asperger’s syndrome

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He was just 18. He had been followed by child psychiatry with a diagnosis of depression. He had long refused to take any pills.  As far as this poor, agricultural county was concerned, I was just seeing him so I could bill MediCal and fatten up the county coffers. The previous psychiatrists had simply noted he was depressed, was not suicidal, and refused any participation in his own treatment.

He was a young man of few words, with a common Hispanic name.  He sat there and twirled one of his lush curls. It became pretty obvious he wasn’t going to give me a complete history.  He said he would never take pills, not ever. To his credit, he did say I could talk to his mother, if I wanted to, but he had to be in the room and hear what she said. Someone brought her to me, from the waiting room.  She spoke only Spanish; fine with me. I learned my Spanish mostly from my patients, who in that time and place could rarely communicate well in either Spanish or English. His mother was charming, really grateful that I wanted to talk to her. She kept complimenting my clothes and elegance. I told her it was all thrift shop.  I doubt she believed me. Read more on Diagnosis From The Guts…

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I love being a ”shrink-lady.”  (okay, a “psychiatrist.”)

I did not pick it out of a hat.  I tried a couple of other medical specialties.  The “doctor” part — well, there was never any doubt about that part, really.  I mean the idea of taking care of other folks came into my head pretty early on, as did the idea that I was smarter than most other kids, ahead of where I was “supposed” to be.

My family had some health problems as I persevered in schooling.  It became evident that doctors had not only status but power over other people’s lives. Read more on Your life, Your Work – What’s The Difference?…

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I don’t think we plan what our real specialties are going to be.

I frequently tell patients I am an expert on getting through menopause now that I have been able to come through my own relatively unscathed.

I became somewhat of an expert on Asperger’s because I diagnosed many elements of it in my father and just about all criteria in my brother.

They both carried additional diagnoses of bipolar (a.k.a. ‘manic-depressive’) illness.  Neither one was in any way typical.

Both surely had their problems in life.  My father was assisted considerably by his domineering mother who gave him lots — I mean lots — of direction.  She even helped him choose a wife — my mother — who took care of the things in life that were difficult or even impossible for him. Read more on From Sandy Hook to Santa Barbara — Asperger’s Syndrome And Violence…

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Even though I am both a woman and a psychiatrist, I am no expert on the mother-daughter relationship.

My Mother-Of-Blessed-Memory was a “good” woman by any measure — the faithful and virtuous homemaker.  She spent a lot of time thanklessly trying to nurture my Father-Of-Blessed-Memory — a pretty grandiose if creatively powerful music writing and arranging manic with some Asperger traits — and my Brother-Of-Blessed-Memory — a full blown Asperger’s who was also bipolar.

They took so much of her psychic energy it is a wonder she had any left at all for me.  But she did, and she told me how she had to fight to get me freedom, the days she would drop me off in the car when I went to the Secondary Science Training program, or even just to walk in downtown Boston. Read more on Mothers and Daughters and Such…

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When I was an undergrad at Boston University, I took a course in the department of sociology in “medical administration.”  I was compelled to understand the social context of medical practice, for whatever reason.  I remember little of the course itself.  There was a very attractive older woman sitting next to me who amused herself by “adopting” me, which she thought gave her a right to criticize my then overweight figure and poor clothes.

I remember more about her than I do about the professor, a wacky guy the university had seen fit to import from New Zealand.  He had published a couple of relevant papers down there, but was still pretty new to the American health care system.  He told us that New Zealand had lots of sheep and was a big wool producer.  He talked about this great wool magnate who had this neat wool mill — a big one — and how it was he actually became quite wealthy. This was someone who knew about the tremendously loud machines that were used to process the wool.  The wool mill owner decided to hire only deaf people.  They asked for little; generally, they had problems finding jobs.  They were really happy and thankful to be able to work, so they worked hard.  They did not have any kind of a problem with the very loud machines.

That struck me so much then that I remember the story now, 50 years later.  Even then, I already felt that I would be in some kind of a management position as a physician and could do something that clever, becoming as rich and powerful as that New Zealand guy.  The professor had said something about Americans not thinking that way. The opportunity has not really presented itself.

Probably the closest I ever came was when I was running the day treatment center at the Veterans Affairs Medical Center in Oklahoma.  I had a lot of schizophrenic gentlemen who were not rich in social skills, but many of whom liked computers better than people.  Certainly, they related to computers better than they related to people.  I tried to get them computers, maybe even a little training. Read more on How to Employ an Individual with Asperger’s…

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Perusing the internet, I am overwhelmed with people doing “weird” things.  But how do we define what is weird, when it is weird, and why it is weird?

I remember seeing the movie Fiddler on the Roof when I was quite young.  I shuddered when I heard the song “Tradition,” because it was evident, even then, that descriptions of the way people should or should not be caused a whole lot of pain.  The particular tradition that drove poor Tevye to hell and back was getting three daughters married off and being Jewish, which required dowries and Jewish grooms.

My parents attempted to receive my husband — who at that time called himself “the goy next door” and was willing to wear a yamelke and articulate a few words of yiddish he had learned from Mad Magazine.  But you could tell that this was a problem for them.  An eventuality I found just excellent in my life and which I credit with an uncommon level of happiness. I can say now that my marriage is happier than theirs ever was, at least from all that I saw.  Part of this comes from my willingness to ignore a tradition they took as dogma. Read more on The Rights of Individuals to Punish Each Other…

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I Am A Doctor, But I Don’t Play One On TV

Personality-wise, the cranky and inconsiderate title character of the hit TV series House, MD are mirror opposites.  I actually LIKE people – especially people who need help (patients).

Obviously many people enjoy this series, since it is one of the highest rated. But for me, the challenge is to out-diagnose him.

In case you’ve never watched, the formula for each episode is a seemingly straight-forward illness, which (of course) is the wrong diagnosis.  The rest of the show is slapping another diagnosis on the patient, and testing the patient, which makes the patient worse.  Read more on Being Locked-In May Not Be So Bad For Everybody…

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People get abused a lot.  More than anybody wants to believe and certainly more than anybody could ever justify as necessary.  Here are a few facts.  Yes, facts.

child abuse1.  My own brother of blessed memory, above average IQ and (later, I believe to be accurate) diagnosis of Asperger’s syndrome, did not tell me until eight years afterward that as a student in a school for the emotionally disturbed, with an older headmistress who was renowned for her knowledgeable treatment of children, an internship program with a famous teacher’s college, and many awards, beat him with a belt when she was sure there were no witnesses, in order to “help” him behave.  She told him to tell nobody.  By the time that he discussed it with me, he said he did not want to think of it ever again, and that the famous headmistress had died and she was probably in Hell anyway. Read more on How Can We Stop All The Abuse?…

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