More Self Than Self: At Autismýs Edge

By Henry Kong

Author Henry Kong's More Self than Self: At Autism's Edge will take you on a captivating exploration of the autistic mind as Dr. Kong shares the latest discoveries in genetics and neuroscience.

As a child, Kong was an awkward Asian American bookworm with oversized glasses and an overbearing father. Made to feel like an outsider, Kong was bullied by his classmates and endured degrading nicknames. Kong's stories tell of his childhood gift for memorization and the challenge that it creates later in life, and of his struggle to grasp and apply concepts to real-life situations. Through it all, Kong manages to finish medical school, educate himself about Asperger syndrome, write books, and open a private practice.

In a conversational style, Dr Kong intersperses anecdotes with passages that cover both basic science and also delve into the cutting-edge research that has helped solve some of the mysteries behind autism. Not only will More Self than Self provide a comprehensive look into the differences between the autistic and neurotypical brain; it will also inspire anyone who has ever felt isolated and unaccepted to believe that they too can make their dreams come true.

• Language: English
• Publisher: iUniverse
• Release date: Jun 30, 2006
• ISBN: 9780595836895

Henry Kong

Henry Kong, MD was born in Seoul, South Korea, in 1968. He has been intrigued by the mysteries of the mind for as long as he can remember. He studied biology at MIT, philosophy at Oxford, and medicine at Rutgers. He is an internist in private practice in Toms River, New Jersey.

Book preview

Contents

Foreword

1

Long Night’s Journey into Day

2

Millennium

3

Klutz

4

Anxiety

5

Contingency

6

Geek

7

Sex

8

Chink

9

American Seoulman

APPENDIX A

Genetics

APPENDIX B

Consciousness

In memory of Hans Asperger (1906-1980)

and to the millions around the world who share his syndrome.

For Sir Francis Crick (1916-2004), the greatest biologist of the twentieth century. He made DNA plausible.

For Professor Jessica Treisman, the greatest biologist of the twenty-first century. She made this book possible.

For my parents. They made me probable.

Foreword 

For those who have wondered what it feels like to get under the skin of someone with autism or Asperger’s syndrome, this first book by Dr. Henry Kong will convey the experience. Personal vignettes are interspersed with explanations of the science underlying the various defects associated with Asperger’s syndrome. His fascinating account of how the brain accomplishes perception, motor coordination, emotion and decision making sheds light on normal function as well as suggesting what might have gone wrong in the autistic brain. He effectively conveys the excitement of the latest discoveries in neuroscience to the lay reader. Dr. Kong takes his analysis to the genetic as well as the anatomical and behavioral levels, and even discusses how evolution has shaped our minds and brains. In one chapter he mentions the savant skills and obsessive mental pursuits of some autistics; it seems that his own obsession has been effectively directed towards understanding the cause of his disorder.

Dr. Kong’s honest description of the difficulties he faced growing up not only as a high-functioning autistic, but also as an Asian immigrant to the US with an overbearing father, illustrates the interplay between genetic and environmental factors in determining the course of an individual’s life. For example, the relentless teasing he faced in school because of his race, his focus on arcane scientific and historical information, and his lack of athletic talent contributed to his later social difficulties. Dr. Kong also gives hope to family members of autistic children by showing that many of his earlier flaws were overcome to some extent, allowing him to integrate into society and to produce this book. Readers will follow his story with both intellectual and emotional interest.

Dr. Jessica Treisman Professor of Molecular Genetics Skirball Institute NYU School of Medicine

1

Long Night’s Journey into Day 

A crimson sun casts long shadows across the Manhattan street grid. It is Saturday, July 26th, 2003. After a pleasant afternoon of bike riding through Central Park, I am looking forward to getting back to my girlfriend’s apartment in the East Village. We meet at the Lexington Avenue subway stop on 77th Street.

