The Good Doctor and Autism

[HumbledHuman]

I have been watching a new show called "The Good Doctor" which portrays an incredibly autistic surgeon who lacks bedside manners and people skills but compensates via his gifted integration of medical knowledge (diagnosed savant syndrome).

[earlier I stated that the physician is characterized as having no sense of emotion, I was wrong. I reviewed the clip and the show does not explicitly express this viewpoint. The character does not want to love, not that he is incapable of love]

As a student, I haven't had the opportunity to work with a diverse group of medical physicians, and therefore never encountered a highly autistic physician.

1. I am curious if anyone has ever worked with a colleague who has ASD and what sort of challenges do they face?
2. What sort of impact (negative/positive) was made in patient care?

Thank you for your time and insight.

---

Members don't see this ad.

 

[Redpancreas]

ASD is a spectrum and their obstacles vary. In addition to any social barriers, you'll also find barriers in procedural learning so surgery isn't really the first place you'll find autistic individuals, but it can be overcome in individuals with mild Autistic traits.

Also, it's very unlikely for a physician to be highly autistic. Individuals who are highly autistic struggle with even the simplest tasks as kids. It's more likely that this individual has high-functioning Autism or Asperger's (if that's still the right term). Either your description of this show or the show itself is doing a disservice to the autistic community, by creating the notion that autism or even high-functioning Asperger individuals have an advantage when it really does not. The savant-like quality is incredibly rare and for every HF-autistic individual with those skills, there's hundreds of Autistic and HF-Autistic people who don't get to enjoy many things normal individuals take for granted like love &relationships, much less any savant-traits. If producers really cared about autism, they'd make a show depicting their struggles in society rather than making something that capitalizes on people's fascination with savants.

Also, the notion that ASD individual can not love is bleeping ridiculous. They can feel anger and love just as deeply, but the issue is that they can not express these emotions as "fluidly" as most people so they give off awkward signals which are misinterpreted. For example, when they're the butt of jokes, they don't really express stereotypical signs of anger to signal to others to back off. This lead some people to think ASDs don't understand social situations or emotions, but they know exactly what's going on and can verbalize it to you with remarkable clarity after the fact. I have several cousins who range from non verbal to high functioning autism so I'm more apt at recognizing signs in others and all I've learnt from that experience is how big of dinguses some people can be to them.

 

[Matthew9Thirtyfive]

ASD is a spectrum and their obstacles vary. In addition to any social barriers, you'll also find barriers in procedural learning so surgery isn't really the first place you'll find autistic individuals, but it can be overcome in individuals with mild Autistic traits.

Also, it's very unlikely for a physician to be highly autistic. Individuals who are highly autistic struggle with even the simplest tasks as kids. It's more likely that this individual has high-functioning Autism or Asperger's (if that's still the right term). Either your description of this show or the show itself is doing a disservice to the autistic community, by creating the notion that autism or even high-functioning Asperger's has an advantage when it really does not. The savant-like quality is incredibly rare and for every HF-autistic individual with those skills, there's hundreds of HF-Autistic people who don't get to enjoy many things normal individuals take for granted like love &relationships, with no benefits on the side. If producers really cared about autism, they'd make a show depicting their struggles in society rather than making something that capitalizes on people's fascination with savants.

No, the show is terrible and is definitely just capitalizing on the autistic community for ratings.

 

[HumbledHuman]

ASD is a spectrum and their obstacles vary. In addition to any social barriers, you'll also find barriers in procedural learning so surgery isn't really the first place you'll find autistic individuals, but it can be overcome in individuals with mild Autistic traits.

Also, it's very unlikely for a physician to be highly autistic. Individuals who are highly autistic struggle with even the simplest tasks as kids. It's more likely that this individual has high-functioning Autism or Asperger's (if that's still the right term). Either your description of this show or the show itself is doing a disservice to the autistic community, by creating the notion that autism or even high-functioning Asperger individuals have an advantage when it really does not. The savant-like quality is incredibly rare and for every HF-autistic individual with those skills, there's hundreds of Autistic and HF-Autistic people who don't get to enjoy many things normal individuals take for granted like love &relationships, much less any savant-traits. If producers really cared about autism, they'd make a show depicting their struggles in society rather than making something that capitalizes on people's fascination with savants.

Also, the notion that ASD individual can not love is bleeping ridiculous. They can feel anger and love just as deeply, but the issue is that they can not express these emotions as "fluidly" as most people so they give off awkward signals which are misinterpreted. For example, when they're the butt of jokes, they don't really express stereotypical signs of anger to signal to others to back off. This lead some people to think ASDs don't understand social situations or emotions, but they know exactly what's going on and can verbalize it to you with remarkable clarity after the fact. I have several cousins who range from non verbal to high functioning autism so I'm more apt at recognizing signs in others and all I've learnt from that experience is how big of dinguses some people can be to them.

