Autism spectrum/A few impertinent questions/Should doctors and scientists refrain from expressing skepticism about theories of colleagues in other fields?
I went for the appointment with the child psychiatrist. His office was on San Francisco Bay, overlooking a small boat harbor, Gerald Jampolsky - author of popular books on child psychiatry. My encounter with him was brief and straight forward, and Jampolsky is his real name. Please, please let this psychiatrist at least be candid! I thought, as I parked the car and took Tony with me into the psychiatrist's office. How could I trust doctors who seemed to be keeping something from us? Why was the medical profession suddenly behaving so deviously?
Doctor Jampolsky invited me to leave Tony in the waiting room and come into his office.
Leave Tony in the waiting room? Alone? The psychiatrist didn't seem to have a receptionist. A couple of chairs and a lamp seemed to be the only furniture. Maybe there wasn't much for Tony to destroy or dismantle. "Be a good boy," I admonished with a heroic display of confidence, as I put him on a chair. There was no telling what Tony might do if left alone, but sometimes circumstances demand that we live dangerously, I decided. Tony looked angelic as I left him sitting in the waiting room. Although alert looking and curious about everything, there was never a trace of guile on his bright, innocent little face.
A big window with its spectacular view of yachts took up one side of the psychiatrist's office. I seated myself in a big comfortable chair. At least it wasn't a couch. I always dreaded the possibility that I might be asked to talk to a psychiatrist from such a submissive position. The psychiatrist, a personable, obviously intelligent man, listened as I told about the Child Guidance Clinic and my disagreements with Dr. Zircon.
"Dr. Zircon says Tony is very bright," I explained.
The psychiatrist sat waiting for me to continue.
"Extremely bright!" I emphasized.
The psychiatrist still didn't react. Probably all mothers who consulted him considered their children to be extremely bright. I didn't know how to suggest Tony's superior intelligence seemed to have some mysterious relationship to his unusual development. When I tried to talk about some of Tony's mischief, the psychiatrist kept glancing uneasily toward his waiting room, where I hoped Tony was still sitting unattended.
"I honestly don't understand why you consulted me," he finally said.
"I want to know what might happen to Tony."
"I've seen many of these children end up in institutions." he said gravely. I stared at him in horror, too shocked to ask what he meant. I couldn't think of any reason for putting people in institutions other than retardation, psychosis or criminal acts.
“Do you believe children are born like Tony, or do you think their condition is caused by something in their environment?” I finally managed to ask. 'Mother' was obviously the environmental cause psychiatrists seemed to agree upon, but like most of the doctors, I couldn't bring myself to come right out and put the awful accusation into words.
"There are psychiatrists who believe children are born like this. I'm not one of them."
That was at least an honest answer. I was impressed by this doctor conceding that people might disagree with him! Disagreement was something Dr. Dingle apparently couldn't tolerate. I wondered if he would take offense if I asked where I might find one of those disagreeing psychiatrists. The request probably wouldn't be tactful, I decided, and I tried to figure out how I might word it so as to not offend him.
"The purpose of psychotherapy is to get to know yourself," the psychiatrist said, apparently still puzzled about what I wanted from him.
"But I already know myself as well as most people do. And it's damned unpleasant having that psychologist sit around waiting to pounce upon one of my alleged emotional problems."
"Therapy is not like a social relationship. If you are angry at the psychologist, don't keep your feelings to yourself. Tell him exactly what you think of him!" After a moment's hesitation he added, "What would you like to tell him?"
“I'd like to tell that pompous little fugitive from the Organization Man he has more emotional problems than I have!” I declared. A recent book, The Organization Man, criticized psychological tests among other things. Most psychiatric theories were accepted with religious fervor in those days, but I had begun to search out anything I could find that was critical of either psychology or psychologists. I wasn't in the habit of “telling people off”, though, and wouldn't even know where to begin. “But what could 'telling that psychologist off’ possibly accomplish?” I asked helplessly.
The psychiatrist stared at me. Not a muscle of his face moved. He just sat staring at me.
"Is Tony a rocker?" the psychiatrist asked with sudden heightened interest. "Or have you ever noticed him attach something to a piece of string and spin it?"
I was reminded of the time a year ago in the first pediatrician’s office. Something about me, my grades in school, had seemed to suggest Tony's mysterious diagnosis. Other people's thoughts had always been inscrutable to me. I've since read descriptions of the difference between analytical brains and intuitive brains, and have decided that my brain is on the analytical side. However I've also read that the difference lessens as we grow older, and analytical thinkers sometimes acquire more intuitive abilities. Under the awful trauma of the past year, my mind might have made a quantum leap. To my surprise I felt sudden insight into this psychiatrist's thinking. He was finally recognizing Tony's mysterious diagnosis, I decided.
"He rocks his head back and forth before he goes to sleep, and he spends a lot of time walking around vigorously shaking a limber stick," I answered, "in a way that sort of resembles spinning something."
“Did you work before you were married?” That first pediatrician had wanted to know what type of work I did in Alaska. What was it about the kind of work Ike and I did that could be relevant to Tony's diagnosis?
