In a Different Key: The Story of Autism (7 page)

In the United States, most psychiatrists started out as garden-variety MDs who
learned the specialty by going to work in mental institutions—just as Kanner was doing. The discipline of psychiatry was still young enough that doctors largely taught themselves, sorting out what worked and what didn’t patient by patient, by trial and error, gradually formulating their own guiding principles for how to treat mental illness. It was at Yankton that Kanner noticed, and rejected, an institutional penchant for pigeonholing patients by syndrome. He hated this. Too much emphasis was put on figuring out what label to stick on each patient, he concluded, and not enough time was spent listening to the patients themselves. Kanner developed his own style of writing up an individual’s medical history. Instead of the usual dry compendium of dates and previous illnesses, he presented his patients’ histories in full sentences, with well-developed paragraphs and telling details taken from his personal observations. This would become a hallmark of his work: to appreciate the actual
stories
of his patients, and to use that understanding as the key to diagnosing and treating them.

More controversially, Kanner became increasingly impatient with medical procedures that seemed to have no rationale other than habit. One Christmas Eve, Kanner ordered that most of the restrained patients be released from their straitjackets for the evening. The floor supervisor objected strenuously and took the matter to the hospital director, but Kanner prevailed—by volunteering to spend Christmas in the ward personally. It worked out—there were no incidents—except that his wife had to spend the day without him. By the time the holiday was over, it was clear that the straitjackets were unnecessary. The patients remained unrestrained from then on.

In 1928, Kanner, ever ambitious, met and impressed Adolf Meyer,
the head of psychiatry at Johns Hopkins, which led to Kanner’s landing a fellowship there. Two years after arriving in Baltimore, Kanner was tasked with establishing the university’s first clinical department of child psychiatry.

In short order, he became the field’s most prominent figure. This was not least due to Kanner’s penchant for seeking the spotlight. He wrote often for the popular press, where he positioned himself as a demystifier of the art and science of childrearing and as a defender of the weak and vulnerable—clearly relishing, and even cultivating, the recognition that came with that role.
He also worked for years on an autobiography in which he related, in minute detail, his striver’s story of a small-town boy who wanted to be a poet, making good instead as a man of medicine on the world stage. While he looked in vain for a publisher, the manuscript went through several rewrites. But it remained a portrait of a progressive doctor fighting with skill, wit, and humility against entrenched forces that sought to crush the human spirit.

In fact, his self-portrait was not entirely unjustified. When Jewish psychiatrists and other medical professionals were fleeing the Nazis in Germany and Austria, he personally intervened in scores of cases to ensure that the refugees were granted permission to enter the United States, and then he helped them find jobs so they could support themselves and start over again. Taking into account the families of those he aided, Kanner can be credited with saving hundreds of lives.

More publicly,
Kanner blew the whistle in 1937 on a racket run out of the Baltimore Home for the Feebleminded. While working on a study of outcomes for released patients, he and a social worker named Mabel Kraus learned that ten to twenty years earlier, close to a hundred teenage girls had ended up in what he described as slavery. The scheme was engineered by a corrupt judge and a lawyer working on behalf of dozens of wealthy Baltimore families. For a fee—which the two men split—the judge authorized the release of the girls to specific families who claimed to be giving the girls homes. Instead, they put them to work as servants, scrubbing their toilets and in some cases, Kanner hinted, sexually servicing males in the family. Many of the young women ended up on the street, in prostitution. By the time
Kanner found out about this, the judge enabling this abuse had long since retired. But Kanner went public with the details anyway, in a speech to the American Psychiatric Association. After that he told the story to newspaper reporters.

The man who had released mental patients from their straitjackets also held relatively progressive views—for his day—on race. In 1938, he told a young doctor who wrote asking for
“a comparison of the Negro child’s mental abilities with that of the white race” that no difference existed.
“The fact that a child comes into the world as a Negro does in no way serve as a barometer for his intellectual potentialities,” Kanner wrote back. At the time virtually all mental hospitals were still segregated by race.

