Chapter 6 #3
"Oh, yes. My father is a surgeon and my mother is a nurse.
When I was six, we moved to Kenya to become missionaries.
Being fascinated with all things medical already, I attended the clinic where my parents worked on a regular basis, and frequently watched my father perform surgeries while my mother assisted as his nurse.
Many thought it wildly inappropriate, if not borderline abuse, to allow a six-year-old to watch her father reduce a leg fracture, or stitch up a laceration, or repair a severed artery.
But my parents knew that I was different.
It was not common back then to apply the ASD label to girls, as it presents much differently in females than it does in males, especially cases like mine. "
"Cases like yours?"
"Yes. My presentation of autism is high-functioning with savant tendencies.
" She smiles, anticipating my questions.
"It means I am capable of autonomy. I do not need constant care and supervision.
I can function in society—feeding and clothing myself appropriately, navigating, learning, all the things that a neurotypical person takes for granted as everyday actions, things you don't think about doing—you just do them. Savant tendencies indicate the overlap of my eidetic memory and hyperfixation—meaning, my somewhat extraordinary capacity for informational intake and retention.” She pauses, thinking.
"For many with autism, savant tendencies or hyperfixation tends to focus on one thing, either to the exclusion of all else or nearly so. "
"The kid in class who's obsessed with dinosaurs and can tell you everything about them," I say.
"Yes," she says. "Exactly. Or trains. Or space. Or World War Two, or any subject. I tend to focus on medicine, but not exclusively."
I think about what she's telling me, and a billion questions crop up, too fast to seize any of them. One in particular ends up floating to the top, and I address it to her. "You tend to refer to your brain almost as this…other, d'you know what I mean? Something that's not…you.”
She nods. "Yes. An astute observation. In your experience, I believe, you are one cohesive whole.
Your mind and your body are one entity. Not so for me.
My brain operates…not independently, but it often seems that way.
I cannot stop my brain from spinning out of control.
If your brain is an engine, you have both brake and throttle controls.
I do not. My brain is stuck revving at the redline at all times.
Day and night, waking and sleeping, my mind races from topic to topic, usually on multiple tracks at once, as well. "
I frown at this. "Dude, that sounds…exhausting."
"Yes, it is, rather. One adjusts, however, as one must. My point is that more often than not, I feel…" she sighs, looking away, thinking. “Like an observer of myself."
I shake my head. "Yeah, I have not a single fuckin' clue what that means, honey. How can you be an observer of yourself?"
"Most frequently, it means it feels to me that my body is merely a kind of…
exoskeleton in which I am a passenger. My body operates to carry me through the world, but that is all.
I feel disconnected from my physical self.
In fact, dissociation from one's body is a common trait in the neurodivergent experience. "
"Meaning?"
"Meaning I forget about my body. When I am studying or reading or am otherwise fixated on something, I forget to eat, to drink, to sleep. I do not feel tired, or hungry, or thirsty. I can go dangerously long periods without remembering that I have a body that has needs."
I shake my head. "I don't understand that at all."
She smiles. "How could you? It is beyond the understanding of a neurotypical mind.
You are your body. I am my mind. But sometimes, when I am stimming, crashing, turtling, or experiencing a functional freeze, I am something else, something beyond my mind or body.
I am just an awareness isolated within the chaos of my mind and the disconnection of my body. "
"Stimming, crashing, turtling, or freezing?"
"Stimming is something you will have noticed, surely, though likely not in me, as I do not stim very often. It is a repetitive action or vocalization meant to calm and soothe, examples being tapping one's fingers together, flapping one's arms, rocking back and forth, humming, things like that."
I nod. "Ah, yeah. There was a kid in high school who did this whole thing where he tapped his middle finger to his thumb, like all the time."
"Walking on the toes is another common example. I imagine your schoolmate did that as well."
"Yeah, he did."
"You have witnessed me crashing, turtling, and freezing. When you first encountered me, I was crashing."
"Okay, but anyone would be crying in that situation,” I say.
"Perhaps. The situation with the alarm clock is a better example.
I had fallen asleep and was awoken abruptly and unexpectedly by a loud, jarring noise.
