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Mel wasn’t particularly surprised when she finally got her autism diagnosis. She would’ve been surprised a few years ago, but not anymore.
Growing up with Becca, Mel had only really known the way autism presented in her sister. She related to Becca in a lot of ways, but she had always figured it was because they were sisters and best friends, not for any other reason. But, a few years ago, Mel had started seeing more and more online about autistic people with low support needs, and a lot of it hit very close to home. So she’d started doing proper research and … suddenly a lot of things in her life made a whole lot more sense.
She’d sought out a diagnosis after that. And now, finally, she had it. The question was: What now?
She told Becca first, obviously. She told Becca almost everything first, no matter what it was.
“Really?!” Becca said, struggling for a moment to take in the news.
They were sitting on the couch in their apartment, the TV on but with the volume off. Mel twisted her hands in her lap, unexpectedly nervous about this.
“Really,” Mel confirmed. “I got the diagnosis today.”
Becca nodded a few times, then broke into a smile. “Cool!”
Mel broke into a smile too, ten times bigger than Becca’s. A huge weight lifted off Mel’s chest.
“Can I hug you?” Mel asked.
Becca thought about it for a moment, then nodded. “Yup!”
Mel wrapped her arms around her sister, feeling a lot of pieces fall into place in her life.
Then came the harder question, which was: What now at work?
She decided to speak with Dr. Robby first. It was hard, because he was always busy, and honestly, so was she. But she caught him in the break room one day, eating a protein bar at a speed that was decidedly not recommended.
“Dr. Robby!” she exclaimed, her heart suddenly jumping to her throat.
Was she really doing this?
Yes. Yes, she was.
“Dr. King,” he said, wolfing down the last of the protein bar. “Do you need my help with anything?”
“No. Uhm. Yes. Kind of?” Mel swallowed, hard. “I was wondering if we could talk.”
Robby glanced out of the window of the break room, seemed to decide that he wasn’t needed immediately, and nodded.
Mel fiddled with her hands, looking down at her shoes. “I … Uhm. I… Uhm …”
Why did this have to be so hard?
Robby took a few steps toward her, clearly concerned. “Is something wrong, Dr. King?”
Mel shook her head. Nothing was wrong. She was just … She was just… She was so unnecessarily, nonsensically, annoyingly nervous.
“I recently got a, uhm, diagnosis.”
That was obviously the wrong thing to say, which she only realized after the words had left her mouth. Robby took an automatic step towards her, his eyes widening.
“Not like that!” Mel rushed to say, noticing the way Robby’s shoulders immediately sagged in relief. “I- I’m autistic.”
Robby put a hand to his chest, letting out a relieved laugh. Mel cringed at herself.
“Thank God,” Robby said, laughing a little more. “Jesus, Mel, why did you have to word it like that?”
“I don’t know,” Mel muttered, her cheeks heating up with embarrassment. “I was just nervous, I guess.”
Silence. Then he asked carefully, “Why?”
Mel looked anywhere but Dr. Robby. She shrugged. “People don’t know a lot about autism, not even people here, so…” She shrugged again.
She wasn’t even fully sure herself what she’d been afraid of. Just … something. A big, scary something.
“That is true,” Robby agreed. “And it’s something I’ll personally work to change.”
Mel looked up at him, relieved to see him smiling at her. “Oh. Good.”
“Do you need or want any accommodations, Mel?”
Oh.
Mel had spent her whole life with Becca, who needed a lot of different accommodations, but she’d never really considered if she needed those herself. Sure, she wore headphones and listened to white noise and watched sensory videos to calm down, but those were coping mechanisms, not accommodations.
… Or were they?
Mel thought about Becca’s accommodations, wondering if she’d want any of those herself. Oftentimes, when Becca got overstimulated, they found the nearest quiet room and she’d stay there until she’d calmed down. That might be nice. Not for hours, but for a few minutes, maybe?
“Yeah,” Mel said after a while. “I think I’d like some accommodations.”
She told Samira next. They’d become fairly good friends, and Mel wanted her to know. So, one night, as they both clocked out and walked to the parking lot, Mel cleared her throat.
“Uhm, Samira?”
“Yeah?”
“I uhm…” Mel wondered how long it would take until saying the words ‘I’m autistic’ became as easy as saying ‘My name is Mel.’ A few decades, she figured. At least.
Samira stopped and turned to look properly at Mel. It made her a little uncomfortable, so she looked away.
