Autism and medicine - is it worth pursuing diagnosis or will it be a barrier?

Update: Went ahead for various reasons - GP seems convinced and is referring to "somone" but doesn't know quite who to yet because by the time anything happens via CAMHS I shall be an adult for funding purposes so they're reluctant to accept but the local "Adult ASC team" won't accept somebody without adult funding, the politics of the NHS being how it is. Apparently I should hear from the GP surgery exactly which service is getting the referral within a month, and then it's up to them.

Thanks for your help, now it's a case of wait and see! 

Sounds like you have received excellent advice.

I'm both a qualified doctor and have Aspergers Syndrome. Although I didn't know when I applied or through medical school.

As long as you can prove you have the right qualifications and attidude they are looking for you shouldnt have a problem getting in.

I am a very empathetic person when I can see someone is suffering but struggle more when its not clear. Medical school gives you lots of teaching on communication skills which is definitely helpful.

Writing this on nights, which messes up the routine system!

All the best!

Thank you all for your replies - I really do appreciate it.

Marjorie195, with regard to the multiple empathies theory, could you explain exactly what this means? If cognitive empathy relates to the ability to identify the thoughts of others then what function do the others have?

When you mention taking hints, in social life I guess I have similar issues - always ending on an awkward silence and then being avoided, but I guess that's something I'm exactly used to! In practice though, "is there anything in particular you're worried about" is a strategy I've been told about for dealing with concerned patients who are struggling to find the right words but I've never really considered using this type of exchange before. It's rather helpful how discussions like this are producing new ideas!

I'm probably going to wait and see how the new academic year and transition to A2 level goes, and decide based on that how to proceed. Thank you very much for all your help, everyone!

I am rather confused about the empathy/autism issue. I would say that in the medical field you need to be able to imagine what the patient is going through to a certain extent, in order to show sympathy/take appropriate action, but it probably doesn't matter if you have arrived at that point via pure logic. 

It is probably an advantage if you are able to remain emotionally detached - if I am ill it is nice to have a bit of tea and sympathy, but without practical backup, it is useless. Actions speak louder than words!

I scored 31 on the empathy test, if anything I am hyperempathetic, eg seeing people cry even over minor issues makes me tearful (rather annoying at work!!) In a major crisis however I do go into logic mode, which I see as a good thing.

I have read a bit about empathy in the past, as I often feel what the other person feels too strongly. I cannot bear to be near someone who is very distressed. I can also easily empathise with someone who has experienced something I have experienced.

It is cognitive empathy that we lack. We do not know what the other person is thinking unless they tell us. I have lost many friends by outstaying my welcome. I often ask people what they are doing later, so that I know when to leave, or ask them to tell me if they need to be elsewhere. I cannot take a hint. I often trample all over other peoples views, blissfully unaware of the fact at the time.

If it is your job to find out what the other persons problem is, then you will focus on that and learn how. You may not spot those who cannot bring themselves to say what their problem is. They can go to someone else. I think every GPs surgery and hospital department would greatly benefit from having staff with Aspergers to help raise understanding of the patients with Asd. I would say secure your place at medical school and seek diagnosis later, if and when you think that you will benefit from it.

NAS18906 said:

@Vimes, I hope the hat is tasty! Phrases like that can flummox some people with ASD but I think we'll cope. Seriously though, I had to look up the meaning of empathy as I hadn't really got it straight in my mind - it is common for us to have good vocabulary but sometimes to be wide of the mark when using particular words. When we struggle for understanding what a word means can be a particular issue. I would guess that we struggled with the word because we really don't have much use or meaning attached to empathy as we don't really "get it". I think this discussion has helped me distinguish it from sympathy - I never really understood that there was a difference.

I don't think that psychotherapy should be ruled out completely but it might be harder work than for other people. I had some sessions with a counsellor around the time I was diagnosed and found it useful to get things off my chest. You have to expect to talk at cross purposes from time to time but that doesn't mean that the effort is wasted.

lol, I had chips with my hat:)

I'm recently diagnosed myself after some conflicts at work, I'm a software developer. 