Swipe. Beep. Swipe. Beep. I’m stuck at the turnstile. Jessica is upset with me. She goes on ahead through the gate (somehow her card works). Let’s try a third time. Swipe. Beep. Shit. The handicapped service gate to my left is wide open and someone just walked through when the clerk wasn’t looking. Should I? Damn, the train’s coming.

‘Excuse me,’ I ask the guy at the booth, ‘the machine won’t read my card; can I just go through the gate?’

‘Use another one!’ he tells me without looking up.

I hear the train getting louder. A quick swipe. Beep. Another quick swipe. Beep. I let the woman behind me try. She gets stuck too.

‘Hey, I’m telling you, none of these stupid machines work. I’m going through the gate!’

Halfway down the short flight of steps with my bike in the air above me, I hear the clerk on the loudspeaker hollering over the screeching brakes: ‘You can’t do that; go back up and pay! Go back up and pay!!’

‘THE MACHINES DON’T WORK, ASSHOLE!’ I scream back.

I can’t believe I just said that. A sudden and unexpected wave of self righteous excitement, even exhilaration, washes over me. The southbound number 6 is pulling into the platform. The doors open. I glance over at Jessica; on her face is a mixed look of consternation and disappointment. So what? Was that so wrong? Now let’s get this mother outta here.

Just as I’m entering the open subway doors, I feel a hand on my right shoulder. I turn around. Two uniformed officers of the NYPD.

‘You didn’t pay your fare,’ the taller one says to me. On his badge is the name ‘Garcia’. My heart starts to race and my palms sweat up. We miss the train.

‘Officer, my metrocard didn’t work. I tried twice on two different machines. Really.’

The shorter one, ‘Cavanaugh’, points towards a small crowd of people that has gathered around us. ‘It seemed to work for all of them’, he says.

‘Well, it didn’t work a minute ago when I tried to get my bike…’

‘Okay, okay,’ Garcia interrupts. ‘You’re under arrest.’

Cavanaugh grabs my left wrist and ties it to my right using a pair of plastic handcuffs. Jessica, now wide-eyed, pleads with him.

‘Officer, why don’t you just give him a ticket or summons? He really did try to pay. He can pay right now.’

‘Are you trying to bribe us?’ Cavanaugh asks, with feigned astonishment. ‘Do you realize you’re under arrest for jumping the turnstile?’ he says, enunciating each word. ‘You have the right to remain silent.’

I feel numb and powerless. This whole scene seems unreal, as if I’m watching myself in a movie. The last time I felt this way was when I was watching the twin towers go up in smoke two summers before. There’s really nothing I can do, I’m under arrest, I just have to cooperate and let things be. The officers escort me up the concrete stairs. I worry about Jessica having to carry my heavy mountain bike. She gets it done. I glance nervously around at all the faces staring at us. I’m still wearing my bike helmet. What a relief. I hope no one recognizes me. I used to work at Lenox Hill Hospital, just above the subway station, until the previous summer.

There’s a police van waiting on the corner. ‘What about my bike, officer? I live in the East Village.’

‘You can’t take it with you, have your friend carry it back on the train,’ Garcia says.

‘What’s going to happen to him?’ Jessica asks.

‘He’ll be in holding overnight and go before the judge in the morning’.

‘Officer, I can’t go without my girlfriend, she has to come with me!

‘Look, take your helmet off and come with us; she and the bike stay here.’

‘Where’s the police station?’

‘69th street.’

‘Jessica, meet me there!’

I want to know what time it is but I can’t see my watch because my hands are tied behind by back. I pull really hard but I can get free. I look over at the digital clock in the police van. I is 9 pm. The last 15 minutes have taken forever. We arrive at the precinct station. A breathless Jessica enters with my bike a moment later.

‘You made it!!’ I exclaim with relief.

The station house is an old building with a high ceiling. It smells dusty and the voices echo off the walls. I think back to the first time I entered the cavernous cafeteria of the Donald Quarles School on the first day of first grade. The kids were loud and rowdy. I was really scared and started to cry uncontrollably. My teacher, Mrs. Dixon, took me to the principal’s office, where Mr. McNeill gave me soothing words and shared his milk with me. Back to now. The officer at the front desk is busy directing a disheveled and disoriented man in filthy sweatshirt. He staggers out into the street. Two other officers are laughing (at him or at me?) and drinking coffee in the corner. They seem so relaxed. Is this really happening to me?

