municipal rules and regulations literally, and he felt it was his duty to take corrective action whenever and wherever he found miscreants.  He often spent hours watching the check-out lines of local supermarkets, and essentially “pounced” (his wife's term) and bellowed “Manager!  Manager!  This rotten fat lady here is cheating!” when he discovered a store patron using the Express Check Out – 6 Items or Less line having more than six items.  He watched and timed how long citizens parked in a yellow zone – 10 minute parking.    He prowled the sidewalks measuring the distance between parked cars and fire hydrants  in inches, and always called the police when he discovered the car was too close.  This is a partial list of his standard pre-diagnosis and pre-treatment symptoms and behaviors.  

 

Gregory refused to consistently take medication (Prozac) which reduced his fervor and fixation for pursuing perceived law breakers.  His wife insisted he was far more relaxed, “easy going,” nicer to everyone, and even welcomed at his estranged daughter's home for holidays while he was taking the medication.  His wife read many books and articles about AD and was very convinced my diagnosis and treatment plan was correct.  Gregory refused to read any published materials about AD, lied to me and his wife about refusing to take his medication, and often traveled without his wife to smaller cities so he could consult with various psychiatrists and psychologists for “second opinions.”  Without his wife's presence in these evaluations, he often convinced other professionals he was “perfectly OK,” had been misdiagnosed with AD, and didn't need any medication Rx. 

 

When I last heard from him his wife had divorced him, and had obtained a legal judgment awarding her most of their community property as well as savings and pension accounts.  Gregory actually wound up, so far as I know, essentially destitute.  He could never overcome his fierce denial.  I regret to report this dismal outcome is not uncommon in adults who have AD.  Stories later in this paper about Vincent and Alice are perhaps even more tragic. 

              

                                              Please go on to Chapter 2