House Rules

They might be obsessed by routine or rules, or be fixated on a certain subject. They can't read expressions very well, or body language. They are overly sensitive to lights, textures, smells, and sounds.

  --You are going to hear from Jacob's doctors and his mother about his limitations, and how they've tried hard to help Jacob overcome them. Part of what you're going to hear is Jacob's very concrete sense of what's right and what's wrong. In his world, rules are not just important, they're infallible. And yet, he has no understanding of the underlying bases of those rules. He can't tell you how his behavior might affect another person, because it is impossible for Jacob to put himself in someone else's metaphorical shoes. He might be able to recite to you every line from CrimeBusters episode forty-four, but he can't tell you why the mother is upset in scene seven of the show, or how the loss of a child impacted the parents in that show. If you ask Jacob, he can't explain it. Not because he doesn't want to, and not because he's a sociopath, but because his brain simply doesn't function that way.||

  I walk behind the defense table and put my hand lightly on Jacob's shoulder.

  Immediately he flinches, just like I figured, beneath the jury's watchful eye. --If you spend some time with Jacob,|| I say, --you'll probably think there's something ...

  different about him. Something you can't quite put your finger on. He may seem odd, or quirky ... but you probably also won't think of him as insane. After all, he can hold a legitimate conversation with you; he knows more about certain subjects than I'll ever know; he isn't running around listening to voices in his head or setting small animals on fire. But the definition of legal insanity, ladies and gentlemen, is very different than what we typically think of when we think of the word insanity. It says that, at the moment an act was committed, the defendant--as a result of a severe mental disease or defect--was unable to appreciate the wrongfulness of his acts. What that means is that a person with a neurological disorder like Asperger's who commits a crime--a person like Jacob--can't be held responsible in the same way you or I should be held responsible. And what you will hear from the witnesses for the defense is proof that having Asperger's syndrome makes it impossible for Jacob to understand how his actions might cause harm to someone else. You will hear how having Asperger's syndrome might lead a person like Jacob to have an idiosyncratic interest that becomes overwhelming and obsessive. And you will see, ladies and gentlemen, that having Asperger's syndrome impaired Jacob's ability to understand that what he did to Jess Ogilvy was wrong.||

  Behind me, I hear whispering. From the corner of my eye, I see a dozen notes, stacked on my side of the defense table. Jacob is rocking back and forth, his mouth tight.

  After a minute he starts to write notes to Emma as well.

  --No one is suggesting that Jess Ogilvy's death is anything less than a tragedy, and our sympathies must lie with her family. But don't compound that tragedy by creating a second victim.||

  I nod, and sit back down at the table. The notes are brief and angry: NO.

  YOU HAVE TO TELL THEM.

  WHAT I DID WAS RIGHT.

  I lean toward my client. --Just trust me,|| I say.

  Theo

  Yesterday, I was sitting alone in the back of the courtroom squished between a woman who was knitting a newborn baby cap and a man in a tweed jacket who kept texting on his phone during the testimony. No one knew who I was, and I liked it that way. After Jacob's first sensory break, when I went to the little curtained room and the bailiff let me slip inside, my secret identity was not so much of a secret anymore. The knitting woman, I noticed, moved to a spot on the other side of the courtroom, as if I had some dread contagious disease instead of just a last name shared with the defendant. The man in the tweed coat, though, stopped texting. He kept asking me questions: Had Jacob ever been violent before? Did he have the hots for Jess Ogilvy? Did she turn him down? It didn't take long for me to figure out he was some kind of reporter, and after that, I just stood in the back near one of the bailiffs.

  Today, I'm sitting next to my father, a guy I don't know at all.

  When Oliver starts talking, my father leans toward me. --What do you know about this guy?||

  --He likes long walks on the beach, and he's a Scorpio,|| I say.

  Here's what I really know. Oliver was rubbing my mom's arm today. Not in the oh-you're-about-to-fall-are-you-okay way, but in a sweet-child-o'-mine mode. What the fuck is that all about? He's supposed to be saving my brother's ass, not hitting on my mother.

