"We're Not Broken," an interview with author and autistic journalist Eric Garcia

Many thanks to journalist Eric Garcia, author of "We're Not Broken: Changing the Autism Conversation," for joining me on this episode of The Art of Medicine with Dr. Andrew Wilner! 

I heard Eric speak on another podcast, "Uniquely Human,” named after the best-selling book by autism specialist Barry Prizant.

Eric is a successful journalist who covers Washington, DC. He is the Washington Bureau Chief of "The Independent." 

Eric knows the political scene inside and out. He's exceptionally knowledgeable about how legislation affects people with disabilities, and more specifically, people like himself who are autistic. Eric has become the "go-to guy" for fellow journalists regarding questions about autism.

During our 35-minute conversation, Eric emphasized that autism research should not focus on vaccines, which have already been proven not to cause autism. Instead, funding should be directed to help people with autism lead more fulfilling lives.

Eric also self-identifies as a person with autism. Due to sensory processing issues, he doesn't drive a car. Eric also has trouble in noisy, crowded places and consequently waits until after rush hour before taking public transportation to work. He also still struggles with socialization. We also discussed how certain of his autistic traits have facilitated his career.

To hear more about what Eric’s thoughts about autism, check out his book, "We're Not Broken: Changing the Autism Conversation."

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Transcript

[Andrew Wilner, MD] (0:08 - 1:54)

Welcome to the Art of Medicine, the program that explores the arts, business, and clinical aspects of the practice of medicine. I'm your host, Dr. Andrew Wilner. Just a little note, I think I finally figured out SRT files, so I'm adding timed transcripts to each podcast, which makes for easy reading or reference.

Let me know if this is a worthwhile addition. There's a button you can press on your phone for feedback. Today, I'm pleased to welcome Eric Garcia.

Eric is the author of “We're Not Broken, Changing the Autism Conversation.” I heard Eric speak on another podcast, “Uniquely Human,” named after the bestselling book by Barry Prizant about people with autism. 

Eric is a successful journalist who covers Washington, D.C., and he knows the political scene inside and out. He's particularly knowledgeable about how legislation affects people with disabilities, and more specifically, people like himself, who are autistic. I'm looking forward to a very meaningful discussion in just a few moments. But first, a word from our sponsor, locumstory.com.

Locumstory.com is a free, unbiased educational resource about locum tenens. It's not an agency. LocumStory answers your questions on their website, podcasts, webinars, videos, and they even have a Locums 101 crash course.

Learn about locums and get insights from real-life physicians, PAs, and NPs at locumstory.com. Now to my guest. Welcome Eric Garcia.

[Eric Garcia] Thank you for having me. 

[Andrew Wilner, MD] Eric, let's talk first about your profession. Give me an idea of your daily routine.

[Eric Garcia] (1:54 - 3:53)

Mostly my daily routine mostly constitutes like, so three out of four, three out of five days of the week, I'm typically on Capitol Hill. Typically, I try to get there by around 10 a.m. Morning, I typically message my boss and say, this is what's going on. And I try to get to Capitol Hill around 10 in the morning, try to get there for votes, try to talk to lawmakers, try to work on stories that we have cooking up.

And then also I write our newsletter inside Washington, which is kind of our breakdown. It's kind of interesting because I'm the Washington bureau chief at The Independent, which is, of course, a lot of people see it as a British newspaper. We see ourselves as a global newspaper that's based out of the United Kingdom, which is funny because I actually haven't been to London.

I haven't been to the United Kingdom ever. But I want to though, but, you know, I think that what we're trying to do is we're trying to explain what, why what's going on in Washington affects the rest of the world. And look, you know, for better or for worse, America is still the leading superpower in the globe.

So what we do matters. We set what the president says and doesn't matter what Congress does matters. And really what I try to do is with our White House reporter, Andrew Feinberg, and our campaign reporter, John Bowden, and a few other reporters, we try to kind of demystify and explain it to a global audience to say why beyond the headlines of the tit for tat, what he said, she said, why what's going on matters and what does it mean for the day to day around the world.

