On the first day of class, Gregory stood out as different, even bizarre. While he contributed eagerly to class discussion, his comments were off topic and they often focused narrowly on his own concerns. Because this was a composition class, I noted immediately that his way of thinking about writing was rigid, mechanical, and occasionally extreme. In the first several weeks of class, for instance, Gregory probably asked a hundred questions, in and outside of class, about the mechanics of MLA citation. In addition, his speech was stilted and he did not look at anyone but me when he spoke. He also could not follow the class's jokes, although he seemed to have his own private sense of what was funny and would smile and rock in his chair when something amused him. There was something so unpredictable and unfamiliar in the ways he used and understood language that our communication always seemed off balance. While Gregory's oddball charm saved him from becoming a complete outcast, everyone in the group, myself included, had difficulty interacting with him.
The challenge that Gregory posed for me and for the other students in the class is that of understanding and empathizing with neurological difference. That is, while the other twelve students in the class and I all seemed to be distributed along the "normal" band of the neurological spectrum, Gregory presented as someone with Asperger's syndrome, a condition related to autism. People with autism are very rarely found in college classrooms, of course, owing to their typical difficulties with language and social interaction. Although people with Asperger's also have impaired social skills, fixed interests, and, at times, repetitive behaviors, they are more likely to attend college because they possess normal intelligence and language. Some, like Gregory, are characterized as "little professors" because they display both the extraordinary [End Page 1] intelligence and the social eccentricities commonly associated with the figure of "the absentminded professor." Although Gregory's behavior was unusual, his fundamental difficulty was communication. The other students struggled to make sense of his offbeat modes of self-expression, and he struggled even more profoundly to make sense of us and our expectations. Autism experts Uta Frith and Francesca Happé have examined the verbal communication of people with autism and Asperger's and found that, even for those whose language, vocabulary, and syntax are like those of neurotypical adults, communication and comprehension are still impaired, especially in situations that require them to take into account a listener's thoughts and feelings, such as when a listener needs to be supplied missing facts. They can also have difficulty with non-literal language and with the double-voiced and implicit humor of irony.1
Because Gregory's neurology limits his comprehension of irony, he could not appreciate that his presence forced me to confront the challenges of neurological difference in a course about medicine and culture that grew out of my research into the puzzle of autism. In fact, my work with Gregory compelled me to reframe my interest and to consider the challenges to affective and intellectual understanding posed by neurological difference in the particular context of the classroom. Thus, in what follows, I explore the promise and problems of empathy in situated institutional practices, such as teaching and medicine, as well as in writing. My central questions are these: In the interpersonal and institutional contexts of teaching and medicine, how does one make contact across a neurological divide? If language impedes comprehension as much as it enables it, then will such contact always be frustrated? In situations where verbal and affective communication are difficult, such as with neurological difference, is empathy possible?
A turn toward empathy is a turn into contested territory. In my chosen disciplines of literary studies and composition studies, as well as in clinical medicine, there is, understandably, considerable apprehension about venturing into realms of understanding that are governed by feeling rather than reason. Scholarship in the medical humanities, however, has focused more and more attention on the necessity of empathy in medical practice. Howard Spiro's anthology, Empathy and the Practice of Medicine: Beyond...