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I now work at an animal hospital again. Only part-time, because autism, and at the front desk, because after multiple surgeries my dog-slinging days are officially behind me, but a place to be around pets and animal lovers and use my veterinary/animal sciences knowledge.
There is a white board in the back that lists pets that are on the way and have just arrived, with the pet’s name and the reason for the visit. Like, “Fluffy ingrown claw” or “Chloe V+ D+” (vomiting and diarrhea). The other day, it had “Crash HL lameness” and my anti-central-cohering autistic brain did not immediately register “Crash” as the name of the pet.
Crash Thomassen (not his real last name) was a black lab (not his real breed) who had apparently, appropriately enough, torqued his knee at the dog park for reasons not unrelated to his moniker. Once I met the gregarious pooch and it clicked that Crash was the name and not the injury, I thought that Crash was probably the perfect name for him.
Pet owners tend to be rather uncreative when it comes to names. At any given time, we have multiple Peppers, Lolas, Sadies, Luckys, and Buddys in and out of the facility. (Oh, side note here, please do not name your pet Lucky for any reason.) The only exception is pug and bulldog owners, who lean towards hipster names that are much cuter on dogs than on people’s kids, such as Martha, Gertrude, Chauncey, or Walter. So when someone comes up with an excellent dog name, it gets noticed. Crash was a hospital fave.
And a personal fave. The name Crash speaks to me. Because that’s me, right now. I have crashed, and burned.
Three semesters of grad school via Zoom have wrecked me. Class discussions and impromptu tangents are the fun part of grad school. They balance out the herculean and thankless labor one must otherwise expend reading gross amounts of peer-reviewed literature and pulling together a research project that will culminate in a thesis or dissertation, otherwise known as the longest and most harrowing paper you will ever write in your entire life. Zoom took the fun part away and made the herculean gross part exponentially more thankless. Grad school work requires a level of sustained intellectual concentration that I simply cannot muster right now. And I am not just tired of schoolwork. I am tired of thinking. I have completely lost the motivation to apply mental effort to, well, anything.
I got an email today through my professional website from someone who listened to an interview I had given in April of 2020, before Zoom wrung every last drop of passion out of me for the work I had been doing. The email referenced my desire to create a new language around autism, to amend the ADA to more specifically address accommodations for those with neurological and other invisible disabilities, and even the problematic use of the word “disability” to describe autism, a condition many, including myself, regard more as a gift than a burden (or at least, equal parts therein). The email writer’s interest and excitement were palpable even in the brief note, perhaps all the more so in the context of my thorough lack thereof.
I used to think someone needed to do this work, and that I was as well-equipped as any to do it. It used to be my excitement that was infectious, my dedication that was so enviable. But it’s just gone. Now the only intellectual work I do is counseling first-time pet owners that most of the time, a vomiting puppy is not an emergency and that sometimes, cats stop eating for inscrutable reasons and will start again when they are hungry enough. (Er, this is not intended as medical advice. If your puppy is throwing up or your cat has stopped eating, please call the vet.)
I used to have a five year plan on the wall in my home office space, with a timeline specifying numbers of articles in the lay press and in peer-reviewed journals, conference attendances and presentations, what I expected my career to look like as I leaned in to advocacy following completion of my master’s which was, at the time, a given. I tossed it when I packed up and moved into a new house last month, perhaps assuming I’d print out a new one and hang that up instead. But I didn’t, and I haven’t.
I know Zoom courses were hard on everyone, instructors and students alike. But I relied on my peers for more than stimulating conversation and alternative insights. They reflected and amplified my passion for the work, commiserated with me on the challenges, and made me feel like what I was doing, as crazy and unlikely as it seemed for someone like me, was worth doing, and even more, that I was the right person to be doing it.
Even as we joked about the difference between reading an article and “going over” it, bickered good-naturedly over whether you could include something for which you only read the abstract as a reference, and self-consciously modeled academic wherewithal for undergraduate students in courses where we were TAs, we were reifying ourselves and our reasons for being there. As difficult as it was for me to sit in a room for three hours and stay “on” and mentally engaged, it was exponentially more so when my peers were tiny, disembodied faces on a computer screen, if I could see their faces at all, as a plurality of us would turn off our cameras at various points during the online lecture to shop or put laundry in the dryer or cook dinner or whatever other mundanities we could now engage in whilst attending class at home.
At some point, I was always going to have to learn to look inside myself for the necessary passion and work ethic. But I feel as though the collegial part of the process was truncated unnecessarily in the most abrupt and painful way possible, like being in a relationship wherein the other party has suddenly become incapacitated. When we switched to online coursework after Spring Break in 2020, it was like a fun, weird, interesting new thing that I engaged in with people I had forged relationships with in the preceding eight weeks. By the Fall, though, I and a collection of mostly strangers slogged through the material as individuals on separate islands, only communicating through online, inaptly named discussion boards that only facilitated discussion in the presence of a real world counterpart and were woefully inadequate to the alternative.
I could no longer spontaneously bounce ideas off a classmate or professor walking to or from my car. The friendly arguments about reading material that I cultivated–I loved engaging with people who disagreed with me because I got so much out of being forced to justify or change my point of view–were completely gone. Even the online Zoom discussions were nothing of the sort. One person would talk and stop. Another would talk and stop. And another. Half of the students wouldn’t bother talking at all. There was no back-and-forth. And we were all so starved for casual interaction that when the professor would shunt us off in smaller Zoom rooms of two or three, we wound up talking about just about anything other than whatever it was we were supposed to be discussing because in that dark fall and winter of 2020, those little groups made up the lion’s share of our social interaction.
I think part of the reason I’m recalcitrant is because I’m pissed. I feel like I was cheated out of something I was owed. I harbor no small amount of resentment at being forced to pay full price (through loans, of course, so it’s not even like it was my money) for a lousy facsimile of a graduate school experience, as useless as paper doll clothes on a Bratz, and about as fungible. I barely even remember what my Zoom courses were about. Instead, my strongest memories are of being lost and frustrated, of finding so much of the material opaque, and of feeling like I was completely out of my depth. I would rather re-take an in-person class I hated three times over than have to take courses I would have thrived in in an in-person setting online again.
So, like any self-respecting adult, I’ve decided to invest in my inner two-year-old and turn away from the whole business and answer phones at an animal emergency room. To say this is a waste of my experience and talents would be an understatement, but I don’t care. It’s my way of thumbing my nose at the whole sad dumpster fire that this pandemic made of my plans. Fuck that, I keep thinking. What’s the point. I threw all that time and energy into it and now I’d rather watch football and pick out curtains for the window in the downstairs bathroom than pad up and dive back into the indignant moral superiority I felt when advocating for neurodivergents, a fire that kept me going even when it seemed like nothing I did would ever have that much of an impact.
Maybe this post is the first step in finding my way back to that passion and energy, in rediscovering what it was inside of me that made me think I had any business doing it in the first place. It didn’t used to be hard. It was easy. Graduate school was so easy for me compared to some of my fellow students. I bloom under the right kind of pressure, especially with a little friendly competition, with really smart people around me that force me to stay sharp and keep up with them. Nothing hones my writing skills like a deadline. Now that I’m out of the coursework and into the thesis portion, though, with an ultimate deadline still a year and a half away and no other striving, quick-witted grad students around me, it’s just easier to slip into obscurity, especially wearing the same scrubs as everyone else and a mask to hide my face. If no-one reminds me that I’m special, then I don’t have to be special. Fuck that. What’s the point.