And I think that's kind of what we do. So I lead our newsletter. And on top of that right now, especially with the Trump administration, I've been doing a lot of work coverage on not just Secretary of Health and Human Services, Robert F. Kennedy, Jr., but also all of the sub-bureaucracies within the Health and Human Services Department. So the Administration for Community Living, Centers for Medicare and Medicaid Services, the Department of the National Institutes of Health, and also what kind of legislation is governing it. So there's a big fight right now that's getting ready to happen about Medicaid.

So covering that as well.

[Andrew Wilner, MD] (3:55 - 4:50)

OK, sounds like a busy day. 

[Eric Garcia]Yeah, and that's not during the election season. 

[Andrew Wilner, MD] We're recording this April 28.

So I think no matter where you are in the world, and particularly in the United States, I know today I think they're voting in Canada and Trump has had a big impact there. And really all over the world, we all feel that. I want to just seg a little bit to your book.

[Eric Garcia] Yeah. 

[Andrew Wilner, MD]We're Not Broken. After I heard you speak, and I thought it was a book worth reading, and I read it.

It's written by a journalist. There's a lot of documentation and references. I think it's a very well-researched book.

There's a lot of information there. But before we kind of get into the book itself, tell me, why did you write it?

[Eric Garcia] (4:51 - 9:46)

Yes, I mean, so I mean, I'm autistic like a lot. You know, that was really kind of the impetus to that. But it was really the beginning was about 10 years ago, I was at a party.

And a guy by the name of Tim Mack, who's a really great journalist. He offered me a drink at his party. And I said, I don't drink because I'm on the autism spectrum.

And some of the medicine I take doesn't mix. And instead of him saying, come on, have a drink. He said, oh, there's a lot of autistic people in Washington, D.C. You should write something about that. And I thought, you know, look, I'm really early in my career. I don't want this to be about me. You know, you're taught in journalism school.

Don't make yourself the story, you know. And then what happened was I was working at National Journal at the time. I was covering economics and politics.

That was a great job. That was probably my favorite job I've ever had. You know, it was funny because like that job early on, like, you know, you would go to financial regulation conferences and you would see Elizabeth Warren.

And you go to labor conferences and you'd see Bernie Sanders. And so when Bernie Sanders decided to run for president, like I met a lot of the people who would go on to work for his campaign. But like what happened was the magazine, they decided to, David Bradley, the owner of the magazine, decided to shut down the print edition of the magazine, put everything behind a paywall so you could only pay to read all the stuff.

And so, you know, everybody was deciding to leave. And then what happened was the print magazine editor, a guy by the name of Richard Just, who had been an editor at the New Republic and at Newsweek, he basically said, you know, I want, you know, all you guys to pitch whatever stories you want to me, you know, because I'm going to be out of a job at the end of the year. So I pitched that story idea.

And initially it was going to kind of be like, I don't know, like the secret lives of people in Washington, you know, because Washington DC is such a city where like socialization is so important. Like this weekend, this last weekend was White House Correspondents Dinner Weekend. And like, you know, going to the parties, you know, yes, the parties are fun, but like, it's also like you're working, like I'm handing out business cards, you know, I'm getting business cards.

These are just a few of the business cards I got, you know, so I'm sending out emails right now, like literally right before I talk to you just to follow up with people I met. And that was kind of the plan. It was kind of going to be this kind of like talk of the town kind of piece, this kind of talk of the town kind of piece.

And then Richard, God love him, said, why does this piece need to exist? And I said, well, I think we focus too much on trying to cure autism and not enough on trying to help autistic people live more fulfilling lives. And he's like, there's your piece, go.

And initially he said, I want it to be 10,000 words. I turned in like 14,000 words and then 12,000 words. And then we cut it down to like 6,500 words.

And the reason why, and it was funny because all the while Donald Trump is getting ready to run for president. This is in 2015. And if you remember, Trump was saying in one of the first debates, he says autism has become an epidemic.

It has become something. And he talked about the vaccines. And the thing that I thought was, OK, look, Trump is a liar.

And he peddles conspiracy theories. But I grew up in Southern California. And there are a lot of people who vote Democratic who believe the same thing he does.