  I know I should be relieved that my father is here, but actually, I'm not. I'm sitting here wondering why we are spectators at a murder trial, instead of on the first base line at Fenway, watching the Sox play. I'm wondering how I learned to tie a tie, like I did for Jacob today, considering that my own father wasn't the one to teach it to me. I'm wondering why sharing the same DNA with a person doesn't make you automatically feel like you have something in common.

  As soon as Oliver finishes his statement, I turn to my father. --I don't know how to fish,|| I say. --I mean, I wouldn't know how to stick a worm on a hook, or how to use a pole, or anything like that.||

  He just stares at me, frowning a little.

  --It would have been cool if we'd fished,|| I say. --You know. Like in that pond behind the school.||

  This, of course, is just plain stupid. I was six months old when my father left us. I could barely hold myself upright, much less a fishing pole.

  My father ducks his head. --I get seasick,|| he says. --Even just standing on a dock.

  Always have.||

  After that, we don't really talk at all.

  I went to Dr. Moon once. My mother thought it would be a good idea for me to talk to a shrink about feelings I might be having, given the fact that my brother sucked up all the time and energy in our household like some giant karmic Hoover. I can't say I remember much about her, except that she smelled like incense and told me I could take off my shoes, because she herself could think better without shoes, and maybe I would, too.

  On the other hand, I do still remember what we talked about. She said that, sometimes, it would be hard for me to be the younger brother, because I had to do all the stuff the older brother usually did. She told me that this might frustrate Jacob and make him mad, and that would make him act even more immature. In this she was the psychological equivalent of a weather forecast: she could tell me with precise probability what was coming, but she was completely unequipped to help me prepare for the storm.

  She looks different on the witness stand than she does when she is at her office. For example, she is wearing a business suit, and her crazy long hair is tamed into a bun. Oh, and she's wearing shoes. --At first, Jacob was diagnosed with general autism spectrum disorder. Then we tweaked his diagnosis to pervasive developmental disorder. It wasn't until sixth grade that we amended his diagnosis to Asperger's syndrome, based on his inability to interpret social cues and to interact with peers in spite of his high IQ and verbal ability. For kids Jacob's age, that progression of diagnoses is very common. It doesn't mean he didn't always have Asperger's--he did--it just means that we didn't necessarily have the correct language to label it.||

  --Can you give a definition of Asperger's syndrome for people who aren't familiar with it, Doctor?|| Oliver asks.

  --It's a developmental disorder that affects the way information is processed in the brain, and it's considered to fall at the upper end of the autism spectrum. People with Asperger's are often very intelligent and very competent--in this, they differ from profoundly autistic children, who can't communicate at all--but they have crippling disabilities in the area of social interaction.||

  --So someone with Asperger's might be smart?||

  --Someone with Asperger's might even have a genius-level IQ. However, when it comes to making small talk, he'll be completely inept. He has to be taught social interaction as if it's a foreign language, the way you or I would need to be taught Farsi.||

  --Lawyers sometimes have trouble finding friends,|| Oliv
er says, raising some laughter on the jury. --Does that mean we all have Asperger's?||

  --No,|| Dr. Moon responds. --A person with Asperger's desperately wants to fit in but simply can't understand social behavior that's intuitive to the rest of us. He won't be able to read gestures or facial expressions to assess the mood of the person he's speaking to. He won't be able to interpret a nonverbal cue, such as a yawn signifying boredom when he's hogging the conversation. He won't be able to understand what someone else is thinking or feeling; that kind of empathy is unnatural to him. He truly is the center of his own universe and will react based on that principle. For example, I had a patient who caught his sister shoplifting and ratted her out--not because he thought he was morally responsible to report his sister's crime but because he didn't want to be known as the boy whose sister had a criminal record. Whatever a child with Asperger's does, he does because he's thinking of how it will affect him, not anyone else.||