I don’t know what it will take to reignite my pilot light. I keep hoping it will be something outside of me. Like the email I got today, although all that has done is brought my current dilemma into sharp relief, illuminating just how far off the path I have wandered since the pandemic forced my graduate education into a state of suspended animation. I had assumed I was just burned out and needed a break, and that’s probably true. But am I supposed to wait for my body to tell me I can go back, or will I need to pull myself up at least part of the way out of this hole by sheer will power even though I’d rather stay here in this nice, dark, quiet little space uncluttered by my or anyone else’s expectations?
I don’t know. But at least I’ve started writing again.
The Ape is on hiatus to recover from a surfeit of anxiety and stress, and will return in Fall 2021.
Or, Why I’m Not Happy that Elon Musk is Autistic.
I am always grateful when someone famous announces that they are autistic. Or so I thought. Now I have to say that I am almost always grateful, because in the case of Elon Musk, gratitude was not the first, or second, emotion that I felt. Instead, I felt apprehensive and weary, because I knew I was going to have to write this post, re-inform people as to what autism isn’t, and explain why I’m not happy about his announcement, over and over, because people love asking the one autistic person in their lives about every little thing that has anything to do with autism. And not only am I the only autistic person they know, I’m the only autistic person I know, so this blog is the only place I get to vent about it.
Basically, the last thing the autism community needs another example of a white male autistic who fits the vanishingly rare stereotype of the super-genius misanthrope. At the risk of stating the obvious, most people with Autism Level 1, as Asperger’s is clinically termed, do not have 99th percentile IQs and aren’t billionaire entrepreneurs. A considerable number are not even white men. People with “high-functioning” autism are a diverse group of individuals with a range of functionalities of which those like Musk’s (and, full disclosure, mine) are the ceiling, not the average. Such outliers are exceptions to the rule, their success unattainable for the rest of the autism community.
Most people on the spectrum, including me, struggle in our day-to-day interactions because we don’t intuit social norms. We pay a price for unintentionally upsetting neurotypicals (non-autistics) around us, who often accuse us of having a “bad attitude” and “negative tone.” But these traits are just fine if you are a white male of outrageous wealth, autistic or otherwise.
Musk is a self-centered blowhard whose only goal in announcing he had Asperger’s was the promotion and benefit of Elon Musk. When someone like him comes along and says they are autistic, it reaffirms stereotypes about autistics being unfeeling savants and reifies a social structure where the norms that apply to an overwhelming majority of the population are lifted for the elite few.
This is a problem for several reasons, of which being allowed to be a jerk if you’re privileged is the least of them. Lack of knowledge about autism makes a celebrity of Musk’s stature a template against which all other autistics, including the non-white, non-male, non-rich and non-genius, are measured, thereby setting an impossible standard none of the rest of us can reach. People already carry around a lot of negative implicit bias against autistic people, even though most would claim otherwise, and Musk just reaffirms what they already feel.
For autistics who aren’t named Elon Musk, there are severe penalties for not adhering to social guidelines. We have to work for bosses, at the local fast food joint, retail store, or office, and we do so at their pleasure and according to their rules. Musk may be a genius, but he wouldn’t last a single shift at the local Starbucks, and he’d undoubtedly blame everyone else for getting himself fired, because that’s the kind of guy he is. Most autistics are not like that, but those like him make it that much harder for us to convince people of that fact.
Do we need people to make autism more visible to non-autistics? Yes, absolutely, and that’s why Musk’s reveal isn’t all bad. At least we’re talking about autism, right? There are as many different types of autism presentations as there are people with autism, and I have no doubt as to his diagnosis. But autistics struggle to hold down jobs, make and keep friends, and meet the expectations of the neurotypical (non-autistic) people around them, challenges that, if Musk ever faced, he certainly doesn’t have to worry about now. If only his admission had come with caveats, with a “Yes, I’m successful, but I’m the exception, not the rule,” I would have cheered him on. Instead, he’s become the latest front in our ongoing battle against tired autism tropes.
Most people will never be billionaires. Most autistics will never be Elon Musk. This is an opportunity to recognize that autism is more common than we realize. So long as we realize that Musk is not a common autistic, that is good thing, and I [wearily] welcome it.
Online newspapers are strange animals. Unlike the paper versions that have a different set of articles every day, online outlets show certain pieces with lots of hits for weeks on end, while the less popular/clickable ones can slip out of view in a matter of hours. So you’ll keep seeing the same headline over and over in some cases, and be unable to locate one you saw that morning in others. In this context, there’s one headline that seems to have been up for months, although it’s probably more like weeks, on one of the online newspapers I frequent. It’s about a [presumed, and presumed female] travel writer whose advice for those of us unfortunate enough to have more prosaic lives is that we just need to “get past fear.”
That’s it. That’s the headline. “[Travel writer name] to [us poor schleps]: Get past fear”
I’ve gotten some pretty useless advice in my time (chronic pain sufferers are constantly–constantly–fielding unsolicited medical advice), but “get past fear” takes the prize. First, fear, in and of itself, is a hard-wired evolutionary response that has served us well at the species level for tens of thousands of years. I’m really glad my ancestors never “got past” fear or I might not be around. Second, advice to just “get” past whatever “fear” means to the travel writer is nothing more than a particularly annoying manifestation of an already swollen category of misguided, inadequate life “hacks.” It’s like telling someone to “get past sleep.” Wouldn’t life be amazing if we didn’t have sleep? Think of all the things we could do! All the leisure time we’d have! It would be so freeing!
And it’s about as likely. Get past fear? What does that even mean? Fear of what? In the context of solo travel by a woman, that seems like really, really bad advice. Fear is what makes you careful. Fear is what keeps you from being alone with strange men, from going on a hike out of cell range without telling anyone, from buying LSD from a bartender you just met. What kind of fear is this woman talking about? Fear of not being able to pay your rent? Fear of being kidnapped? Fear of having an emergency in a strange country where you don’t speak the language?
Or is it the “fear” (if I could put more scare quotes around it without looking stupid I would) of “discovering” “who you really are”? And who is even afraid of that anyway? How is it possible to be afraid of something that, let’s be frank here, is all but impossible in any real sense? How much about yourself that’s available as self-knowledge could you not know already, and how much more is likely to be revealed, EatPrayLove-style, by a change of scenery?
It’s not like you will suddenly discover that you are a completely different person. And despite what most marketing executives would like you to believe, it’s not even a real thing, this “new you” that could be brought about by traveling, drinking organic hard seltzer, getting a Peloton, or buying designer clothes at 70% off. (It’s still the same you, just in a different place, buzzed, in more debt, and in a different outfit.) And even if some unexpected self-discovery was out there to be made, how is that a terrifying prospect? Gee, I always thought I was the kind of person who liked sushi but I’ve just realized I’m not. How horrifying! Well, I better make sure not to have any more epiphanies like that one. I barely survived!
Assuming there is some other type of “fear” to get past in this context that has escaped my literalist autistic brain, I sincerely doubt that a simple admonition to “get past” it is all that was missing from the experience. OMG! I just need to get past fear! I wish someone had told me sooner! This is the answer to all my problems!
As an example, here’s a little personal disclosure: I hate large flying bugs. I can handle flies and small moths, but anything over an inch long with wings is scary to me. Maybe not a phobia in the truest sense, but definitely anxiety-inducing discomfort that increases exponentially with the number of said creatures around. The area where I live is a few weeks away from being beset by a once-every-seventeen-years, biblical surfeit of harmless but extremely large and clumsy flying bugs. I’ve got real fear, unfounded as it may be, about this upcoming event. In fact, my heart rate goes up just thinking about it.