“What’s up?” Her tone was lighthearted, but it was clear that she was concerned. Mel really needed to stop making people concerned when she was just trying to tell them about her autism.
“I’m autistic,” Mel forced out.
“Oh,” Samira said. “Thank you for telling me, Mel.”
“You sound a little surprised,” Mel pointed out.
“I guess I am, a little,” Samira admitted, which Mel appreciated. Hell, Mel had been surprised when she’d first started to suspect it, so it was completely fair. “I guess I don’t know enough about autism.”
“Very few people do,” Mel said.
“I’ll do some reading,” Samira promised, which made Mel’s heart warm.
“Thanks. Not everything out there is great, though, so, you know, be critical of your sources.”
Samira shoved her shoulder lightly. “I’m a doctor, Mel. You think I got this far just believing everything Google told me?”
Mel laughed, another little weight lifted off her chest.
The next time Mel told someone, it was kind of an accident. She was looking at the board to find her next patient. Beside her was a box full of different pamphlets. She looked at them, noticing a few new pamphlets in the box about autism that hadn’t been there before. She made a little note to herself to thank Dr. Robby later.
Dr. Santos sidled up beside her.
“Finding anything fun?” Santos asked.
“We’re not allowed to cherry pick,” Mel reminded her.
“Oh, I know. But don’t you just hate it when there’s zero percent chance of your patient dying?”
Mel’s jaw dropped. “No, I absolutely don’t, I–”
“Calm down, Dr. King,” Santos said with a laugh. “I’m kidding.”
“Oh.” Mel’s cheeks flushed. Before she fully knew what she was saying — the autism pamphlets clearly still on her mind — she blurted out, “I’m autistic, so I don’t always pick up on sarcasm and jokes.”
It was as if the entire ER froze. It didn’t, of course. Only Santos and Dana — oh my God Dana — had heard her, so they and herself were the only people who had actually frozen still. But in Mel’s mind, everything had stopped.
Had she really just said that?
Santos let out a breath. “Mel, I’m so sorry, I–”
“It’s okay,” Mel rushed to assure her. “Really, it’s fine, I don’t mind. I don’t know why I said that. I didn’t…”
Desperately, she looked to Dana.
“Dr. Santos, Dr. Mohan needs assistance,” Dana said, gesturing to Samira with her head. It didn’t look like she needed help, but Dr. Santos nodded and rushed over to her nonetheless.
“Thanks,” Mel breathed.
Dana grabbed her hand and squeezed it once before letting go.
“You’re brave, kid,” Dana said with a wink. Mel let out a small laugh and winked back.
“Dr. King?” Robby called out to her as she was walking to the board to find a new patient. Her head snapped up to look at him, switching her route as she saw him wave her over.
“What’s up?” she asked when she got to him.
“I need your help with a female patient, Emily Anderson.” He gave her a quick rundown of the patient's injuries, then lowered his voice and said, “She’s pretty agitated and refuses to be touched. She’s autistic, so I figured maybe you know more than me about how to best handle this?”
Mel’s heart stuttered, then soared. “I- I will try my best.”
Robby clapped her on her shoulder. “You always do. Hey, maybe one or two people can observe, to try to learn some from the best?”
Mel hesitated. “I’m sorry, but I think it might be too overwhelming.”
“That makes sense. Thank you, Dr. King.”
Mel did what she usually did when she knew or suspected that her patients were autistic: she closed the doors, dimmed the lights, talked through what she was going to do as thoroughly as possible. Autism was a spectrum, and everyone had different needs, so she tried her best to listen to her patient and notice their body language and other non-verbal communication — listening to the patient was always the best way to make them feel safe, regardless of their neurotype.
Emily seemed calmed by her presence, which made Mel incredibly happy. It also made her a little annoyed at her coworkers. It wasn’t rocket science. They just needed to accommodate their patients and try to understand their needs better. Sure, if you knew nothing about autism, it might be harder, but they ought to know this stuff. Their patients deserved it.
“Incredible work with Ms. Anderson, Dr. King,” Dr. Robby said later that day.
“Thank you! And sorry for not being able to bring anyone in to observe,” Mel said, even though she wasn’t all that sorry.
“You did what was best for the patient, which is always the most important thing.”
“I was thinking, though, maybe I could do a little presentation or something about how to treat autistic patients?” Mel suggested, the words coming out in a nervous rush. “‘Cause I think a lot of our patients would benefit from it.”
