That was the hidden disability of autism in me, even though I didn’t know it at the time. The result: I quit the music business thinking I was a failure, because I couldn’t tell how people felt about me and my creations. There had been a sense of kinship living with the musicians in my first band. That vanished when I started to work with the bigger, more glamorous groups. When I was on tour, I was either working or alone in my room. When I wasn’t touring, I was by myself in my lab designing and building gear. The community of musicians and artists that had welcomed me as a teenager seemed to have left me behind in my twenties.
So I took a corporate job for a while, engineering electronic toys and games for Milton Bradley, and then later I worked as a consultant for government contractors and running the power systems engineering group for a laser manufacturer. The technical work was fun, but the interpersonal parts of the jobs were not. People told me I said unexpected and disturbing things, and my words got me into trouble more than once. “Good engineer” was how I wanted to be described, but “jerk” was the more common appellation, even as my circuit designs were superstars. My bosses told me I was quick to dismiss incompetence in others and was not much of a team player. As I advanced in the corporate world, it was increasingly evident that the people who made it to the top were the total opposite of me. People skills got you to the pinnacle, and it seemed like emotional cunning helped keep you there. The ability to say one thing and feel another was a good trait for a manager, as was the ability to dissemble smoothly on demand. Neither of those things was me.
After two layoffs and more than one threat of dismissal I decided to quit on my own terms. I left electronics and went back to cars. They certainly felt safer; I could work for myself and there wasn’t anyone to fire me. There weren’t any office politics to navigate either—just me and my four-wheeled friends. I had to answer to my customers, of course, but if one got mad and left, the others would remain. That seemed a lot less risky than having one boss I could never figure out.
I started fixing old Mercedes and Land Rovers in my driveway, and the business grew and prospered enough for me to move it to Springfield, to a bigger commercial garage. The flow of work increased, and I hired mechanics to assist me. Suddenly, I was the boss!
Just before turning twenty-five, I’d married my high school sweetheart, Mary Lee Trompke. I called her Little Bear because she was short, belligerent, and my best and sometimes only friend. We fought quite a bit, but we had a deep bond from our shared dysfunctional childhoods, and at least initially that was enough to sustain us through the bad times. A few years later we had a son, named Jack in honour of my grandfather, but to me he was always Bear Cub or just Cubby.
There was nothing better than watching our little boy grow and thrive, and I told everyone how much better he was than me. That was true, except on the playground or in school. Seeing my son commit one sandbox gaffe after another—and alienate the tykes around him—brought back painful memories of my own childhood. I did my best to coach him, using my own experience as a guide. It seemed to work, because he started making friends in grade school—something I never really mastered.
Schoolwork was another matter. Cubby struggled mightily to read and master his assignments. His mom and I tried to help, but we didn’t get too far. It was clear that there was a problem, but we had no idea what it was.
That was where things stood when I learned about my own Asperger’s and its place on the autism spectrum from a therapist who also had become a client of my car business. “It’s a new thing they’re talking about in the mental health world, and you could be the poster boy for it.” He left me with a book—Asperger’s Syndrome, by Tony Attwood, an Australian psychologist. Once I got over the shock of his announcement, I started reading. Ten pages in, I knew in my heart he was right. Whatever this Asperger thing was, I had it.
Looking at my son, I saw the same signs in him. But I still believed he was better than I was, and in the first flush of awareness, I felt sure Asperger’s was not a good thing for him to have. He’s not like me in that way, I insisted to myself, even though I knew deep down that he was. A decade would pass before he got his official diagnosis, but the differences in him were there all along. Just as they were in me.
I occasionally encounter people today who tell me they wouldn’t be able to face an autism diagnosis in their child. Their words take me back to the days when I learned about my own diagnosis but denied the obvious about my son. Today I say my diagnosis was a huge relief and a source of empowerment, but it took me a while to come to that realization.
I kept reading and schooled myself in the history of Asperger’s and autism. Some doctors actually called my condition the “Little Professor syndrome,” because kids with Asperger’s can speak with great precision and detail about the things that interest them, often becoming fascinated to the point of obsession. Reading those words I was struck by how accurately they described me, and I didn’t know what to feel.
Should I be happy? Should I be sad? Should I be relieved? I felt all those things and more. Learning about autism and Asperger’s was a huge deal for me, because it gave me a legitimate explanation for why I was different. Hearing that I was different and not defective was certainly inspiring, though it took years to fully sink in. Reading about how folks with Asperger’s typically act helped me to see some of my own behaviours in a new light. With that insight it became clear why some people reacted negatively to things I said or did.
Having a neurological explanation does not change the fact that I often acted like a jerk. That’s one of the problems with growing more self-aware—you have a lot more moments where you think back on things you said and did and cringe in shame.