Yet for all his manifest high-mindedness, Kanner was no radical. Having worked so hard to reach the upper ranks of American society, he never took a stance that truly ruffled feathers or risked alienation from that society. Instead, he hedged. While exposing the scandal of the servant girls, for example, he rued the fact that the women were having children, who were likewise mentally disabled, and he refused to name the wrongdoers publicly. And his letter to the doctor about racial differences was private. In public, he never questioned the racial segregation that prevailed in the wards of Johns Hopkins into the 1950s. Similarly, although he spoke out against euthanasia for the disabled, and opposed the forced sterilization of those with low IQs, he described sterilization as
“a desirable procedure” when parents were too intellectually impaired to care for their children safely, in which case the obligation for care would fall to society. Thus, Kanner, who clearly aspired to land on the right side of history, was still in many ways captive to the views of his day.

This then was the man Beamon and Mary turned to in 1938 to get help for their son. But before meeting the boy, the doctor who liked stories asked to know a bit more about him. So in the late summer of 1938, Beamon set out to write for America’s greatest child psychiatrist the complete story of Donald.

—

B
EAMON
T
RIPLETT
didn’t type. For that, he needed Katherine Robertson, who commanded the outer room of his one-man law practice. Hardly a word went out above Beamon’s signature that did not go through Katherine. Beamon would dictate in his mild Mississippi drawl while she
filled her notepad with shorthand. Then, she typed.

Kanner would later remark on the sheer amount of detail Beamon packed into the letter, which struck him, frankly, as the output of an obsessive man. Perhaps so, for Beamon did come with a few personality wrinkles of his own. There was his tendency to tune out the world when he went for walks, to the point where he couldn’t remember afterward where he’d been or whom he’d seen along the way. While at Yale Law School, he had cracked under the pressure and taken to his bed with what he regarded as a nervous breakdown. A doctor he consulted diagnosed an irrational fear of teachers.

But that had been years ago. Beamon was successful now, a sharp lawyer, a man with first-rate observational skills who had every reason to want to get this letter absolutely right. And he was determined to compose a full biography of this four-year-old child trapped in the Preventorium, a place that made no sense for him. In time, Beamon’s words would travel far and wide. They would be quoted in scholarly research; discussed in university classrooms; translated into multiple languages; excavated, late at night, by frantic parents scouring the Internet. But that humid day in Forest, it was just one father speaking, and it was Katherine Robertson alone who heard this story, for the first time, and got it down.

“He never seems glad,” Beamon dictated, “to see father or mother. He seems almost to draw into his shell, and live within himself.” In minute detail, he described Donald’s eating habits, his verbal patterns, the clarity of his enunciation, the ages at which he learned to walk and count and hum and sing. And so it poured forth, what would become the seminal account of a child with autism, a term and diagnosis that did not yet exist.

The Donald that Beamon described was unreachable by any of the usual ways parents connect to their children: “He seldom comes when called but has to be picked up and carried or led wherever he ought to go.” Yet, at the same time, the toddler Donald tantalized his parents
with hints of a sharp intelligence. His focus on the activities that captivated him could not have been more intense. “He seems always to be thinking,” Beamon observed, “thinking and thinking.”

Beamon listed the things Donald had committed to memory at the age of two: the words of many songs and the melodies that went with them; the names of all of the presidents of the United States; and “most of the pictures of his ancestors and kinfolk on both sides of the house.” Yet Donald could do little with these facts beyond reciting them. Conversation was impossible, Beamon said, as “he was not learning to ask questions or to answer questions.”

He appeared indifferent to the company of other children, and in one episode Beamon recounted, he positively shunned them. One day, in what was meant as a pleasant surprise, a playground slide was delivered to the Triplett backyard. Donald seemed not to grasp its function, but a small crowd of neighborhood children did. As they clambered all over it, Donald held back, resisting furiously when his father picked him up and sat him at the top to show him how it worked. “When we put him up to slide down, he seemed horror-struck,” he recounted.

