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The sun was warm on Mel's skin, and the colours of the playground looked brighter than ever in the summer light. Around her, the rest of her kindergarten class buzzed like dragonflies flitting from swings to slides to climbing frames. But Mel hardly noticed them. She sat happily alone, cross-legged, a calm point at the centre of the chaos. She plunged her fingers into the sand pit over and over again, delighting in the transition from hot surface to cool hidden depths. As she felt the scratch of individual grains against the soft skin of her hands, it was like an itch in her mind was also being soothed.
"Okay, kids! Time for hide and seek!"
Mel was assigned to be one of the hiders by Miss David. Determined to do well, Mel found the perfect spot behind the wooden climbing set. She even made sure to climb out of the boundary of the sand pit so that her shoes wouldn't be visible. Happy with her choice, Mel crouched down and waited to be found. As she so often did, she turned inwards, and thought about everything and nothing at all. She wondered how Becca was getting on at her new activity group, and half wished she could have gone with her. Time passed. From her position behind the climbing frame, Mel saw a family sit down to eat a picnic. After a while she watched them finish their food and clear their things away again. Still no one had found her.
Cautiously, Mel peered round into the play area. Her classmates were no longer playing, but were lined up, chatting excitedly amongst themselves. Mel felt an odd sort of pulling inside her chest that made her want to cry. As she slipped silently, unnoticed, to the back of the queue, the children at the front began to move towards the waiting bus that would take them all home.
—
The near constant vibration of his phone against the nightstand pulled Frank reluctantly from his sleep. Squinting against the brightness of the screen, he saw six new notifications from Mel.
Mel: [video link: early vs. late autism diagnosis]
Mel: I'm so man
Mel: Mad
Mel: None of this is true! She must know that's not what the evidence says
Mel: Is she saying adults are just making it up? You have to provide so much evidence to get diagnosed!
Mel: I'm so angry at her! It's irresponsible!
Frank rubbed at his eyes.
Frank: it's 3am…
He followed it up with a couple of lava lamp emojis; the little image having become their shorthand for "this sounds like a spiral - deep breaths, then let's talk". He opened the video to find a clip of a psychology professor talking about the collapse of the spectrum and the softening of diagnosis.
Mel's messages continued to scroll in at the top of Frank's screen. Seemingly this was a bigger spiral than the lava lamp could handle. He clicked out of the video and sat up to focus better.
Mel: I've been thinking about getting assessed. Am I just attention seeking?
Mel: Things were easier for me than Becca, but that doesn't mean my childhood was "unremarkable" does it?
Mel: Every time I think I know what to do, something else makes me think I'm imagining things. It's so confusing.
Frank: hang on
He hit the call button next to Mel's name. She answered almost immediately.
"You're thinking about getting assessed?"
"Yeah, kind of…" she sounded tearful, Frank realised. "Do you think that's silly?"
"No not at all. I just… I thought you already had a diagnosis?"
"What? No. Becca does, but… Frank, do you think I'm autistic?"
Frank thought back through all of their hundreds of conversations, trying to pinpoint exactly when he thought Mel had told him about her diagnosis, until it dawned on him that he'd always just assumed. He pinched the bridge of his nose, knowing that three in the morning - mid-spiral - was not the time to own up to it.
"Frank?" Mel sounded worried that he might have disappeared.
"I don't know… you're very similar to Becca in a lot of ways and -"
"Things have been really difficult for Becca, though. She got bullied so badly and needs a lot of care. And I'm fine. I'm working, I manage things."
"I know you do." Frank paused, unsure if he should bring up all the times when Mel hadn't been fine. Deciding that she already sounded upset enough, Frank went for the safer option. "Mel, do you want me to come over?"
There was a long silence punctuated by infrequent sniffles from Mel's end of the line.
"Uhm. It's okay. Thanks though."
The call ended and Frank stared at his phone until the screen faded black.
—
Mel loved school. She loved sitting in class and watching Miss Clavel write in chalk on the blackboard. She loved reading books and writing down her ideas in her notepad. She loved the shapes of the different letters and the way they turned into words when you put them together. But most of all she loved Math. The worksheet in front of her consisted of pairs of ladybugs, each with a different number of spots. Her job was to add up the number of spots for each ladybug pair and write the answer neatly into their corresponding box.