By the early 1990s I was spending all my time in Springfield, trying to make my car business a success. But the ups and downs of commerce at times shook my business, and my confidence. Repairing cars had seemed simple, and I was pretty good at it, but mechanical skill alone wasn’t enough. A successful auto service company was as much about fixing the motorists as their vehicles, and that was something I was slow to understand. Meanwhile, Little Bear was increasingly immersed in a world of science fiction and graduate school. At night I’d find her reading fantasy and sci-fi till the wee hours, and her days were filled with the study of Central American culture as she pursued a doctorate in anthropology. It began to seem that we had very little in common outside of our son, and we ended up getting divorced as Cubby entered third grade. Miserable as my marriage had been at the end, its failure shook me something terrible. Getting married had seemed like a big step toward being a normal adult. Having that unravel made me feel like a total misfit and failure. Whenever I started to feel good, it seemed that something would happen to knock me back.
Dr. Attwood’s book about Asperger’s sustained me through all of that. Reading it backward and forward till the pages fell out, I resolved to make myself “normal.” As an autistic person, there were a lot of things I missed—like the nonverbal signals other people sent one another. Learning what I was missing from a book didn’t help me receive the signals, but knowing that they were there was enough to change my behaviour, and I taught myself to emulate the social behaviours that others seemed to pick up instinctively. My gradual successes made me feel better about myself, but my growing confidence was always tempered by a trace of sadness, because now I knew: this is how I am and my behaviour is immutable. I might learn to act more appropriately and fit in better, but I would always be different and socially, well, dumb as a rock.
It took a few years, but things finally started looking up again. I’d gotten a new girlfriend and we began spending more and more time together. Martha was the opposite of my first wife—quiet where Little Bear had been loud, neat where she had been messy. She had also grown up essentially self-employed, working in her father’s business. Now she lent a welcome hand, building a presence for Robison Service on the newly ubiquitous Internet. Luckily she and my son got along, and life settled into a
new routine as we moved in together. Cubby split his time between our place and his mom’s.
In 2003 Martha and I got married, and we built a new home in Amherst so Cubby could attend the same local high school that I’d attended. “It’s one of the top-rated schools in the state,” people told me. Somehow I put aside my own memory of their tossing me out of ninth grade thirty years before. Cubby is better than me, I repeated, and he’s going to succeed where I failed.
Meanwhile, the business prospered. I’d picked up enough interpersonal skills to keep some customers coming back, and the company grew steadily. At the same time, thanks to the tips in Dr. Attwood’s book, I began making more friends. I wasn’t the life of the party by any means, but the changes I’d made in my behaviour—responding to people, saying the right things, acting the way others expected—made me a thousand times more popular than I’d been as a kid. I attributed much of the good that happened to my new self-knowledge and what I did with it. So much that had been mysterious finally made sense. Now people seemed to assume I was just eccentric, whereas before they’d thought I seemed crazy, or worse.
I felt like it was time to give something back, and I began visiting places like Brightside, a group home for kids who’d been taken out of bad or dangerous family situations. Speaking to teenagers who were “different” seemed useful for them and felt fulfilling for me. Everywhere I went, I got the same message. People want hope. They want to see people who come from bad—however that’s defined—and end up making good. I realized my story might well be useful to young people who were like me and trying to find their way but not knowing how. That was what made me decide to write a book, and that changed everything.
Learning about autism, and then sharing my own story with the world, had been an important step in my life. Perhaps this TMS adventure was going to be the next one.
Medical Magnets
“IMAGINE YOUR BRAIN as an electrical organ. We propose to rebalance it by adding tiny amounts of electricity.” That was what Dr. Pascual-Leone said to me across the dinner table the first time we met. Lindsay had suggested getting together when she’d introduced herself at Elms College a few weeks before, and they had agreed to join me at my favourite Boston area restaurant.
Alvaro was about my age, medium-sized, and was dressed in a tweed sport coat like a college professor. Which, actually, he was, in addition to being a practising neurologist and a research neuroscientist.
My friend Richard had cautioned me about neuroscientists. “They’re the most cold and inhuman of doctors,” he warned. “All they want is to experiment on your mind, and they won’t care what happens to you later.” I’d raised my eyebrows a bit at that warning. Unspoken messages—like I’m bored, or I’m excited, or Let’s get out of here—go right over my head, yet in spite of my social oblivion I’ve always had a decent sense of self-preservation. My ability to sense danger and recognize dangerous people has always been very good indeed, and nothing in this situation had set off my radar. It made me wonder whether Richard’s opinion was based on real life or old horror movies.
Alvaro had struck me as warm and friendly from the moment we met. He told me about having a relative whose autism was more disabling than my own, and even with my limited ability to read people, it was clear that he was a caring man with a personal stake in the research he was doing. I trusted him right away.
