Why I don’t watch Doc Martin any more

Doc Martin is a British ITV medical dramedy that has run continuously since 2004 (series takes a year off in between showings). The series depicts a fictional surgeon, Martin Ellingham, whose sudden onset of a fear of blood had caused him to retreat from his career in a busy London hospital to a sleepy fictional Cornwall town of Portwenn as a general practitioner, where the run-ins with blood would presumably be less frequent. The scenery is spectacular and the characters are suitably quirky.

Though it’s never stated that Doctor Ellingham, or “Doc Martin” as the locals call him (to his uptight chagrin), is on the Autism Spectrum, in one episode a character playing a psychologist flatly said so. In addition, Doc exhibits many of the markers of Aspergers, including social deficits, appearing to lack empathy, unusual facial expression or postures, intense interest in one or two ‘special interests’ (medicine and clocks), no social filter, and etc.

The show presents the typical trope of fish out of water, and the fish is Martin and the waters are Aspergers. His gruff and to-the-point manner with no filter means the character has absolutely no bedside manner. He is a rule follower, and isn’t nuanced. This means the character does not handle situations sensitively, either socially or medically. He has no friends, not for lack of trying on the people of the village’s part. His empty social life doesn’t bother him. He is single minded, once on a track he is like a bloodhound on the trail, nothing can make him give up. His main saving grace is that he can diagnose like nobody’s business and he is never medically wrong.

He falls in love with school teacher Louisa, deeply. After many seasons, he gets up the nerve to ask her out and they begin a relationship. Of course, Martin isn’t romantic and he often ruins dates or social situations with his bluntness. But what Louisa falls in love with are his positive qualities: he is loyal, courageous, brilliant, dedicated, a good listener, and in his own way, he cares deeply for Louisa and would never abandon or hurt her.

Just as in a neuro-typical relationship, an Autistic person has good qualities and irritating qualities. What I grew weary of is the writers’ attempt to make all the compromises occur on Martin’s side. Despite the character being unromantic, which Louisa knew going in, Louisa constantly complains Martin is not romantic. Despite Martin’s abhorrence of social situations, Louisa constantly complains that he never wants to go out. And so on. Martin tries valiantly for Louisa’s sake to adjust to her needs, which I found admirable. Louisa is never shown to be patient with Martin or make any compromises on her part. She just yells at him a lot for his deficits, making him feel crushed and bereft. Or she gives him the silent treatment, which, he doesn’t understand why and he retreats back to medicine or clocks.

The series became all about Martin’s inability to be the man Louisa wants, and it never focuses on his good qualities. A decent, loyal, brilliant, caring man is something to be valued, but the writers only deal with Martin’s negative traits.

This is how people on the Autism Spectrum are often portrayed. The subtle or not so subtle issues with an autistic person are that they must change in order to fit in to a neuro-typical world, or worse, change in order to function at all.

Yet Doc Martin functions perfectly well. He had a brilliant career in London, and though he is dealing with a phobia, is making a success of his second career in Portwenn. He has a love interest, a satisfying hobby (clock repair), and soon, a son. He has two aunts who love him, a home, and a life. Just like anybody else. But these things are seen as less than, because he is autistic.

It’s been my observation that people on the Spectrum (myself included) can and do function well by making accommodations on behalf of fitting in to the society around us, but also working in tandem with the culture by making our own unique accommodations.

But in Doc Martin, it’s all about how Martin must change to make Louisa happy, never that Louisa must also change to make Martin happy.

Another television show that has recently been released that explicitly features a main character on the Spectrum is The Good Doctor, on ABC. The character is Resident surgeon Shaun Murphy at St Bonaventure Hospital. Shaun has a unique ability to visualize any part of the body in 3D, as well as an eidetic memory. These talents are brought up in the interview and touted by his mentor, Hospital President Dr Glassman. Glassman advocates for hiring Shaun, “despite” his autism. Other interviewers worried that Shaun’s lack of bedside manner would hinder the good qualities he has, as well as any unpredictable responses he might emit when in stressful situations, such as occur in surgery. By a close vote, Shaun is hired.

I’ve enjoyed the presentation of how an Autistic character functions in a stressful employment situation. Shaun’s ‘special interest’ of course, is medicine, but over the course of the show, Shaun branches out and enjoys watching football games, makes a friend or two, and even has a romantic encounter with a female friend who values him for who he is.

The show presents a young man functioning in ways that are surely Autistic, but are in parallel with all other people who also function in stressful situations and come up with their own solutions. For example, when stressed, Shaun holds and manipulates a plastic knife his dead brother had given him. A female neuro-typical character twists her hair. Others go home and drink.

