"It's a professional matter, Doctor," Diamond assured him, uncomfortably kowtowing. The days when he could pull rank on smart-mouthed forensic experts were just a memory now. "I'm interested in Naomi, the Japanese girl. She's here because they believe she's autistic."
"Correct."
"So you agree that she is?"
"I didn't say that. I was merely confirming your statement" "But have you formed an opinion yet?"
"No."
"Is that because you have doubts?"
"Certainly not," Ettlinger snapped. "Dubiety is unscientific. I am open-minded. Do you understand the difference? You may harbor doubts. I am open-minded."
Diamond was tempted to remark that the state of Ettlinger's mind interested him less than Naomi's, but he checked himself.
Ettlinger added, "I would need to study the child in a more systematic way than I can on occasional visits. She is not my patient"
"I understand she shows some of the classical symptoms of autism."
"Classical?" Ettlinger almost choked on the word, he was so indignant. "Classical? The condition wasn't given a name until 1943, and it wasn't studied in a serious way until the 1960s. How can you speak of symptoms as classical?"
"Typical, then."
"I could object to that as well."
Diamond didn't give him the opportunity. "She doesn't speak. She avoids eye contact. Is that the profile of an autistic child? Because if it is, Naomi fits it perfectly."
"What you have just described, Mr. Diamond, may be indicative of autism; it is also the appropriate behavior of well-brought-up young women throughout much of Asia. Have you thought of that? One cannot discount the possibility that her behavior is governed, to some degree at least, by her culture."
A persuasive point that Diamond accepted. He supposed he had borne it in mind up to now without articulating it. "But not to speak at all, not even to the woman from the Japanese Embassy?"
"That, I grant you, is exceptional."
"How do you recognize autism, then?"
Ettlinger sighed and glanced up at the staffroom clock.
"All right, how does anyone recognize it? Are there tests?"
"What do you mean?"
"X rays, blood tests, scans. I'm no expert."
"There are no objective tests of that kind," said Ettlinger with disdain. "One looks at the behavior. What I will say is that every child who fits this syndrome suffers from some degree of speech impairment, ranging from mutism to aphasia-which is confusion over the proper sequence of letters and words. Every child, Mr. Diamond."
Diamond placed a mental tick against Naomi's mutism.
"It is also true by definition that the autistic child is manifestly indifferent to other people, especially other children. Autism comes from the Greek, as you probably know. Autos. Self. Right?"
Another tick.
"However, one would expect to observe other impairments, such as problems of motor control."
"Odd ways of walking, you mean, like Rajinder?"
"Yes."
"Naomi isn't like that She seems well coordinated."
Ettlinger nodded. "Some of them are. Curiously, they sometimes have the ability to keep their balance better than other children. They climb on furniture and leap around in a surefooted manner. They could probably perform prodigious feats on a tightrope."
Which wouldn't be easy to test, Diamond thought.
"And they won't get dizzy if they spin around."
"That's something I didn't know."
"It's commonly observed."
"Anything else?"
Ettlinger spread his hands. "Much else, Mr. Diamond. Repetitive behavior, such as head banging, or rocking, or staring into a mirror, or spinning things. The wheels of a toy, for instance. You must have watched Clive do that."
"Of course. I don't think Naomi does it."
Ettlinger was already onto other symptoms of autism. "Abnormal reactions to sensory experiences, such as pain, or cold or heat. Hostility to being touched lightly." There was the hint of a smile.
"You heard what happened to me?"
"I can see."
"Was that to be expected of an autistic child?"
"They bite, yes."
"I mean does it make the diagnosis more likely?"
"It's a small indication. Next time you should try being more boisterous, and see if she responds to it They often enjoy a good romp." The moral objection to a strange man "romping" with a small girl seemed not to have occurred to Dr. Ettlinger.
"Is anything known about the cause of the condition?"
A laugh came from deep in Ettlinger's throat "The cause, 70 you say? Nobody knows. No known cause and no cure. There are theories. More theories than I have time to list, my friend. Personally, I am inclined to believe that the problem is organic, rather than emotional. It has nothing to do with the way the children are reared, as was once suspected. It goes back, in my opinion, to pre-, peri- or postnatal injury or illness affecting the brain. And don't ask me what can be done. Every week, practically, I read of some Svengali claiming spectacular success. Cures, even. You can hug these children, reward them, punish them, isolate them, put them on diets. They can be trained to some extent. I don't deny it. But so can chimpanzees. Personally I would rather train a chimpanzee. They're capable of affection, you know. Autistic children give none. They are tyrants."
Diamond had heard all this with mounting distaste. "That's hardly a scientific word, is it? Tyrants?"
The little doctor glared. "Think of a better one. Spend as long as you like observing Naomi and think of a better one-if you can." He turned his back on Diamond and went over to talk to someone else.
CHAPTER TEN
This morning Diamond was equipped with a pad of drawing paper and a marker. If this intractable little girl wouldn't respond to sounds, he'd decided, maybe it was a problem of language. He was going to see whether symbols would do the trick. He moved his chair next to hers and placed the pad on a low table in front of them. Then he drew a large circle and added a smaller one on top. A body and a head, evoking childish memories of beetle drives on wet afternoons in English holiday camps. Except mat this was meant to represent his body and his head. He added stick legs and arms, followed by the facial features, with a scribble of hair above each ear to establish the margins of his bald dome. He held it up for Naomi, beamed encouragingly and said, "Diamond." He pointed to his chest
Possibly, he persuaded himself, her eyes gave his artwork the credit of a glance. They certainly didn't linger on it. And she remained silent.
He touched the drawing and then tapped himself on the head.
"See? Diamond."
Not a muscle twitched.
Refusing to be discouraged, he folded the picture over and drew a smaller figure on the next sheet, with the suggestion of a skirt and a passable attempt at fringed hair.
"Naomi."
He pointed to her. Indicated her hair. Then added a flourish to the drawing, a small bow poised on top of the head. "Like it?~ He chuckled a little, and was conscious how forced it sounded. "It's you."
Not only was she unamused, she hadn't even looked.
Determined not to be thwarted, he turned back to the first drawing, tore it from the pad and set it on the table beside the second one, to make clear the contrast in size. "Big Diamond. And little Naomi. Diamond. Naomi. Me and you."
She seemed frozen.
Several more attempts to establish the significance of the drawings came to nothing.
"Would you like to draw?" He slid the pad across the table in front of her. Once on television he'd seen a boy suffering from autism who could do remarkable drawings of buildings from memory, precise in detail and perfect in perspective. After a visit to London the boy had made sketches of St. Paul's and other buildings equally ornate. Two books of his drawings had been published.