Alvaro had come to Harvard from Spain and he was certainly an expert in his field, with both MD and PhD degrees and twenty years of experience at some of the top university hospitals in the world. I would have thought that a guy of his stature would be a bit standoffish and would want to be addressed formally as Dr. Pascual-Leone, but he was friendly and approachable from the moment we met. He’d even agreed to come to Legal Sea Foods! (Or maybe he simply liked boiled crustaceans as much as I did.) Despite his impressive credentials he was just Alvaro to me, just as Dr. Oberman was simply Lindsay. They took turns answering my questions, with Alvaro taking the lead. He spoke articulately and with a bit of an accent, enough to make me listen closely.
Between mouthfuls of swordfish and shrimp, he described TMS and how it worked, how he’d gotten involved with it, and how it might affect my blindness to other people’s unspoken emotional cues.
The brain is an electrical matrix, he explained, with each brain cell or neuron connected to countless other neurons through a maze of microscopic cables and junctions. Someone familiar with electronics might equate the circuit board traces and gates in a computer with the axons, dendrites, and synapses of the brain. But the circuitry of the brain is infinitely more complex. The biggest electronic chips we can make have just a few million transistors on board, whereas a human brain contains about 86 billion neurons, each with hundreds or even thousands of connections. Counting all those connections would be like counting stars in the sky . . . they just go on forever.
To get a sense of that scale, consider one of the smallest things you can see—a grain of salt. A typical grain is about four thousandths of an inch in diameter. Two hundred and fifty of them, lined up on the edge of a ruler, would only stretch an inch. The average neuron is one-tenth that size, which means your brain packs at least a million into one single square inch. Stacked in three dimensions, one cubic inch of brain may hold a billion neurons—each capable of thought at some level. And that third dimension is what sets human brains apart from computers. Computer chips are essentially two-dimensional devices in three-dimensional packages. Most of the space inside a computer is empty air. The space inside your head, however, is filled with brain cells in numbers that defy comprehension.
Axons and dendrites are the electrically conductive threads that connect the neurons together, joined at points called synapses. This living wiring inside our brains carries thoughts from one area to another. Even as they do that, the biological wires in our brains can also pick up outside electrical energy through the process of electromagnetic induction. You might remember induction from science class, where the teacher waved a magnet next to a coil of wire, and the motion of the magnet induced enough energy in the wire to move it a metre as the class watched. Our brains have thousands of miles of microscopic wire strung between their neurons, all with the potential to receive electromagnetic radiation.
“By pulsing a powerful electromagnet next to your head, we can do the same thing inside your brain,” Alvaro explained. “We can induce tiny electrical currents in those microscopic threads. Depending on their polarity and pattern, the currents we induce could enhance or inhibit the function of neurons we affect. The more tightly we focus the magnetic field, the more concentrated the effect.”
His explanation made me remember that I had heard of TMS before, in a 2003 New York Times story called “Savant for a Day.” In the piece, writer Lawrence Osborne described becoming a better artist after experiencing TMS at Dr. Allan Snyder’s lab in Sydney, Australia. He walked into the lab with nothing more than the ability to draw primitive stick figure cats, and after a short session of TMS he was rendering the creatures like a virtuoso. He’d written, “Somehow over the course of a very few minutes, and with no additional instruction, I had gone from an incompetent draftsman to a very impressive artist of the feline form.”
And then his talent had faded away, leaving him as he’d been before. Who wouldn’t want to try something like that? A few other writers have since described their own experiences with TMS—how it can alter speech, sight, creativity, and even mood—but I hadn’t read any of those accounts at the time. The idea that it could turn a newspaper reporter into an amazingly talented artist for a few hours was very impressive, but what might it mean for someone like me? Osborne’s experience sounded like a medical parlour trick, and not exactly life changing. Could TMS actually remediate autistic disability, as Lindsay and Alvaro were suggesting? And if so, would it last?
Alvaro explained that each area of the brain does something different, and any part of the outer surface can be targeted with focused TMS. Stimulation of the v
isual cortex at the back of the head might make me see stars, while stimulation of areas in the front of the brain could remediate depression. He said the study they were inviting me to join would focus on five small areas in the frontal lobe, any of which could affect emotion or language. “We think those areas may work differently in people with autism,” he said. When I asked for more details about the target areas, Alvaro said that I would have to wait until the study was complete.
The frontal lobe is involved in many functions, like speech, reasoning, decision making, and many of our deeper thought processes. “Stimulations just an inch apart can have very different effects,” he explained. “The impact of TMS can be complex because the stimulation of one area can spill over into other interconnected regions, and the results may be hard to predict.” Alvaro said that our brains are interconnected from side to side, so a stimulation that “turns up” an area on the left side may “turn down” the corresponding area on the right. Or at least that’s what he and the other researchers predicted. And TMS could stimulate areas as small as 1 percent of total brain mass. “There’s no other technique that can do that today,” Alvaro told me.
It was time to get right to the point.
“So how do you propose to use this technology to help autistic people like me?”
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