In an early episode, a fellow resident (Dr Claire Brown) and Shaun are attempting to solve a medical problem and as a colleague, Brown asks Shaun a series of questions. He never answers. After a while she noticed that Shaun does not answer questions but will respond if she makes a statement. She altered her communication style and they began to engage with each other. Just like neuro-typical people do.

In another episode, a friend visiting Shaun’s apartment made note of the unusual configuration of his furniture and the eclectic mix of it. As a boy, Shaun had lived homeless for a while with his beloved brother in an abandoned school bus. He arranged his apartment furniture to mimic the layout of the bus. This comforted him and reminded him of home. The furniture itself was eclectic because different caring adults in his life at that time had given the items to him. The bookcase came from the local librarian, the bureau from a teacher, and so on. It comforted him to have these things around him and to remember their kindness. And don’t neuro-typical folks arrange their furniture for maximum comfort and maintain keepsakes (usually photographs) to remind them of good times and nice people?

The show presents an autistic person functioning in society as a whole person. He is a bundle of quirks, eccentricities, attributes, and traits that make up a complex person, just like any other person. Sometimes Shaun is a jerk, not because he is autistic, but because he is acting like a jerk. Sometimes he makes accommodations on behalf of the society around him, and sometimes the people around him make accommodations on behalf of Shaun. What a refreshing way to show someone on the Spectrum.

Though both are medical dramas, I enjoy The Good Doctor much more than Doc Martin. Maybe in the future the television writers will have more characters like Shaun Murphy. Meanwhile, Doctor Ellingham? Some advice. You’re too good for Louisa.

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Recipes and shutdowns

It’s a glorious sunny 74 degrees outside, with little humidity. Isn’t Fall great? God is His wisdom provided for us here in the south a break from the relentless heat, and from summer’s air feeling like hot, wet cotton. Leaves swirling and cool air make me want to bake.

This weekend I’ll be baking oatmeal-raisin cookies (vegan, with only banana holding them together), cream of mushroom soup, baked potatoes, field pea salad with quinoa and cukes, roasted chick peas, and crispy baked eggplant rounds. Mmm.

I had a very good week at work, which is in an elementary school. It was pleasant, there was nothing frustrating or distracting, the kids were very cute, and all the people I interacted with were very nice and helpful and professional. Which makes what happened Friday afternoon and evening perplexing, but instructive.

Usually I come home on Friday overloaded with the week’s accumulated sensory stimuli. The accumulated stimuli are like leaves blown against a wire fence. By Friday, I’m exhausted.

But often I don’t know how exhausted. I can’t see the leaves. Often I don’t even know they are there, never mind how many of them.

Yesterday it was another glorious fall day, so after I got done with work, I left school and decided to zip up to my favorite store 7 miles up the road. I had borrowed some plastic tubs I wanted to return. It is a nice ride, with two long, high swooping hills, little traffic, and a straight road. It was nice. I dropped off the tubs and had a pleasant short chat with the proprietor. I browsed some CDs and bought 2 for $1 each- Westminster Choir singing hymns and English songs from 1870s. LOL.

Anyway, I popped them into the car CD player for the ride home. Since it was so nice out I decided to take the long way home and stop at Kroger for kitty litter, which I was in dire need of. When I got there, I decided to do a mini-shopping for fruit and veggies, which I was also out of. I could stop in again after church on Sunday for proteins for the coming week to complete my grocery larder.

I had a nice time shopping there, the store is clean and organized and not too bright. The wealth of fruit and vegetables from which to select always delights me. I didn’t take too long, but I felt my energy flagging and checked out shortly after grabbing some milk. I still had the drive home, lugging in the heavy items from the car, and putting them away before I could finally settle down for the evening.

When I got home I did all the above, and also cleaned the kitty litter pan and fed the cats. As I sat down with a glass of water, I realized I had overdone it.

My entire body was throbbing. My legs were shaking. When I get overstimulated my skin throbs, my muscles throb, even my organs seem to throb. I could feel my blood coursing through my veins, and it felt like it wasn’t blood, but poison. I felt sick, but not symptomatic regular sick like nausea or fever or having a cold. A poisonous sickly sick like I’d been turned inside out with exposed skin raw and then dipped in a vat of toxic chemicals. I sat numbly like a zombie, without energy even to work the mousepad. I stared at things in the apartment as if trying to untangle what they were.