Robby stopped and smiled at her. “Mel, that’s a wonderful idea.”
A week or so later, after the day shift was over, both doctors and nurses gathered in the break room. Mel hadn’t made a PowerPoint or anything, but she’d written a two page script for herself. She was clutching it nervously now, watching her coworkers file into the break room.
Dr. Robby gave her a thumbs up, letting her know that she could start.
Mel took a deep breath. “Hi, everyone.”
She was met with tired smiles, which was fair, since it had been a long day.
“Don’t worry, this won’t take too long,” she assured them. “But I hope you can agree with me that this is important knowledge for you.”
She cleared her throat, looking down at her script. The words turned a little blurry. Maybe she was even more nervous than she’d thought.
“As some of you know, my sister is autistic.” Mel smiled at the thought of Becca. “Uhm… As fewer of you know, I …” Mel looked up at her coworkers. Samira sent her a supportive smile, which was enough for Mel to get the courage to say, “I am also autistic.”
A few wide eyes. A few confused looks. A few supportive smiles. Not the worst that could’ve happened, Mel supposed.
The scariest part was over. Now Mel could do the thing she actually wanted to do: educate her coworkers.
The presentation went smoothly. She spoke a little about both her and Becca’s experiences with autism, a lot about her experience with autistic patients, and a fair amount about autism in general and how to best accommodate it. She stressed the importance of actively listening to the patient (and their caretakers) — even if they were non-speaking.
“What you might see as rudeness or refusal to cooperate, is likely just an attempt at communicating a need in a stressful environment,” Mel said. “Try to make the environment less stressful, then try to figure out your patient’s needs. That’s what we’re here for, right?”
A pause. Mel folded her script and put it in her back pocket.
The room exploded in applause. The sound was loud and overwhelming, but also made her want to cry tears of joy.
Then Samira said in a somewhat joking tone, switching from clapping to snapping her fingers, “Guys, have we learned nothing?”
A few people laughed, and then everyone switched to the much less overwhelming form of applause. Mel smiled gratefully at Samira.
After the presentation, almost everyone came up to her to compliment her and thank her. Mel was overwhelmed with joy. It was weird and terrifying that basically all of her coworkers knew that she was autistic now. It was also pretty freeing. She didn’t have to worry about how to tell people anymore. Now it was done. Over. Everyone knew.
Dr. Santos came up to her and apologized for laughing at her for not understanding sarcasm, to which Mel said, “Honestly, Dr. Santos? I don’t really know if I can ever forgive you for that. It broke my heart.”
Santos’ eyes grew so big that Mel couldn’t help but burst out laughing. Santos punched her shoulder lightly, muttering, “Asshole.” Her tone sounded weirdly affectionate, though.
Samira hugged her and said, “That was so insightful, Mel. You’re amazing!”
Dr. Collins told her, “That presentation was so important, Mel. Thank you.”
Dana called her brave again.
Everything was perfect.
Then Langdon came back.
Everyone knew more or less why Dr. Langdon had had to leave, and everyone was walking on eggshells around him when he came back. Mel noticed both dirty and concerned looks. She tried to give him neither; she tried to treat him like a normal person.
Because that was what he was. A normal person who had been ill and was now in recovery.
He was also a normal person who had been gone for several months, completely missing everything that had happened with Mel since the day they first met.
Mainly, he didn’t know that she was autistic. And she wasn’t sure how to tell him. It had been so long since she’d had to tell anyone that she wasn’t sure if she knew how to anymore. She remembered how she’d told Dr. Robby, still cringing at herself after all these months, and decided that she at least had to do better than that.
She tried several times, but was always interrupted by a patient in critical condition being rushed in, or someone asking for her or Langdon’s help, or something else. The ER was far too busy for personal conversations. It took weeks before the opportunity presented itself.
The day she finally told him, Mel was taking a short break in an attempt to calm down her overstimulated brain and body. She sat in a small storage closet that was mostly full of mops and stuff, in which Robby had put a pretty comfortable chair when Mel had asked for somewhere quiet and private to take breaks.
He’d initially talked about getting her her own break room, perhaps in one of the upper floors, but Mel had declined. She didn’t want to be far from the ER in case something happened, and she also didn’t want to take up more space than necessary — which wasn’t something she was ready to unpack quite yet.
So, storage closet it was. It was honestly pretty cosy. She liked the small, dark space and the comfy chair. She had her headphones on, watching a sensory video on YouTube, which was why she didn’t hear Dr. Langdon knocking.
