Tuesday, April 2, 2013

World Autism Awareness Day

There are many people who played a role in my career choice many years ago, and I regularly think about the fact that I am so lucky to have found a profession that is fulfilling, challenging, and rewarding on a daily basis.

Once I decided on and then entered the Occupational Therapy program at Washington University in St. Louis, Missouri, though, there were still several different career paths within the field of O.T. that I could choose, based on various demographics of the patients with whom I would be working in the future - from very young to very old, by diagnostic grouping like "hand therapy" or "neuro rehab," and/or in different treatment settings such as an inpatient hospital or a school system.  In fact, the diversity of the options within my chosen field was one of the main things that drew me into Occupational Therapy initially.

During my final year as an O.T. student, I landed a part-time job working for my favorite professor, the woman who taught the pediatric-focused courses in our program.  Some of the work I did was data input, mainly typing the treatment notes that she had recorded on a mini-tape recorder and entering appointments into her schedule on a brand-new Mac Classic computer that seemed so high-tech and cool to me at the time.  I liked that work; it allowed me to learn a lot about computers and my teacher's clinical practice from the sidelines.  A second part of my job was to go to the medical library and research topics about which my instructor needed more information; through this, I learned to love research and to how to be organized in my approach to finding out what scientific studies and data said about a particular subject.

There was one more part of my job, though, and it was the part that I thought was the best: going with my instructor to clinical visits.  I primarily served as a hauler/transporter/equipment cleaner at the treatment sites, but, rather than feeling like a grunt who was limited to schlepping and scrubbing, I felt like I was a sponge, soaking up knowledge and inspiration from all around me.  Two of the children in particular who were being treated by my teacher that year ended up influencing my decision to set a goal of practicing in the field of pediatrics as an O.T.; after getting to know each of them, I was certain that my future was in working with the younger population.  

One of these kids was a boy named Johnny who had cerebral palsy that affected all four of his limbs, his trunk, and his speech.  A couple of month after I'd met him, my instructor had me sit with him while she left the room to take a phone call.  I had to focus and listen closely to make out what he was saying as he chatted away about his love of the Cardinals, St. Louis's major league baseball team.  After a couple of minutes of that, he abruptly changed the subject by asking, "What does it mean to be handicapped?"  His question took me off-guard; I spent several seconds trying to think of the best way to respond.  He beat me to the punch, though, blurting out the answer to his own question before I could say anything: "Oh, I know: it means you have to work harder to do things,"  and then he went back to talking about baseball.  I thought his answer was perfect, and I knew at the time that I would never forget this exceptional child or his profound words.

The second child was a girl named Casey who was at a different facility than Johnny.  Casey was a six year-old girl who had been diagnosed with autism.  She was verbal but had many social and other challenges that affected her ability to interact with the world in what is considered to be a "typical" manner.  Casey wasn't as touchy-feely as Johnny was; in fact, she didn't like to be touched at all, but I still found her to be very lovable and sweet.  She had some "quirks" - some habits and patterns of behavior that I found to be both interesting and endearing during the year that I knew her; one of these idiosyncrasies was that she coped with stress by pretending that she was interacting with a cat that she kept in her pocket.  Cleverly, I thought, she used this as a way to divert attention to something other than herself whenever she felt like she was being put on the spot; instead of answering a question or completing a task that she didn't feel like doing, she often emulated taking the cat out of her pocket and petting and talking to it.  

I was fascinated by this tactic; I thought the fact that she had devised such a creative strategy for gerrymandering was brilliant in many ways.  Some of the people who worked with Casey scolded her for talking about or to her pretend cat; I, in my squeaky-clean lab coat and with my very limited knowledge base and experience in the clinical world, tried to find out more about her and her world by playing with her and by asking her about the imaginary creature.  In turn, she often made better eye contact with me, and she talked and talked about things that were on her mind, all while pantomiming holding and/or petting the make-believe cat.  

Not long after my job working with Casey ended, I decided to get a kitten, and, as I looked through the want ads in the newspaper, I knew already that I wanted to name this cat Casey, after the child that first drew me into the world of autism, a condition about which I was sure I wanted to learn much, much more.  I ended up getting a male cat instead of the female I had envisioned, but I still went with the name Casey for the first pet I had as an adult, the cat that was with me as I graduated from college, found my first job, moved into my first apartment, met and later married my now-husband, and had both of my children.  

Like Johnny and his words of wisdom, I will never forget the girl named Casey, the child who drew me into one of the main fields of interest in my profession.  Today, on World Autism Awareness Day, and on many other days, I will think of her and the cat in her pocket and hope that she is somewhere doing something she enjoys.

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