ROBERT ~ A Dear Man with Asperger’s
by Martha Stark, MD / Faculty, Harvard Medical School
Robert, a patient of mine with Asperger’s, was a brilliantly prolific and well-known writer. Ever gracious and polite, everybody liked him – although people didn’t really matter all that much to him.
Nonetheless, this dear man somehow managed to be in therapy with me for many years – but mostly because his wife Jane insisted that he keep coming. So he and I decided to make the most of it and settled into a very comfortable routine of weekly “conversations” (as we called them), in which we discussed things like complex adaptive, nonlinear dynamical, self-organizing chaotic systems and this our confusing world (made up of “islands of predictability amidst a sea of chaotic unpredictability”).
Actually, we had a great time of it. And Jane was extremely grateful because she felt that, over time, Robert was indeed becoming much more “present” in their relationship – and “engaged.”
Among other things, I would have him “memorize” certain socially appropriate behaviors – for example, that he needed to make a fuss over Jane’s birthday and that he needed to make some effort to stay in touch with his (adult) kids – every now and then anyway. He told me that I was helping him to appreciate the importance of using his intelligence to figure out what he should be doing in different situations. We decided to call it “cognitive empathy” – doing the right thing – not from the heart, but from the head.
Jane, albeit a bit controlling, was a good woman who loved Robert dearly – and Robert was extremely attached to her and did love her, even though he had difficulty telling her that.
So one day I found a poem that I thought captured beautifully the essence of Robert’s feelings for her. He and I decided to rewrite it in order to make it a custom fit. He wanted to call the poem – “To Jane, From Robert” but I told him he should call it “To Jane, With Love, From Robert” – so he did.
We invited Jane to join us for one of our sessions so that Robert could read our poem to her.
You say it is hard to keep waiting,
For me to say “I love you too,”
But I have been telling you everyday,
In many ways you never knew.
It pours down upon the umbrella,
That I hold for you in the rain,
Is captured when I kiss your bruises
In order to relieve your pain.
It’s in the cake I bake for you
And offer you the biggest slice,
And when you tell me that you love it,
How I then bake it for you twice.
It’s buckled into the seat belt,
I always tell you to put on,
And in all the ways that I miss you,
Whenever I find that you’re gone.
Maybe I don’t say those four words ("I love you too"),
In the routine and standard way,
But I hope that my actions speak louder,
Than anything that I might say.
So if you are tired of waiting,
For those four words to leave my mouth,
All I can say is that outside it is cold,
So don’t forget to take your coat.
As Jane listened, she wept and said it helped her to understand him a little better – and then she leaned over and kissed him tenderly on the lips, a kiss he returned.
Robert, by then 58, died a little while later. He had been suddenly stricken with terminal cancer but told me matter-of-factly that he was not afraid to die. He said that his family would be better off after he died because of his generous life insurance policy.
Robert wanted to continue our work right up to the end. Interestingly, never once did he flinch in the face of his impending death – it held no fear for him. Unlike Dylan Thomas’s “Do Not Go Gentle Into That Good Night,” in which Thomas is urging his father to “rage, rage against the dying of the light,” Robert accepted the fact that he would be dying from his cancer with grace and dignity.
Those many of us who loved Robert still grieve his passing.