In a Different Key: The Story of Autism (6 page)

Their scores, recorded while the Kelleys were at the Georgia State Fair, had astonished the national contest organizer, a Mrs. Watts, who was struck giddy at finding such talent in a part of the South where, until then, she had not run tests. “Kansas still has the high-score family so far,” she told the
Press
reporter, “but it is a question how long they can hold it. Georgia is a close second.”

A matronly presence, impeccable in appearance, draped in pearls that swung to her waist, Mrs. Watts had been organizing Fitter Family Contests across the South and Midwest since 1921. Over the next several years, these contests would also take place in Texas and Louisiana, and as far north as Michigan and Massachusetts, often with a healthy dose of newspaper coverage. It was great human-interest stuff.

Mrs. Watts staged her contests at state agricultural fairs, always timed to overlap with the main event—the livestock contests. Farmers had trucked in their best-looking cattle, their most perfect pigs, to compete for blue ribbons. The judges, fellow farmers, gave prizes for breeding animals that came as close as possible to flawless examples of their species. Better-bred animals, when crossed again and again, led to unending improvement in the stock of the breed.

Mrs. Watts had the same goal for humans. “While the [cattle] judges are testing the Holsteins, Jerseys and whitefaces,” Watts once said, “we are
testing the Joneses, Smiths and the Johnsons.” When she declared the Kelleys to be “of the highest type,” she meant that they were the sort of Americans who should be encouraged—exhorted, even—to reproduce.

They had been
examined by an expert team that included a dentist, a psychologist, a psychiatrist, a pathologist, a pediatrician, and a historian. They’d had their urine tested; their skulls measured; their teeth evaluated for the orderliness of their alignment and the durability of their enamel. They were asked about childhood diseases, broken bones, and bathing schedules. Mothers were required to provide a list of daily meals, which was assessed for the percentage of protein versus non-protein. And each family member was observed chewing food, with notes taken when this was performed “too slowly” or “too hastily.” There was also a written IQ test—timed—that the children, as well as the adults, had to complete.

The wild card for every contestant, however, was ancestry. The Fitter Family Contests were designed to get something across to the masses: a rudimentary understanding of the way human genetics determined all that was good and evil about modern American society. A hand-painted sign hanging by the entrance to the competition booth carried an urgent warning:

EVERY 48 SECONDS A PERSON IS BORN IN THE UNITED STATES WHO WILL NEVER GROW UP MENTALLY BEYOND THAT STAGE OF A NORMAL 8 YR. OLD BOY OR GIRL
.

A second sign added perspective:

EVERY 15 SECONDS $100 OF YOUR MONEY GOES FOR THE CARE OF PERSONS WITH BAD HEREDITY SUCH AS THE INSANE, FEEBLEMINDED, CRIMINALS AND OTHER DEFECTIVES
.

And a third offered hope:

EVERY 7½ MINUTES A HIGH-GRADE PERSON IS BORN IN THE UNITED STATES
.

An electric lightbulb was affixed to each sign, flashing on at the appropriate intervals: every forty-eight seconds, every fifteen seconds,
and, much too infrequently, every seven and a half minutes. Good heredity was falling behind at an alarming rate.

It had to be a rude shock for families that went into these contests concerned about the dire message of the lightbulbs, only to come out with a flunking grade. They would leave the state fairgrounds that day branded unfit for America. But this was useful knowledge, in its way, because if Mrs. Watts’s hopes for these contests were to be fulfilled, a failing family would know never to procreate,
for the good of society. And those from families “of good stock” would know never to let their children mate with someone from an unfortunately blighted family.

The caliber of the herd as a whole is lifted when only the best of its members are permitted to breed. Obviously, that applied to humans as well.

—

M
ARY AND
B
EAMON
T
RIPLETT
came of age during the era of the Fitter Family Contests. People of lesser mental capability were portrayed as a menace to society, and extreme measures were justified to eliminate that menace. This was not merely theoretical, and not nearly as benign as the smiling Mrs. Watts made it out to be with her quaint contests. Her operation was merely the extreme retail end of
a scientific, political, and philosophical movement that, in the two decades leading up to Donald’s birth, had dedicated itself to the proposition that children like him didn’t deserve to be born. In the movement as a whole, Mrs. Watts was a bit player, a self-appointed and enthusiastic popularizer, civic-minded and hardworking, but not a scientist, academic, or statesman.

