Going to the Doctor

So, the doctor. Ah yes, the doctor. It is an interesting experience for me as an Autistic person. It is simultaneously predictable and unpredictable, orderly and chaotic, sensory overload and understimulating. Today, I will focus on some stories in which I explore various Autistic themes. Join me as I go to the doctor.

Growing up, the nightmare of many a child is that of a shot. The sharp, quick pain of the needle is frightening. Even worse is the thought of blood being drawn. For some, this fear never goes away, becoming a constant stressor when going to the doctor. But for some reason, this anxiety subsided early for me. So, why? Well, maybe part of it has to do with my unique sensory profile. In my tweens, sharp objects became a sensory fascination. For obvious reasons, this was not safe. But I suspect this fascination, which included playing with knives and scissors (do not do!), may have destigmatized needles.

Another factor that helped was my doctors and mom. For me as an Autistic person, being told the direct truth, the reasons and logic behind an action, like why I am getting a vaccine, will always trump a “shut up and you’ll get a lollipop.” Of course, the candy never hurt, but the explanations which would bore others calmed me down; I felt safe and confident in these procedures. In addition, I felt confident with my physicians. In the wise wisdom of my mother, she worked in making my doctors feel like approachable, safe figures. We always had a few minutes to chit-chat or even do small banter; this continues today. In fact, my Autism mask goes down in front of physicians, especially ones who I gain trust from. This has made needles less of a concern for me. While I was nervous at first, over time, needles became routine. I got used to the shots and eventually even started donating blood. This slow, safe exposure to a necessary part of modern medicine led me to not even think twice when receiving a vaccine today.

More recently, I’ve started going to the doctor on my own. Previously comforted by the presence of my mother, grandparents or father, I was now all alone. This wasn’t too hard at first, as I just went to doctors I had known for years. But then, towards the beginning of winter break, I needed to go see a dermatologist to remove my skin tag. My mother directed me to Walk-In Dermatology where we booked an appointment with a new doctor. Given that she had to work that day, I was going there all alone. This meant signing in as a new patient at a new place. This meant getting acquainted with a new doctor all on my own. And this meant trusting someone completely unknown. A frightening task. My main goal was to not even think about it. I focused my attention on my grocery shopping after this task. Distracted, I tried to approach this challenging task as routine, just following the front desk’s instructions at my own pace and keeping my mind occupied. It worked. My appointment went relatively smoothly. By approaching this frightening endeavour as routine and banal, I succeeded in making my experience smooth. The doctor was patient and kind, and when I asked her to explain things in more detail she obliged. My skin tag was removed.

Lastly, let me introduce you to the dentist. The dentist I have been going to, Dr. Angela Boudounis (Dr. B) has made what would seem on the surface the hardest doctor visit for an Autistic person, the dentist, relatively easy. This comes back to the main theme of this blog: trust. Whereas I had to gain trust with the procedure of needles or the completely new dermatology practice, I have gained trust over pretty much my entire lifetime with my dentist. In my recent visit, we realized that I only have a few more years before I must switch to a different dentist. This is frightening. For me, being reliant on and comfortable in the same dental practice for fifteen years has meant the staff know how to communicate with me. They have the patience and years of experience in treating me to know what does and does not work for me. In turn, I have grown incredibly trusting and deferential to them. I know they are reliable and caring, and that they know me and my family incredibly well. Despite the fact that I only go in twice a year (because my dental health is so good!), it feels like home. Explaining things in detail, being patient with me, and overall just being friendly has made what is difficult for many an exciting task for me. This means that when the time comes and I graduate from their care, I have to find a new dentist who will meet my needs. 

In these stories you’ve probably noticed some themes of trust, patience, detail-oriented communication and unpredictability. As much as I feel safe at the dentist, for example, there can always be a surprise or an unexpected twist. Being a doctor, especially caring for neurodiverse patients, is no easy task. But the doctors who excel, like Dr. B, make a huge difference. Her support and welcoming attitude have made me open about and consistent in managing my dental health. If I viewed the dentist as a negative force, like I did with my first cardiologist who fat-shamed me, I might have neglected my dental health. Instead, despite slip-ups, I have felt comfortable asking questions and following advice, leading to my dental health being relatively solid. These factors, of course, don’t just apply to neurodiverse patients; these skills are important for any doctor-patient relationship. The crux of this – trust – is something I really want to emphasize. For Autistic or Neurodiverse people, we often experience physicians or providers who just don’t get us. They make assumptions or seemingly innocuous but actually cruel comments. Building that trust by meeting the patient’s needs makes all the difference, and that is what I will be looking for as I transition from pediatric to adult providers.