“Six years ago, your symptoms would have gone unnoticed.  They were easily written off as reactions to the trauma of your near-death experience.  Outwardly, as a respectful, intelligent young man, few people would find reason for concern with your behaviour,” Dr. Moss began.

            “However, you were a memorable case, and I often found myself going back over your file from time to time.  Such a bright young man, so mature for your age.  Abnormally so.  An extensive reader, often reading far beyond your age level.  I remembered how you felt isolated from your peers because of that.”

            “So?”

            “Ah, yes, the point.  You always want to know the point.  Never just able to make chit-chat.  I remembered that, too.  I was at a conference a year or two ago, and one of the presentations stayed with me.  I compared it with your file.  A pattern emerged.”

            “A pattern,” I repeated again. 

            “Yes.” Dr. Moss smiled.  “You always liked patterns.  You said they helped you understand things, if you could grasp a pattern you could predict what was to happen next.  They comforted you.”

            “I suppose.  I like knowing what’s expected.”

            “Like greetings and responses.  You like knowing the right way to behave.”

            “Yes.  Of course.”

            Dr. Moss smiled, but it looked a little sad. 

            “Dear boy, have you ever heard of Asperger’s Syndrome?  It was barely a blip on the radar in 1994, but has recently been given more attention in psychological circles.”

            “No, what is it?”

            “The simplest explanation is to call it ‘high-functioning autism,’ but that’s not entirely accurate, nor helpful.  Every autistic is an experiment, a unique case with their own patterns and interests.  However, they exist in worlds of their own, uninterested in other people.”

            “And people with Asperger’s, how are they different?”

            “People with ‘AS,’ as they call it, are interested in socializing.  However, they lack the necessary empathy and skills to navigate the social world appropriately.  Conversations are often one-sided, and focused on the individual’s interests.  Those interests border on the obsessive.  Others, whether friends or family, are usually seen as people to talk ‘to’ instead of ‘with.’  They serve roles to meet the individual’s needs, instead of an equitable, reciprocal relationship.”

            I wrinkled my forehead, trying to make sense of what he was saying.

            “People with ‘AS,’ they want to talk to others, but it’s egocentric?  They don’t realize the other person has needs, too?” I tried to summarize.

            “Sometimes.  They often care deeply about those around them.  But their empathy is certainly lacking.  They don’t possess the same instincts for socialization.  They won’t always understand relationships, flirting, or deception.  Change can be overwhelming, routine is safe and comforting.”

            I gripped my hands.  Opened and closed them.  This sounded familiar.  This sounded like my life.

            “People with AS are alone in a crowded room, wondering how they can communicate with the people they see.  With their social confusion, they feel out of place, aliens from another planet.  They struggle to find the right way to reach out,” Dr. Moss tried to explain.  “But they never really see the others as others.  They see them as the roles they fulfill.  Thus, a kind old man becomes just a doctor who solves problems, and not someone to have a chat over cocoa with.”

            “I never meant to offend…” I started to say.

            “You didn’t.  Because I understand.  But many of your friends, perhaps they don’t.  I recall a young girl, who visited you in the hospital.”

            “You mean Hope?”

            “Yes.  What kind of friendship did you have?  How did you feel about her?”

            “I don’t know.  I felt grateful that someone cared enough to visit me in the hospital, I didn’t think I was that important.  I tried to repay her kindness throughout high school by giving her my attention as much as possible.  She was nice to me, so I tried to be nice to her.”

            “In all fairness?”

            “Yes, I like being fair.  But I got out of control, after awhile.  I thought too much about her, followed her around.  It was like I couldn’t stop thinking of how to show her she mattered.”

            “Did you have romantic inclinations?”

            I shrugged.  “I thought so at the time, but I didn’t really feel anything.  It started as a way to value her the way she seemed to value me, and then it just became like an obsessive thought pattern.  I was like a hamster, spinning in a wheel.  But I never actually felt emotionally connected or attracted, no.”

“That is consistent with the AS.  Your sense of fair play and your need for rules combined with the tendency towards obsessive thoughts caused a cycle.  You were perseverating, and lost control for a while.  It sounds like you didn’t appreciate Hope for her own qualities, but rather responded to the role she played in your life.  If it is indeed Asperger’s syndrome, your feelings of isolation could stem from that.  Your depression is likely a result of you perseverating on your circumstances so much that you make yourself miserable.  I suggest you take this file I made, read up on it.  See what you think.”

            “What do I do?”  I felt my insides churning.

            “You will struggle with it all your life.  But you will find ways to manage, and to connect.  It just takes really listening to others, and finding ways to share yourself.  Go make some friends, get involved.  You’ll find your way.”

            “I hope so.” 

            The alternative was to be alone forever.

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