But those levels of society were well represented in the movement as well. At Harvard and Yale, in the pages of the
New York Times
and the
Saturday Evening Post
, and in the hearing rooms of Congress, men who stood at the pinnacle of their fields and of society had embraced, in a burst of optimism,
a brand-new science.

Eugenics—derived from a combination of other relatively new sciences like anthropology, zoology, genetics, and psychometrics—opened up the possibility of purging rot and impurity from the lineage of
humanity. President Teddy Roosevelt himself touted a eugenics manifesto called
The Passing of the Great Race
, written by his friend, New York lawyer Madison Grant. In his book, Grant recommended a program of mass selective breeding to rid the United States of the genetic influence of “the weak,
the broken, the mentally crippled,” the millions of citizens he deemed “worthless” and “wretched.” Roosevelt praised the book’s compendium of “
facts our people most need to realize.” A young man wrote Grant a fan letter from Austria, announcing that his book was now his “bible.”
His name was Adolf Hitler.

Grant argued for the forced sterilization of people deemed not worthy of procreating. So powerful was the enthusiasm for eugenics that seventeen states legalized forced sterilization in the 1920s. These measures found support all over the political spectrum. In 1926, Margaret Sanger, the founder of Planned Parenthood and a defender of the disadvantaged, said to a Vassar College audience: “The American public is taxed, heavily taxed, to maintain an
increasing race of morons, which threatens the very foundations of our civilization.”

The state of
Mississippi’s sterilization law was written to cover hereditary “
insanity, feeblemindedness, idiocy, and epilepsy.” In fact, Mississippi was less aggressive in sterilizing its disabled than some other states. By 1933, the year Donald was born, twelve people had been forced to undergo the procedure, versus 1,333 in Virginia and 8,504 in California. In 1939, Mississippi’s laxity seemed to
bother an editorial writer for the
Delta Democrat Times
in Greenville. Envying Virginia’s record, and “the money the state was set to save by practicing preventive eugenics”—which reduced the financial burden of caring for “defectives”—the writer suggested hopefully that “Mississippi might profit by Virginia’s example.” Donald was five years old when that editorial appeared.

Of course, Hitler, once in power, took things a great deal further. He started World War II eight months after that
Delta Democrat Times
editorial, and under his rule, following his “bible,” the number of disabled Germans murdered to purify the racial stock of the Third Reich reached into the tens of thousands.

—

R
EMARKABLY, CONSIDERING
that the United States was by then at war with the Nazis, a soberly worded endorsement of “mercy killing” for mentally disabled children appeared in the July 1942 issue of the
American Journal of Psychiatry
, published by the American Psychiatric Association. It was written by Robert Foster Kennedy, an Irish-born American neurologist.

“Nature’s mistakes,” Kennedy argued, deserved relief from the burden of a life “that at no time can produce anything good at all.” He called for painless methods of killing and spelled out a careful selection process. First, the parents of such a child would need to request the death. Then, three examinations should be conducted, over time, but only after “a defective…has reached the age of five or more.” Should it then be found “that the defective has no future nor hope of one,” he wrote, “then I believe it is a merciful and kindly thing to relieve that defective—often tortured and convulsed, grotesque and absurd, useless and foolish, and entirely undesirable—of
the agony of living.”

Not everyone took Kennedy’s side. In the very same issue of the
Journal of Psychiatry
, there appeared a six-page clarion call for the “humanization” of the mentally disabled, a recognition that each disabled person has a place in society. The author used the language of the era—
defectives, feebleminded, imbeciles
—but his compassion for the disabled and his respect for their dignity and right to exist was palpable. Indeed, he wrote, it was time that psychiatrists ceased “to treat the term mental deficiency as a swear word,” and to recognize that when a society diminishes the standing of its weakest, the whole society is diminished as well. “By exonerating the feeble,” he concluded, “
we thus exonerate ourselves.”