"When you've added all the spots, you can colour in your bugs!" Miss Clavel called out to the class. Mel imagined neat rows of bright red ladybugs and smiled.
She was only on the third pair of spots when Miss Clavel interrupted the class again.
"Okay, everyone, it's our turn to have our class photo taken. Please line up by the door."
Mel froze. Her stomach did something strange that made her grip her pencil tightly. She felt her body stick in place.
"Mel, leave your work and line up, please!"
Mel blinked. In front of her the worksheet grew until it was all she could see. Her heart was beating too fast. She counted the next set of spots and wrote the number 8 into the box.
"Melissa King! Leave your work and line up!"
"Mel come on, you can stand with me!" Becca called.
Their voices sounded a lot smaller than usual. A tear splashed onto the next ladybug on Mel's worksheet, wrinkling the paper and blurring the spots. Mel tried to look over at Becca, but found that her eyes were frozen in place just like the rest of her body. She couldn't work out what to do, so she counted the next dots on her fingers.
Miss Clavel was standing next to her now. Mel heard her ask what was wrong, but she didn't know what was wrong or how to answer. She didn't know why her body had stopped working, or why she suddenly wasn't allowed to complete the worksheet that she was so proud of. Then Mel heard it - a horrible sound - a gasping, gulping sound like the glugging noise the bath at home made when the water was almost drained. The sound terrified her, pressed in at her from all sides. Mel opened her eyes, scared of what she would see coming for her, and found herself wrapped up in Miss Clavel's arms. She could hear Becca crying too, but the awful sound was almost drowning it out. Slowly, as she fought for breath after desperate breath, Mel realised that the sound was coming from her own throat.
—
Several weeks had passed since their late night phone call. Frank often tried to bring up the conversation again, but Mel seemed to be resisting it. She told him that she was sorry to have bothered him, or that she'd realised she was "just being dramatic". Each time she did so, Frank felt himself get ever more defensive of the idea of Mel's need for a diagnosis. If nothing else, it would hopefully help her to be a bit kinder to herself and trust her own instincts more.
Because now that the idea of autism had been put into Frank's head, he was starting to see the signs everywhere. He watched as Mel agonised over the exact wording of her clinical notes, unable to move on despite his encouragement that they were "good enough already". He saw the way she pulled apart the sandwhich he'd grabbed for her from the patient supply, her careful rearranging of the cheese slices and lettuce leaves, and the way she chewed so precisely. He already knew about the way that Mel's body would tense up and her hands would wring together whenever she was particularly upset, but for the first time he also noticed just how often this happened each shift.
Frank also realised that it wasn't just Mel that was different. People were different with her, too. He noticed the way that Javadi rolled her eyes behind Mel's back when she got excited about something. He watched the way that Garcia frowned whenever her quips towards Mel were met with confused silence. He overheard the new batch of students talking about how Doctor King had "a touch of the 'tism" after she'd spent the morning helping them with suturing. He wondered how long all this had been happening and why he'd never noticed it before. He felt his heart drop when he wondered if Mel knew about any of this.
Things came to a head for Frank when he found Mel sitting alone in a darkened exam room at the end of a long shift. She was staring at her lava app and rocking her torso side to side, which was a new one for Frank. He sat quietly next to her on the bed and waited until she was ready to talk, not minding that they should have clocked off an hour ago. After a while, Mel's rocking stilled, and she told him about the patient who had been so upset by their diagnosis that they'd screamed loudly in her face until Dana had come to rescue her.
"It wasn't even the screaming, really" Mel explained. "It was so loud and high pitched, but I can manage that. I just didn't know what to do. I couldn't work out if she was angry or scared. I couldn't tell if she was screaming at me. I've never read about what you should do to help someone who's screaming like that."
Once again, Frank was hit with the feeling that Mel's autism was such an obvious part of who she was. He weighed up whether it was a good time to broach the subject of an assessment again and decided to chance it.
"Does that happen often? Struggling to know how people feel?" He asked.
Mel looked like she might cry. "I'm not stupid…" she whispered.
"Of course you're not," Frank kept his voice soft and low. "Let me ask you a question. Do you think autistic people are stupid?"
Mel looked horrified. "No! That would be an awful thing to think!"