Garcia turns to the first officer. ‘We picked him up at the subway platform. Turnstile jumping.’

‘Okay, bring him in,’ the clerk says.

I turn to Jessica. ‘Take the bike home and try to get me out of here. This is a big mistake. I don’t belong here. I LOVE YOU!’

‘I love you too,’ she says, her eyes moist.

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Garcia and Cavanaugh take me to a table. I am told to empty my pockets and remove my shoelaces. I do as I’m told. A pair of keys for my bike lock, my watch (Jessica’s gift to me for my 34th birthday the year before), a twenty dollar bill, some loose change, my metrocard. I get to keep a quarter for a phone call. Then I am escorted to a holding cell. My handcuffs are removed. There is blood on my hands from the scratches I made trying to get those cuffs off.

There is a guy already in there. He’s big and black, and slouching in the corner, his oversized unlaced sneakers propped up on the bench. I try not to act scared. Don’t sit too close to him, but don’t sit too far away, either. I think I’m dressed funny: a short Asian guy wearing a T-shirt and floral print shorts. Fortunately, the guy with the sneakers doesn’t even glance over at me. But he seems to know Garcia.

‘Yo, I gotta get my wheels back, man. I got places to go, man, shit to do. Every little thing, man, every little thing,’ the sneaker guy mumbles.

‘What’s this, your third offense? You’re driving with no license, man. What you expect? A pat on the back? Come on, get your act together, Dion.’

‘I’s workin’ on it, know what I mean, it takes time, yo, shit don’t come easy.’

‘You got that right, ‘specially on nights when I’m on,’ Garcia says with a hearty guffaw.

‘Shit’ Sneakers says, then appears to fall asleep.

Garcia starts to read the sports pages in the New York Daily News. Several officers come down. One of them, a short man resembling Joe Pesci, is telling a joke. Another, with a face full of zits and looking like a high school bully I once knew, is munching on a bag of BBQ chicken wings.

‘So what’s the difference between OJ and Superman? Huh? Give up?’

Chicken Wings is too absorbed with his dinner to reply.

‘This is the fiftieth time you’re telling that stupid joke, Pigano,’ Garcia says, still reading the baseball scores.

‘Shut up, man, did I ask you? Anyway, what’s the difference between OJ and Superman?’

‘What the fuck is the difference between OJ and Superman? Hmmm, let’s see, Superman is not a nigger?’ ventures Chicken Wings, mocking puzzlement.

‘No, man, OJ walked! OJ walked!’ Pigano starts to giggle.

‘You’re a regular fucking Conan O’Brian, Pigano.’

I can’t fall asleep. My back hurts; my ass hurts. Unfortunately, this is not a padded cell. These NYPD officers are endlessly telling crude jokes and bantering irrelevant gossip. Sneakers wakes up and asks me what I’m here for. I try to sound tough.

‘Fightin’ over drugs and shit, man!’

‘He gives me a tired, dismissive look, and falls back to sleep. I don’t think I sounded very convincing.

Finally, as I’m starting to doze off, the steel doors slide open with a screech. Pigano orders me out.

‘Alright, time for fingerprints and photos,’ he tells me.

After having my mug shots taken, I am led to what looks like a cross between a photocopy machine and an ATM.

‘You should check this out. You’re gonna love this machine! State of the art. It’s like high tech. They just taught us how to use this last month. So what do you do? Are you like a computer programmer or a scientist or something?’ Pigano asks me while fiddling with the buttons.

‘I’m a doctor’ I tell him. I shouldn’t have said that, but I’m afraid that he might catch me if I lie.