And the reason why I did, and then so what my feeling was, and I still believe it, is that almost any conversation about autism in Washington began or ended with vaccines. And my feeling was, and I still feel this way, is that like it is so divorced from what autistic people really need. It is divorced from discussions about autistic people being able to get a job or being able to be able to get out of poverty or transitioning to adulthood or any of the other stuff that we haven't been able to, that autistic people really need.

And, you know, I think that what I wanted to do, the reason why I said changing the autism conversation, is I wanted to move on from that because the vaccine autism thing has been debunked thoroughly. Study after study, the guy who put out the original study lost his medical license, had the study retracted. I wanted to just move on from that.

And what's funny is if you read the actual book, which I know you did, Andrew, you notice I don't mention Robert F. Kennedy Jr. in the hardcover edition. I mentioned him in the paperback, but only once.

And the reason why I did that is because I just thought that we'd already moved on from it. And the book came out in 2021. Um, never in my wildest dreams would I have expected R.F. K. Jr. to become health and human services secretary. So now I feel like it's more relevant than ever.

[Andrew Wilner, MD] (9:47 - 10:54)

Yes. And, uh, you know, this is a medical show and we'll just say that autism is not caused by vaccinations. And as you stated, this has been proved.

It's kind of like, you know, our brain tumors caused by cell phones. It's one of those things that never goes away. And they say it doesn't.

And then five years later, somebody says, oh yeah, but you know, that cell phone, it's right where the brain tumor was. And then they want to spend millions of dollars again to research it and prove that it's true when it isn't. So autism has nothing to do with vaccinations.

Little kids do get autism and little kids do get vaccinations. But, you know, it's just one of those things. It's not, uh, it's association, but not causality.

So you're right. Time to move on. But now we're back.

Uh,, there was just a, you know, there, for those who are following current events. Right. So now there's a new investigation spearheaded by, uh, RFK that, uh, we're going to show that autism is caused by something.

And the subtext is, it's probably vaccinations. Yeah, we're going to do it by September.

[Eric Garcia] (10:54 - 10:59)

Yeah. I was at his, uh, his press conference two weeks ago. And he also said it could be environmental factors.

[Andrew Wilner, MD] (11:00 - 11:17)

All right. So he left the door open. You left the door open to say it wasn't the vaccine.

That's progress. That's progress. Now I want to make this a little more personal.

Um, you self identify as a person with autism, is that correct?

[Eric Garcia] (11:17 - 11:17)

All right.

[Andrew Wilner, MD] (11:17 - 11:28)

So we're talking, we're having a pretty, I would say, usual conversation here. Why, what makes you a person with autism? What does that mean?

[Eric Garcia] (11:28 - 15:10)

I mean, I think that one of the main things is that, um, I still deal with sensory processing. Um, you know, so for example, I don't drive a car. I, um, I try to take mass transit, but even then, for example, um, I, I, you know, I mentioned, I try to get by, get to Capitol Hill by 10 AM.

The reason why I do it is because I can't get on the train by rush hour because there's flashing lights, you know, all the people packed in like sardines, things like that. Um, you know, uh, I have to make sure that, you know, my lights are too low, are low enough in my apartment. Um, uh, you know, I think that also, like, I still have a great deal of difficulty with socialization and kind of interactions and social reading, social cues.

It takes a lot of work. Uh, if you, one thing I'm like, I'm, I'm looking straight into the camera right now. I'm actually not talking, looking, making eye contact with you right now, doctor.

Um, you know, I think that also, like, you know, there are just, there are certain things that are, you know, I think I still deal with overstimulation. Um, and so I think that, but like to the point, um, and I think what was really important for me when I wrote this book, when I wrote my first book and I'm writing my second book now is, um, is to really try to get a good perspective on the entire spectrum, a good perspective on the entire spectrum of autism. So I made sure when I was writing my first book to, um, to really include as many autistic people of any permutation as I could.

So I included non-speaking autistic people. I included speaking autistic people. I included, uh, autistic people who, uh, with intellectual disabilities.

I included women and people of color and transgender people. Um, so I still, so I, I, you know, I think that, you know, to your point that my book is a book by a journalist. Um, I'm very, very aware that, um, my experience is not the entire experience, is not the, not the experience writ large of autistic people.