So she was startled when he opened the door and looked down at her. Generally, people knew not to disturb her during her breaks, but Langdon of course didn’t. She felt more than a little guilty for not having told him yet.
“Is something wrong?” Mel asked.
“No, I just–” Langdon looked at her like she was the biggest mystery in the world. “I saw you walk in here, and I figured you were just going to get something, but when you didn’t come back out, I got a little concerned.”
How long had he been watching her to make sure she was okay? The thought made very embarrassing butterflies appear in her stomach.
“I’m okay,” Mel assured him. “I’m just taking a break.”
“In a storage closet?”
“In my own private little break room,” Mel said with a smile.
Langdon let out a laugh. “And why do only you get one, huh? I’d love a private break room.”
“Because I’m autistic,” Mel said, the words coming out more easily than she’d expected. Maybe she still knew how to do this.
“Oh,” Langdon breathed.
Mel watched him, trying to analyze his reaction, but she wasn’t able to. It made her feel like her heart was trapped in her throat – medically impossible, of course, but still a very vivid feeling.
“Can I come in?” he asked after a while.
Mel nodded. He closed the door and sat down on the floor somewhere in front of her. She could see his vague outline, but not much more than that. Only after he’d sat down did she register the fact that she was alone in a small, dark room with Frank Langdon. Her cheeks flushed, and she was glad he couldn’t see it.
“So Robby knows?” Langdon asked.
“Yup.”
“Who else?” he asked. “So I know who I can and can’t mention it to.”
“Uhm.” Mel always felt bad when Langdon was reminded of how long he’d been gone, and she hated that she had to be the one to do that now. “Everyone knows.”
“... Oh.”
“I had a presentation a while back on how to better treat autistic patients,” Mel rushed to explain. “I thought it would be useful. Uhm, I can have that presentation for you too, if you want? So you’ll be on the same page as everyone else.”
Langdon let out a breathy laugh. “Yeah, that’d be nice.”
Mel smiled. “After this shift, maybe?” She still had the script in her locker.
“Sounds good.”
They sat in silence for a while. Mel couldn’t tell what Langdon was thinking. It was a little terrifying. She wondered if she should get up and leave, but that would mean no longer being alone in a small, dark room with him, and she honestly wasn’t ready to give that up just yet.
His legs were so close to her feet. If she moved just a tiny bit, they’d be touching.
“Do you want to tell me a little about it?” Langdon eventually said, his deep voice breaking the tense silence.
“About what? I can have the presentation now, I guess, if you’d rather hear it immediately, but–”
“No, I mean about you,” Langdon said, gently interrupting her. “How does it affect you? Is there anything you need?”
Mel smiled a little. “How much time do you have?”
Langdon chuckled. “Okay, tell me one thing. Then you can tell me more when our shift is over.”
“All right…” What was the one thing she wished people knew? That she wished Langdon knew? She could tell him about her sensory issues, about how easily overwhelmed she got, about how much everyone else’s emotions affected her own… But the thing she really wanted him to know, that she’d always wanted people to know, even before she knew that she was autistic, was: “I have a hard time understanding all the ins and outs of social interactions. I often misunderstand people and often say the wrong thing. So if you ever think I’m, like, super weird, that’s why.”
Mel hated that word. Weird. Becca had been called it more times than either of them could count, and Mel had been called it a fair amount of times herself. It was such a strange insult, because there was nothing wrong with being weird. It wasn’t like being an asshole or something. “Weird” people weren’t hurting anyone by being weird. And still, people managed to get so wildly offended by someone existing and living in a way that didn’t make sense to them.
Mel didn’t want people to think of her as weird. She didn’t want anyone to think of anyone as weird, but that was far outside of her control.
“I’ve never thought of you as weird, Mel,” Langdon said, his voice soft. “And I never will.”
“Oh… Thank you.”
“Thank you, for sharing this with me.”
Mel almost wanted to reach out and hug Langdon, but before she had even fully formed the thought, he stood up and opened the door.
“You ready to go back yet?” he asked.
Mel nodded. She’d calmed down her senses. Her heart was another matter. But having a high pulse while working in the ER wasn’t that unusual.
“Great,” Langdon said with a smile. “Let’s go find a patient, huh?”
Mel followed after him, smiling as yet another piece fell into place. Everyone knew now.
She could be herself, fully and truly.