‘No kidding,’ he says, turning to me. ‘My uncle’s a doctor. He’s an orthopedic surgeon. He fixes bones and stuff. I kind of figured you were a doctor. You people are like really smart, right?’

‘I guess,’ I say, not wanting to argue with this little man.

Pigano takes my right hand and presses my fingers and palm onto a glass screen one at a time. For some reason, the computer won’t register my prints. He tries at least a dozen times. I fight the urge to interrupt him. He finally calls Chicken Wings for help. Again, no success.

‘Are you Chinese?’ Chicken Wings asks me.

I am taken aback, but answer him. ‘No, I’m Korean, why?’

‘There might be something with Asian fingerprints, the ridges are too short or something. I’ll get my supervisor.’

I can’t believe I’m hearing this crap. I lose what respect I had for the NYPD.

The supervisor arrives. She is a middle aged woman who finally gets the machine to work. Finally! Damn idiots. I can’t believe I’m relieved to have my fingerprints permanently stored in the NYPD criminal databank, but I am.

6484.jpg

I am dreaming about spending a precious Saturday evening out on the town. But that terrible metal door awakens me again. The clock says 2 am. ‘All right, time to go!’ an officer yells. I am half expecting someone to tell me it was just an unfortunate misunderstanding. Perhaps they’re releasing me.

No chance. We are handcuffed again. Sneakers and I are escorted out into the chilly night and into a van. Two officers are sitting in the front; a third joins us in the rear compartment facing us. I look down at his gun; I wonder if he’s ever had to use it. I look over at Sneakers. He’s fallen back to sleep.

‘Jerry, go down Lex and swing over on 42nd, let’s check out the nightlife,’ the officer in front of me tells the driver.

We are in Times Square surrounded by giant neon billboards for Victoria’s Secret and wrap-around jumbotrons showing news from Baghdad. It is still quite crowded at this hour, but the tourists seem to have been replaced by bums and prostitutes. We slowly drive around in circles for several blocks. Dozens of yellow taxicabs pass us. The air is filled with the sounds of traffic, loud conversation, and dropping bottles. Hundreds of people walk on by without the slightest inkling of what kind of shit I’ve gotten myself into.

‘Whew, look at the hooters on that one,’ says the cop on the passenger side with a chuckle. Walking across the street in quick little steps is a black woman with very high stiletto heels and a red skintight miniskirt. ‘Hey, mama, you can get arrested for hooters like that,’ he tells her through the open window. She flashes a big toothy smile and blows him a kiss. ‘I got your number, babydolls,’ he yells back.

A few blocks away, we encounter a group of Latino men arguing on the sidewalk. The van’s sirens sound, bright lights flash, and the men scatter about. We idle for several long minutes. ‘That’s enough fun for one night; let’s drop these gents off,’ says the cop in the back. We start moving downtown again.

6486.jpg

I am standing in a line just outside the basement entrance to one of the criminal justice buildings in Lower Manhattan. Ahead of me is Sneakers and about six or seven other men, all black, all handcuffed like me. Behind me is a small woman in her early twenties with tight bushy hair. She carries on an obscenity-laden conversation with herself. We are soon joined by another group of people brought in on a dark painted school bus. The line moves slowly. ‘You can’t keep us out here like cattle, we is cold!’ a woman yells. ‘That’s all we is to them, animals. Wild animals,’ a man replies. The cops ignore the protestations.

At the front of the line, two police clerks are cross checking papers, photos and fingerprints. One of them looks me up and down. She is a middle aged blonde woman who I imagine could once have been attractive, but now has bags and wrinkles under her eyes. ‘What’s with these separate prints? You got three different guys here or what?’ she says in a gravely voice to the officer who has accompanied me from the uptown station. ‘Yeah, we had some problems getting his prints with the new machine, so we made some duplicates.’ She looks down at my file again and glances over to her colleague. ‘Idiot rookie’ she mutters under her breath.

