Written by Dr Sarah @autisticdoc
I filed that sentence away for later review. Receiving my Autism diagnosis at the age of 38 was transformative. I felt like I’d been knighted. I joined online groups for Autistic people, with a sense that I really belonged.
I should add that I fully recognise that obtaining a formal diagnosis is fraught with barriers – high costs, long waiting lists, lack of awareness of diverse Autism presentations among medical professionals – but as a doctor myself, I had a wealth of knowledge about navigating the health system, and the financial resources to make it happen. Until the system removes those barriers, autistic self-identification is the only option for many.
My diagnosis validated so many of the things I find difficult in my job. During my morning hospital ward rounds, the noise overload is overwhelming – people talking, monitors beeping, phones ringing, pagers bleeping, elevators dinging, trolleys rattling, the hum of electric beds …
So many times I wish I could run and hide away from it, but the job demands my presence. The job also demands a caring, professional demeanour, which I’ve had to practise and learn to uphold even when I’m uncomfortable. This is masking.
For me, phone calls are the worst, as I try to tune into the sound of one voice, out of numerous possible sounds in the air, to get the information I need. When you’re a doctor, an information error can be really high-stakes. A minute or two on the phone and I feel like my brain has run a marathon.
What if my patients find out? My employer? Would I be discriminated against? Can my doctor colleagues tell how different I am? Feelings of fear and isolation would intrude on me at work, and I decided I’d keep the news of my diagnosis out of my professional life for now. It felt a bit lonely at times.
A year later, I came across an article in the British Medical Association News, “Recognising Human Variation”. Dr Mary Doherty, an Autistic anaesthetist, wrote of her Autism and an online peer support group that she’d founded, Autistic Doctors International. One Facebook message and a couple of hours later, I was admitted to the group.
I hadn’t dreamed there would be enough Autistic doctors in the world to form a support group, but I probably shouldn’t have been surprised. Our profession selects for Autistic strengths. Attention to detail. Pattern recognition. Strong memory. Empathy. Conscientiousness and loyalty to our patients and colleagues.
The strict protocols and guidelines within hospitals can even be supportive for those of us with executive dysfunction. And then there’s our innate dedication to our passions. I love my job – the challenge and the variety and the sense of mastery give me a thousand little joys each week.
We trade tips on how to manage sensory overload in our noisy, chaotic hospital wards. We discuss the pitfalls of facial expression and body language differences when we talk to patients and colleagues. We discuss what “reasonable accommodations” might look like for Autistic doctors – unfortunately uncharted territory in many medical workplaces.
Not everyone is thriving in their job: some of us are perceived as “too blunt” or “scattered”. Some of us struggle with the cognitive load of masking whilst juggling night shifts, long hours and unpredictable patient loads. Some of us have burnt out and left medicine, to protect our health. Some of us have experienced discrimination and bullying in their workplaces, because of our Autism.
I had a really important job interview last year. Oh, how I detest job interviews! Arranging my body and face. Processing and remembering questions (often with multiple parts – horror!). Sequencing my answers, remembering the right information at the right time, all within seconds.
I shared with my Autistic doctor community my fear of underperforming in the interview and losing my chance at a dream job. We debated: disclose my diagnosis? I might get accommodations at the interview. But I’d risk discrimination. In the end, I disclosed, not my Autism but a part of it – my auditory processing disorder. I asked for written questions, pen and paper, and 15 minutes’ preparation time before facing the interview panel. These accommodations were granted to all the candidates. It was the best interview I’ve ever done, and those simple adjustments levelled the playing field for me. In fact, I got the job!
Joining Autistic Doctors International helped me feel more connected and supported professionally.
My professional Autistic peers and mentors have given me a “map” of how I might be a doctor without hiding my Autistic identify. There are doctors in the group who are open in their professional lives about their diagnosis. They are presenting at conferences and producing academic research. They speak of the rich experience of treating Autistic patients as an openly Autistic doctor – how safe and welcome it makes their patients feel. They advocate for change within the profession – to improve systems for both Autistic patients and doctors.
I am growing bolder. Recently I spoke to my son’s primary school class about being Autistic. When I gave the talk at Ben’s school, the kids were all sitting cross-legged on the floor. Ben was so excited to see me in his classroom that he leapt up and ran over to me. He couldn’t resist climbing up on my lap to snuggle! I started off by telling them that I’m a doctor, and had come to talk to them about different bodies and different brains. The kids were so eager, putting up their hands to answer my questions about what the brain does.
I asked if any of them knew the names of different kinds of brains – the room was silent. Then I told them a little about neurotypical brains, Autistic brains, ADHD brains, and dyslexic brains. That each kind of brain is good at some things, and also needs help with other things. I told them that I, Dr Sarah, have an Autistic brain. That’s the kind of brain I was born with.
That night one of the other class mums sent me a photo of her daughter’s writing activity. She wrote, “This week Dr Sarah showed us about Autistic brains. Ben was so excited he went on top of his mum. He must realy [sic] love his mum.” Those imperfectly spelled, wobbly-lettered sentences filled me with such pride at what I’d been able to show those kids: the love in our Autistic family, and pride in our Autistic identity.
To read more about Dr Sarah’s life as a late diagnosed, Autistic ADHDer doctor and parent please visit her blog, Neurodivergent Doctor.
The Reframing Autism team would like to acknowledge the Traditional Owners of the lands on which we have the privilege to learn, work, and grow. Whilst we gather on many different parts of this Country, the RA team walk on the land of the Birpai, Awabakal, Wattamattagal, Whadjak, Amangu, Bunurong and Kaurna Yarta peoples.
We are committed to honouring the rich culture of the Aboriginal and Torres Strait Islander peoples of this Country, and the diversity and learning opportunities with which they provide us. We extend our gratitude and respect to all Aboriginal and Torres Strait Islander peoples, and to all Elders past, present, and emerging, for their wisdom, their resilience, and for helping this Country to heal.