Chapter 8

Empathy

Traveling from Port Wenn to London in Dad's old Ford wagon, Edith feigned interest in Martin's monotonous conversation about arteries, veins, capillaries and the minute body parts he found mesmerizing One more year at St. Mary's and she will be through with England and can begin her life anew in Quebec. Residency programs are demanding, but she will be with patients rather than mired in the grind of academic life.

Being away from her family will be a relief as well. She has had one too many tiffs with her brothers and their various girlfriends, lovers and wives. Mum and Dad were still angry with her about Christmas when she traveled to Morocco with a friend from St. Paul's rather than to Larchmont Hall. Ellingham was to join her there and arrived on Christmas Eve to learn Edith had gone to Marrakech. Mum would not hear of him leaving, particularly as he had no place to go, and kept him there through Boxing Day.

Newly-married to Simon, Helen took charge of Ellingham and her brother-in-law, David, hoping to ingratiate herself even more with Mum. Helen confided to George's wife, Fiona, that it was torturous trying to coax conversation from either of them. By Christmas night, she had counted 11 words from Martin and 13 from David. They were most content when she left them to read or stare through windows whilst others enjoyed the festivities.

Fiona, the outspoken Australian, had read psychology at Trinity College and announced to Helen and her mother-in-law that David and Martin were obviously afflicted with Asperger's Syndrome. Nonplussed, Mum had said: "Yes, very likely. But they both seem to have adapted to it quite well." Helen went out of her way to repeat Mum's comment to Edith when she finally arrived in Larchmont on New Year's Day.

Edith had endured only the required psychology classes at university and med school and shared Ellingham's low opinion of the subject. Certainly, Fiona was correct about David. Her parents had him tested for Asperger's on the advice of his Year 3 teacher at the village primary school. Treatment was not recommended, but the entire family was relieved that David's odd behaviour could be explained.

Her curiosity piqued by Fiona's comment, Edith looked a bit more into the developmental disorder. Most research focused on the condition in children as it greatly affected their performance at school. Little research was being done on the effect of Asperger's in adults. At the time, it was generally accepted that people somehow grew out of the condition or learned to live with it.

The more Edith read, the more she began to recognize signs of Asperger's in Ellingham. He was gentle, unworldly, highly attentive and charmingly old-fashioned. These were his good traits. Those not so easy to bear were his discomfort in social situations, somewhat cold and distant nature, aloofness often interpreted as snobbery, and what Edith charitably thought of as his inadvertent rudeness.

Thinking she was being helpful, Edith asked Ellingham if he had ever been diagnosed with Asperger's. He became very sharp with her and would say nothing other than an explosive "No." Clearly, this was a ticklish subject with him and made Edith more intrigued.

For each of the 21 years following their birth, Mum had dutifully completed a questionnaire about Edith and David's development as part of a longitudinal study of twins born at St. Mary's. Gurveer Sikothra, the psychologist who conducted the research and was now compiling her findings, remained on staff at St. Mary's.

Soon after transferring from Oxford, Edith had sought out Dr. Sikothra hoping to learn more about her work. Little could yet be discussed, but they had tea, and Gurveer became something of a mentor to Edith. They were in two different disciplines and 34 years apart in age, but they shared a strong intellect and acerbic wit. Edith turned to the older woman for guidance with Ellingham.

Sighing, Gurveer said: "Men – and they are generally men – with Asperger's are in a constant struggle to understand the unwritten social rules that help most people act and speak appropriately. They find it difficult to interpret figures of speech, facial expressions and tones of voice.

"As for themselves, they are frequently concise, brusque and literal to the point of rudeness. The world is a stress-filled place for them, and they may retreat into their safe routines, solitude and obsessive special interests. Most importantly, they lack empathy, the cornerstone of any relationship.

"Like your chap, they are often extremely intelligent, have no friends and were likely bullied at school. He was probably the boy who didn't quite fit in, but was left to get on with it. Is any of this consistent with your friend's behaviour, Edith?"

This explained so much about Ellingham! Nodding her head, Edith mumbled "yes."

"I see. Well then, if you are interested in a serious relationship with him, it will likely be difficult. Relationships, marriage and parenthood are particularly challenging for those suffering the disorder.

"It is easy for a woman to fall in love with such a man, because she frequently feels she can nurture this slightly vulnerable person into the perfect husband and father. As the relationship continues, the woman finds her own emotional needs aren't being met.

"Of course, the man will want to make her happy but can't read the signs of how to do so. When the conversation turns to living together or marriage with babies, he'll generally withdraw from the relationship. He has no empathy and it is difficult for him to function in a relationship with more than one person. Asperger's is not conducive to family life."

"Gurveer, he is very intelligent, kind, and a bit of a romantic. He also seems to need no one, so I'm not sure what type of life I would have with him. My twin brother, David, was diagnosed with the condition, but it hasn't limited his life in any way. Except, of course, socially. At Christmas, my sister-in-law thought my friend exhibited Asperger traits. What do you think?"

"You say he's never been tested and seems to have no interest in doing so. There's little you can do. Unfortunately, his lack of empathy may one day cause problems. An incident could occur which will trigger an empathetic reaction – perhaps for the first time in his life. It may create any manner of psychological problems for him.

"Certainly, I could refer him to a psychologist who specializes in developmental disorders, but it would only be if he were willing to consider it. I would not press him, unless you were quite serious about him."

"No, no, I want the residency at McGill. By the time I've finished, he'll likely be the youngest surgical registrar at St. Mary's. He's that brilliant."

"A surgeon then. That's interesting. It allows him the isolation he needs, but it also creates huge dollops of stress. To deal with that stress, he'll need massive amounts of time by himself. He'll likely take up some hobby that involves tinkering with mechanical items, something solitary. I suspect he'll be a fantastic surgeon but will never marry.

"Edith, you could not live happily with a man suffering from Asperger's. You want a husband who will enjoy life, have a family, be part of the world. Find someone such as my Amit, who has tolerated me for these many years. Leave this poor man alone. It is what he actually craves."

Now Martin had raised the idea of marriage during their unpleasant visit to his aunt and uncle in Cornwall. Edith was shocked that he would want to marry her or anyone else. From what Gurveer had said, marriage was likely not what he would want – or even need. Perhaps, Ellingham did not suffer Asperger's but another malady that caused his behaviour.

Oh, bloody hell, why was she worrying about any of this. She had been able to temper her feelings about Ellingham, but it was becoming more difficult to do so. During their fifth year of med school, she came to rely on him not only as a study mate and lover, but also as a friend. In truth, it was quite easy to be his friend as he needed nothing in return.

He listened politely – if not with great concern – as she nattered on about the various injustices she imagined, the stupidity of others and her arduous life as a student. She was embarrassed at the many times he jollied her along by saying she was quite brilliant and would be an excellent doctor.

With most people, she would have thought the comments were empty platitudes, but Ellingham didn't do that. He spoke the truth. That was another of his endearing qualities. Her mother was right: she did not deserve a man as kind as Martin. She would only bedevil him through life and make him miserable.

Her feelings would remain unspoken. If she received the residency at McGill, it would be the perfect opportunity to leave him in London. If not . . . No, she would receive the appointment. She could do very well indeed without Ellingham. He would never leave London, and his safe perch at St. Mary's. He had perfectly plotted his career from Oxford to the top surgical post in England. Nothing - and certainly not following Edith to Canada - would stop him from attaining that goal.

Continued. . . .