"Exactly. So why is it stupid if you struggle with working out people's emotions?"
"But I can. If they're really obvious like happy or sad then it's fine. But sometimes it's not obvious. Sometimes it's just really confusing, and I don't know the right thing to say, and I panic and that makes me feel stupid. Sometimes I think I'm saying the right things and it only makes it worse and… And…" Mel twisted her hands together again. "No one wants a doctor who doesn't know the difference between angry and scared."
"Mel, people mainly just want a doctor who hasn't made them wait in chairs for eight hours."
Mel frowned.
"The thing is, maybe it would feel less confusing if you knew why some of these things feel difficult?"
Mel sighed and gently rested her head against his bicep, seemingly worn out. Frank's heart stuttered.
"Will you help me with it? The assessment?"
"Yeah, of course I will."
—
"You'll need to find a partner to team up with today!" Mr Perry called out as the last of the stragglers filed into the cold classroom. Mel wrapped her arms around herself and lowered her eyes. She couldn't even remember the last time someone in her class had spoken to her, let alone wanted to work with her. She made a show of flicking through her textbook, hoping there'd be an odd number of people and that she might get away with working alone.
"Oi, Mel!"
Mel turned and against all the odds saw the Amber Smith - captain of the girl's hockey team - smiling at back at her.
"Wanna be my partner?"
The surge of relief inside her body was like receiving a gift. Mel smiled widely and carried her books over to sit by Amber at the workbench. When Amber seemed not to understand the work, Mel went to great efforts to explain what they were supposed to do.
"You see the really cool thing about neutralisation is that it's actually an exothermic reaction!"
"Right, yeah."
The class passed by quickly, with Mel talking excitedly to Amber about the experiment. She'd almost exhausted her thoughts about the magic of chemistry when she suddenly remembered the social skills exercises she'd been helping Becca with recently: it was important to ask people questions too.
"So Amber, what's your favourite chemical reaction?"
Amber's response was cut off by the bell signalling the end of class, and Mel bent down to put her books back into her bag. When she stood up again, eager to know more about her new friend, she found that the majority of the class were now crowded around their workstation.
"I can't believe you actually sat next to her!"
"A whole class with Smell King!"
"That's a dollar off each of you, I told you I'd do it!"
Amber was laughing. Mel felt the familiar hot scorch of shame on her cheeks, and fought hard not to cry in front of everyone. Once the class was finally dismissed, she made her way to hide in her usual stall in the girls' bathroom. She tucked her face into her elbow to guard against the smell of cheap body spray that always lingered in the air at school. Once her chest felt more normal again, Mel made a mental note to check in with Becca. If she couldn't make sense of the social skills workbook, how on earth was Becca supposed to?
—
It was just past 12:30 when Frank got to Mel's apartment for what she'd referred to in her text invite as "a criteria review". Frank was pleased to find Mel looking comfortable and calm when she answered the door to let him in, having spent the trip over wondering if talking about the assessment directly would be upsetting for her.
Mel was dressed in her usual plain pants and graphic tee, her hair up in her trademark braid. Frank noticed her relaxed smile and couldn't help but smile back.
"I've made a spreadsheet!" Mel announced by way of a greeting. Frank nodded.
"Great. And I've brought sandwiches, have you already eaten?"
Mel shook her head, taking the wrapped food out of the proferred paper bag.
"Uhm. Is this sliced cheese?"
"Not sure, why?"
"It's just that if it's sliced bread it needs to be grated cheese. Sliced cheese is okay on things like a baguette if there's lettuce or other things on it too. But if it's sliced bread then it can't be sliced cheese… Sorry to be awkward."
Frank tried to process this information while Mel looked crestfallen, gently poking at the sandwich wrapping.
"I thought we'd had cheese sandwiches at work before?"
"We have."
Frank thought back to how he'd noticed Mel eat so slowly whenever they'd managed to have lunch together.
"You could have just told me you didn't like it, I would have stopped bringing you sandwiches."
"But I like you bringing me sandwiches. It's nice. Besides it's rude not to eat the food people share with you."
Frank felt like he was losing some sort of logic battle. "But you just told me about the sliced cheese thing… So, you don't wanna eat these?"