Even though I scored low on this EQ test I don't understand why, I don't think I lack empathy or sympathy. I'm sometimes called cold and unsympathetic but I don't know why.

Medicine is such a wide field that you're bound to find an area that suits you.  You're clearly interested in the subject, and when someone on the spectrum is interested in something they tend to be pretty good at it.

Vimes said:

It's a myth that we lack empathy, there are HFA that do work in the health service as nurses, physicians and even psychologists. It may take more effort for you to navigate the politicial environment rather than communication and teamwork. At least judging from your articulate posting. As to the diagnosis itself it is really up to you whether you disclose or not. If you do then you will be in an excellent position to dispel these myths you recite in your post

Panda - I managed to reach the age of 57, and get 3 degrees before I realised, a couple of months ago, that I was autistic, although I am still awaiting diagnosis.

I think Vimes has given you very good advice! Go for it, but plan to get help - there will be times you can use it.

There are plenty of people in academia/the professional world, diagnosed or not who have autism, I am sure - I was one. There are also plenty of professionals who lack empathy! Your uni should have counsellors in whom you can confide - confidentially. That may be enough to help you cope, learn to deal with stressful situations, and develop confidence in your coping ability. I don't think suspected autism should be any kind of barrier to education or a professional career and it may well help to discuss going for a dignosis with a counsellor first.

Wishing you luck!

It isn't a diagnosis but it's a fairly robust indicator with that score - particularly when combined with the EQ score. I believe the main issue with the AQ Test is false negatives i.e. that it doesn't pick up everyone who is ASD (when comared with expert diagnosis) rather than false positives but I may be wrong on that.

Your transition to univresity may introduce you to a lot of social contact that you may have side stepped so far. It may be worth considering a diagnosis as Universities do have provision for assistance these days - it may be a good time to get some formal training/coaching before you go into the workplace. There is no rush and you may wish to discuss with your tutors when you get there. Be prepared for ignorance and prejudice though. This isn't a widely and well understood condition.

@Vimes, I hope the hat is tasty! Phrases like that can flummox some people with ASD but I think we'll cope. Seriously though, I had to look up the meaning of empathy as I hadn't really got it straight in my mind - it is common for us to have good vocabulary but sometimes to be wide of the mark when using particular words. When we struggle for understanding what a word means can be a particular issue. I would guess that we struggled with the word because we really don't have much use or meaning attached to empathy as we don't really "get it". I think this discussion has helped me distinguish it from sympathy - I never really understood that there was a difference.

I don't think that psychotherapy should be ruled out completely but it might be harder work than for other people. I had some sessions with a counsellor around the time I was diagnosed and found it useful to get things off my chest. You have to expect to talk at cross purposes from time to time but that doesn't mean that the effort is wasted.

Again, thank you. I didn't intend for "extreme" to refer to a degree of severity, rather than exceptional compared to the average, but I understand it as a screening device and nothing diagnostic.

For what it's worth, I scored 10/80 for the EQ test, and you're probably right in saying that there has been no significant academic problems up to now. I do find, however, that I have a 'clinical mode' and a normal self which are completely separate, with the clinical mode being emotionally detached and following an action plan based on situation - dependant procedures  (mostly taken from the first aid manual and organised into a  sort of mental flow chart for dealing with most situations I can imagine myself in I've developed) or when delivering first aid training  to others, and the other, awkward personality in all other situations not related to medicine in some way, almost as if it's some bizarre obsession I've developed over the years.

https://psychology-tools.com/empathy-quotient/score.php 

Your Empathy Quotient score was 3 out of a possible 80.

Scores of 30 or less indicate a lack of empathy common in people with Autism or Asperger’s Syndrome.

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I'm eating my hat!

I scored 48 on the AQ test too.  As I understand it the test should not be interpreted as a test for autism, more an indicator of increased likelihood.  A high score does not in itself mean somebody is autistic.  The quoted figures are that 80% of people diagnosed with autism scored 32 or higher.

Another interesting test I had during my assessment was the empathy quotient (google it, it's all over the web).  I scored 1 out of 80 - which I'm told is unusually low for anyone, autistic or otherwise.

