The Man Who Mistook His Wife for a Hat: "The Autist Artist"

He drew swiftly but minutely, with a clear line, without erasures.

I nearly always ask patients, if it is possible for them, to write and draw, partly as a rough-and-ready index of various competences, but also as an expression of ‘character’ or ‘style’.

And otherwise there was an odd mixture of close, even obsessive, accuracy, with curious (and, I felt, droll) elaborations and variations.

The cover depicted an idyllic scene of people canoeing on a lake, against a backdrop of mountains and sunset.

All the hallmarks of what Richard Wollheim calls ‘iconicity’—subjectivity, intentionality, dramatisation—were present.

The original had lacked character, had looked lifeless, two-dimensional, even stuffed. José’s fish, by contrast, tilted and poised, was richly three-dimensional, far more like a real fish than the original.

It was not only verisimilitude and animation that had been added but something else, something richly expressive, though not wholly fishlike: a great, cavernous, whalelike mouth; a slightly crocodilian snout; an eye, one had to say, which was distinctly human, and with altogether a positively roguish look.

My friend and colleague Isabelle Rapin had actually seen José years before, when he was presented with ‘intractable seizures’ in the child neurology clinic—and she, with her great experience, did not doubt that he was ‘autistic’.

Extraordinary proficiencies of some autistic children for putting together puzzles, taking apart mechanical toys, or decoding written texts may reflect the consequences of attention and learning being inordinately focused on non-verbal visual-spatial tasks to the exclusion of, or perhaps because of, the lack of demand for learning verbal skills.

I had a lengthy chart available to me, containing early descriptions of his original illness: a very high fever at the age of eight, associated with the onset of incessant, and subsequently continuing, seizures, and the rapid appearance of a brain-damaged or autistic condition.

They are invariably associated with disorder in, or damage to, the temporal lobes, and severe temporal-lobe disorder, both left-sided and right-sided, had been demonstrated in José by innumerable EEGs.

For fifteen years he scarcely emerged from the house, ostensibly because of ‘intractable seizures’, his mother maintaining she dared not take him out, otherwise he would have twenty or thirty seizures in the street every day.

This, then, was the tale I received, or, rather, put together from his chart or charts, documents as remarkable for what they lacked as for what they contained—the documentation, through default, of a fifteen-year ‘gap’: from a social worker who had visited the house, taken an interest in him, but could do nothing; and from his now aged and ailing parents as well.

But none of this would have come to light had there not been a rage of sudden, unprecedented, and frightening violence—a fit in which objects were smashed which brought José to a state hospital for the first time.

Suddenly too, after the moral closeness, the febrile intimacy of his house, he now found others, found a world, both ‘professional’ and concerned: unjudging, unmoralistic, unaccusing, detached, but at the same time with a real feeling both for him and for his problems.

I had a qualm of horror when I saw him like this, for I had imagined, had indulged, the notion of ‘a steady recovery’.

I had to see José in a regressed condition (as I was to do again and again) to see that there was no simple ‘awakening’ for him, but a path fraught with a sense of danger, double jeopardy, terrifying as well as exciting—because he had come to love his prison bars.

Once more I took a fine pen from my pocket, for he seemed to have an aversion to crayons, which was all they used on the ward.

It was still a trout, rainbow-spotted, with fringy fins and a forked tail, but, this time, with egregiously human features, an odd nostril (what fish has nostrils?), and a pair of ripely human lips.

Rapidly he sketched in a little fish, a companion, swooping into the water, gambolling, obviously in play.

I couldn’t avoid the feeling, perhaps a facile one, that this drawing was symbolic—the little fish and the big fish, perhaps him and me?

In his drawings as in his life hitherto, interaction had always been absent. Now, if only in play, in symbol, it was allowed back.

But—what was happening?—the dry winter twiglet, next to the tree trunk, had shot up in his drawing, expanded into florid open bloom.

But the salient and exciting and most significant transformation was this: that José had changed winter into spring.

Now, finally, he started to speak—though ‘speak’ is much too strong a term for the strange-sounding, stumbling, largely unintelligible utterances that came out, on occasion startling him as much as they startled us—for all of us, José included, had regarded him as wholly and incorrigibly mute, whether from incapacity, indisposition, or both (there had been the attitude, as well as the fact, of not speaking).

But, equally important, he now was fighting for the recovery of his understanding and speech (egged on by all of us, and guided by the speech therapist in particular), where previously he had accepted it, hopelessly or masochistically, and indeed had turned against virtually all communication with others, verbal and otherwise.

Even to the most sanguine of us it was very apparent that José would never speak with any facility approaching normal, that speech could never, for him, be a real vehicle for self-expression, could serve only to express his simpler needs.

It is, to my mind, rather similar to, and not inferior to, the fine vivid flowers one finds in medieval botanies and herbals—fastidiously, botanically exact, even though José has no formal knowledge of botany, and could not be taught it or understand it if he tried.

The abstract, the categorical, has no interest for the autistic person—the concrete, the particular, the singular, is all. Whether this is a question of capacity or disposition, it is strikingly the case. Lacking, or indisposed to, the general, the autistic seem to compose their world picture entirely of particulars.

No one...has felt the heat and pressure of a reality as indefatigable as that which day and night converged upon the hapless Ireneo.

No one...has felt the heat and pressure of a reality as indefatigable as that which day and night converged upon the hapless Ireneo.

Nigel Dennis, in a brilliant essay on Nadia in the New York Review of Books (4 May 1978), wonders how many of the world’s ‘Nadias’ may be dismissed or overlooked, their remarkable productions crumpled up and consigned to the trash can, or simply, like José, treated without thought, as an odd talent, isolated, irrelevant, of no interest.

‘No man is an island, entire of itself,’ wrote Donne. But this is precisely what autism is—an island, cut off from the main. In ‘classical’ autism, which is manifest, and often total, by the third year of life, the cutting off is so early there may be no memory of the main.

For though ‘horizontal’ connections with others, with society and culture, are lost, yet there may be vital and intensified ‘vertical’ connections, direct connections with nature, with reality, uninfluenced, unmediated, untouchable, by any others. This ‘vertical’ contact is very striking with José, hence the piercing directness, the absolute clarity of his perceptions and drawings, without a hint or shade of ambiguity or indirection, a rocklike power uninfluenced by others.

Is there some ‘place’ for him in the world which will employ his autonomy, but leave it intact?

Or, to take a strange but not illogical leap, could he, with his peculiarities, his idiosyncrasy, do drawings for fairy tales, nursery tales, Bible tales, myths?

His current ‘job’ is hand-printing sundry notices for the ward, which he does with the flourishes and elaborations of a latter-day Magna Carta.

He has carved exquisite lettering on tombstones. His current ‘job’ is hand-printing sundry notices for the ward, which he does with the flourishes and elaborations of a latter-day Magna Carta.

These include ‘negative’ characteristics, such as derivativeness and stereotypy, and ‘positive’ ones, such as an unusual capacity for delayed rendition, and for rendering the object as perceived (not as conceived): hence the sort of inspired naïveté especially seen.

These include ‘negative’ characteristics, such as derivativeness and stereotypy, and ‘positive’ ones, such as an unusual capacity for delayed rendition, and for rendering the object as perceived (not as conceived): hence the sort of inspired naïveté especially seen.