According to this travel writer, I just need to “get past” this fear. (Specific instructions not included, of course.) But you know what? No, actually, I don’t need to do that. I need to go somewhere where there aren’t masses and masses of large flying bugs, which is what I did last time this happened and it turned out great. Unlike visiting old friends, getting past my fear of large flying bugs will not improve my life in any quantifiable fashion, and, worse, would require a significant investment of psychological resources better spent on improving my fair-to middling self-esteem and not losing my s**t about my upcoming thesis project. I do not need to get past my fear of giant insects–or anything else, for that matter–in order to live a fully-realized and happy life. (What I do need to get past is how annoying I find life hacks to be in general. Life is supposed to be lived, not hacked.)
And that’s it? That’s all she’s got? That’s her sage advice after soldiering through all the trials and tribulations life has thrown at her? After all of the experiences, tragic and sublime, that she’s had to confront, move through, and learn from, this is the fresh, novel insight she’s offering to the masses laboring through drab existences of unfulfilled potential? I’ve read fortune cookie fortunes with more depth and purpose. Get past fear? Get past my middle finger. The least she could have written was “I conquered my fear of [X] by doing [Y].” [Y] might not work for me but it least it would have carried some weight in terms of context, in terms of the person doing it, in terms of her unique existence and fear of [X].
There are lots of difficult things in life that we have and do need to get past, the pandemic and resulting fallout being the most present and significant therein. “Fear” of some intangible personal discovery, however, is not among them. On the other hand, fear of something genuinely dangerous, like mountain cats, is a healthy and well-respected survival strategy. My advice? Don’t get past fear. Pay attention to it. Assess and analyze it. Decide if it’s helping you or holding you back and deal with it as such. And don’t go someplace with lots of hungry mountain cats.
Eventually, people will stop clicking on that stupid headline and I will be able to get past it and start writing blog posts of substance again. Now, that is something to be feared.
I can’t get this episode out of my head. Normally, I find Law & Order SVU to be tepidly provocative, if clumsily, a show that at least tries not to traffic in stereotypes, with mixed results. But I watched Episode 4 from Season 16 last night and it made me so angry that I went on a lengthy, apartment-stomping tirade after the episode was over that my significant other was the innocent and unfortunate recipient of.
The show is entitled “Holden’s Manifesto.” It features a socially estranged teenager passionlessly documenting his hatred of women for their stupidity in passing him over, a clean, polite, intelligent young man, for attractive but manipulative brutes that use women and toss them out like garbage. The teenager’s name is Holden March, and the episode is entitled “Holden’s Manifesto,” after a 300 page work he composed outlining the details of his personal philosophy towards women.
When the episode begins, it becomes apparent that this misguided young man has just snapped. He films himself with his phone calmly discussing that he is finally about to exact revenge on all of the people who wronged him. The screen goes black and the next scene is of a young woman on a stretcher being wheeled into an ambulance, the victim of multiple stab wounds.
Holden manages a small but surprisingly effective killing spree before finally being killed himself in the final climactic scene. Typical crime show, right? Nothing new here, right?
Sure. Almost. Actually, no.
About a third of the way in, SVU detectives track down Holden’s parents to talk to them about their son. And the father mentions that he suspects Holden is “on the spectrum.”
Cue my annoyance.
I kept watching anyway, hoping that at some point during the remainder of the episode, some possible reason for the casual slandering of autism as producing murderous sociopaths would present itself. But it didn’t. It was never mentioned again. Not one other person in the episode who had ever come into contact with Holden ever reaffirmed the father’s suspicion. The word “autism” never came up, not once, not even at the very end.
Cue my fury.
You know, it’s almost worse that it was so casually inserted, instead of being explicitly addressed or at least woven into a plot point. It’s just more subliminal negative messaging about the neurologically divergent, in this case, that autistic boys are destined to become psychopath killers before they reach adulthood. His father blurts out “on the spectrum” in such a way to indicate that it causes him both disgust and shame. The result is that the entire episode associates this sadistic teenager with autism with the kind of insidious subtlety that colors people’s views about something without them consciously knowing why.
But I know. And even my significant other, Captain Ape, who you wouldn’t think would otherwise be attuned to subtle disability discrimination, looked at me right after the father said it, in anticipation that I would have a negative response, an intuition that proved correct.
TV takes a lot of liberties when it comes to people who are intellectually or psychologically disabled. The former, the intellectually disabled, are usually physically imposing, heavily overweight men who have been manipulated into committing violence either by circumstance or bad actors who are generally family members. Things tend not to work out well for them in the end (that is, they die a lot).
The latter, the psychologically disabled, are nearly always both schizophrenic and unhinged killers when off their meds, and the show typically broaches the conundrum of medication side effects vs. mental disease without ever offering an opinion about it beyond stopping the unhinged killing.
And then there’s autistics. There are two kinds of autistics on popular media. There are nonverbal male children who wail and howl in response to people coming within a few feet of them, coupled with physically distorted flapping and hitting themselves, who, if necessary for the plot, can only be suddenly calmed by some special cast member.
Then there are the adult male hyper-articulate but monotonic, emotionless, and nonreciprocal savants who also howl and hit themselves when upset.
Notice there aren’t any women. Notice that they are universally portrayed as physically acting out, sometimes in violent and dangerous ways. Throw that into the stew with the SVU episode I just mentioned and there’s nowhere for someone like me to go, to be, to be real or realized. And there’s no wonder society’s views about autism remain stuck in flawed research from the 70s and 80s and a targeted disinformation campaign by a well-known charity claiming that having an autistic zombie, I mean child, is the worst tragedy a family can suffer, even worse than death.
For every person who with an autistic loved one who gets it, there are countless others who associate autism with wailing and howling and barely-contained violence. Who see autistics as underdeveloped humans, a subspecies in the no man’s land between man and chimpanzee.
And I can’t, I just can’t, I can’t let it go, not even a little thing like this, which isn’t a little thing at all to those who live on the business end of autism falsehoods and myths, about being incapable of empathy or communication or reciprocal relationships. About being lassoed into a vaccine controversy that still claims far too many proponents who think disfiguring and fatal childhood diseases are preferable to being autistic. Where people look at me and assume that I am lying about being autistic for some nefarious purpose of my own. I can’t not be emotional about it, not scream and rant and rave while at the same time just wanting to throw up, give in, and curl up into a ball because the social construction of autism is too deeply embedded, too indelibly calcified into our culture for it to ever change.
So instead I just go on and on about a single episode in a series with literally hundreds of them because that single episode explains my entire life story and sometimes you just need someone or something to blame. For the years and years of abuse, the infantilizing, minimizing, belittlement and disbelief that have carved psychological scars in me that are so deep I might never be able to fully heal from them.
This is what I think about people who think of autism with disgust and shame. Stop spreading around your insecurities and calling them opinions, stop ignoring disabled people in hopes they will disappear for your convenience, and for the love of god please stop thinking that autistic people are zombie sociopaths. (Or alternatively, go f*** yourself.) Thx.
So after reading yet another article about how the “wellness” (cough, puke) industry uses unregulated and non-factual claims to sell products to unsuspecting women while managing to completely ignore the reason women are searching for such things, followed by me writing fuming paragraphs in my head despite watching kittens play quasi-football, I figured perhaps I should write a blog post.
Warning: This post will not end anywhere near where it began.
