'The Good Doctor' sensationalizes certain aspects of autism

ABC premiered the show “The Good Doctor” on Sept. 25. The show follows an autistic medical student named Shaun Murphy who is enlisted into the pediatric surgical unit of San Jose St. Bonaventure Hospital. Dr. Nicholas Sibrava, a psychology professor at Baruch College, says that while certain elements accurately portray autism, “The Good Doctor” is a dramatic show that reveals horrific details about Shaun’s childhood.

Autism is a disorder characterized by social interaction challenges and a predisposition to take part in recurrent behaviors. pilot episode begins with Shaun leaving his rural Wyoming town for a job interview at the St. Bonaventure Hospital. While Shaun is walking to the Laramie bus stop, a young boy accidentally kicks a soccer ball toward him.

At this point, viewers see Shaun’s first flashback, where he is punched by soccer players until his younger brother, Steve, saves him.

Sibrava says that kids who are different in any way are more likely to be bullied, and autistic children fall into that category.

“If some children have different behavior than others, then this increases the risk of them being bullied. But sensitivity to this disorder is improving in recent years because more people are aware. Teachers and doctors are becoming better at accepting. But it’s fair to say that autistic children are not only bullied, but are excluded too. They are left out from sports and other activities in part because of their lack of social communication, isolation and tendency to be loners,” the professor says.

Sibrava explained that the word autism is taken from the Greek root auto, meaning “self.” He said that the word itself reflects isolation, as autistic children are likely to keep to themselves and do not have a strong desire to connect to others.

In another flashback, Shaun talks about rain smelling like ice cream, raising the question of whether it is common for autistic people to sense things differently. Sibrava asserts that this is not the case.

Sibrava described that, “In Shaun’s case, it seems he associates certain smells with memories of his brother and pet rabbit. But to have an involuntary blending of the senses is a neurological disorder called synesthesia. The senses are jumbled. Orange has a particular sound, and numbers have colors."

Before Shaun checks in for his flight at Cheyenne Regional Airport, travelers witness a young boy being seriously injured when shards of glass fall and penetrate his skin. Shaun steps up to help, but realizes that he needs a knife for the procedure. He decides to go to the airport security screening section to see if there are any knives. He sees a bin full of them, and asks a Transportation Security Administration officer if he can have one.

Sibrava says that this situation introduces the psychological concept of the theory of mind. At some point in development, one can take a different perspective and imagine the world through another person’s eyes. To Shaun, it makes perfect sense to ask for a knife because he wants to save the boy. But he is unable to take the perspective of the TSA officer, who thinks Shaun’s question is alarming.

“A person who does not have autism would explain that there is a medical emergency and that they need the knife for the procedure. They can even tell the TSA officer to come with them to prove that the knife is needed for an emergency. They can anticipate how the TSA officer will react if they ask for a knife. But Shaun does not understand that. The TSA officer has never seen this guy and does not know that Shaun is autistic, so he is resistant to Shaun’s request,” Sibrava says.

After the boy is brought to San Jose St. Bonaventure Hospital for further treatment, the hospital’s board of directors has a meeting to discuss whether to hire an autistic surgeon. Sibrava points out that in reality, the issue of whether Shaun can succeed in this field should have been debated before he reached medical school. However, resolving  this issue  during a surgical residency adds to the show’s drama.

“A meeting to discuss if it is worth it to hire an autistic worker is likely to happen because of liability. The board of directors are thinking about whether the hospital will get sued if Shaun makes a mistake. It’s realistic that they envision the worst-case scenario instead of the best-case scenario. This scene is interesting because it’s a clash between doing the right thing or imagining the worst-case scenario," according to Sibrava.

Sibrava further discussed that it is a reasonable question to address a person’s mental state and whether their gifts offset their limitations.

Because autism is diagnosed on a spectrum, some people have milder symptoms and others have high-functioning autism. It is reasonable to discuss how severe Shaun’s autism is and the challenges he could face.

When Shaun gets hired, he is placed into the group overseen by Dr. Neil Melendez, the attending surgeon overseeing surgical residents. Neil explains that Shaun does not belong at the hospital. Shaun replies, “Do you think being arrogant makes you a better surgeon?”

According to Sibrava, problems with social communication are hallmarks of autism. Shaun has difficulty understanding sarcasm and irony. Shaun believes Neil is asking a genuine question when he stands up to him. Lacking social grace when asking awkward questions, he says what most people think but do not have the courage to say.

This genuine curiosity is also evident when Shaun asks Dr. Claire Browne, a surgical resident at the hospital, why she was so nice to him the second time she saw him but mean to him when they first met. She called Shaun a “weird guy” when she met him, but asked for his help later. Claire forms a special bond with Shaun in later episodes, and defends him when Neil criticizes him again.

Frustrated with Shaun’s bluntness when he tells patients that their illnesses are terminal, Neil sends Shaun to check up on patients outside of the surgical unit in the second episode. When Shaun runs a test on a girl with a stomachache against Neil’s wishes, he rushes to the girl’s house at 1 a.m. worried that she may not be alive by the afternoon. He saves the girl’s life.

“Shaun is an extreme example because he is a brilliant surgeon. It is possible for him to have this obsessiveness and to be focused on this girl’s health problem. He focused on the issues at hand. But autistic people can disregard rules and authority,” Sibrava says.

The professor adds on that “The Good Doctor” is sensational. Flashbacks reveal adolescent Shawn, enduring awful experiences such as abuse, death of a loved one and homelessness.

Sibrava concluded that while the show is interesting, it can be dramatic at times. Shaun is an exceptional protagonist, but does not represent every autistic person because peoples’ positions on the spectrum vary.

“It is a good idea to show what autistic people can do at their best, but it is important to note that people struggle. A show won’t give an average depiction of autism because it won’t be interesting enough for a TV show. Shaun is a brilliant surgeon, but try not to let Shaun create stereotypes for autism.”