And one of the things that I did when I, when somebody approached me about writing a book is I said, I don't want this to be a memoir. I was 25 when I, you know, uh, began writing this, writing the book proposal. Um, and I think that my feeling was, look, I'm 25 years old.

I don't have anything interesting to say, you know, as far as a memoir, like you're 25 for God's sake. Um, and I'm 34 now. Um, you know, and I tend to think that if you're writing a memoir at 25, you've got a problem, um, or you're incredibly self-involved.

Um, but, uh, my feeling is, you know, I wanted to, but my feeling was as a journalist, um, the more I thought about it, the more that I realized like all of, like, I didn't get to where I am by accident. I didn't get to where I am because, you know, I'm particularly accomplished or good looking certainly, but like, you know, I think that what I thought was like, oh, like when I started looking at all the policies around people with disabilities, I realized like, okay, I was born in 1990. I was born in the year that the Americans with Disabilities Act was signed by a Republican president and a Democratic passed by the Democratic Congress.

Uh, I was, that was the same year that the Education for Handicapped Children Act became what is now, uh, the, uh, Individuals with Disabilities Education Act or IDEA, which, so I've never known a world where my rights as a disabled person were not codified. Um, now codified does not mean enacted, you know, uh, just because something is the letter of the law doesn't mean that it's actually, you know, put in place. Um, and I think that that was one of the things that really kind of shaped me was like, I, you know, and I think what kind of motivates me as a political journalist is recognizing that, uh, the language of my life, uh, has been policy.

Um, and I think that that was kind of what motivated me to write this book.

[Andrew Wilner, MD] (15:11 - 16:06)

You know, it's hard. I think it's difficult to talk about autism because of the spectrum. Um, and, uh, I'm a neurologist and I wrote a book a number of years ago about epilepsy and epilepsy affects some people in a very mild way.

They might have one seizure a year, you know, they take medicine, their seizures are controlled and they live pretty much a regular life indistinguishable from anybody else, except they take a couple pills a day. But on the other end, there are people who have multiple seizures a day who have severe disabilities and, and they all fall under this category of epilepsy. And it was very difficult to sort of put, you know, how do you write a book for such a, of a diverse audience?

Tell us what you, what do you think about this concept of the autistic spectrum?

[Eric Garcia] (16:07 - 20:16)

Yeah. I mean, it's funny. My friend, John Marble probably put it to me the same way, the way that I think about, you know, you mentioned epilepsy.

It's one of the biggest killers of autistic people, as you know, um, uh, epilepsy, I think like a third of all autistic people have epilepsy. And, um, I think it's, I think the biggest killer of autistic people with intellectual disabilities. So I think it was really important when I was writing my book to include as many voices, but I think the reason why it's so important to talk about, um, a spectrum is a, you want to include as many people as possible, but B, I think that a lot of people, when they think of a spectrum, they tend to think of like left to right, more autistic or less autistic.

Whereas really it's more like a color wheel. Um, uh, you know, a lot of people said this, and I think in the same way we've seen that like, you know, so one of the things that, one of the examples that I use all the time, and I read about it in my first book is, uh, there's this one woman who I profile, her name is Aria. She's speaking.

She is married. She has children. Um, but she couldn't graduate college.

She had trouble in school. Like a lot of it was ableism. A lot of it was like, you know, she had a disability, but like, she just didn't get the proper supports.

Uh, and she had trouble finding work. Um, and then conversely, I interviewed this young man by the name of, uh, Hari Sreenivasan, who was not speaking, um, has, you know, multiple combination needs, high support needs. And, um, you know, for the longest time has put through a lot of therapies, trying to force him to learn how to speak, things like that.

But then he communicates now with a communication device. Um, and he graduated from Cal and he's now, uh, from Berkeley, University of California, Berkeley. And now he's a graduate student at Vanderbilt University.

So tell me who, which one is the low functioning and which is a high functioning autistic person. And I think that that's why I'm not a fan of those terms, because I think that they focus more on what we see, uh, on the outside, rather than what we see what's going on in here and what's going on in here. You know, like, um, studies have shown that autistic people, even non-speaking autistic people learn and process things as much as they can understand what people are saying about them just as much as anybody else.

