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.  


Claudia Mazzucco said...

The Good Doctor is not really about a person with autism; it is about the diminution of genius. Someone with genius-like talent has never conformed to what an American/Puritan culture believe they should be. So, therefore, it sought to explain genius away by associating genius with mental disorder. For years, before Asperger’s met the DSM criteria and became a popular diagnosis, they tried to associate genius with depression. It did not work. Now autism is new best possible explanation for prodigiousness, mostly because nobody can really define what autism is.

......I'm Anonymous said...

I remember that the DSM used to, as a matter of diagnosis, held that an autistic person mush have fine motor skill deficiencies. I guess now that everyone is autistic, that doesn't matter anymore. Thus we have autistic surgeons. The world has gone to shit and ND is responsible for this horseshit.

jonathan said...

@your anonymous I don't really recall that. I have very poor fine motor coordination and on that reason alone would make a poor surgeon. I also do poorly on the block design test. However, Stephen Wiltshire has an autism diagnosis and is a highly skilled artist and others with autism (legit diagnoses) probably have good fine motor skills and do better on the block design test than on other subtests of the Wechsler, so I don't know why that would be in the DSM. However, I completely agree with your last sentence.

Unknown said...

Hello all, while it is true that nobody has an absolute definition that is reasonable as to what autism is, this does not mean we have no Autism epidemic. Official definition of autism is that it is A disorder and this and that however in reality all autism is in reality it is a label. Autism does not require a medical test or any kind of scientific realistic explanation or anything to back it up other than the DSM which is not backed up by science it is however backed up by opinion and it’s more political than scientific it is more about what you think then about what you find So what this means is that autism and ADHD and most illnesses how they got their name and how they are organized or determined it’s not scientific and is completely made up. I am speaking complex so if you don’t understand this so what this means is that autism and ADHD and most illnesses how they got their name and how they are organized or determined it’s not scientific and is completely made up. I am speaking complex so if you don’t understand this comment please ask for elaboration or a better or different explanation do not be offended at least don’t be offended by mistake thinking that I said something I didn’t actually say or intend to say so just feel free to reply to my comment my website is www.seeingclearlymedia.weebly.com, The reason I included my website in this comment is because I talk a lot about autism from the pro-cure perspective from the realist perspective and I also post on the anti-care a lot and there’s a lot of literature that might be interesting or relevant so that is why I am bringing my website up, I have no interest in personal gain other than the gain I have disclosed that being said to spread the message that autism is bad and there are no arguments against that I listed to what seems everything and nobody can make a solid argument on why autism is good everyone I talked to ended up doubling down at me with insults and profanity and false conspiracies on how I am brainwashed into believing autism is bad by bleach mongers or what not.

Unknown said...

Have you ever heard the saying that people would believe anything? If you tell someone that stealing is good can you make it sound convince people would believe it.People are falling into the propaganda by these businesses and corporations and losers which I religiously believe that they are demonically processed and that is why people believe a falsehood because they hate the truth and are deceived by their own wickedness. The definition of good and evil is something the human race has long forgotten what it means. We are Entering an era where people are believing that there is no true there is no right there is no wrong there is no good there is no bad,There is no such thing as health or disease and of course there is no such thing as a boy or a girl or a woman or a man. You may ask aren’t we all one?The same people that scream diversity are also the once that believe that there is no such thing as diversity. It was perverted it is perverted. They call good bad and bad good, they call diversity typical and typical diversity. Down syndrome people all look one alike they are downtypical not neurodiverse. you are not being inclusive when you label someone as different for being no more different than you or anyone else is and instead of calling different a disease call a disease a disease and different different. If you are intolerant of blue eye people for example that is your problem but nobody should have to tolerate blindness, if you are intolerant of people’s creativity and neurodiversity that is your problem but we should have to tolerate mental illness or autism in other informal words.

Jeff said...

I'm quite certain that some of us could perform well as physicians, nurses, therapists, teachers, parents, etc. I'm a nurse and I have serious limitations that would prevent me from doing well in certain settings (i.e. the E.R.) but I'm fortunate in having developed some ways of compensating for my weaknesses early in life that happen to work very well for what I do now. Personally, I like the idea of ND .... but I think you (and others) raise extremely important concerns that ND proponents aren't particularly good at addressing. My experience is valid (whatever that means) but it isn't necessarily typical (heh!) and I really appreciate what you share here because it helps me see/understand/consider things I would otherwise probably overlook.

imho said...

First off, I have to say you are bold to write on the subject while admitting you are so non-committal as to have chosen not to watch the show or read a reference you provided.But since your article was to enlighten people to the fact that real life an autistic doctor was fired for being too autistic and not to speak on the show or the condition, I guess whatever. I'm cool with that, as you know every tv show portrays unreal things, especially reality shows.
The Accountant and A typical were both as you eluded using the condition for purposes of the genre. One to give him super savant skills, yet he seemed fine with loud gunfire and such, so only when convenient for the plot did he seem afflicted with symptoms. A typical used the social awkward angle for comedy and to shine a light on how stupid we normals are, mostly for comedy as well. But I felt that show made the character seem like just that-a character with fairly predictable behaviour.
This show is a more earnest attempt at building a character who happens to have Autism. And it is also a medical drama with many elements of that genre. I suggest you give it a try, not as a study on autism but because it is an entertaining show. If you are allergic to sentiment I would not recommend it, as that is the shows greatest strength...imo.

jonathan said...

Though I have not seen "the good doctor" (and still refuse to do so), I've seen promos and YouTube videos of it and that's good enough for me to know it's a show whose premise I take great offense to and I felt does harm, so no point in my seeing it or supporting a show like that. I can still write about the improbability of an autistic( except in maybe very rare instances) being able to effectively perform the duties of a physician, let alone have savant skills that enable him to diagnose diseases others can't, etc.

Not sure what reference you're stating I did not read.

jonathan said...

oh i guess you're talking about sara luterman's article. I read the article, but not the links at at the time i wrote this blog post, I guess I should have. I've read them now and she just claims there are plenty of autistic doctors and medical students, but just cites someone who has a twitter account written in sweedish, and someone else who is a 22 year old neuroscience graduate student which is not a clinical doctor. But having interacted with Sara on twitter on a number of occasions, such sophistry and playing fancy with facts if not outright dishonesty is par for the course with her.

Anonymous said...

Korean version (original) of The Good Doctor is better. Yeah it has the stereotypes and savant stuff but the main character is a believable person. Moody, not always smiling, and the autism is part of the plot. It's not used to promote neurodiversity.