Now that that’s out of the way, I am going to write that the reason women are susceptible to all this “self-care” bulls*** has nothing at all to do with self care. It has to do with the frustration, anger, hopelessness and exhaustion that comes from struggling in a society that pays women about half of what it pays men for the same jobs. That simultaneously treats women like fragile saints or pariahs with no space in between. That thinks it’s perfectly okay for women in two-income households to shoulder the majority of house keeping and child care while at the same time suspecting them to be incapable of making a large purchase without their husbands in tow, that will punish them by charging them more for things like car repair and loans because there isn’t a Y chromosome around to speak up on their behalf.
It’s a society where sexism, racism, ableism, and cronyism in hiring are allowed to continue unabated under the laughable euphemisms of “good fit” and “right chemistry” that really mean “looks like me.” Women watch men (and BIPOC watch whites) half their age with a tenth of their qualifications get promoted over them by people who move goal posts for the express purpose of hiring some frat brother or son of some frat brother, club member, etc. whose sole qualification is the white appendage in their pants. Where the word nepotism must be expanded to include “any white dude who knows another white dude.”
For the record, I’m not talking about all white men here. I’m talking about the ones who engage in these practices while pretending to do otherwise, and the ones who see this happening, and while they don’t do it themselves, still think that it isn’t a big deal because things “have always been this way,” which might be the stupidest reason for doing anything, ever.
I am blessed to have white men in my life who wouldn’t dream of passing on the best and most qualified person for a position just because they didn’t have the aforementioned appendage or didn’t have it in the right color. In fact, these men have at times expressed frustrated to me about having to deal with incompetent co-workers that were hired for the wrong reasons. They find the whole nepotistic system to be pretty much useless. And because these guys actually see what’s going on, don’t think it’s good for business or anything else, and don’t care what other men think about their decisions (another privilege reserved for members only), these men can paradoxically find themselves excluded from these good ol’ [white] boys clubs just because they had the temerity to buck the party line by hiring someone who didn’t look like them.
Er, isn’t this supposed to be a blog about autism?
Yes, it is a blog about autism. But I am not just an autistic. I am an autistic woman. I still run up against walls built by Eurocentric conceptions of autism develped from studies in male children that continue to pervade the psychiatric and research communities. I’m not allowed to be autistic because I don’t look right or act right; that is, act like the male autistics on TV who are superhuman geniuses that speak in monotones and don’t make eye-contact and flap around in crude imitations of the self-soothing behaviors autistics use to cope in a world designed for non-autistic people.
(That depiction, by the way, is complete fiction. It has nothing to do with the lived experience of being autistic. It’s not even a caricature; it’s totally made up out of whole cloth by non-autistic, so-called experts in autism.)
We live in a society that punishes people who fail to adhere to white, male, Eurocentric culture, and who think of that not as culture, but a default against which everything else is an aberration. Women are punished for not being dependent on men, for acting like men, for engaging in tasks originally performed by men, for being independent of men.
BIPOC are punished for not “knowing their place” alongside centuries of junk science claiming they feel less pain than whites and are naturally more inclined to violence, views that pervade modern society even though they are completely erroneous.
LGBTQIA+ people are punished for not falling into a superimposed cis hetero binary that even animals don’t adhere to.
Disabled people are punished when they don’t hide or compensate for their disability to make other people feel better, for making non-disabled people feel uncomfortable despite the fact that the fault for that discomfort lies in the abled person, not the disabled person.
I live in a society that has a narrowly inscribed default for autism that I am punished for not fitting inside. Even in responses to the articles I write about autism, parents of severely autistic children claim that I’m not “really” autistic and that I have no idea what “real” autism is. And when I try to point out that it is they, and not me, that have no idea what it is like to be autistic, that really rubs their fur the wrong way and then come the personal attacks.
I’m not saying raising an autistic child is easy. Having an autistic child that is non-verbal and/or developmentally delayed is one of the steepest challenges parents can face and I’m not suggesting their kids are like me. (But by the way, not every screaming child pulled out of a restaurant or movie is autistic. Maybe it’s time to cut these parents some slack.)
What I am suggesting is that at least some of the behavior they struggle with, the screaming, the violence, the stimming, is because the child feels not just overwhelmed but not understood. Do we validate the misbehavior of three-year-olds? No. But neurotypical three-years-olds can talk to us and we can listen to them and reassure them. Autistic children who aren’t verbal can’t tell their parents what they’re feeling. Their options for communication are all but non-existent, a frustration in and of itself that I can’t imagine any three-year-old coping with well. I wish ABA therapy focused on finding ways for autistic children children to communicate, even rudimentally, instead of shaming and punishing them for their understandable frustrations.
But in every situation I’ve mentioned in this post, the problem isn’t with the woman, the non-white man, the disabled child, the lesbian. It’s with a society that refuses to validate their membership. We aren’t mad at white, non-disabled, heterosexual men. We are mad because not enough of them understand that there remain historic and indelible barriers to entry that are only visible to the people they exclude, barriers that include decades of both explicit and implicit policies that kept non-white, non-male people from owning homes, from attending college, from accumulating wealth, from having access to good schools, friendly law enforcement, or towns where people don’t lock their doors, barriers that only people who don’t face them can remove. The woman isn’t mad at the useless guy who got promoted over her. She’s mad that this kind of thing still happens in this day and age and no-one in a position to change it seems to care, and there aren’t any vitamin supplements or bath salts that can fix that.
The autistic parent who dismisses me isn’t angry at me. She’s angry at a society that refuses to acknowledge the humanity of her autistic child, that doesn’t want said child in their schools, on their playgrounds, in their quarantine pods, at their birthday parties.
And that’s what this post is about. It’s about shifting the focus and blame away from the people who are harmed by this structure and on to the people who can actually do something about it. Women don’t need scented oils or rose quartz vaginal eggs or supposedly rejuvenating supplements or little pieces of fancy chocolate in gold foil wrappers. They need to be paid what they’re worth, promoted when they deserve it, supported in the home, and not criticized for being insufficiently female.
I don’t need adjudicate what autism is or isn’t. What I need is to be accepted for who I am by a society that has yet to fully acknowledge my existence. That’s what this post, and indeed, this blog, are all about.
For many, this pandemic has been an exercise is making do with a truncated list of unpalatable choices when it comes to work, relationships, and a social life. But this situation has plagued me and autistics like me for most of our lives. Autism consigns one to a life defined by a lack of choices in some of the most essential elements of modern existence, like employment, social group, living arrangement, and even who we want to be. The pandemic has offered neurotypical people a glimpse of what our lives are like, where we nearly always find ourselves in situations with too few options, all of which are suboptimal. The difference is that while neurotypicals are able to make a lot of these choices consciously, autistics are frequently unaware of how autism has blinded them to other options. Similarly, we struggle to navigate the boundaries imposed by a non-autistic society, not seeing them, or if we see them, not understanding them.
I attempted to pursue a career as a singer/songwriter starting in my twenties. This was long before I thought I might be autistic. Nonetheless, my autism meant I wasn’t able to discern when I was being manipulated and made me easy pickings for bad actors. My pathological lack of success in finding people who genuinely wanted to help me, and instead landing with those who just wanted to take advantage of me, demonstrates how autism imposed a lack of agency that was completely invisible to me. Not knowing what I needed to do meant I accepted at face value whatever anyone told me to do, with the lion’s share of those anyones and whatevers being dead ends.