Um, and I think that that's what I, what I want to say is that like, you know, I think that when we talk about high functioning and low functioning, we really are doing a disservice to ourselves. And really we're doing, we're doing a disservice to, uh, autistic people because what we're doing when we say somebody is low functioning as an autistic person, we are writing them off. Um, in society, we're, we're dismissing the ability for them to do anything or accomplish anything.

Um, and of course they would still have worth and value even if they never played baseball or wrote a poem as RFK Jr. Likes to say. Um, but on top of that, we often just write off their ability to do it. I don't do anything at all.

And I think conversely, when we say somebody is high functioning autistic, we do a disservice to that because then we don't give them the accommodations or supports that they need because, oh, they're high functioning. They might not need that much. You understand this as a doc.

He said, like, they take a couple of pills. Well, you're still, if you're with that, you still need to take your pills. You still need insurance.

You still need, you know, addict access to healthcare. If you don't have a job, you still need Medicaid. You know, um, uh, and you know, my, my, my friend, John Marble, who's autistic, um, he said it best.

And I, uh, you know, and I use this term a lot. Being autistic is a lot like being French, which is to say that, uh, you know, a fashion designer in Paris is going to be very different from a nun in Bordeaux versus, um, a farmer in the Champagne region. But if they were to all have lunch, the Champs-Élysées near the Champs-Élysées, they would have this esprit de corps.

They would have this common understanding of what it means to be a Frenchman or Frenchwoman. Um, and then you and I, you know, we're Americans, you know, where I was like, you know, look, I'm an American. I grew up in Southern California.

Um, but, uh, you know, if I were to hang out with my friends who I went to college with in North Carolina and, uh, you know, some of my friends who live in Brooklyn and some of my friends who live in Florida, we would still have this common understanding as being Americans. Um, it's a little bit more divided these days, but, uh, you know, I, I see that kind of the same thing with autism, you know.

[Andrew Wilner, MD] (20:16 - 20:35)

Let me, uh, ask you, you mentioned, uh, there's some practical ways that the autism gets in the way of you getting to work on time and you have to basically accommodate yourself by taking the bus at a later hour. Are there any ways in which autism has helped your career? Yeah.

[Eric Garcia] (20:35 - 20:44)

I mean, I think it kind of helps me with like, kind of, um, focusing singularly on something like something like what is a journalism beat, but a special interest.

[Andrew Wilner, MD] (20:45 - 20:55)

Um, right. So hyper-focus that's one of the qualities, right. Of people with autism is they have these special interests or hyper-focus or.

Yeah.

[Eric Garcia] (20:55 - 22:36)

No, like I genuinely, I genuinely love and live for campaigns and looking at election data, looking at FEC data, I tend to think that that's like such an instructive, um, bellwether. Um, you know, it was funny, like just a few weeks ago, I was looking through campaign data and I noticed that Senator Dick Durbin had not raised a lot of money. And I was like, oh, this might be a sign that he might be getting ready to retire.

And like a week later, he announced he was not running for reelection. Like, you know, you could just tell that if somebody is 80 years old and it's not fundraising when they're up for reelection, you can just, you can just tell, um, that they're not running for reelection. Um, and in the same respect, I think that like, you know, um, you know, I'm not somebody who's like that good at like talking to people on background or things like that.

You know, like I'm good at like asserting myself. So like when I went to that press conference with RK Jr, I wanted to park, I parked myself immediately up in front of him so that he couldn't ignore me and that I would be the first person to get a question. In the same way I do that at press conferences with, um, with, um, Speaker Mike Johnson, with, uh, House Minority Leader Hakeem Jeffries or any kind of, and I'm, I'm good at somebody who's, I'm, I'm good at not taking no for an answer.

I'm good at kind of like making sure that I get somebody to answer my question, even when it, even when they, even when they're kind of trying to dodge, you know, uh, or as they say these days, uh, you know, but, uh, but, but, but like, I mean, I think that that, I think also like as an autistic person who kind of finds, you know, socializing and social interactions really weird. I think it kind of allows me to take a step back and look at like kind of the whole board just because this is kind of a foreign language to me. So I think that, I think those are some ways.

[Andrew Wilner, MD] (22:37 - 22:44)

I, you know, the, uh, numbers now are approximately, I think they just revised them about one.