Hey, excellent input and appreciate you sharing your personal experience. Earlier I stated that the character was incapable of love, I was wrong. The distinction in the show is that he does not want to love - not that he is incapable of love. There are many misrepresentations in the show I find to be frustrating in portraying autism, but in the grand scheme, the show does accomplish the task of exposing the struggles that these individuals might face in the workplace. This I find to be beneficial in cultivating diverse ideas and promoting empathy.

 

[CyrilFiggis]

portrays an incredibly autistic surgeon who lacks bedside manners and people skills but compensates via his gifted integration of medical knowledge

The show was created by the same guy who did House MD. Seems like he's really branched out in his character development.

 

[sugarangelcake]

The original Korean show is worth a watch if you can stand subtitles and have the time (1 season, 20 hours). The show is a lot more focused on romance though.

 

[zhopv10]

I’m kinda torn on this show, my little guy has autism so in a sense I appreciate the potential awareness the show could bring. However, the portrayal of the docs, medicine (not just the medical inaccuracies, those are expected on a tv show), and most importantly the continued portrayal of those with autism as all being awkward geniuses/savants is somewhat irksome. I think it is somewhat of a disservice since a good chunk (I forget the real incidence but it’s well into double digits) who are non-verbal, have severe behavioral co-morbidities (ODD, CD, ADD, etc) that is the daily reality for far more parents/individuals than the <10% who have the savant subtype. Really though it’s a show and needs to be entertaining I suppose so I just try to be pleased with the increased publicity for the condition.


Sent from my iPhone using SDN mobile

 

[premeddad29]

No, the show is terrible and is definitely just capitalizing on the autistic community for ratings.

I don't think it's "terrible" or that they are taking advantage of the autistic community. The show has a great story line and is showing the progression of this autistic person. It shows that people with disabilities are capable of doing things "normal" people do. It also teaches people who are not educated on the topic of autism on the everyday battles people with autism have. All in all, I think the show is great even though that acting is shanty.

 

[WingedOx]

I don't think it's "terrible" or that they are taking advantage of the autistic community. The show has a great story line and is showing the progression of this autistic person. It shows that people with disabilities are capable of doing things "normal" people do. It also teaches people who are not educated on the topic of autism on the everyday battles people with autism have. All in all, I think the show is great even though that acting is shanty.

inspiration porn.

 

[Kurk]

Sounds like a great show. We should be incorporating these people into the field instead of the arrogant academics pushing their own political agendas. I do hope the Americans with Disabilities Act is implemented stronger with academic institutions.

 

[HumbledHuman]

Sounds like a great show. We should be incorporating these people into the field instead of the arrogant academics pushing their own political agendas. I do hope the Americans with Disabilities Act is implemented stronger with academic institutions.

Normally I would agree, but there's too much at stakes in medicine. If an individual cannot communicate adequately and take a proper history/gain patient's sincerity and trust for a thorough examination, it places quality of care at risk. I don't think it's a big factor for people with mild/moderate autism, but the highly autistic spectrum draws a grey line.

 

[Kkshake]

I can't imagine many people turning away savants...Yes, on the show they make it clear that he has autism...but think about how many people view individuals that are in the top 1% of their class..many feel they are odd, and I'm willing to bet that many (obviously not all) have some form of autism that just wasn't diagnosed.

 

[WisNeuro]

I can't imagine many people turning away savants...Yes, on the show they make it clear that he has autism...but think about how many people view individuals that are in the top 1% of their class..many feel they are odd, and I'm willing to bet that many (obviously not all) have some form of autism that just wasn't diagnosed.

I think you are vastly overestimating the functional ability of most autistic savants.

 

[HumbledHuman]

I can't imagine many people turning away savants...Yes, on the show they make it clear that he has autism...but think about how many people view individuals that are in the top 1% of their class..many feel they are odd, and I'm willing to bet that many (obviously not all) have some form of autism that just wasn't diagnosed.

Growing up I was incredibly fascinated by savants and watched numerous documentaries on them. The capacity of the brain is truly a marvel. What I learned is that they have specific gifts that are unique to them, however, they also have weaknesses. Like most things in medicine, we still have to assess risk/benefit ratio.

Lol, I've met plenty of them in medical school, also after 14-16 hrs/day studying for boards I feel a bit schizoid and mildly autistic as well.

ASD is a really interesting condition and I can't wait to see what we will uncover in the future.

 

[Peach Newport]

An autistic savant doctor has no people skills but is an incredibly gifted surgeon, and has no interest in love and pushes people away?

Guys, Greys Anatomy already stole that one from House. Remember the Dr. Virginia Dixon plot line?

 

[mk059]

An autistic savant doctor has no people skills but is an incredibly gifted surgeon, and has no interest in love and pushes people away?

Guys, Greys Anatomy already stole that one from House. Remember the Dr. Virginia Dixon plot line?