Some suggested I move to a locale with more opportunities, like New York City or Nashville. I remember being terrified at the prospect. I could not conceive of how to handle arriving at one of these places with nothing more than a guitar and the clothes on my back. And although I was completely unaware of it, I was also terrified at the idea of being that far from my parents and sister, who made up the majority of trustworthy people I knew. These realities meant the choice to move somewhere else just wasn’t available to me. (A silver lining here is that in retrospect, it seems unlikely that I would have been successful no matter where I went, because my autism, and its associated gullibility, would have still been with me.)
There was a period around the same time where I washed out of a series of entry-level jobs, like receptionist, salesperson, server, that sort of thing. I would start out well, and then a few months in I would lose focus and start making erroneous assumptions and mistakes. I was drawn to people who seemed to get away with bad behavior, making it seem like bad behavior was not a big deal. I would mimic them, with inevitable negative consequences that were always surprising and always seemed unfair. The problem was me, but I not only didn’t realize it, I wouldn’t have known how to fix it even if I had.
I had the same problems socially, bouncing from group to group, doing well at first, only to have people suddenly start withdrawing from me and shutting me out after a few months without me knowing why. I landed with a group of addicts and alcoholics for whom social ineptitude was far less important than keeping the river of mind-altering substances flowing. They glorified their horrific lifestyles and there I was again, trying to mimic them, not having any idea what the consequences of it might be since I never saw anyone suffer any. I narrowly escaped some dangerous situations, and was lucky that after a few years, I got tired of the whole business, and ducked out and dumped my phone before anything life-changingly bad happened to me.
This meant I had to start over with another new group of friends. I got better at choosing associates as time went on, but my instincts remained unreliable and I was still plagued by bad actors when it came to music. I exerted myself to model good behavior instead of bad, but I didn’t have a scaffold to hang it on. It was just rote memorization and guessing. And my anxiety, no longer smothered by substance [ab]use, became immobilizing. For a year, I suffered from horrible stage fright and was so nervous I could barely perform in front of an audience.
I also still didn’t understand how friendships worked. I didn’t know how to maintain them, and I was afraid to ask for help after so many instances of being burned by people who exacted a toll for “favors.” In my late thirties, having exhausted every possible avenue I could think of and having failed to figure out what I needed to do to be successful, I gave up on the music career altogether.
This led to another social group change, this time with a new boyfriend and his friends and a new line of work, training to be a veterinary nurse. I had more success with this friend group–I’m actually still friends with some of them, including the now ex-boyfriend–but I still had to deal with regular screw-ups that required a ton of apologizing for things, some quite serious, that hadn’t seemed wrong to me. And while I was a good animal nurse, I was still a crappy employee. Another several years were thus invested in another dead end; not only could I not keep a job for more than a year (and often less), I was beset with pain and injuries that made it impossible for me to do the animal wrangling. These were a surprise, too. Many autistics, like me, are generally unaware of their bodies’ internal states. I just pushed myself till I broke, an occurrence I repeated almost a half a dozen times over the last thirty years, and for which I’m still suffering the consequences.
While the first few years with the boyfriend were wonderful, I stayed with him too many years after that because by that time in my life, while I wasn’t sure if I was autistic (although I had started considering it), I had learned that my instincts could not be trusted, and if a kind and loving person thought our relationship should be a certain way I assumed that he was a better judge of the situation than me. Also, he was the first genuinely good man I’d ever been with; someone who didn’t want to take advantage of me, or alternatively, have some major psychological issues of his own, and I was afraid if I left I’d never find anyone else like him. Our first real argument came after nine years, when I was finally able to tell him that I wanted something other than his preferred relationship parameters. We broke up not long after.
I didn’t start privileging what I thought was best for me–and not what other people told me–until my early forties. And while this seems late, I’m not sure I would have been able to figure out what was best for me any sooner. It wasn’t until a few years later that I gave myself permission to treat myself as a person of value. And while I look back on my life and resent the choices I made, the sheer number of instances where my autism kept me from accessing alternatives makes me doubt whether it could have happened any differently. Peers did try to help me, but I couldn’t tell the difference between help and harm. Other people were always opaque jumbles of seemingly unrelated attributes, and well-meaning or no, I didn’t understand them and they didn’t understand me. I didn’t figure out how to start seeking out people who did understand me until relatively recently.
Now I’m in a position where people ask me to explain their autistic children or loved ones to them, and it they’re almost always disappointed. First, since autism affects everyone differently, I’m inherently limited when it comes to specifics. There are as many different forms of autism as there are people on the autism spectrum. Second, the labels people fall back on to try to understand us or contextualize us, like high or low-functioning, verbal or nonverbal, hyperlexic or hypervisual, fail to express what the experience of autism is actually like, including that those labels are the least important differences we have.
What actually makes autistics different is that we experience our internal and external environments in a way that is completely unlike that of non-autistics. But most people don’t know what to do with this information. They want something they can grab on to, a context they can place themselves in so they “get” it. As a result, people who want me to “explain” autism to them are rarely satisfied with what I tell them. I’d rather say “I can’t explain it to you in a way you would understand,” but I have learned that is not something you should say to people.
Sometimes I pivot to the real world implications of autism, that the most important challenges autistics face are the ones imposed by a neurotypical society that punishes us or tries to force us to change when we think or feel or act in ways that feel natural to us. I don’t usually get very far with this, either. The idea that human instincts are not universal and that autistic instincts are vastly different from neurotypical ones, let alone that autistics have to completely suppress their instincts to relate to neurotypicals and that I am suppressing my instincts just to have this conversation with you–it’s all but inconceivable. Neurotypical people rely on their instincts to function. They struggle to imagine something as completely foreign as having to navigate life without them.
But this is how it is. Autistics are trapped in an indelible structure of ableist boundaries that we don’t understand, and this combined with our neurodivergence robs us of the ability to make choices neurotypicals take for granted, like how take care of ourselves, not just the basic needs like personal care or employment, but higher needs, like what kind of life we want to have, where we want to have it, and who we want to be in it.
We just want to be able make these life choices for ourselves. We want someone to explain our choices to us in ways that we understand, not shrouded in suggestions and metaphors and surreptitious judgements that render these choices invisible to us. We want to throw off the narrow confines imposed by employers, peers, families and caregivers of what is “normal” or “appropriate,” of needing to act and speak and even think a certain way so that we don’t upset non-autistic people, so we can work with them, so we can have relationships with them.
I never had a choice about any of those things. From a young age, I received near constant external feedback that the things I did and said, and even felt and thought, were wrong. As an adult, I so craved validating experiences that I created a completely opaque neurotypical mask that covered every natural thing about me, and made sure I was useful in some way to everyone I had a relationship with so they couldn’t stop speaking to me, or shut me out, or disappear. I’m only just now figuring out how to disentangle all that from the person I actually am, with that person still ensconced in the working draft phase. I’m only just now learning to forgive myself for the huge pile of screw-ups I accumulated because autism made it so I didn’t know what else to do; to forgive myself because in far too many of those situations, I didn’t have a choice.
Now that I’m allowing my autism to be a part of who I am, some have referred to me as a role model, much to my dismay, because I strongly advise against signing on for the crippling self-doubt that propelled me to learn to hide my autism so completely. I sacrificed my true self on the altar of a neurotypical ideal for over two decades; I am a poster child for unhealthy, self-defeating coping mechanisms. I’m still trying to figure out how to be social creature in this milieu while maintaining my self-possession, how to break from the negative self-talk that was a precondition for maintaining my social facade. I’m still working on accepting that my real self is not bad or wrong or worthless, after a lifetime of feedback to the contrary.