I sat in front of the computer, wanting to read my Bible, but could not. I wanted to do this week’s lesson on Biblical Doctrine, but I could not. I wanted to just do something mindless like watch cat youtube videos, but I could not. I literally could not. My thoughts, usually zooming along its smooth pathways like a night time lapse of streaks of light as cars go down the road, were instead like a swarm of gnats I couldn’t follow and vainly tried to catch. I was completely numb but also in physical pain, and all I wanted to do was curl up with a soft blankie over my head.

Why was this so? I had a good week. I was not stressed. I had no conflicts, no surprises, no unexpected trauma or even minimal drama. Since I am not self-aware, I looked it up.

It’s called autistic shutdown.

A shutdown is basically an episode where the brain briefly stops processing and making sense of information in response to stress or sensory overload. The lights are on, but nobody’s home. Source

I found the following description of the autistic brain and its thoughts which is exactly like mine. It’s from The Everyday Aspie, the essay is “From the Inside Out

My brain, like all autistics’ brains, seeks connections through patterns. It is on super drive all day long. It solves, reasons, rearranges, deciphers, and concludes. Every move I make is an effort, an action I am noticing, and behind that action multiple scaffolding thoughts. Where in an average person might think about six things in relation to a feasible outcome, I am thinking of sixty. What one throws out as a die with six sides, I throw out as ten dice with six sides. What commonly goes unnoticed by others, is a heavy blink to me with multiple facets, some hidden, some upright, some tossed off the table.

The questions of how many steps to take, which room to enter first, which task to accomplish next, which word choice to use, how long to linger on one topic, are not just familiarities, they are essential elements of my existence. And behind those questions, evidence gathered in the past, visual flashes of what has been and what could be. In many moments, I am a bystander set within a machine, carried where it leads, with no steering wheel or access to controls—an entity within a larger calculating entity. And this entity is deciphering the feasible best route to everything, including my thinking process.

As my mind works, nothing is disqualified from being factored into an outcome. Even my toothpaste brand, how much paste I squeeze out, and the flow of the water from the faucet, are scoped out and theorized, and then neatly tucked into a web of accumulated data. My thoughts gathered, molded, and placed into a previously opened drawer, a unit only to be reopened and reassembled during a later point of time. I am essentially a vast storage house with feelings.

This is why we crave familiar routines. If it’s familiar, it doesn’t have to be theorized, tested, and decided. Or at least not as much. It’s less stressful and less mentally taxing.

It’s funny what she said about the toothpaste. Just the day before I was wondering about this with myself. Now I know. She described her own shutdown this way and mine mirror hers to a great extent. The normal thinking process just…stops.

–I am unaware that I am in shutdown at the starting stage. Usually a part of me knows, but the most of me feels confused and off-balance. At this point I can do nothing but be. I have not an ounce of energy or thought process left to help myself or anyone else. I am literally a computer unplugged. (non-responsive, unaware of surroundings, lost somewhere)
–I might be unable to form complete thoughts or talk aloud.
–I spend the majority of time alone, in isolation and away from people. However, I could be sitting in the same room as someone else, but be lost in my mind.
–As a result of little to no energy whatsoever, I skip showers, don’t brush my hair, stay in my pajamas, don’t eat. (This is different than depression. I am too tired to do anything, even if a part of me wants to.)
–I finally feel like I can breathe and not think.
–I curl up into a ball and sleep.
source Everyday Aspie

I pushed myself until I could not handle staying up anymore and went to the bedroom and huddled under a blanket at 7:00. I slept until 9:30.

After I got up I still felt terrible until I finally went to bed at 11:00, slept fitfully, woke up at dawn, and have been a zombie all day. I have not listened to music or sermons, or watched TV. I haven’t even cooked or read, or even blogged. It’s 6:30pm the next day and I finally feel like I’m “coming to.” I am drinking some good, organic tea, took a long hot shower to relax, and had a good nap earlier. These are all helpful. Now I’ll write The End Time blog for the day and then maybe later I’ll either read or watch a movie.

The shutdown that happened to me was perplexing, but now I know about shutdowns. It was instructive because now I know that no matter how seemingly good I feel, by Friday afternoon I’m not, so don’t go anywhere except straight home. I also now know that my tiredness and desire for solitude especially on Fridays are a need and not a character flaw, weakness, or laziness.

I’ll research shutdowns some more, especially what happens to the brain and body during one.

Sunday I’ll cook.

It’s been an eventful week.