[Eric Garcia] (22:44 - 22:45)

One in 31.

[Andrew Wilner, MD] (22:45 - 23:32)

One in 31. So that's basically roughly three in a hundred. And so there are a lot of parents out there that have, you know, little children, two years old, three years old, and they send them to school and the kid has trouble and the principal comes and talks to them and says, you know, I think you need to have your child tested.

Your, your child is not doing well in our, in our pre-K, um, might be autistic. I'm not the one to say, but we would like to refer you for some testing and, and until that's accomplished, please don't come back. And, um, what, what kind of advice would you give to parents who are facing a new diagnosis of autism in, in, in their beautiful little, you know?

Yeah.

[Eric Garcia] (23:32 - 26:12)

What I would say, what I would say is that now there are, are, is that, you know, don't be afraid of the label. You know, I hear a lot of parents say, oh, we don't want to give our kids a label of being autistic. The label is also a roadmap.

You know, as soon as you, as soon as you know what your, what kind of brain your kid is working with, then you realize, oh, they're not, you know, I think about it because like even I got diagnosed when I was eight, you know, when autism, a lot of the public understanding around autism was kind of changing in the nineties. Um, and I think that like, that was so incredibly helpful. Um, and also like at the same time, I, I, I, I don't envy any parents right now because like, you know, there's so much misinformation, so much disinformation, especially now, you know, given the current administration.

Um, but I really do think that giving that, like, if you have that roadmap, then you realize like, I think about what I'm trying to make is that like, it wasn't until I got older and I met a lot of other autistic people that I realized, oh, I'm not a bad person. I'm not lazy. I'm not maladaptive.

I just, I, you know, this is just how my brain works. And then I learned and I tailored, you know, to your point, like I said, I kind of self accommodate, like it's really funny how, um, for all of the talk about how autistic people are inflexible or they don't, uh, or they're intransigent or they're not good with adjusting to change. Autistic people are remarkable in their ability to self-innovate and self accommodate and come up with things to almost contort themselves, to make other people, to make neurotypical people comfortable.

And I think that what I would say is that nowadays you now have a society where there are enough autistic elders and autistic adults who can, who are resources, who are willing to help, uh, who are willing to be on the war footing with you, not to like combat or fix autism, but just to like fight it, fight and protect your kids and make sure that you have the supports you need and to fight for the resources you need. Um, you know, I've said that like, you know, right now, um, autistic people kind of, we autistic people, their parents, their educators, their loved ones, their, their doctors and everybody else right now needs to be on a war footing, given how much misinformation is being spread right now around autism.

And I think that right now more than ever getting an autism diagnosis is so important, but like also, unfortunately what I would say is like, I totally, like, I, I wouldn't begrudge any parent who is afraid of giving their kids the label right now, just because we're seeing so much misinformation and so much, uh, stigmatization. But I would say that in the aggregate, getting a diagnosis is much more important, uh, even in a really, really fraught time, such as this.

[Andrew Wilner, MD] (26:13 - 26:27)

Doctors always recommend pediatricians, uh, when the diagnosis is made, say in a three year old or a four year old, or in your case, eight early intervention, we need to do therapies. Um, what helped you the most? Yeah.

[Eric Garcia] (26:27 - 27:41)

So I was in occupational therapy a lot, you know, ADA, even though it's been around since the seventies, that wasn't really something that was practiced. We did a lot of occupational therapy. We did this thing.

I remember when I was a kid, we did this thing called handwriting with no tears. And, uh, you know, when I'm, I'm, I'm telling me it's funny, my mom and I were, my mom was the one who recalled it earlier today or last week with me when we were talking. And she was like, you know, it was so, um, important because that was the first time somebody could understand your handwriting and you want an award for your writing.

Cause you wrote about what it was like. We were living in Texas at the time and you wanted to be an astronaut and you wrote about what it must be like to be in space. And so I think about that.

And, uh, again, you know, the point that I make is that that was part of what I was living in Texas at the time when George W. Bush was governor of Texas. And the reason why I said that was important is that George W.

Bush, a Republican, the son of George H. W. Bush, um, believed in special education and believed in disability education and poured a ton of money into it.