I sympathize with both sides of the ongoing controversy in the autistic community about whether we should or shouldn’t mask (hide) our autism. Because, you know, of course we shouldn’t have to…but if we want to have any choice in our lives at all, well, hiding is the only option. Our society just isn’t ready to accept people like us yet. It still doesn’t have a lot of good choices for us. Someday it will, I hope, even though it will be far too late for me, and maybe even the generation after me. But, hopefully, someday, because of the choices I’m making now, it will.
My latest blog post appears on the Neuroclastic online magazine! Click here (or below) to read it.
These events took place from Monday, October26th to Friday October 30th.
For the last two months, my search for a pain professional who accepted Medicaid and was willing to work with my autism medication regimen had resulted in my being disbelieved, belittled, insulted, and dismissed at every turn. During this time, my pain was poorly managed—if at all—and I dealt with constant anxiety. By mid-October, I was down to rationing the last few doses of the only pain medication I had left that didn’t interfere with my autism prescriptions.
The light at the end of this dark tunnel was a long-overdue cervical fusion surgery scheduled for Tuesday, October 27th at 11 AM. The surgeon would be able to prescribe medicine to handle the post-surgical pain, with the promise of reduced pain over the long-term.
But that isn’t what happened. This is what happened instead.
Monday, October 26, 2020
The day before my surgery was a mad scramble of emails, laundry, and housekeeping to prepare for being out of commission for a few days. My sister, TNC [Takes No Crap] Ape, had come into town Saturday to be my pain advocate and was bustling around on my behalf, learning where things were, how things were done. Captain Ape arranged to have a break from work to be our chauffeur. We had planned and for prepared everything, down to the smallest detail, but I was still so anxious I couldn’t sit still. “I have a bad feeling about this,” I confided in my sister, in Captain Ape. They offered reassurances that, while appreciated, were not able to quell this burgeoning dread lodged in my stomach.
My anxiety wasn’t completely unfounded, although I didn’t realize it at the time. A lack of notification from the surgeon’s office that my surgery time had been changed from 11 AM to 7:30 AM, which I never would have known about if the nurse hadn’t mentioned it during pre-op testing, set me on edge. Distracted and tense, I forgot I had a cell phone (actually, this happens a lot) and missed a late evening call and voicemail from my doctor’s office.
Tuesday, October 27, 2020
The day of the surgery, Captain Ape dropped off TNC and me at the hospital at 5:30 AM, two hours before the surgery, as instructed. But when we checked in at the COVID testing station, they couldn’t find me on the list of admissions. They let us through anyway, but upstairs in the surgery waiting area, the nurse escort for surgical patients also did not have me on her list. She told us to wait there while she made some calls.
She came back fifteen minutes later. “We couldn’t get a hold of your doctor” she said apologetically. After a pause, she added. “I’m sure he’s on his way.” I knew she was lying, but I clung to the hope that she was right. TNC and I sat down to wait.
After a half an hour, the nurse let us know she found me on the list—for 11 AM. I was too angry to respond and couldn’t stand to be in that waiting area another second. I abruptly got up and strode out, leaving my sister scrambling to catch up with me at the elevator. “So we’re leaving?” she asked.
“Hell yes, we’re leaving,” I snapped. Once we got outside, my sister called Captain Ape to come pick us up so we could wait at home until it was time to come back.
It was only then that I discovered the missed call and voicemail from the doctor’s office the night before. The message stated that the radiologist had “filled out a form incorrectly” and they had had to resend it, and they had moved my surgery back to 11 to give the insurance company time to send back confirmation.
I leapt from annoyed to furious, about the pointless loss of the three hours’ sleep, with myself for not checking my phone. I remembered I had assumed that no phone calls of importance would show up the day before my surgery, or at least, nothing that couldn’t wait another day or two. Changing my surgery time the night before? Yeah, no, not on the list.
We got back to apartment around 7 AM, but I couldn’t get through to the surgeon’s office until they opened at 8. Once I did, the surgeon’s assistant repeated what was on the voicemail, saying the radiologist had messed up the form, that they had corrected it and sent it back, and that they were just waiting for confirmation from the insurance company to proceed. I was still to plan for surgery at 11.
An hour went by. I called my surgeon’s office again but no one answered. I left a message in which my tone of voice was not well managed. Captain Ape had slipped out at some point; he returned with Starbucks. I wasn’t supposed to have anything to drink, but I was thirsty and my willingness to cooperate had declined precipitously. I gratefully accepted the decaf Americano (my favorite) and sipped on it while I waited. Another hour passed.
My call was finally returned a little after 10 AM. This time, the assistant admitted that, rather than a form mix-up, the insurance company had rejected the procedure as not medically necessary, and what had actually happened was that they had entered an appeal but hadn’t heard back. She insisted that the preauthorization had been approved “this past Friday” and that none of this “made any sense.” She then asked if she could reschedule my procedure for two or three weeks down the road.
I had been planning for this surgery—no, I had been counting on it—for over a month. I was looking forward to a few days off from worrying about work, about school, about taking care of the apartment and the pets, about where my next prescription was coming from. It was all going to be taken care of for me, by TNC and Captain Ape, by the surgeon who could hopefully fix my neck and prescribe post-surgical pain medication. There was even a possibility that, once I healed from the surgery, my pain would be lessened significantly.
And then, less than an hour before it was supposed to happen, it was all yanked out from under me, just like that, in a single instant. It was so sudden, so devastating, I could barely breathe. I wanted to scream, to cry, to hit something, to throw something.
The surgeon’s assistant then had the audacity to ask if they could just “bump” my procedure to a few weeks from now, like moving a surgery was as simple as changing a meeting date in your phone.
“No, I can’t do this in a couple of weeks.” I snapped. “I already had to push back work and school obligations to make room for this. My sister had to put in for time off over a month ago. If we don’t do this now, I won’t be able to do it until December.” My control over my emotions, already tenuous, slipped even further. I struggled to keep the tears from coming.
The surgeon’s office had been lying to me since the day before, stringing me along, until the god from the machine they were expecting failed to show up. I was expecting an apology, some accountability, maybe even some sympathy. None was offered.
“Well, if we could do Friday, would that be OK?” the assistant asked. I mouthed “Friday?” to TNC Ape, who nodded, and told the assistant that, yes, I could make that work.
“Well, we’ve appealed the decision and we’ll call you back to reschedule as soon as it goes through.” she said.
I was unable to keep the tears back any longer. “OK,” I mumbled softly.
After a long pause, she said “Sorry about all this.”
I was afraid if I tried to talk I would start sobbing in earnest. “Mm-hmm.”
“So we’ll call you back soon.”
“Mm-hmm” I hung up and fell apart.
My sister came over to the couch. “What’s going on? What happened?”
“The surgery isn’t happening.”
“Isn’t happening today or isn’t happening ever?”my sister asked.
“I don’t know. They don’t know. Nobody knows.” I don’t remember what she said after that; I was crying too hard to hear her.
After a few minutes, I crawled into bed, my phone next to me on the pillow on the off chance that the surgery still might go through, and cried myself back to sleep.
The phone rattled me awake a little while later. “Hi there, this is the __________ hospital. Is this Ms. Ape?”
“We just wanted to let you know that the insurance rejected your claim for being out of network.” Wait, what?
“No, my doctor’s office told me it was because it wasn’t medically necessary.”
“Well it says here you’re out of network. That’s all we know, ma’am.”