The men and women are separated. Then the men are split up into smaller groups. We are led through a corridor lined with cinder blocks and exposed ceiling pipes. On the wall is a poster that says, ‘You have the right to see a lawyer within 24 hours of your arrest.’ That could be anytime until Sunday night. I think of all the patients scheduled to see me in my New Jersey office Monday morning. I have to be out of here. No one can know what’s happening to me. Panic wells up in my stomach and chest; it is hard to catch my breath. Get a hold of yourself! Think of other things. Think of other things.

Yet another clerk behind a desk. ‘Sir, when can I see my lawyer?’ I ask imploringly.

‘Sometime in the morning.’ Relief. ‘But things are slower on Sundays.’

‘How much slower?’

‘Might have to wait ‘till Monday, depends on the number of cases.’ Panic and unease fill my stomach. I’m starting to feel abdominal cramps. I hope to God I won’t have to use a toilet here.

We are led past several cells, each full of lethargic people sitting around with blank stares. We are put into the last one. This cell is larger than the one in the other station. It is also much better lit by the harsh glare of numerous fluorescent bulbs. There are no windows, and no clocks. My watch has stopped working. There are about two dozen men crammed in here with me. I sit on one of the two metal benches. There is no room to lie down; another man is already sprawled out beside me. At least a dozen more are lying on the floor. In the corner, someone is sitting on the toilet taking a crap. He seems undeterred by the lack of doors or screens for privacy. In another corner is a pay phone. I reach into my pocket. Nothing. I have lost my quarter. Shit. I try but cannot fall asleep.

‘Fuck this NYPD bullshit, man! It’s fuckin’ racism, man! Every dark-skinned brother is a fuckin’ terrorist to them, man! I guarantee you, if we was white, they wouldn’t bother with us, you know what I mean? How many white brothers you see in this shithouse, man?’ A slight man with tan skin and a heavy Arab accent is carrying on an animated diatribe with a much taller black man in a red tracksuit and dreadlocks. ‘Institutionalized racism, man, from the top down. Nine-eleven, man, they planned it all out. Who do you think was behind that, man, huh? Who do you think?’ Dreadlocks just shrugs. ‘The CIA, man, and Bush. You think they didn’t see it coming? They ordered that shit!’ The Arab’s big eyes are dart back and forth wildly. This nonsense lasts several minutes before Dreadlocks retires to his bench. The Arab, still full of furious energy, paces back and forth, talking to himself. I try not to catch his eye. Too late.

‘Hey, Chinaman, what they get you for?’ I contemplate feigning no knowledge of English, but can’t quite go through with it.

‘Turn style jumping.’

‘That’s all, man?’

‘Yeah.’ I’m too exhausted to elaborate.

‘That’s the fucking NYPD. You see them arresting white people for things like that?’

‘No,’ I say wearily.

‘Institutionalized racism, man!’

Sometime later we are joined by half a dozen others. Among them are the first white prisoners I’ve seen all night. One is a very tall man in his twenties. He is wearing a faded blue denim jacket and heavily moussed black hair and looks a lot like a young John Travolta from Welcome Back Kotter’. Another is a balding man in his forties with a prominent paunch and rumpled business suit. The two are discussing how much time they would have to do for drunk driving. Being surrounded by these people, I am suddenly overcome by an indescribable feeling of claustrophobia and despair. I squeeze the cold steel bars and try to force them apart with all my strength. They will not budge. For a moment it becomes difficult to breath. Somehow, I pull myself together enough to approach some of the less offensive looking prisoners and ask them for a spare quarter. One of them, a man with very dark skin and an African accent, gives me fifty cents. I thank him and walk over to the payphone.

Jessica answers on the second ring.

‘Sweetheart, it’s me. What time is it?’ I whisper.

‘Half past five,’ she replies with a mixture of fatigue and concern. ‘Are you alright? I was so worried about what might have happened to you I couldn’t sleep. Did anyone hurt you?’

‘I’m alright, but you have to get me out of here, I can’t take much more of this.’

‘I don’t know what to do!’ she says, her voice cracking.

My eyes burn as I fight back tears.

