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Asperger's Syndrome

When Will ABC Get Asperger's Right? 

The character with Asperger's portrayed on "Grey's Anatomy" is unrealistic.

Key points

  • The character with Asperger's on "Grey's Anatomy" embodies a stereotype: She has all the diagnostic criteria, all at once, and all to an extreme.
  • The portrayal of Asperger's on "Grey's Anatomy" doesn't consider that adults with Asperger's often have coping mechanisms to deal with symptoms.
  • People with Asperger's may struggle to understand and predict others' emotions, but that does not mean they don't care about them.

One of the measures of inclusion of a specific culture is the quality of media portrayals of members of that culture. The transition from merely stereotypical, to more complex, multi-dimensional characters is all-important. Despite multiple attempts, ABC, much lauded in recent years for its culturally diverse casting and development ideas, has not yet accomplished this in its portrayals of characters with Asperger's.

When the announcement came out that Grey's Anatomy was going to be adding a character with Asperger's, played by Mary McDonnell, an actress I generally like and respect, I was cautiously optimistic.

I had some cause to be cautious, after my extreme disappointment in their first major Asperger's character, Jerry Espenson of Boston Legal. When he was first introduced, I was very excited to see how they would portray a lawyer with Asperger's. Quickly, I began to feel that the way the character was written was exploitative, unrealistic, over-the-top, and insulting. The storyline in which Alan Shore got him off on attempted murder charges by using his Asperger's diagnosis marked my departure as a viewer of the show.

Unfortunately, with McDonnell's character, Dr. Dixon, I've been disappointed yet again. She seems to embody all the stereotypes. She has all the diagnostic criteria, all at once, and all to an extreme. She over-engages with her new colleagues, lecturing them on her subject area, jumping tangentially from subject to subject. She doesn't look anyone in the eye. She avoids physical contact. She struggles with any and all social subtext going on between her fellow doctors and their patients. She shows no feelings and doesn't appear to appreciate them in others.

The other characters are condescending and patronizing to her, including the chief of surgery. He introduces her as "a little off." Then, in a rant about what is wrong in his life, he says: "No one wants to come here. I can't keep a cardiac surgeon on staff. Burke quit. Hahn quit. Dixon's autistic. My OR roof collapsed, the whole place flooded. The interns are literally chopping each other into little pieces. No wonder we're number 12. Twelve!"

The fact that his brilliant new heart surgeon has Asperger's is on par with a roof collapse? Her career is so illustrious that she is being courted by a teaching hospital—shouldn't her work stand for itself, irrespective of labels?

What "Grey's Anatomy" misses about Asperger's

The writers appear to have missed a few key things in their research:

  1. People with Asperger's are individuals. The profile of skills and deficits vary with each person's personality and makeup. Some may affect the person only slightly, others very strongly—and the same diagnostic criteria may manifest in a completely different way in two different individuals.
  2. Adults are different than kids. While Asperger's is classed as a pervasive development disorder, meaning it doesn't go away, that doesn't mean it remains exactly the same throughout the lifespan. We learn and adapt. An adult, the age of Dr. Dixon, in this type of occupation, would have had to develop coping mechanisms to deal with her symptoms. She would have learned, at least to some degree, to put a veneer of "normalcy" over her more off-putting traits in order to get along in the world.
  3. Gender makes a big difference in how Asperger's manifests. As Newsweek magazine notes, "...some specialists predict that as we diagnose more girls, our profile of the disorder as a whole will change. Anecdotally, they report that girls with Asperger's seem to have less motor impairment, a broader range of obsessive interests, and a stronger desire to connect with others, despite their social impairment." Further, girls with Asperger's " ... are more adept at copying the behaviors, mannerisms and dress codes of those around them than Aspie boys tend to be." Dr. Dixon does not reflect any of this.
  4. People with Asperger's are as capable to have a brilliant career as anyone else. The Asperger's "islets of talent" can actually give certain gifts that may make that person better at the job than a person without Asperger's (think engineers, scientists, computer programmers, musicians, artists). Wouldn't doctors know this? Isn't this why they'd be courting her in the first place?

In her first appearance, watching the character relate to her colleagues, I found myself wondering if the writers were aware of these things. I found myself thinking that while the performance seemed out of place for a high functioning woman with Asperger's, it could fit for a young boy... a thought that made sense to me when, in an interview on the Grey's Anatomy Insider, the actress mentioned that one of her inspirations was a young boy with Asperger's she met at a sci-fi convention.

Her second appearance was very difficult for me to take. In this, the writers attempted to portray what they believed lack of empathy would look like in Asperger's. A young patient dies, and Dr. Dixon completely bulldozes over the family's obvious grief, making her look like a heartless monster. An adult of Dr. Dixon's age and intelligence would not have missed the grief of a young girl weeping as if her heart might break. So, essentially, what the writers are portraying is a woman who doesn't care about the grief of others, which isn't true of the majority of people with Asperger's at all.

As laid out in the diagnostic criteria, "lack of empathy" only means that we may struggle to understand and predict others' emotions. It doesn't mean that we don't care about them once we are able to decode them, which is a distinction many seem to miss. In fact, as researcher Isabel Dziobek wrote in Who Cares? Or: The Truth About Empathy in Individuals of the Autism Spectrum:

"More generally speaking, our data shows that people with Asperger syndrome have a reduced ability to read other peoples' social cues (such as facial expressions or body language) but once aware of another's circumstances or feelings, they will have the same degree of compassion as anyone else."

By this standard, Dr. Dixon would most surely have felt compassion for a family whose grief was blindingly obvious.

Her third appearance, in this past Thursday's episode, was a little more toned down, but not without its problems. When another doctor interrupts her while she is explaining the prognosis of her patient to the parents, she becomes extremely agitated, culminating in an outburst when the patient's parents reach out to hug her. This scene reminded me very strongly of the "dancing scene" in the movie Rainman when a touching, intimate moment between the autistic character and his brother is abruptly interrupted by his violent reaction to a hug.

Afterward, Dr. Dixon asks two of her colleagues to hug her to calm her down. While the two doctors hold her, she begins talking aimlessly about cattle shutes, explaining how pressure reduces stress, eventually moving on to hug machines. While all the information was factual, it came off like the writers lifted a few paragraphs from one of Temple Grandin's books and awkwardly grafted it into the scene. Once again, to me, this seemed to not fit.

Has she not had these anxiety attacks before? If she has, hasn't she developed some way of coping with them herself? If she's a professional, I can't see her routinely asking her coworkers to hug her in this way (and if she did, I find it difficult to believe she'd stick around for long).

All in all, I'd have to say that so far Dr. Dixon has been a letdown, however, I have to at least acknowledge ABC for the attempt. Perhaps not all is lost. Toward the end of the last episode, Dr. Dixon is shown using her unique Asperger's logic and observation skills to come to a realization about another character (Dr. Bailey), that the character herself has not yet realized. This is real. People with Asperger's think differently, but sometimes, the results of those thought processes may be surprising. We may see what others do not see. If the writers should decide to move forward with the character, they should follow the direction set by this scene. Then they might have something.

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