“OK. Thank you,” I responded. I hung up and went back to sleep.
I slept for a few hours, ate, and started making phone calls. I called my Medicaid caseworker, who was sympathetic but said there was nothing she could do—they only managed eligibility. They didn’t have any control over whether the provider authorized something or not.
I moved on to the insurance company’s customer service line, which was littered with menus for things I didn’t need and forced me to listen to their COVID preparations nearly a dozen times. The system kept dumping me back to previous menus or disconnecting me as I searched for the right options. The first person I got a hold of at told me I was in the wrong department and that I had to call back. Finally, after so many failed attempts I lost count, I managed to reach a human in the authorizations department. I explained what had happened, again fighting off tears, and asked if there was anything I could do to move things along.
The person on the phone pulled up and scanned through my account. After a few moments, she said the procedure had been rejected as not medically necessary and that it was being appealed, and that the appeal process took up to 30 days.
30 days? I forged ahead anyway. “So why did the hospital say I was out-of-network?”
“I don’t know anything about that. It just says here that it was denied as not medically necessary and is now under appeal. There’s nothing else you can do.”
I thanked her, hung up, and started sobbing again. I didn’t know who else to call, and even if I did, I was not up for yet another “sorry but I can’t help you” rejection. I gave up for the day. I don’t remember eating dinner. I don’t remember going to bed. I only remember I woke up crying in the middle of the night and that it took two hours to get back to sleep.
Wednesday, October 28, 2020
I was still red-eyed and exhausted the next morning, but after copious amounts of coffee, it was back to the phone. First, I called another surgeon I’d had a consult with the earlier in the month. He’d been kind and understanding about my condition, his office had an efficient and compassionate staff, and with any luck, maybe he would take my case and I could still get the surgery sooner rather than later. His office scheduled me an appointment for the next day, Thursday, October 29th.
As no pain medication was in the offing, I temporarily gave up on my search for a Medicaid- and autism-accepting provider and called back my original pain management practice, the one I had been seeing before I lost my health insurance, in hopes of getting enough medication to allow me to function until my surgery came through (or didn’t).
When I told the scheduler I would run out of medication before the end of the week, she miraculously found an appointment for me for Friday, October 30th. I would have to pay out of pocket, but I didn’t care. What had happened this week had left me so exhausted, traumatized, and desperate that I didn’t have any bandwidth left to think about anything else.
Thursday, October 29, 2020
Thursday, I drove to the surgeon’s office only to find out that I was at the wrong facility. “But they said it was in A_____ when I made the appointment,” I insisted weakly. Another staff member responded, “Oh, the S_______ office is also in A_____.” Notwithstanding how ridiculous that was, this wasn’t the first time something like this had happened to me; being autistic means you tend to miss “obvious” things and your assumptions are often wrong. I didn’t like it, but I was used it, and normally, I would have just handled it.
But that day, still drained from the previous days’ events, I didn’t have enough energy to deal with another setback. In fact, I didn’t have enough energy to summon any response at all, appropriate or otherwise. I just stood there, frozen, at a loss for what to say or do next. The other office just wasn’t going to happen; there was no way I’d be able to interpret a new set of my phone’s GPS instructions. Even just rescheduling felt like more than I could handle.
The receptionist saw the look on my face, or perhaps the lack thereof, and told me to wait a moment while they called the S_______ office and got the surgeon on the phone. Once they did, they relayed that the surgeon said he would not perform the surgery; he didn’t think it would help my pain, which he asserted was atypical for the type of damage I had.
Yet another rejection. My heart sank, and tears started to well up again. I held myself together—barely—long enough to thank them and get back to my car.
And then I started crying again. There was nothing else I could do. The grim reality of my situation, that the surgery wasn’t going to happen any time soon, if at all, finally set in. I sobbed the whole drive home.
Friday October 30, 2020
The pain appointment on Friday had the distinction of being the only interaction with a medical professional that resulted in a positive outcome that week. In fact, it was the only positive interaction I’d had with anyone in the medical community since before my insurance had run out three months before.
I briefly brought the NP up to speed on what had happened with my surgery. Then, I explained what had been going on with my search for a pain practice that accepted Medicaid and how dismissive those I’d tried had been about my autism. I stressed that medications that interfered with those I took to manage my anxiety and sensory sensitivity were off the table. I said that I understood that this meant diverting from usual protocols, but that I wasn’t the usual patient.
She nodded, echoed what I said back to me (another first), and scanned through my file on her laptop. “This much short-acting medication, you’re right, it’s not what we would normally prescribe, but it looks like in your case we have to throw the book out and just go with what works. For now, let’s just put you back on your regimen from before.”
I nodded. “OK. Thank you. That would be wonderful. Thank you.” She sent my prescriptions to the pharmacist and I picked them up later that afternoon.
But by then, I was completely used up. I never got those days off, from worrying, from advocating, from dealing with all the indignities one suffers at the hands of the American health care system. Instead, I’d had the week from hell followed by being unceremoniously dropped back where I was before, to a life inscribed by pain and anxiety, back to being disbelieved and dismissed, with medication that barely helped and a backlog of work.
Back into that dark tunnel, but with one difference. The light I had been working towards was gone.
While I was fortunate to finally get back to my original pain treatment protocol, the physical damage resulting from two months of anxiety, loss of sleep, and little to no pain control, plus a week of extreme stress, was not so easily undone. My pain remained intense and unrelenting for a week and a half while the medications built back up in my system. It has been over two weeks and it is better, but it remains worse than it was before.
The psychological fallout took its toll, as well. The week after the surgery I was a zombie, unable to concentrate, unable to write, forcing myself to do my chores through a mental exhaustion that was almost palpable, and sleeping ten or more hours a night. What had happened to me was so unbelievable, so cruel, I couldn’t get past it. I hovered near tears for days, trying to process, trying to find something positive about it, and failing at both. The surgeon’s office has yet to call me back. If the procedure isn’t approved, they probably never will.
Two Weeks Later
Just when I thought the surgeon’s office could not have possibly screwed this up any worse, I got a packet a couple of days ago from the insurance company about my case, with copies of what the surgeon’s office had sent them for the preauthorization, authorization, and appeal.
For posterity, the surgeon’s office had led me to believe that the that the denial was the radiologist’s fault, and that both the denial and appeal had occurred Monday, October 26rd.
The packet, however, told a different story. The real story.
First, my preauthorization went through on Monday, October 19th, not Friday, as the assistant had claimed, and included a report of severe neck and upper back pain, an affirmation from a second surgeon that surgery was strongly recommended, and a diagnosis of encroachment leading to nerve impingement in the C5-C6 vertebral space.
The authorization did not contain any of those items, but that wasn’t the worst part. The worst part was the date, of both the denial and the appeal, as indicated by the dates on the faxes the office had sent. It wasn’t Monday, October 26th.
It was three days earlier. It was Friday, October 23rd.
The office had known about my denial since Friday afternoon and didn’t say a word to me about it for three days.
Three days. It may not seem like much, but for an autistic, three days to get used to the idea that my surgery might have to be postponed would have made such a world of difference that words fail to encompass it.
And here’s where people’s total ignorance about autism is especially poignant. Change is extremely difficult for autistics, exponentially more so than for neurotypicals. We need time to mentally prepare for changes, even positive ones. Those three days would have completely altered this experience for me. I would have been upset at first, yes, but by Tuesday, I would have been prepared for a possible negative outcome. To deny a normal person that time to adjust was already misguided, at best. But to deny it to someone on the spectrum? It was downright cruel.