  --Are there other hallmarks of the disorder?||

  --Yes. Someone with Asperger's might have difficulty organizing and prioritizing rules and tasks. He'll tend to focus on details instead of the big picture and often will become obsessed for months or years at a time by one specific subject. And he can talk about that subject--even if it's a sophisticated topic--for hours at a time. For this reason, the disorder is sometimes referred to as the Little Professor syndrome. Children with Asperger's speak in such an adult manner they often get along better with their parents'

  friends than with their own peers.||

  --Does Jacob have that sort of obsessive focus on one subject?||

  --Oh, yes. He's had several over the years--dogs, and dinosaurs, and most recently, forensic science.||

  --What else might we notice about a person with Asperger's syndrome?||

  --He'll adhere slavishly to routine and rules. He's painfully honest. He will dislike making eye contact. He might have hypersensitivity to light or noise or touch or taste. For example, right now, Jacob is probably working very hard to block out the sound of the fluorescent lights in this courtroom, which you and I can't even hear. One moment a child with Asperger's might present as an extremely bright, if awkward, child--and the next, when his routine is disrupted, he might have a meltdown that lasts between ten minutes and several hours.||

  --Like a toddler's tantrum?||

  --Exactly. Except it's a lot more debilitating when the child is eighteen and 180

  pounds,|| Dr. Moon says.

  I can feel my father staring at me, so I turn to him. --Does that happen a lot?|| he whispers. --The tantrums?||

  --You get used to it,|| I say, although I'm not sure this is true. In reality, you don't ever change the hurricane. You just learn how to stay out of its path.

  Oliver is walking toward the jury now. --Will Jacob ever be cured of Asperger's?||

  --At present,|| the shrink says, --there's no cure for autism. It's not something you outgrow; it's a condition you have forever.||

  --Dr. Murano, which of the symptoms you've related here today has Jacob manifested over the years?||

  --All of them,|| she says.

  --Even now, at age eighteen?||

  --Jacob's gotten much better at rolling with the punches if a routine is disrupted.

  Although it's still upsetting, now he has coping mechanisms he can draw upon. Instead of having a screaming fit, like he did at age four, he'll find a song or a movie and repeat the lyrics or lines over and over.||

  --Doctor, this court has allowed Jacob to take sensory breaks when necessary. Can you explain what that is?||

  --It's a way for Jacob to get away from the overstimulation that's upsetting him.

  When he feels like he's spiraling out of control, he can remove himself and go to a place that's quiet and less chaotic. In school, he has a room where he can pull himself together again, and in court, he has the same type of area. Inside are all sorts of materials that Jacob can use to calm himself down--from deep-pressure weighted blankets to a rope swing to fiber-optic lamps.||

  --You said that kids with Asperger's have an affinity for rules. Is that true of Jacob?||

  --Yes. For example, Jacob knows that school starts at eight-twelve A.M. and because of that rule, he is on time every day. However, one week his mother told him that he would be late for school because he had a dentist appointment. He had a meltdown, put his fist through a wall in his bedroom, and could not be calmed down enough to be taken to the dentist. In Jacob's mind, he was being asked to break a rule.||

  --He punched in a wall? Do kids with Asperger's have a propensity for violence?||

  Oliver asks.

  --That's a myth. In fact, a child with Asperger's is more likely to not misbehave than neurotypical children are, simply because he knows that's the rule. However, a child with Asperger's also has a very low fight-or-flight threshold. If he feels cornered in any way--verbally, physically, or emotionally--he might either run or strike out blindly.||

  --Have you ever seen Jacob do that?||

  --Yes,|| Dr. Moon says. --At school last year he was given detention for swearing at a teacher. Apparently a young woman tricked him into behaving inappropriately by saying she'd be his friend if he did it. Afterward, he retaliated by shoving her and was suspended.||

  --What triggered the violent response in Jacob?||

  --Being belittled, I imagine.||

  --Did you talk to him about the episode?|| Oliver asks.