"I was an architectural draftsman."
"And your husband?"
"He used to be a newspaper reporter."
The psychiatrist smiled and nodded. He continued sympathetically, "You consulted me because you don't believe they have been honest with you at the psychiatric clinic, didn't you?"
"They have refused to tell us anything."
The psychiatrist suggested I try another psychiatric clinic, Langley Porter in San Francisco. The last thing I wanted was to be treated at another psychiatric clinic. I was looking for someone to tell me all they knew about this mysterious diagnosis they suspected.
“Would you be willing to take Tony as a patient?” I asked. This doctor also appeared to be suddenly suspecting some diagnosis about which he wasn't being explicit, but he didn't seem devious. He actually appeared to disapprove of Dr. Zircon’s deviousness.
"Do you think you could afford my fees, several hundred dollars a month?" he asked.
"We have some money saved. I would pay almost anything to learn something definite about Tony."
"Well, I don't have any free time right now. But if you'll give me the name of your psychologist, I'd like to phone him."
Please don't do that!" I exclaimed. "He's already angry at me. He'd probably kick Tony right out of the clinic."
"I don't think you have to worry about that!" He spoke as if treating Tony was considered a privilege that no therapist would willing relinquish. (Or maybe we were involved in a scientific study, from which Dr. Zircon wasn’t permitted to expel us.) "No, I'm going to phone him," the psychiatrist repeated, and he sounded provoked.
Not again! Please not again! The psychologist's annoyance did seem directed at Dr. Zircon, not at me. Nevertheless this doctor visit was going to be as futile as the others. It was like a nightmare, where one is aware of dreaming, but was powerless to stop the terrible events from running their awful course. If only there were something I could say to stop this doctor from dismissing me without discussing Tony!
“I read every psychology book in the local libraries,” I confessed, remembering that Col. Mann complained to Ike that I didn’t tell them I read psychology books.
Dr. Jampolsky looked startled. "Now I'm not going to charge you full price for your consultation today," he said, ignoring my confession. "Fifteen dollars will be enough."
It had happened again. He expected me to leave!
"I think I've made a wonderful adjustment to life, considering the way I am," I defended myself. "I could have been an alcoholic like my father."
There! No one could accuse me of withholding information now! I'd revealed both my habit of reading psychology books and my father's alcoholism. Secretly, though, I still preferred "however I was" to being whatever the psychologists defined as “normal”, and that was the truth! We are all a mixture of talents and deficits. I was grateful for my talents and willing to work on my defects. Skepticism, which I regarded as one of my talents, was overwhelming me with serious doubts that these professional "people fixers" actually possessed the skills they were claiming. They misread Tony's emotions and they seemed oblivious of my anger and resentment.
The psychiatrist only looked a little bewildered. Reluctantly, and feeling defeated, I got up and collected Tony from the waiting room. Thank heavens he was still sitting in the chair and hadn't found anything to dismantle. I had apparently hit bargain-day, and the psychiatrist had only charged me half-price. However economizing on doctor’s fees wasn’t one of my priorities at the moment. I’d hoped this doctor would at least be candid. But the only advice he'd given was to go tell Dr. Zircon exactly what I thought of him. The psychiatrist apparently planned to reveal my feelings over the phone, and besides, Dr. Zircon was undoubtedly already aware of my anger. Doctor Jampolsky's disapproval appeared to be directed at Dr. Zircon, not at me. I had been attending Dr. Dingle’s group for nearly a year. Surely Ike and I were surely entitled to know our child’s diagnoses. At first Dr. Zircon may have felt that by keeping me ignorant of details, I might become frightened into cooperating with his treatment - more likely to confess some of his neuroses. By this time Dr. Zircon might have been willing to discuss autism. Maybe he didn't want to talk about it in the group, and was waiting for me to consult him privately. But I no longer trusted psychologists. Col. Mann insisted Dr. Zircon didn’t say things I heard him say, and I preferred to talk to any psychologist in front of witnesses. During that time, I made other attempts to find a doctor who would talk to me. The results were always similar. Psychiatrists would not contradict each other, and medical doctors would not interfere with their colleagues, the psychiatrists. During those years some doctors may have had reservations about psychiatric treatment for mothers of autistic children, but they remained silent. The only treatment available to Tony seemed to be psychotherapy for his mother.
As a nonconformist I'm accustomed to finding people who disagree with me. Authorities sometimes become upset when people challenge their beliefs. Those few biologists who dare to question the creative power of Natural Selection, for instance, are accused of being "ignorant creationists”. Ben Stein narrated a movie, Expelled: No Intelligence Allowed, documenting how scientists who question Neo-Darwinism can be denied tenure, and sometimes even lose their jobs. Perhaps challenges to entrenched orthodoxies sometimes have to originate outside the establishment.
- The original images may be found on this pdf copy of the book.
Current page: Should doctors and scientists refrain from expressing skepticism about theories of colleagues in other fields?
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- Current page: Should doctors and scientists refrain from expressing skepticism about theories of colleagues in other fields?