I wouldn't be where I am. Had it not been for those accommodations, nobody, I wouldn't have had the opportunity to, you know, I was still, you know, people still would have thought I'm, I'm a bad student and I wasn't good at writing cause my hand, my handwriting was illegible. But it was because of that, that I was able to succeed because of that, that somebody recognized that it was a good writer.

[Andrew Wilner, MD] (27:41 - 27:58)

And that's how I have a job as a writer today. So there was the, these accommodations were extra time, some one-on-one teaching. So someone could help you with your handwriting.

What, what, give me an example. What were these other accommodations that were made that help you develop? Yeah.

[Eric Garcia] (27:58 - 28:33)

So like when I was in college and you said, you said extra time and extra, um, you know, I was able to take my tests specifically for math in a quiet setting. And that was the only way, I mean, I still got a C in math, but like I, you know, for some of them, but like I still was able to pass. And it showed that like, you know, if I was given the opportunities and I was given the same chances, uh, you know, I didn't get any help on these tests.

It's not like I had somebody looking on my shoulder, giving me the answers. I, you know, but just like having that extra time and being in a quiet space allowed me to even succeed and have a fighting chance to graduate college. Which you did.

Yes, I did. I went to the, I went to the University of North Carolina, baby.

[Andrew Wilner, MD] (28:33 - 28:38)

All right. Let's get back to your book. What, what's been the response to your book?

Yeah.

[Eric Garcia] (28:38 - 30:09)

I mean, so it's, I, you know, I mean, there are always people who are always going to, you know, be critical and things like that. But for the most part, it's been really positive. And I think what's really funny is that, so I wrote, I published the book in 2021 and it was really interesting because I published it.

We did, we, we, we published it later because we were hoping, hoping that COVID would be over. And then, you know, if you remember like, you remember how glorious April, 2021 was when we were all getting vaccinated and we were going to restaurants, that was an amazing time and then Delta hit. And then, so most of, most of the events I did in August of 2021 were remote.

I think I only did one in-person event, two actually. I did one in-person event at the University of Delaware and I did another at the University of Chicago. And then, but then what was funny was it wasn't until 2022 when the paperback edition came out that I started getting a lot more feedback on it.

And then more people started reading it. And I think a lot of people really started to realize what I was doing. And I think it might also, like, take into account that might be selection bias because like, look, if you're writing a book, if you're reading a book by an autistic person saying we're not broken, you're more likely to believe that like autistic people are fine as they are, you know, like that, that might just be selection bias.

But I think for the most part, it's been mostly positive. And, you know, it's, it's really something, I mean, and now ironically enough, I've kind of carved out a niche for myself in Washington writing about autism, especially in this kind of weird time with Robert F.

[Andrew Wilner, MD] (30:09 - 30:36)

Kennedy Jr. Well, there's so many topics I want to broach. This is a difficult one, and I just want your take on it. And you mentioned it in the book that there seems to be a relative increase in the number of people who identify with the LGBTQ plus.

Correct. Domain in the autism population. Can you make any sense out of that?

[Eric Garcia] (30:37 - 32:59)

Yeah. I mean, I think, you know, I often joke that when I'm, that when I'm, that when I'm on autism, when I go to autism conferences as a cisgender straight dude, I'm often in the minority and I'm only half kidding. But like, I mean, I think it totally makes sense because, you know, study after study has shown that most, that a large chunk of autistic people, more than the general population do not identify as cisgender or heterosexual.

And I think one reason why that's the case is I think that a lot of autistic people, I actually think a lot more autistic people are a lot more comfortable coming out than like the general population. I mean, I can't say that, you know, I'm not a researcher, I'm not a doctor, I don't have a PhD or anything like that. But I think a large reason is that like, if you're autistic, you're like, what, like gender norms and sexual norms, what are they?

They're just, they're social norms. So you're more willing to question them if you're autistic. You're more than willing to question, you know, why do I believe this?

Why am I, why do people do this? You know, even like, you know, even when I was a teenager, I was like, am I sure I'm a guy? Like, how do I know I'm not a woman?

Because I knew trans people. And then like, I was like, you know, I was like, am I sure that I'm attracted to women? And then like, and then like, and then like, after a certain amount of time, I was like, oh, no, I am attracted to women.