  --I did.||

  --Did you explain why his violent response wasn't appropriate?||

  --Yes.||

  --Do you think he understood that what he did was wrong?||

  She hesitates. --Jacob's sense of right and wrong isn't based on an internalized moral code. It's based on what he has been told to do, or not to do. If you asked him whether it's right to hit someone, he would tell you no. However, he would also tell you that it's wrong to make fun of someone--and in his mind, the young woman broke that rule first. When Jacob hit her, he was not thinking of how he might hurt her, or even of how his actions would be going against a rule of behavior. He was thinking of how she'd hurt him, and he simply ... reacted.||

  Oliver approaches the witness stand. --Dr. Murano, if I told you that Jacob had argued with Jess Ogilvy two days before she died, and that she'd told him to get lost, how would you think that had affected his behavior?||

  She shakes her head. --Jess was very important to Jacob, and if they had a fight, he would have been extremely upset. In going to her house that day, he was clearly manifesting that he didn't know how to behave. He stuck to his routine rather than let the argument run its course. Most likely, Jacob's mind processed the fight like this: Jess told me to get lost. I can't possibly get lost because I always know where I am. Therefore she didn't really mean what she said, so I will just go on as if she never said it. Jacob would not have understood from Jess's language that she might truly not have wanted to see him. It's this inability to put himself in Jess's frame of mind that separates Jacob from his peers.

  Whereas another child may just be socially awkward, Jacob is dissociated entirely from empathy, and his actions and perceptions revolve around his own needs. He never stopped to imagine what Jess was feeling; all he knew was how much she was hurting him by arguing with him.||

  --Does Jacob know that it's against the law to commit murder?||

  --Absolutely. With his fixation on forensic criminology, he probably could recite the legal statutes as well as you could, Mr. Bond. But for Jacob, self-preservation is the one inviolable rule, the one that trumps everything else. So just like he lost his temper with the girl at school who'd humiliated him--and truly didn't understand why that was problematic, given what she'd done to him first--well, I can only imagine that's what happened with Jess, too.||

  Suddenly Jacob stands up. --I didn't lose my temper!|| he shouts, as my mother grabs his arm to make him sit down again.

  Of course, the fact that he's losing his temper at this very second sort of negates what he's sa
ying.

  --Control your client, Mr. Bond,|| the judge warns.

  When Oliver turns around, he looks the way soldiers do in movies when they crest a hill and see a swarm of enemy forces below them--and realize that, no matter what, they don't have a prayer. --Jacob,|| he sighs. --Sit down.||

  --I need a break,|| Jacob yells.

  Oliver looks at the judge. --Your Honor?|| And then suddenly, the jury is being led out and Jacob is practically running to the sensory break room.

  My father looks completely lost. --What happens now?||

  --We wait fifteen minutes.||

  --Should I ... Are you going to go back there with them?||

  I have, every time so far. I've hung out in a corner, playing with some Koosh balls, while Jacob gets his act together. But now, I glance up at my father. --Do what you want,|| I say. --I'm staying here.||

  In my first memory, I'm really sick and I can't stop crying. Jacob is around six or seven, and he keeps asking my mother--who has been up with me all night--to get breakfast ready. It is early; the sun hasn't even come up yet.

  I'm hungry, Jacob says.

  I know, but I have to take care of Theo right now.

  What's the matter with Theo?

  His throat hurts, very bad.

  There's a moment where Jacob takes this information in. I bet if he had ice cream his throat would feel better.

  Jacob, my mother says, stunned. You're thinking about how Theo feels?

  I don't want his throat to hurt, Jacob says.

  Ice cream! Ice cream! I yell. It's not even really ice cream I'm screaming for--it's soy-based, like everything else in the freezer and fridge. But it's still something that's supposed to be a treat, not a breakfast food.

  My mother gives in. Okay. Ice cream, she says. She puts me in my booster seat and gives me a bowl. She gives Jacob a bowl, too, and pats his head. I'm going to have to tell Dr. Moon that you were looking out for your brother, she says.

  Jacob eats his ice cream. Finally, he says. Peace and quiet.

  My mother still holds that up as an example of Jacob transcending his Asperger's to exhibit empathy for his poor, sick kid brother.

  Here's what I see, now that I'm older:

  Jacob got a bowl of ice cream for breakfast and didn't even have to be the one to beg for it.