Social butterfly hand in hand with autism

My social dream calendar was packed last night, which turns out to be the case in real life too.

Tonight I've got two different dances to attend - the queer social at Century and the monthly "Third Friday" salsa dance put on by one of my favourite salsa leads.  Saturday, after I work for the usual 8h long teaching day, I'm heading to a destination birthday party.  Sunday is lunch with a friend.

In last night's dream I was finalizing plans for a potluck with my granny aerobics group when my sister showed up unexpectedly from out of town - with ten friends in a big car caravan - in order to party at my house.  I was thrilled to have her but unsure how to organize and attend both events.  Finally I realized the first group, which consisted of mostly older women, would wrap up around 9, around the time my sister and her friends would probably just be getting started.

I drove to the store to get some supplies and just before the supermarket parking lot, saw a car come to a sudden screeching halt inches away from driving into the median ditch on the freeway.  It was a small navy blue compact and the front tire had gone flat.  I stopped to help and discovered the driver was my friend Phil* from grad school, who now runs a lab in upstate New York.

Phil's wife Bea got out and literally handed me their son, also Phil.  Which is to say she took Phil Jr.'s hand, a boy of about 15, gangly, eyes downcast, and put it in mine.  "Would you mind watching him while we take care of this?" she asked.  

Phil's son was autistic, but relatively high-functioning and verbal.  He needed his hand held 24h a day.  He rambled facts and observations off to me as we walked hand in hand to my car.  Let his hand go, Bea had warned me, and he'd become more and more anxious, till he was screaming and crying.

Phil had never told me about his son's condition and I wondered if it was because he had a hard time dealing with the situation.  I pondered what seemed to me to be the sudden rise in autism - going through all the causes I knew had been proposed.  I thought about my handful of friends whose autistic children were nonverbal and how difficult that made things. 

Phil Jr would never be independent, not if he needed physical contact every moment of the day - though perhaps at some point he could transition to a companion animal.  But he had a set of basic skills and he could talk. That was no small something.

Phil returned and it was instantly clear he deeply loved and enjoyed his son.  Also it was clear that Phil had become entirely gay.  The vibe practically rose from him like a heat wave.  I glanced at his wife, wondering if she knew, or if it just seemed beside the point with a special needs child.  

  *not his real name.

So in the real world, I know as many people with autistic children as I know people who've had breast cancer.  Does this seem like a large number to you?  It does to me.

I'm not suggesting cancer and autism are similar in a superficial way - one is a progressive life-threatening disease; the other a developmental condition.  The comparison holds for another reason. Cancer is ultimately genetic and it runs in families, but not in a straightforward Mendelian way.  It skips generations; it doesn't affect everyone with identifiable "cancer genes".

For years cancer eluded sophisticated treatment or biological explanation because it turns out that several cellular systems have to fail one after another before cells become cancerous.  Much of the research was like that old story about the blind men stroking the elephant.

So each progression towards cancer, we now know, shares broad similarities. And still many challenges remain since each cancer is the result of a rapid, independent series of evolution events and so is best treated on a case by case basis.

Likewise there does not seem to be one easy answer that explains the autistic spectrum.  My money is on some combination of side effects from the processes of first world industry.  Some pollutant, hormone disruptor, factory-made chemical, waste product.   Something in the environment or our lifestyle or both is boosting the disruption of a genetically complex system whose dysregulation drives autism.

I think there will turn out to be autism genes, not one or two but many, from select classes of molecules that perform similar functions and converge on the same process.  Cancer genes are in one of five or six classes, but each class has several members, so that the suite of genetic defects in a given breast cancer is not necessarily identical to another similarly-behaving tumor from another individual - or even a second tumor in that person's own body.

I also think that, like cancer, autism will prove difficult to treat or predict even once we have a biological mechanism.  Cancer retreats and recurs.  Anyone with a severely autistic child is familiar with the disconcerting, sometimes heartbreaking, ebb and flow of skill acquisition. 

In my dream we sat at a table under a huge umbrella at an outdoor fast food hamburger place - me, Bea, Phil, and their 15 year old son.  It was a bright day, no clouds, a little breezy.  Phil held his son's hand, and Phil Jr. talked about everything under the sun.

With no pause in his stream of chatter, Phil Jr said, "Wet.  I'm wet."  Bea immediately rose and took her son to the bathroom to be changed.  I hugged Phil and said how nice to see him and his family.  I left to go home and finish party planning.