As of this writing, the surgeon’s office has yet to own up to a single mistake. They changed my surgery time weeks before my surgery and didn’t tell me. The claim was denied and they didn’t tell me. The reason for the denial was due to their own failure to include the right information, and they didn’t admit to that, either. Even when they told me the “truth” about what happened, that had been a lie, too. There has been no formal apology, no sympathy for what they put me through, not a single indication that they felt in any way responsible for what had transpired.
It remains to be seen whether my insurance will or won’t approve the surgery. I went ahead and sent in a patient appeal, which included the things the surgeon’s office had left out of their October 23rd materials. Even if it does get approved, though, I have no idea who will perform the procedure. Certainly, the practice that screwed up the authorization, failed to notify me of a denial they had known about for days, and has yet to be straight with me about what actually happened, is not an organization I trust to be accountable for my surgery and aftercare.
At this point, I’m not sure when I’ll have the surgery, or even if I will have it all. And there is no next step, no Plan B. My experiences since my health insurance ran out strongly suggest that, even among the few medical practitioners who accept Medicaid patients, the number of them who actually care about Medicaid patients is vanishingly small. To most of them, I’m just a statistic, a box to be checked, someone they could do the bare minimum for so they could get back to the patients that made them money.
Even now, over two weeks later, I’m still exhausted, mentally, emotionally, physically. I don’t want to do this any more. I don’t want to be this any more. I’m tired of spending hours on the phone, having to expend energy I don’t have to perform my neurotypical persona, only to be told, over and over, by everyone I call, that they can’t help me.
And this is about more than just last week. I have endured three months of being invisible, my concerns unheard, my problems unsolved, my well-being unattended. There doesn’t seem to be any space in the world we live in for people like me. I know I should keep pushing and advocating for myself and those like me but I’m tapped out. I wish I could just sleep and eat and watch TV, and not have to take care of anyone or anything any more, even myself.
But that’s something else that won’t ever happen.
So the latest hand-wringing over smartphones is that they remove the need for people to memorize things when using the GPS function for directions; that people don’t actually see and commit to memory their surroundings any more.
And by people, of course, they mean neurotypical (NT) people.
And I’m thinking, well, gee, that must be nice, not having to memorize things. So NTs no longer feel the need to memorize visual information when they’re making their way around. Good for them, I guess.
Aaaaaand that will never be me.
Because as an autistic, I am constantly memorizing and engaging in recall of memorized information to go about my daily business. Hygiene routines are memorized so I don’t have to rely on [nonexistent] tacit knowledge of what is appropriate. I memorize landmarks when driving along common routes (grocery store, etc.) just in case I forget whether I made a turn or not (yep, I actually do this). I teach myself to switch things on and off in my car in the same order so I don’t walk away with it still running.
I memorize things about people when I first meet them. Names are associated with objects, like pink-sparkly-phone Kate and American-flag-shoelaces George. If I don’t do this, I won’t remember the name and there is an excellent chance I won’t remember the face, either.
When I’m using my phone’s GPS, I memorize directions and how things look while I’m driving so that I don’t have to look away from the road while driving back. Autistics are lousy task-switchers. Having to interpret the information the phone is providing (silently, of course) takes away from my ability to concentrate on what’s around me. I mean, thank god my parents insisted I learn to drive thirty years ago so that I can operate a vehicle without thinking about it while I’m doing it, something that only took maybe ten or fifteen years to achieve, but I need every spare iota of mental faculty when I’m driving somewhere I haven’t been to a dozen times or more.
Interestingly, some things get memorized without my meaning to. Despite my total lack of facility when it comes to figuring out where I am in relation to somewhere else, I’m really good at memorizing where things are kept. Although faces slip by unmarked, my mind happily snaps a picture of my spice rack, the condiments aisle at the grocery store, and the reception desk at my pain doctor’s office.
I used to work at a large, multidisciplinary animal hospital with two floors and a half a dozen different storage spaces. Within a few months, I knew where every single thing was kept, even some things I never used and would never need, or those for other departments, because my mind is constantly printing and saving visual information on inanimate objects for later use. Pretty much everywhere I’ve ever worked, “ask TGA” was a common response when someone wanted to know where the spare whatevers were.
More important, my and other verbal autistics’ social skills are derived directly from memorization. We memorize social encounters and whether or not they were successful, and file that information for later use. Since intuitive social activity and communication is not an option for us, everything we do is based on some memorized social interaction or another–including those we observe between other people.
And (warning, seemingly unrelated tangent here) that’s one of the reasons I hate commercials. They show people laughing over social activities that are not funny and would not work in real life. Like stealing food from someone’s plate, or oops-on-purpose making them spill or drop something. Or, my new least favorite, writing “new friend check yes or no” on a gum wrapper and handing it to someone. I pray to god no autistic kid is watching that and thinking Oh, is that OK? Look, the other girl laughed. I should try that.
And that’s another problem. Nothing “looks” fake to us. The ways in which commercials fail to reflect real life are no problem for NTs. They take them as fiction as a matter of course, and advertising’s distortion of reality rarely rises above an eyeroll for minor annoyance.
We autistics don’t have that luxury. As I’ve mentioned before, nothing is fiction and everything is real. Commercials, posters, cartoons, memes, it all looks the same to us. Even when we understand intellectually that such things aren’t meant to be real, we can’t keep our brains from treating them as such, making it frustrating when we try and fail to employ these actions in real life and even more so once we realize how fake they are and how much of our lives we wasted thinking otherwise and trying to imitate them.
But back to memorizing. I’m never going to be in a position where I don’t have to memorize. In class the last two weeks, the articles have been all about visual rhetoric and how [non-autistic] people are better able to absorb pictorial than written information, due to their facility with central coherence.
Ah yes, central coherence. That must be nice. I have exactly zero points of reference for this, and have been unable to disentangle my frustration about it from my response to the unit overall. Basically, visual information is nothing but a wall of stimuli for me that I can’t make head or tail of.
Let me use the example of a polling place.
Poll workers are given signs to put up to make sure people move through the polling place in a single direction. They also have lots of other signs up about which table to go to for sign in, what you need for proof of ID, getting your ballot, how to fill things out, what to do with your ballot when you’re finished, and which way to exit.
A lot of these signs are simply arrows, because neurotypical people will prioritize and categorize these as the most important automatically (speaking of things that must be nice). My brain doesn’t do that. It prioritizes text because that’s what is easiest to understand. Text is only so ambiguous (although there are exceptions). So all of the signs with text on them bombard me, while those without all but disappear. And even if I do see it, an arrow by itself is not the simple guideline for me that it is for NTs. It doesn’t say to whom it applies, what it points to, or when it should be followed. And sometimes, it’s not even pointed properly, because for NTs, its mere presence is all they need.
I was a poll worker for a couple of elections back in the nineties, before I realized how ill-suited I was to that sort of work. I remember obsessing over the signs, the arrows, arguing about where they should be, suggesting tape on the floor (yeah, that didn’t happen), and overall spending a lot more time worrying about it than the other workers did. Of course, there weren’t any problems because autistics like me would pretend there weren’t even if that wasn’t the case, and, of course, NTs had no trouble at all.
Think about all of the places we see these arrows. Grocery stores, department stores, driving. Imagine what your world would be like if they were enigmas to you, if you knew from experience that they were untrustworthy. Imagine how much harder it would be to find your way around, to know where the right place–and wrong place–was to be.
That’s my life. That’s why I memorize. That’s why I can never stop memorizing.