You know, but like, and I could see how if you're trans, I mean, if you're autistic, you might be more willing to examine those kinds of social norms. And you could realize, oh, yeah, I really am trans, or I really am non-binary, or I really am gay or bisexual. And I think that you're, I think that like, or I think that just you're willing, you're willing more because like these social norms are just not a native language to you.

You're more willing to examine and question them. Just like how, you know, if you are a black person, you're more likely to think about whiteness and power structures within that exist within whiteness. Or if you're a woman, you're more likely to examine gender norms and gender hierarchies.

Or if you're an immigrant, you know, the kind of, you know, what are the kind of privileges and rights and benefits that come with being a native born American versus being a naturalized citizen, you know. So I think those are all kind of the contributing factors. But like, what worries me the most is that like, I worry that a lot of bad faith actors are using the fact that a lot of people in the LGBTQ community identify as autistic as an impetus to kind of restrict their ability to live their lives fully.

[Andrew Wilner, MD] (33:00 - 33:03)

Right. So it could magnify the stigma.

[Eric Garcia] (33:04 - 33:04)

Yes.

[Andrew Wilner, MD] (33:05 - 33:20)

Yeah. That would be unfortunate. I got one last question and it's kind of a tough one.

Suppose Pfizer comes out tomorrow and they announce that they have a pill that you can take and it will cure autism. Would you take it? I can only speak for myself.

[Eric Garcia] (33:21 - 35:12)

I don't think I would because I think that, you know, it would be changing immutable traits. I would love if there were a pill that would help with sensory processing. I would love if there were a pill that would make it easier for me to drive a car.

But I wouldn't change who I am. And that's a very different thing. You know, like, I mean, I think that, you know, it's funny, I live in Washington, D.C. And I used to live near H Street, which is where Gallaudet University is. And I met a lot of deaf people. I met deaf people, you know, you just would see deaf people like they were my neighbors, you know, or they worked as baristas. And, you know, a lot of deaf people are saying like, would say like, no, I don't want to, you know, cure my deafness.

Or, you know, a lot of people say that, like, you know, a lot of my friends use wheelchairs and they're like, no, I'm not wheelchair bound. Being in a wheelchair allows me to get around. I don't think I would change it at the same time.

Like, I would, I go to what my friend John O'Robinson says, like, you know, we should mitigate the parts of autism that are incredibly disabling and magnify and celebrate the parts of autism that allow us to, that allow people to live wonderful lives. You know, I think that, like, you know, it was funny, you know, I think a lot about like, you know, so I feel like it's all a lot. That was what I wanted to do before I'm a journalist.

I think about how much of our, how much great music comes from just accidents, little happy accidents, how many songs were written because you were trying to play one thing and then you come up with another thing. And I think that getting rid of, getting rid of autism, getting rid of any disability, whether it's Down syndrome or deafness or blindness would erase what makes us human.

[Andrew Wilner, MD] (35:13 - 38:08)

I love it, Eric. Okay, we're going to wind up. Is there anything you'd like to add?

Not at this moment, no. Thank you, though. Eric Garcia, thanks for joining me on The Art of Medicine.

Thanks so much for having me, Andrew. I'll just add that for those who would like to learn more about autism, I interviewed Temple Grandin, perhaps the best known person in the world with autism. And that was episode number 125, about six months ago.

I also interviewed Emily Santagatti, who works with the Centers of America, a company that offers ABA therapy, which has its own story. And that's episode number 76. And now a final thanks to our sponsor, locumstory.com.

Locumstory is a free, unbiased educational resource about locum tenens. It's not an agency. Locumstory exists to answer your questions about the how-tos of locums on their website, podcast, webinars, and videos.

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Thanks again to locumstory.com for sponsoring this episode of The Art of Medicine. I'm Dr. Andrew Wilner. See you next time.

This program is hosted, edited, and produced by Andrew Wilner, MD, FACP, FAAN. Guests receive no financial compensation for their appearance on The Art of Medicine. Andrew Wilner, MD, is Associate Professor of Neurology at the University of Tennessee Health Science Center, Memphis, Tennessee.

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