Hi recombinantsocks 

According to the definition that you quote and the description of your feelings "I feel sympathy for others, and their problems, without any difficulty. I often imagine their problem happening to me but sometimes don't know what to do or how to express this feeling to them" 

then you do feel "empathy" you just have problems expressing it. I share this. I frequently stand frozen by when I see someone is upset because I don´t know what to do.

I'm also not able to feel emotions when something important is going on such as an emergency because I'm too busy concentrating on the actual logistics. Afterwards I'm usually exhausted but I can´t describe how I feel. That on the other hand is Alexithymia not specifically Autism. www.ncbi.nlm.nih.gov/.../ 

One can exist without the other.  I score 161 on Alexithymia. www.alexithymia.us/test-alex.html 

This means that I can't do psychotherapy because I can't discuss or verbalise emotions/feelings. Most of the time I'm not aware of them. That does not mean I or you or clearly someone wanting to enter mecicine to make people better lack empathy. 

As I understand it, a score of 48 would mean that there isn't much doubt rather than that you are extremely autistic. If you have got to the point of applying for medicine then presumably you have got through school without difficulty. If you aren't actually having problems then it can be argued that you don't need a diagnosis as there is no need for treatment or therapy.

I score around 40 on the test but have managed 56 years, 3 degrees and no gaps in employment before needing a diagnosis. It is good to be aware and an understanding of ones psychology can help you avoid problems but it doesn't mean that you need treating or "fixing".

Thank you for your comments.

Sandwich Dan, I can definitely say emotional detachment is useful in situations as you describe - as I said I'm an ambulance volunteer, and a few weeks ago I found myself in a situation where one of the few people I'd describe as one of my friends was very seriously ill and needed emergency care before an ambulance arrived - in my "clinical mode" I even managed to use the casualty's name - something I can never normally do - and just got on with what needed to be done. To be honest I'd not considered that in terms of an actual career advantage before - just something that's helped me in first aid Competitions! 

Recombinant Socks, I totally agree, it's not that I can't feel for other people, it's a problem with showing them that I do - I just get flustered and uncomfortable if somebody is clearly upset, I just don't know what to do. I have done that test before when looking into this - I assumed it was broken or not very good and moved on - I got a score of 48, which I understand is extreme?

I'd say that a lack of empathy could be a benefit.  In a medical setting I'd imagine that it would be useful to not be emotionally sympathetic whenpeople around you are ill or in pain.

I'm certainly lacking in empathy, not just the ability to recognise or share emotions but also I very rarely care even if I understand the reasons for that emotion.  When managing people I've found that being detached emotionally certainly helps when faced with having to deliver bad news.  When someone was not behaving as required of their job I would just tell them, I genuinely didn't care if it would upset them.  If they weren't doing their job and there wasn't a good reason for it then I told them.  It's a double-edge sword though, people usually appreciated my straight talking but when faced with another person's emotional problems (which as a manager I was expected to deal with) I was lost.

According to

www.oxforddictionaries.com/.../empathy

Empathy is "The ability to understand and share the feelings of another."

In autism, this ability is normally impaired as we are unable to spot and interpret the non-verbal clues that indicate what another person's feelings are. i.e. in my opinion it isn't a myth. I feel sympathy for others, and their problems, without any difficulty. I often imagine their problem happening to me but sometimes don't know what to do or how to express this feeling to them.

@Panda: have you tried the free test at aspergerstest.net/.../ This is fairly reliable at indicating who might have problems in this department. Self diagnosis is problematic as you don't really have anything good to compare yourself to.

There are lots of people in the NHS who have problems in this area so you won't be alone! Many senior doctors and nurses have progressed by using their academic and practical skills and knowledge without letting their lack of social skills getting in the way.

It's a myth that we lack empathy, there are HFA that do work in the health service as nurses, physicians and even psychologists. It may take more effort for you to navigate the politicial environment rather than communication and teamwork. At least judging from your articulate posting. As to the diagnosis itself it is really up to you whether you disclose or not. If you do then you will be in an excellent position to dispel these myths you recite in your post :)