‘Try to get to the courthouse downtown, and find out when I can be released, call a lawyer, call your parents, call anyone, you have to get me out of this! You know this is one huge mistake.’

‘I know,’ she says quietly, now openly sobbing.

‘I love you.’

‘I love you, too.’

I quickly look around to make sure no one has been eavesdropping. I lie on the floor, close my wet eyes and pretend to fall asleep. Soon, I drift in a fitful delirium, dreaming of awakening under the sheets of a soft mattress with Jessica’s naked body snuggled against mine.

Suddenly I am awake. I look down at my shorts and legs. Thankfully, no one seems to have assaulted me. But I am not with Jessica. I am on a stainless steel floor with no blanket, bathed in harsh lights and surrounded by strange sleeping men. I lie awake for a long time thinking of nothing in particular. Eventually, an officer walks in and announces it is time for breakfast.

They pass out ham and cheese sandwiches and milk. I have no appetite. I give my food to the African gentleman who lent me his quarters. He smiles at me. We tell each other our stories. He was arrested for possession of marijuana. He assures me that the judge will certainly throw out my case. I wish him luck. The despair has passed and I feel a lot better. In fact, I feel strangely exuberant. I take solace in the knowledge that somehow, this ordeal will end.

We are taken to another cell upstairs. This one is darker and older. The bars are still there, but the benches and ceilings are made of wood. A clerk calls out names one at a time. Each prisoner is told to enter a small booth and speak with the court appointed public defendant behind a window protected by thick glass. The names go by painfully slow and in no discernable order. The odor of sweat permeates the still and sullen air. Tempers flare. A tall muscular man in a white tank top who looks like he’s been hardened by decades in the system paces the room yelling and cursing to himself. Everyone seems to ignore him.

‘Motherfucker! You better watch out, you fucking bitch! I should have shot your fucking black ass when I had a chance, you god dammed gold-digger. After all the shit I did for you, after all we been through, you go around and stab me in the back! You take my fucking money, my fucking child support, you take ten years of my life, you shack up with other men, while I suffer in this hell. Well if you think you’ve seen the last of me, you better think again, bitch, ‘caus you got another thing coming. As soon as I’m out I’m gonna get you, bitch! Hey get me and outta here, I wanna see my fucking lawyer, I got my fucking rights…’

‘Hey shut up,’ says the African softly.

‘What the fuck?’ responds the angry man.

‘You talk too much, now shut up.’

Around noon, the lawyers break for lunch. I have not yet been called. Several hours later, the roll call resumes. ‘Kong! Kong!’ yells the female clerk. I wince. The cacophonous sound usually so familiar sounds oddly alien. Finally, it’s my turn.

I take a seat in a low chair facing the tiny window. Facing me on the other side is a young white man in a shirt and tie. He is about my age. The man adjusts his glasses and opens a file.

‘Mr. Kong?’

‘That’s me, sir.’

‘So it says here that you were arrested at a subway station for evading the fare.’

I explain myself.

‘Yes, I am guilty of being obnoxious and yelling an obscenity in public. But I believe the police response was excessive and unnecessary. A ticket or summons would have been more reasonable. But, my first main concern right now is for you to please let me go; I have to see my patients tomorrow. And secondly, I really can’t afford to have a criminal record.’

The lawyer listens to me attentively. ‘Well, it does seem that the officers were out ofline to arrest you for this little thing. My best advice to you, Mr. Kong, is to plead guilty to public disturbance, a so-called ‘quality of life crime’, in exchange for expunging your record in six months. I will make the recommendation to the judge.’

‘What does this mean?’

‘You’re free to go and your police file will be destroyed in six months.’

‘And no fine.’

‘No fine.’

An hour later, still handcuffed and wearing filthy bike shorts and tee shirt, I am led out the door into the courtroom, conveniently located adjacent to the holding cell. There are about twenty or so people in the gallery. Jessica and I spot each other. She waves to me. I give her a big smile. The judge reads the case. ‘Mr. Kong is guilty of public disturbance, and is released on his own recognizance.’ The court officer removes my handcuffs. It is over before I know it. Jessica is full of joyful tears. We embrace each other tightly in the middle of the courtroom.

