A few weeks ago, ABC premiered a new drama called The Good Doctor, about a young surgical resident with high-functioning autism. Dr. Shaun Murphy has a traumatic past and many challenges to overcome, but clear talent in his chosen profession.
He's also a genius. It says so right there in the promotional trailer for the series. In the first episode, audiences can see the visual representation of his brain working overtime as he taps into a bank of memorized facts and manipulates anatomical diagrams in his head, all before synthesizing that information in superheroic fashion during medical crises.
This is not a show I want to watch. I'm tired of what the entertainment business thinks autism looks like—it's a perception that's far removed from reality.
The well-known pop culture motif of the "autistic savant" likely started with the release of the film Rain Man in 1988. While savant syndrome is real, it's actually quite rare—only 10 percent of people with autism are estimated to have savant abilities. But the stereotype has hung around stubbornly since then, appearing in film and television to spread the misconception that autism—despite its varying degrees of impairment—is something that can also bear desirable or even enviable gifts.
That message is damaging in more ways than one. It's insulting to the large percentage of people on the spectrum without savant abilities, because it implies their stories aren't as valuable or worth telling. It also promotes the falsehood that an autism diagnosis nearly always comes pre-packaged with extreme giftedness.
"It's true that many individuals with high-functioning autism have very high levels of intelligence and savant-like abilities," says Harry Voulgarakis, a psychologist and director of the Shoreline Center for Social Learning in Connecticut. "But it's important to remember that this is a small percentage of individuals on the spectrum…in fact, about 40 percent of people diagnosed with autism spectrum disorder [ASD] have an intellectual disability, or a lower range IQ. So while the media representations of ASD are not necessarily inaccurate, they are limited in the many aspects of ASD that they are portraying."
In recent years, nonfiction entertainment has fared better in its balanced and respectful representations of autism: The 2015 documentary 'Autism in Love' deftly handled the challenges people with autism face when navigating romantic relationships, and the following year, the award-winning film 'Life, Animated' took a fascinating deep-dive into one family's attempts to communicate with their nonverbal son through his love of classic Disney movies.
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But stories like these about the reality of autism are rare, and fictional representations of people on the spectrum repeatedly miss the mark. On television, most autistic people are relegated to supporting roles and are often textbook examples—simply vessels for a checklist of characteristics—as opposed to complex, distinct portrayals (with Max Braverman on NBC's Parenthood being one recent exception). Elsewhere, realistic films with autistic main characters are often restricted to smaller production companies and thus smaller audiences (independent dramas 'Mozart and the Whale,' 'Adam,' and 'Mary and Max' come to mind). In other words, there is very little evidence of autistic characters being featured in prominent, mainstream roles unless they possess savant abilities.
Why? Why are we afraid to tell stories about autistic people that show the truth? The most recent estimate from the National Institutes of Health shows that about one in every 68 children has ASD. Yet we are still afraid to look autism in the face on screen and accept it for what it really is: a disability that is difficult, challenging, exhausting, and sometimes painful. This kind of convenient erasure does all of us—particularly those in the autism community—a deep disservice.
Living with, working alongside, and caring for someone with autism is messy. They may never read or write or speak. They might be able to talk extensively about Harley-Davidson motorcycles, but not about how they felt when their mother died. They may fly under the radar, judged simply as "strange" or "odd," and be perpetually misunderstood. They may engage in self-injurious behavior. Their lives may be an endless string of therapy appointments, interventions, evaluations, and insurance battles.
It's lonely and frightening, both for autistic people and those who welcome them into their hearts—the people who love them in spite of all the messiness. Of course, being part of an autistic person's life can also be funny, enlightening, inspiring, and transformative. Autism isn't any one thing: not all bad or good, not all joy or devastation, not all giftedness or impairment. It's called a spectrum for a reason—it possesses a million different shades of itself.
I've seen it up close myself; last year, one of my three sons was diagnosed with autism. He is on the high-functioning end of the spectrum, just like the main character on The Good Doctor. But there is little familiar to me in the show's depiction of autism, and I would rather watch a show about the man my son might actually be in twenty or thirty years.
"For someone to make it through college, medical school, clinical rotations, and internship, by the time they got to residency they would likely have developed more compensatory skills," says Voulgarakis. "Their social deficits would not be as apparent as they are portrayed in 'The Good Doctor,' or as they were in the even more dramatized case of Dr. Dixon, the brilliant heart surgeon who was briefly on 'Grey's Anatomy' [in season five]." [line about dixon]
Although my son is smart and likes to help people—and could certainly become a doctor one day if he had the desire—he's not a savant. If he decided to pursue a career in medicine, what would his life actually look like?
He might ace his medical boards, but have to carefully rehearse his bedside manner to avoid seeming brusque or uncaring. He might look forward to the moment when he could lock himself in his office to complete paperwork, craving silence and solitude. He might cite statistics and studies in a sincere attempt to be comforting when a fearful patient asks about the life expectancy of a cancer diagnosis. He might bottle up his frustrations during the day, maintaining a composed veneer of professionalism, and then release his pent-up emotions on his spouse when he returns home.
Perhaps the more important question is this: How would people respond to him if he did behave this way? Remember, he wouldn't have the saving grace of being supernaturally smart. He wouldn't be Dr. Shaun Murphy—he would just be himself, part of the ungifted majority of people with autism.
If he wasn't a savant, how would people treat him? I don't know the answer. But if someone made a television show about that character, I'd watch it.
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