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Neurodiversity in Medicine

How Autistic doctors can thrive: a medical student’s journey of discovering their self and embracing their difference

Aug 3, 2022

Written by a Medical Student

Neurodivergent doctors are an asset to medicine, but, as a final year medical student, recently diagnosed as Autistic and beginning to embrace their difference, explains, more understanding and awareness is needed to highlight this fact.  

I’m not spending 2022 exactly how I pictured. If all had gone to plan, I would have just finished my job applications and would be excitedly preparing to fly through my final 6 months of medical school before stepping into the workforce. Instead, I’ve just confirmed that I am Autistic. And beyond going through a complicated and expensive diagnostic process, I've been at home, not doing a whole lot, trying to recover from ‘Autistic Burnout’ – the existence of which I’ve only recently learned about. 

I’ve spent most of my life pretending to be neurotypical. I was so good at learning how to act that I blended into the crowd. I passed as neurotypical despite behavioural problems as a child, confusing mental health challenges that had strange triggers (like too much noise), a scary sense of loneliness and disconnection that arose from never showing others my true self, a string of therapists, and self-help. It wasn’t until the combination of Covid-19 and my hardest year of medical school pushed me to a crisis point that a psychologist connected the dots and realised I was Autistic. 

This is a common phenomenon in undiagnosed Autistic people, especially among people raised as female. Many women and gender-diverse people only learn they are Autistic once they are adults, as the diagnostic criteria and clinical understanding is traditionally biased towards boys. In childhood, Autistic girls and gender diverse children just don’t stand out in the way Autistic boys do. Our characteristic ‘special interests’ tend to be more ‘typical’ – think dolls, fashion or celebrities, rather than numbers or trains. We may appear to be more socially motivated, meaning that we work hard to make friends and fit in at school. We are more likely to learn to ‘mask’ our Autistic traits – actively rehearsing and employing facial expressions and carefully studied social rules, forcing eye contact, mimicking behaviours of peers, suppressing reactions to overwhelming sensory stimuli.

All this masking takes a toll. Constantly performing, putting on a forced act, and thinking intellectually rather than intuitively about social rules requires significant cognitive effort. There isn’t much juice left in the tank at the end of a school or work day. Autistic people who mask spend hours recovering alone from a day spent around others. We lose our sense of self, and struggle to set boundaries in social settings. This ‘camouflaging’ causes stress, anxiety and depression. In my case, years of consciously and unconsciously masking my Autism led to Autistic Burnout: my capacity to show up and cope in a neurotypical world was overwhelmed. 

Autistic advocates champion the concept of neurodiversity. The neurodiversity movement argues that there is natural variation in human minds, that some are quite different from others, and that there is immense value in embracing and including these differences. While neurodivergent people can experience challenges in the workplace, with understanding and the right accommodations, we can make invaluable contributions. Industries are catching on – companies, including NASA and Microsoft, have Autistic specific recruitment pathways and are making their offices more accessible and inclusive. 

The value and challenges of my neurodivergence are no exception to this rule. Medicine is my ‘special interest’, meaning it is a discipline that my mind thrives in. I enjoy focusing on and spending long periods of time studying medicine in intense detail. I have strong pattern recognition skills, a highly visual and experiential mind that aids memory and problem solving, and hyper-empathy that allows me to connect with patients and make them feel heard. (As an aside, contrary to popular belief, autistic people do have empathy, and in some cases experience the emotions of others profoundly and intensely). I think outside the box, and I create rules from the bottom up rather than relying on surface learning. Not only am I good at medicine; spending time studying is actually highly beneficial to my mental wellbeing – a form of self-care. 

However, I have found aspects of medicine intensely challenging. I have a heightened sensory experience, so I often develop physical symptoms like a headache, brain-fog and dizziness in response to the smells, sounds, fluorescent lights and PPE requirements of a hospital. I find change stressful and disorientating – it takes me weeks to adjust to a new team, rotation or hospital. I find unspoken rules around doctor hierarchies difficult to navigate, and I become confused by unclear and abstract communication styles. 

I’m not alone being Autistic in the medical field. In 2019 Dr Mary Doherty, a consultant anaesthetist, founded ‘Autistic Doctors International’ (ADI) after being diagnosed in her mid 40s. She was seeking community support, and was sure there would be others out there. Medicine selects for autistic traits – attention to detail, perfectionism, creative thinking and pattern recognition coupled with strong levels of empathy. ADI began with 7 members, and has grown to over 300. 75% of members identify as female. Most doctors who are part of ADI are practicing clinical medicine, with General Practice and Psychiatry being the highest represented specialties. Autistic doctors are an asset to medicine, but we experience interpersonal, executive functioning and sensory difficulties that impair our ability to thrive in the hospital environment. Due to stigma, it’s tricky for us to access the support we need. Many of us keep our diagnosis a secret to avoid denial or discrimination. 

Being Autistic has caused delays in my progression through medical school. When I’m working as a doctor, I know that I will have to use all my resources to survive the tough hospital environment of my junior doctor years. I won’t be able to do much outside of work – I’ll need to spend all my spare time recovering. And I need to attain the best possible mental health before I enter this world. As more awareness and understanding spreads about the needs of Autistic people, I hope that one day I’ll be able to access some accommodations while working in the hospital. 

My university years haven’t gone exactly as planned. But I’m glad. I’ve been able to finally learn about and accept my unique brain. The qualities that I have are ones that I’m proud of. My inner world is vivid and colourful. I feel and experience things intensely. I’m non-judgmental; I see the good in people. I am passionate about social justice. I think all of this will make me a great doctor. Even though my life is hard and overwhelming a lot of the time, I wouldn’t trade being Autistic for anything. 

If any of the experiences outlined in this article resonate with you, consider contacting the national Autism Connect information line for information and advice about exploring Autistic identity or accessing support for Autism.

https://www.amaze.org.au/autismconnect/

1300 308 699

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