As did Chicago Med with Dr. Latham

 

[KnuxNole]

I started watching it last month, and it's a great show.

 

[narla_hotep]

What I'm wondering about that show is, how did this guy get through med school?

 

[Ender1]

It's perfectly possible, in my view, for people with high-functioning autism or Asperger's Syndrome to become excellent doctors. Not all specialties involve a lot of patient contact, and even if they did, people with Asperger's may have some strengths that come along with some of the weaknesses, as a piece in the BMJ from 2004 by a doctor with Asperger's Syndrome describes.

 

[mtdette]

"1. I am curious if anyone has ever worked with a colleague who has ASD and what sort of challenges do they face?

2. What sort of impact (negative/positive) was made in patient care?"


Honestly we never really talked about the challenges, but their patients actually had a lot of confidence in them. I remember them saying once that they thought their autism helped because no matter what else was going on they always appeared as super calm, and the patients found that reassuring. They were always very present with their patients, and the idea that an autistic doctor couldn't take an accurate medical history is super insulting!

Yeah autistic people don't instinctively grasp social stuff the way neurotypical people do, but this doesn't mean they can't learn. Often they can be better at picking up small social cues because they are looking for them consciously, rather than relying on intuition. Working in a super regulated environment like a hospital is actually really great because you know what your role is and what the nature of the interaction is, there are less surprises.

I watched the start of this show, but not the rest bc the 'savant' angle is a huge turn off for me. Good autistic rep I'm here for, but I don't really like this 'you need to be super good at a thing to be interesting' implications of the savantness. I did see the scene where the hospital argued about letting the main character in as a surgeon though, and I thought it was ridiculous. Many surgeons have awful social skills, but are good at the actually 'being very focussed and diligent in surgery' part. If an Austic person's special interest is in surgery, they will know EVERYTHING about it and be happy to hyperfocus on it for hours. They aren't gonna get distracted wanting to chat about their weekend or whatever. Like this is super the kind of person you want as a surgeon imo.

 

[quarky]

I feel a little out of place here, being pre-med and autistic.

I don't personally know of a person who's an autistic physician, but I do know someone who's autistic and working towards a graduate degree in public health. She seems to bring very different ideas to the table that her allistic colleagues and mentors would have never thought of.

I haven't watched The Good Doctor but I've heard a lot of criticism from the autistic community (meaning people who are autistic, not their allistic relatives). Hollywood likes to make their autistic characters savants, which doesn't describe the vast majority of autistic people. And an autistic person doesn't have to be a savant to be competent and intelligent in their field of study. A lot of the criticism also comes from another autistic character being portrayed as a white male. Again.

I'm going to put it out there that using functioning labels ("high functioning" and "low functioning") is really problematic. It undermines the capabilities of those who are labeled "low-functioning". I assume these are the people who are mainly non-verbal. There are plenty of non-verbal advocates (I know a couple of bloggers) and a student at a university I was taking summer classes at was mainly non-verbal. On the other hand, labeling someone "high-functioning" dismisses some of their very real struggles and problems (which can lead to being overlooked for diagnosis, being unemployed, becoming depressed, being in poverty, etc).

Autism IS a spectrum, but the spectrum isn't less autistic -----> more autistic. It's more like the following image:

 

[C.elegans]

Completely unrelated topic here, but does the entire hospital have only three surgeons? lol
We see Dr. Melendez (who is a cardiothoracic surgeon) do everything from organ transplants to fetus surgery to orthopedic prosthetic limb replacement ...wtf? Like is there a surgical procedure this guy literally cannot do (and wtf are the other departments doing). And plus, the hospital president (Glassman was his name I think) who probably hasn't held a blade for like 10 years just casually does a craniotomy and works in a trauma shift.. what is this place. Never expected complete accuracy but come on....

 

[narla_hotep]

lol I know right what is this hospital. One question though - in the show we see surgeons doing a lot more than just surgery - lots of consultations, follow-ups, generally managing the patients' care, etc. Is this part at all realistic or is it something an internist, specialist, or ICU team should really be doing?

 

[RNtoMD87]

Question- I keep seeing people who are seemingly good posters with good input listed as "banned"

What kind of things are they getting banned for?

 

[W19]

Question- I keep seeing people who are seemingly good posters with good input listed as "banned"

What kind of things are they getting banned for?

Moderators that might take their job too seriously...

 

[C.elegans]

lol I know right what is this hospital. One question though - in the show we see surgeons doing a lot more than just surgery - lots of consultations, follow-ups, generally managing the patients' care, etc. Is this part at all realistic or is it something an internist, specialist, or ICU team should really be doing?

Yeah I was also wondering this as well... I guess the interns would be involved in some kind of post-op care and follow-ups...? But where are the pgy2-5s? Why the hell are pgy-1 interns the first assistant in these cases, let alone cutting????