As an aside, autism nearly always carries with it sensory issues, meaning sensitivity or hypersensitivity to sounds, lights, scents, and textures.
I do not wear denim because it bothers me quite intensely.
I do not watch television because the constant shifting of scenes and colors and the sounds…
it is overwhelming. I do not wear tight or constrictive clothing—social norms mean I must wear undergarments, brassieres in particular, which is a form of torture for me. "
I laugh at this. "Every woman I've ever known hates them."
"I, more than most. Anyway. When your alarm went off, I woke up disoriented, confused, and overwhelmed by the noise, in a strange bed and a strange room. It was frightening, and my automatic response was to protect myself."
"By curling up into a ball. Turtling in on yourself."
"Precisely. Many younger autistic children find comfort in small spaces, incidentally. They will hide in closets or under tables or beds—this is a form of turtling."
"And the functional freeze? That was what happened outside the station."
"Correct. My mortification at my faux pas with Sheriff Mannix triggered it.
I am aware of how I am perceived, especially when I crash out in public.
In order to prevent the embarrassment of crying or stimming in public, or simply to contain one's overwhelmedness, one enters a sort of physical paralysis known as a functional freeze. "
"Is that different from when you're sitting here thinking and don't see or hear anything around you?"
"Similar but not the same. That is simply being completely absorbed in my thoughts to the point of tuning out the world around me." She watches me for a moment or two. "Any other questions?"
"I mean…" I look back at her, processing what she's told me. "I guess what I’m hearing is that you have, like, a super-powered brain. Like, super, super rocket-powered, mega-genius level shit goin' on."
Her answering smile is complicated—sweet, flattered, but with a sarcastic "oh, sweetie" undertone.
"Yes, I suppose that is true, to a degree.
But with that super-powered brain comes a host of attendant problems. As you have undoubtedly noted, I am the most socially awkward human being you will ever meet.
" She regards me blankly. "That is hyperbole. "
“Hyperbole? Girl, you're takin' me back to ninth grade lit class—and spoiler alert, I didn't exactly excel at literature."
"Exaggeration for effect," she explains.
"I'm sure I’ll have questions later, but I think I get the overall situation," I tell her. "I'm glad you shared that with me, Cadence. Thank you."
She shrugs, smiles, and gives a little bow at the waist. "And that concludes my TED talk."
This gets a laugh from me. "See? You do have a sense of humor!"
"Occasionally," she murmurs. She searches my face, then. "Riley, after all that, has your opinion of me…changed?"
"If anything, I'm even more amazed by you than ever. It's gotta be tough, dealing with all that shit, day in and day out. Dealin' with assholes not understanding you and not even trying to. Feeling like…I dunno. Like things are going on in the world that you don't see or understand."
She swallows hard, nodding. "It is challenging, certainly. It is my lot in life—I cannot change it, even if I wished to."
"Do you? Want to…be different?”
She looks away. "At times, yes. Who does not, though?
When the world is too much and I cannot breathe and my mind is flying a thousand miles per hour along a dozen different lines of thought at once, yes, I have wished I could just…
silence my mind. Not be…this way. Even for a few minutes.
But when I am working? That is when I truly come alive, Riley.
When I enter an Emergency Room or a triage tent, something in me shifts.
I become…almost a different person. My mind quiets.
I am aware of nothing except the patient, assessing the problem, coming up with a solution, and ascertaining the swiftest and most effective means to that end.
When I am in that world, I am in control. "
"So what exactly is it you do? As a doctor. I mean, you've mentioned the ER, so is that your, what is it—specialty? Your area of focus?"
She nods. "Yes. I specialize in emergency medicine. I excel in high-pressure, chaotic situations."
"So when shit hits the fan, you're the lady to call."
"For medical attention, yes." She appears to be chewing on something, mentally. Considering what to ask, or whether to ask it. "You…you do not think I am…" she drops her voice to a whisper. "A freak?"
My heart cracks. "Ahhh, fuck, Cadence." I reach for her, tug her toward me.
She resists at first, but gradually allows me to bring her close enough that I can cup her cheek.
I hold her eyes—something I've noticed she has a hard time with; after a moment, her gaze drifts away, dropping to my lips. "No."