 

My mother had me tested: Living with autism in the 1960s

Autism as a diagnosis has come a long way since 1908 when the word was first used, as the Timeline of the History of Autism shows. Further, the Timeline reveals that in 1944 and 1945, we learn from Leo Kanner that some of the behaviors associated with autism are “a powerful desire for aloneness” and “an obsessive insistence on persistent sameness” and from Hans Asperger that the boys he observed were “highly intelligent but had trouble with social interactions and specific obsessive interests.”

Not many advances were made in the knowledge base until 1967, when Psychologist Bruno Bettelheim popularized the theory that “refrigerator mothers,” as he termed them, caused autism by not loving their children enough. This turned out to be a false theory.

I was born in 1960 and I displayed the characteristics of the above. In addition, I had no affect (no facial expressions), didn’t emotionally bond with people, displayed extreme aloofness, was selectively mute at different periods, “stubborn” (an attempt to control my environment so as to diminish anxiety I didn’t know I had), perplexed by social cues, didn’t understand emotions- mine or others’, didn’t want to be comforted, and was inter-relationally tactless. (i.e if someone looked terrible today, I’d say “You look terrible today.”)

I know it must not have been that easy to engage with me.

me goofy at age 8
Me at age 7 1/2. I was never too photogenic. Or body aware, lol.

The world was so scary and so confusing, I internalized it all. As a result, my body erupted with physical symptoms of the anxiety I was suppressing. I had headaches and stomachaches all the time, sometimes severe.

I was looking over my elementary school report cards the other night. It seems that every year in most 9-week segments, I’d have good attendance, missing only 1 or 2 days. But in one quarter of the school year, there was always a huge spike, where I’d miss 9, 10, 11 days. This is a lot of days in a school quarter that has only 9 weeks. That means I regularly missed one or two days of school per week that quarter.

In 1968 my mother had me tested. (I think I remember the date correctly). This was the time before autism was in the DSM and during the time the refrigerator mother theory was prevalent.

I remember going to doctor’s offices and the person sitting in the big chair would try to get me to talk. Or observe me. I had many medical tests. The worst one was the spinal tap. A nurse held me in a Half-Nelson and another held my legs at the knees and they curved me and a HUGE needle went into my back. It hurt more than anything I’d ever experienced even to this day. I’ll never forget being held down and the cold steel table under me and the confusion as to why this was happening.

After all that was over, I got curious and eventually I asked my mother why and what and how come.

“What did the doctors say?”
“It’s psychosomatic.”
“What does that mean?”
“It means it’s ALL IN YOUR HEAD!!!”

My mother said the last part with such anger and disdain that she spit.

Psychosomatic means head-body (psycho-soma) connection. Psychosomatic disorders are physical symptoms that mask emotional distress. Unbenownst to the doctors at the time in our little corner of Rhode Island in 1968, the underlying cause was a different brain circuitry- autism. It is genetic and it tends to run in families. My cousin is autistic. I personally believe my father was also.

In the field of psychosomatic medicine, the phrase “psychosomatic illness” is used more narrowly than it is within the general population. For example, in lay language, the term often encompasses illnesses with no physical basis at all, and even illnesses that are faked (malingering). In contrast, in contemporary psychosomatic medicine, the term is normally restricted to those illnesses that do have a clear physical basis, but where it is believed that psychological and mental factors also play a role.” (source)

My parents interpreted the diagnosis as “hypochondria” meaning, not real, or the lay person interpretation of pychosomatic, meaning faked or malingering. They were kind of disgusted with me and left me alone after that.

At least I didn’t receive the most common diagnosis before Autism was included in the DSM, schizophrenia. The doctor was kind of on the right track. My headaches and stomachaches were a real physical manifestation of something in my head, which we now know is different brain wiring. Anxiety and confusion and sensory overload caused my physical symptoms.

I believe that my particular path’s diagnosis led from the 1960s mis-diagnosis of psychosomatic to the 1970s theory of the alexithymic brain, to the 1980s-90s diagnosis of Asperger’s or high functioning autism. (alexithymic brain and autism here, and here).

From Spectrum News, we read about my generation of autistic kids.

In the 1950s and 1960s, thousands of children who had autism were either completely missed or were saddled with the wrong label. The word ‘autism’ wasn’t included in the “Diagnostic and Statistical Manual of Mental Disorders,” the main reference book for psychiatry in the U.S., until 1980. …For these reasons, what autism looks like in older adulthood, and what it means to age with autism, are still mysteries, says Piven. “We don’t have that concept with autism that people live a whole life: What happened to them as they got older? This is just a huge area of no knowledge. There’s almost nothing written about autism and geriatric populations.”

