“My Paradox” by Maisie Irvine
The morning sun is rearing it’s head,
Above the tall Victorian townhouses,
That shield my bedroom window.
The rays dazzle and glow;
The sun dance initiating my morning rituals.
It’s early winter,
The sun hangs lazily beneath my sun visor;
Its rays ricochetting from the glazed tarmac
Intruding my vessel.
Rolling into the surgery’s car park,
My eyes become darting spotlights;
Scanning every row for a desolate box
Rather I see:
The wind assaulting the trees and the humidity in the air and the displacement of gravel and the chiffchaff foraging for insects.
And the lights are so bright,
As I brace the GP waiting room.
And the callous, illuminating panels
Wrap me in their light,
Their embrace unwelcome, I wince
As I advance through that perturbing door
Into the staff room.
The door to my mind
Beholds every detail in the same magnitude
Though I’ve been here plentiful times
Perceiving foreground equal to background –
But processing neither.
Delayed by the friendly chorus of morning greetings.
Your chorus is cacophonous
It clashes with the rainbow prism
Spilling from the fluorescent lights like oil
I wonder – how do you feel in harmony?
I wonder – when God said: ‘let there be light’
Did he mean for it to cause suffering?
My first patient, and I’m joined by my tutor.
Making two of us, evaluating my performance,
For I am my own judge, jury and executioner;
Surveillance myself, in the watchtower of my own mind.
My risorius aches from masking my facial expressions
The room starts to distort like a kaleidoscope
Wait – did the patient just mention a recent bereavement?
Uncross legs,
Swivel chair away from the desk,
Slightly lean forward,
Pinch eyebrows,
Top marks.
The patient leaves
And I stand to attention
For my feedback
What you say I don’t hear
As your surroundings fade into a brilliant halo
But I still see you
My sentience floats above my corporeal shell
A thick fog
Do you see me?
I go home
I shield my eyes from brake lights and red lights
I go home
I draw my curtains
I turn off my lights
I shut my eyes
I finally find respite in somnolence.
The morning sun
Is rearing its head
Can I stay home?
Reflection
With my creative enquiry I set out to challenge the misconceptions, stereotypes and knowledge gaps about autistic people in the medical community – from my own perspective as an autistic medical student.
By sharing my experiences, I hope to challenge the societal barriers that lead to both health inequalities for autistic patients as well as workplace inequalities for autistic doctors/staff. Here I will note that an estimated 1% of GPs in the UK are autistic, according to the British Journal of General Practice. I also hope that reading my creative enquiry will encourage clinicians to rethink their attitudes towards autism, hence promoting inclusiveness in their practices – both at a patient-doctor level and at a colleague level.
The first stereotype I have challenged is that: ‘people with autistic-spectrum disorder experience difficulties in comprehension of figurative language’ – by choosing to create my creative enquiry in written format. I think this is important to address, as I believe some doctors only recognise autism when it presents in the low-functioning (or low-masking) end of the spectrum. When, on the contrary, people with high-masking autism may communicate at a very proficient level – so much so that their difficulties are completely ‘invisible’ to the same professionals, simply due to this stereotype. For example, in my first year OSCE I can proudly say that I scored full marks for my consultation skills station. I believe this leads to the needs of many autistic colleagues being overlooked.
These challenges are present in my experiences as a patient as well. When I first consulted with my GP that I thought I had autism, he refused to make a referral for me. As a result, I was not formally diagnosed as being autistic until I was at the end of my first year at medical school.
I still feel marginalised by the attitudes of my peers in the medical field. This includes a medical student using autistic as an insult (I.E ‘that’s so autistic’) and a nurse suggesting a porter that she thought was ‘autistic’ was privileged to have his role as ‘that’s probably the best job he’ll ever get’ and that she supposed that the ‘NHS is probably more accepting of these people than other sectors’. The worst part of these situations was that I did not feel empowered to advocate for the autistic community in front of these people because I was too scared to ‘break my mask’!
I have structured my prose-poem very intentionally. It specifically focuses on visual hypersensitivity. My stanzas and use of language become significantly less sophisticated towards the end, as this mirrors my own verbal shutdown as a direct consequence of overstimulation. Where you notice a lack of punctuation, this reflects the speed at which I am processing information.
I firmly believe that until we truly embrace autism in all its forms, first and foremost within our own community, we will not be able to challenge the inequalities patients face. Changing the attitudes of medical staff and promoting the inclusivity of autistic medical staff is absolutely essential for mine, and thousands of other autistic doctor’s, careers.