And so a rare gauntlet was thrown down on behalf of mentally disabled children, by a child psychiatrist from Johns Hopkins named Leo Kanner. Kanner was, at that time, less than a year away from publishing a far more important article, one that would be quoted around the world and into the next century. It began with a description of a boy who had been brought to Kanner’s Baltimore office by his parents six years earlier. The boy was from Mississippi, and his name was Donald Triplett.

3

CASE 1

T
he Preventorium had been a premature surrender. True, life was more serene now at the Triplett house. The new baby was so different from Donald. Oliver looked at them when he smiled, and he curved his body into their arms when they held him. Even so, either Mary or Beamon, or both of them, eventually reached the conclusion that the Preventorium was the wrong solution for Donald, and that it was far too soon to give up trying to find the right one. They had already traveled all over Mississippi, and as far north as Minnesota, in search of answers. This time, they would travel even farther, to Baltimore, to meet with a doctor by the name of Leo Kanner.

—

I
N THE
1930
S
, Leo Kanner ranked as the
top child psychiatrist in the United States, perhaps even the world. It had only been thirty years or so
since psychiatry had discovered childhood as a subspecialty; it took the profession quite some time to cease thinking of children merely as miniature adults. Kanner’s 1935 book,
Child Psychiatry
, was for many years the standard, and only, textbook on the topic. He was the first head of the department of child psychiatry at Johns Hopkins University in Baltimore, which was, in turn, the first such academic department of its kind in the United States. To American eyes, Kanner certainly looked the part. Slight and stooped, with oversized ears and a basset hound face, he spoke English in a high, reedy voice, with an accent so heavy that at times he was incomprehensible. Like Sigmund Freud, he was both Austrian and Jewish.

Kanner’s move to the United States, in 1924, happened on a whim.
That was something of a pattern with him. He was once
hit by a train when, on a lark, he took a stroll out onto a railroad bridge where it crossed over water. Having never learned to swim, he was lucky to be saved from drowning by a member of the train crew. He had tried, also on impulse, to join the German army as a young man to fight in World War I. Rejected due to his small stature and two missing front teeth, he headed for the recruiting office of the Austrian army, where he was accepted.

Kanner was sent to the front as a medical corpsman but, with his hands stained with the blood of men far too young to die, he quickly realized that war was not for him. He performed his hospital duties fully and well, then worked just as diligently at arranging a series of transfers for assignments farther and farther from the front. He won an honorable discharge one year into his service, granted on the premise that he would be more valuable to the Fatherland as a fully trained physician. He committed to return to Germany to start medical school.

By late 1923, Kanner, now a husband and father, had been in general practice in Berlin for three years, and his patient list was growing. It might have gone on this way had he not befriended a young American physician, Dr. Louis Holtz, who had come to Berlin to take a few medical courses. Kanner liked Holtz enormously and began bringing him home for dinners. Holtz, who had recently become a widower, took comfort in the Kanners’ company and appreciated the friendship extended him in a foreign land. Over dinner, he would regale Kanner and his wife, June, with stories of the wonders of life in America. Having resolved to repay the Kanners’ kindness, Holtz talked Kanner into applying for a visa to the United States—just in case he ever wanted it—and then turned up bearing a written offer of a position as a physician at the South Dakota State Hospital for the Insane, in Yankton, South Dakota. Within four weeks, Kanner had arranged for a one-year leave of absence from work and shipped the family’s two featherbeds to America.

Kanner was thirty years old and fluent in seven languages when he arrived in Yankton. Unfortunately, English wasn’t one of them. He worked at changing that, just as he worked hard to adopt American ways. He bought a Chevrolet, tried to take an interest in golf, and
joined a weekly poker game. Soon enough, he was publishing medical articles in English. He learned to live with the fact that Americans were always either misspelling or mispronouncing his last name, which rhymed with “honor.” (When they did pronounce it right, they often assumed they were talking to “Dr. Lee O’Connor.”) Eventually, he became known around Yankton as “the German doctor,” not a bad credential when German medicine was seen as the best in the world.