Geriatric? Um, lol, OK. In my geriatric life I’ve gained experience that helps me cope. I have learned how to mimic appropriate social interaction. I have learned that people don’t like it when your face shows no emotion. Apparently my resting face used to  look melancholy, and people would ask me all the time why I was sad. It drove me crazy.  I’ve learned what I need in order to protect myself emotionally, financially, professionally etc.

Not having an “official” diagnosis as a child was a definite disadvantage. It’s OK, an official diagnosis didn’t exist when I was a child. Even today, knowing what I do now but still not having an official certificate to “prove” why I seem rude or grumpy or aloof etc., is also a disadvantage. People still say hurtful things, even ones who should know better. One person said to my face they don’t believe I’m autistic but just use the word to bully people.

I cannot imagine what moms and dads go through who hear people say these kind of things to or about their autistic children. My hat’s off to parents of autistic children. I am sure my parents didn’t know what to do with me!

I am who I am because God made me this way, and therefore I would not have it any other way. I have only spent 47 years with a semi-diagnosis and headaches and stomach-aches and angry parents and insensitive people. I will spend eternity with Jesus, glorified and perfected, being used as His servant in the exact ways He made me. The way He made me will be a gift to His society in heaven, without the physical manifestations from sensitivities and anxiety from misdiagnoses or misunderstandings. It’s a good trade. A very good trade, because God is good.

Asperger’s Are Us

I’m an early elementary educator who teaches children in regular education and also Special Education. I work with Kindergarten through second grade students. Some of the students I have worked with in the past have been formally diagnosed with Autism. They have landed on the Spectrum at greater or lesser degrees.

There is a heavy emphasis on helping children with autism, which is as it should be. Parents, families, the child, all need support and education.

However, I do worry fiercely for the students who are:

–diagnosed with autism early on and transition to adulthood where there are fewer external support systems
–have never been diagnosed with autism and are transitioning to adulthood and do not know why they feel or act as they do and don’t understand why they are so different from everyone else.

In other words, what happens when an autistic child is ready to leave his or her parents’ home and go to college…the military…find their place in a vocation? Where their life-long relied-upon support, understanding, help from parents, family, schools, therapists, doctors, and counselors have always been in place but now will dwindle to nothing? The support systems nearly disappear for the autistic adult. Achieving independent success as an autistic adult is a scary and difficult prospect. It’s hard for any person not on the spectrum but it’s very difficult for those who are. Managing one’s autistic self independently is bewildering and difficult.

I came across this documentary about adult Aspies from Massachusetts who had formed a comedy troupe. I loved it! The documentary focuses on the young men as performers, as people, who happen to be autistic. I have to say I did love the comedy. Their jokes…I get.

You won’t “learn” about Autism by watching this documentary. You will learn about four unique individuals who have dream and goals, work hard, have fun together, and are facing challenges. Just like everybody else.

After the movie finished, I searched for more information about the men. One of the men, Noah Britton, speaks to audiences about autism, and his TEDx talk in MA was interesting. Not the least is because it was captured on camera the moment he met Rachel as noted in the epilogue of the documentary, his girlfriend (or maybe his wife by now). He also spoke passionately against the use of aversives, using unpleasant stimuli to modify behavior and spoke specifically against the Judge Rotenberg Center. Methods such as loss of privileges, food denial, and shock therapy are still used at the Judge Rotenberg Center (JRC) in Massachusetts. They are the only facility in the US still using Graduated Electronic Decelerator (GED) directly on the skin.

My cousin Jennifer Msumba was a resident at the JRC and has spoken publicly about her experience there multiple times. In 2014 she spoke to CBS News, she testified before a U.S. Food and Drug Administration panel, and spoke up about her experience in many other places testifying to the horrendous impacts aversives have. She spoke about it this week in her Youtube channel:

Here, Jennifer speaks about what it is like to live with OCD.

Jennifer speaks with an articulate clarity and shining joy of life. As in this video!

Jennifer recently reached a life goal of becoming a member of Mensa. She plays four instruments, composes her own songs, arranges and performs cover songs, rescues poodles, and generally is amazing. Like the four men in Asperger’s Are Us.

Jennifer and the four men in Asperger’s Are Us have a good support system and seem to be making (or who have already made the transition) well. It’s often a bumpy road, and for those without a support system, it’s often a road littered with roadblocks, potholes, and crashes. It’s nice to see these men and women people doing and working and living and loving and laughing.