It was different, though, when no one else was there. The next morning, he walked out, climbed the ladder, and slid down. He knew, after all, exactly how it worked. Beamon reported that Donald continued to slide on it frequently, but only when no other children were present.

Beamon also shared his own botched effort to foist a friendship upon Donald. In 1936, the year Donald turned three, he approached the Baptist Children’s Home, an orphanage in Jackson, and explained to the people in charge his wish to find a companion for Donald—a boy of the same age who would be a full-time playmate. He made it clear that he did not intend to adopt the child. Nevertheless, this highly unusual arrangement was agreed to. A three-year-old named Jimmy was led outside to where the Triplett family car was waiting.

When the boy arrived at the house, Donald would not even look at him. That did not change, no matter how Mary tried to get the two of them to play together. After some weeks, the
experiment was deemed a failure, and Beamon arranged for Jimmy’s return to the Baptist home.

This was the essence of Donald, as Beamon described him.
Aloneness was his preferred state of being, one he protected with “a mental barrier between his inner consciousness and the outside world.” Only behind that barrier, Beamon observed, in that world of his own, did his son appear content. Donald was fully capable of joy and laughter, and there were days when he seemed “constantly happy.” But it was never prompted by the company of others, never by virtue of sharing a joke. It was, inevitably, only when he was “busy entertaining himself.”

By the time Katherine finished typing it up, the entire thing ran to thirty-three single-spaced pages. Beamon folded it up and sent the letter off. Soon after that, a date was set: Donald would go to Baltimore to meet Dr. Leo Kanner in person the second week of October 1938.

—

F
OR THE LAST
time, Mary and Beamon drove out to the Preventorium. They had resolved that, after they took Donald to Baltimore, they would not bring him back.

Donald had been there for more than a year by then. He was still the strangest boy in the building, as incomprehensible to those around him as ever. No longer the locked, motionless presence he had been at the beginning, he had developed a new habit of swinging his whole head side to side without letup. And he was once again interested in playing with objects in his unique ways, spinning and stacking and counting them. Yet he still didn’t play or speak with the other children, and not because they had shut him out. In terms of connecting to others, his progress had been none to negative.

Still, when Mary and Beamon announced their intention to take Donald home for good, they were met with strenuous argument. The director admonished them to
“let him alone.” He was “getting along nicely” now, hardly any trouble at all anymore. Taking him home would be a terrible mistake.

This much was true: in his white bloomers and top, Donald had grown accustomed to the routines and the discipline of the place. He had adapted. But “getting along nicely” did not mean the same thing to the director as it did to Mary and Beamon. The director was telling them, in essence, that Donald was no longer disruptive to the system.
He was eating, for example, but there was nothing to be said about Donald outgrowing his aloneness.

This fruitless experiment in separation—it was enough now. Mary took Donald aside and dressed him in clothes she had brought from home. In the outer office, Beamon signed the papers and squared their account, ignoring the staff’s disapproving looks. All he requested was a write-up of Donald’s progress over the previous year, so that he could share it with Kanner. Not terribly motivated, apparently, the director came up with a scant half page of terse notes, in which he offered the opinion that Donald’s problem was some sort of “
glandular disease.”

Then, having gathered up Donald’s few belongings, all three Tripletts went out, for the last time, between those massive front pillars. Donald would be turning five in a few weeks, on September 8, 1938. The family would celebrate at home.

—

J
UST OVER A MONTH
after Donald’s fifth birthday, he and his parents traveled to Baltimore by train—a journey of nearly two days, across seven states, including a stop to switch lines in Birmingham, Alabama. For Donald, the journey would have been one of those bewildering, or perhaps mesmerizing, explosions of new sensory experiences. Especially the overnight stretch of it, when from his bed, up against the high, wide windows of the Pullman, he could stare out into the night, watching the lights of the sleeping South slinging past through the blackness outside, with a rhythm that echoed the sounds of the rocking train, a gentle song of repetition that his mind would be drawn to.