Thursday, September 28, 2017

If a new HHS secretary is appointed, will they do something about neurodiversity

Those who have been following the news know there's been some controversy about certain government officials in the Trump administration who have abused their power by using government aircraft at taxpayer expense when they could have purchased much cheaper flights on commercial airlines.  HHS secretary Tom Price is apparently one of the worst if not the worst offender in this regard, piling up a government tab of around 400 grand.  After a barrage of media publicity, secretary price claimed he would not be using the private jets anymore.

According to an article in the Los Angeles Times, president Trump himself expressed displeasure at the antics of his HHS secretary and has not ruled out firing him.

After Price's appointment by Trump and his confirmation by the Senate, I emailed Mr. Price urging him not to allow members of the neurodiversity movement such as John Robison, Samantha Crane, and Noah Britton to serve on the IACC.  I also urged him not to seat an IACC if the executive branch of the federal government could legally do so.  Though congress passed the CARES act which includes having to have an IACC, I'm not sure if that means the president and secretary of health and human services are legally obligated to appoint members.

Not surprisingly, Mr. Price did not respond to my email and, if what I've been reading about him in the news is true, he's apparently less than an ethical person.

If Trump fires Price and appoints a new HHS secretary, then I guess I'm going to have to start all over again and write him/her, urging them to do something about the ND's.  Not just the fact that some of them serve on the IACC, but also those in any position of power such as Scott Robertson's appointment to some other thing outside the IACC and John Robison's and Steve Shore's appointment to review grant applications.

As I've said before on multiple occasions, several anti-cure, anti-treatment individuals have been appointed to the IACC and other government affiliated programs.  Not a single pro-treatment, pro-cure autistic has been appointed to any of these.  This is despite the fact that Roger Kulp and possibly some other individuals on the spectrum who are in favor of cure/treatment might actually have some constructive ideas about autism-related matters.  Roger tried to get on the IACC but was turned down. 

Though John Robison has claimed he's pro-treatment and is in favor of remediating the disabling aspects of autism, he still says he's opposed to a cure, which, in my opinion, is like saying people should learn how to swim, but they shouldn't get wet.

It will be interesting to see if Trump appoints a new HHS secretary and if he does, that individual will be hearing from Autism's Gadfly (me).  So far, secretary Price, NIMH head Joshua Gordon, and President Trump himself have not taken a position against neurodiversity and have not done anything about these people and their influence in government-related autism matters.  If Price gets canned and Trump appoints someone else, I hope they'll do something about neurodiversity. 

Tuesday, September 26, 2017

Life didn't imitate "the good doctor's" art in one case.

There's been lots of hoopla over the new TV show, "The Good Doctor" which uses the cliched trope of autistics as supermen.  Apparently, in the good doctor's case, M.D. should stand for Magical Deity.  Though I watched all eight episodes of "Atypical" I decided to take a pass on "The Good Doctor" as I find the premise of autistics as supermen offensive, was bored and unable to follow the plotline in "The Accountant", and felt the premise of the show was also not compelling.  Therefore, I suppose I can't completely comment on the show without having seen it, so I'll end my comments about the actual show here.

But one of the interesting questions that has come up due to the publicity the show has received is whether or not an autistic could actually be a competent physician in real life.

In John Elder Robison's book, Switched On, he states that one of the other Asperger's research subjects of the Harvard TMS group is an orthopedic surgeon.  

Neurodiversity activist Sara Luterman, writing for NOS magazine, claims there are lots of autistic physicians and medical students. I did not check out her link, so I can't really comment on how valid this claim is.

In a Scientific American Blog an author who I think may be savantism expert Darold Treffert (but I'm not sure) stated that it's plausible that an autistic savant could be a gifted surgeon.

But it's an interesting question.  Even if an autistic is so mildly on the spectrum or can overcome his/her disabilities to such an extent they could get an astronomical GPA in college, get into medical school, have the ability to work with patients during their third and fourth year of medical school, would they be able to perform the functions of a physician effectively?

The reason that it's such an interesting question is that there is one known case of this I've written about previously where the answer appears to be no This is the case of a physician alleging to have Asperger's syndrome named Martin Jakubowski who began a primary care physician residency in a hospital in Ohio.  Though he scored high on his medical knowledge examination, he scored poorly on the emotional intelligence exam.  Supervisors noted his weak interpersonal skills and began to question his ability as a physician.  He had difficulty with instructions to patients, interacting with other physicians and speaking on the phone when doing his job.  Because of all these problems, the autistic physician was fired.

He attempted to appeal his firing, claiming that his disability should be accommodated because of the Americans with Disabilities Act.  Jakubowski lost his case in Federal court because the court agreed with the hospital that Jakubowski's impairment prevented him from being able to perform the job with or without reasonable accommodations.  The "good doctor's" request for the accommodation of  "understanding and awareness" was not deemed reasonable.  He also asked that a doctor be assigned to him to monitor his activities.  The court agreed the hospital had the legal position this was not a reasonable accommodation as it would cost the hospital too much money and time to do this.

Keeping patients safe is certainly a requisite, so it is certainly reasonable not to allow an autistic physician to continue in their residency if their disability prevents them from being effective in their job.

Very few people who have watched and commented on "the good doctor" will ever be aware of who Martin Jakubowski is and the irony that life didn't imitate art in at least one instance.