‘I was so worried about you, I thought you would be raped,’ she says quietly.

‘Thank God. That was the worst experience of my life,’ I say. ‘Is my bike okay?’

The court officer interrupts. ‘All right! Break it up! You have to clear the courtroom!’

It is three o’ clock in the afternoon when I walk out into the brilliant and blinding Sunday sunshine.

2

Millennium 

Anyone who has common sense will remember that the bewilderments of the eyes are of two kinds, and arise from two causes, either from coming out of the light or from going into the light, which is true of the mind’s eye, quite as much as of the bodily eye; and he who remembers this when he sees anyone whose vision is perplexed and weak, will not be too ready to laugh; he will first ask whether that soul of man has come out of the brighter life, and is unable to see because he is unaccustomed to the dark, or having turned from darkness to the day is dazzled by the excess of light.

—Plato The Republic

As the name eyes absent (eya) suggests, the eyes are missing in some eya mutants. However, stronger eya alleles cause lethality or sterility, and expression of the gene is not restricted to the eye, showing that eya has functions in addition to eye determination.

—Dr. Jessica Treisman

I rush out of the Payne Whitney Clinic of New York Hospital on a bright brisk April morning in the year 2000. I have just been diagnosed with Asperger Syndrome. There is a bounce in my step as I make my way across town trying to organize the furious rush of thoughts in my head. At last, here is a coherent explanation, a continuous thread that runs through the disparate scenes of my life, connecting the recurring themes of confusion, alienation, rejection, embarrassment, anxiety, and self-loathing. The lights of Fifth Avenue turn green, but I hardly take notice. I feel weightless, as if the psychic burden of a lifetime had been instantly lifted. By the time my head clears, I am in the Sheep’s Meadow, looking towards the towers of Central Park South. A faint mist still obscuring the outlines begins to lift. In a moment of exhausted elation, I resolve to write a book about all of this.

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The story actually began a year earlier. On Tuesday the sixth of April 1999, I woke up, put on my thick glasses and kissed my then girlfriend Helen on the back of her pale neck as she was putting on her green scrubs. I made her take them off, and we made love. She was supposed to be getting ready for her nursing shift in the surgical intensive care unit at Mount Sinai Hospital seven blocks away. Afterwards, she gave me some affectionate words in that sweet Ulster accent I had grown to love, promising to meet me for drinks that night at the Kinsale, a local Irish bar on 96th Street. I took some comfort in this hint of short-term stability, knowing all too well that our relationship was probably doomed. I saw her out the door of her fifth floor apartment at 130 East 93rd Street. Late for work, she hailed a yellow cab on the street below. The phone rang, and I jumped. Assuming it was one of her friends (since I had no friends), and afraid of an awkward conversation, I let it ring on.

I was off that day, so I decided to walk over to a nearby coffee shop, the Muffin Man, for my usual favourite: smoked salmon and cream cheese on an everything bagel with a mug of coffee and the New York Times. Since moving back in with Helen the previous December, I had grown very used to this routine. But this time something was very different. On the first page of the Science Times, just below a pair of fascinating articles on the origin of life and the invention of writing, was an article entitled, ‘A Syndrome With a Mix of Skills and Deficits,’ by John O’Neil. Intrigued and with some time to spare, I read on. It was about odd self-absorbed children often with above average IQs who suffer from social retardation. The hair stood up on the back of my neck; I was floored. This article was about me.

Remarkably, this was the first I had heard of ‘Asperger Syndrome’. It had not come up in four years in medical school (including courses in psychology, psychiatry, and neuroscience) or in my three years as a resident in internal medicine. I was vaguely familiar with its cousin disorder, autism, but never suspected that I might be afflicted with something like it. I was hungry for more information. That night, I met Helen for bangers and mash and a pint