"I don't want to be ungrateful. It's just…" Mel sighed deeply, as though she was about to reveal a horrendous secret. "If I eat these now I'll have to concentrate really hard on each bite, and not think about how weird my body feels for ages after, and I'll have to remember not to grimace while I eat because I'm not sure I'm ready for you to see that yet. Plus, I'm at home now, not at work." Mel looked at Frank as though this final statement clarified everything. Still feeling somewhat lost, he decided to move the conversation on, rather than dwell on the specifics of whatever "grimacing" meant.
"Have you put all this cheese business down in your notes for the psychiatrist?" he kept his voice light, still testing the waters on where Mel's emotions were today.
"Section B2: insistence on sameness and inflexible adherance to routines." It seemed they were on steadier emotional ground when it came to the facts. Mel's face practically lit up again. "Of course I've not mentioned cheese specifically, more just my general approach to food having a lot of rules. Do you think I should be more specific than that?" She didn't wait for an answer. "Anyway, I've made a seperate page for each of the DSM criteria, and then sub-divided into childhood and adulthood. We can do another column for explanatory examples. Do you want to see?"
Before Frank could answer, Mel had disappeared into her living room to grab her laptop. Frank stared after her, wondering how on earth she'd gone undiagnosed for this long.
—
Now that they'd been permanently separated into different classes, it was hard for Mel to spend much time with Becca. Their parents had tried to explain it would be good for both of them to make friends with other people and be more independent, but Mel felt anxious. What if Becca struggled in her lessons? Who would help her to remember her timetable, or make sure she didn't get lost finding her way around? What if Becca got bullied?
The night before the new term started, Mel knocked gently on Becca's bedroom door.
"King sisters' team meeting?" she asked.
"Oh, hey Mel! Yes please."
Mel sat carefully on the edge of Becca's bed and fidgeted with the stitching on her quilt.
"So I don't want you to be worried about going into a new class tomorrow…"
"I'm not worried! My friend Carmen from the activity centre is going to be in my class too."
"Oh. Well, that's good. But you know we can still meet up for lunch, I don't want you to feel lonely."
"Okay. Can Carmen sit with us too?"
"Uhm. Yeah, sure…"
Becca smiled and held her arms out for a hug. Mel squeezed her sister tight, wondering why she suddenly felt so sad.
"And if you need anything, just let me know and I'll help you with it… And if anyone gives you a hard time it's really important you tell me, okay?"
"Thanks, Mel. I think I'll like it though, I'm excited!"
"Okay, great! Well, just remember it's okay if you don't like it. We King sisters will work things out!"
"Yeah, totally. Well, I'm gonna go to sleep now. Goodnight, Mel."
"Night, Becca."
Mel found their mom eavesdropping just outside Becca's bedroom door.
"You don't have to worry so much about Becca, you know, Mel. Let that be our job," she whispered.
"Oh I don't mind, I want to make sure she's okay."
"I know you do, love. But it's alright for you to make your own friends too. I worry about how lonely you are…" she reached out and pulled playfully on Mel's braid, the way she'd been doing since Mel was a toddler. Mel felt a sudden urge to cry.
"I'm not lonely. I've got Becca."
Her mom just sighed and turned to go back downstairs. Mel spent the rest of the night curled into her quilt, trying to work out what a smile with sad eyes meant.
—
Frank stared at the laptop screen feeling at a complete loss for what to say. He could feel that Mel's initial enthusiasm over categorising her examples had faded into a quiet sort of waiting. But what could he possibly say about this; a whole life summarised into a DSM category list? The brightest, kindest, funniest person he knew pieced up into endless symptoms and deficits. His eyes hovered blankly over example after example of Mel being overlooked and excluded, the sequences of overstimulation and the elaborate coping mechanisms she used to compensate. He couldn't even begin to work out how Mel had managed all of this on top of med school and looking after Becca.
"You've cross-referenced comments from your school report cards too?" he asked, his voice coming out softer and more broken than he'd intended it to.
"Yeah. With my parents gone it's kinda hard to get childhood evidence. Becca had so much of her own stuff going on…"
Frank nodded slowly. "I don't think I realised how much you had going on."
"It's not that bad. I'm okay, really. They might not even think this qualifies."
Frank really had no idea how to respond to such an obvious lack of insight, but Mel appeared to be lost in her own thoughts anyway.
"It feels odd, showing you all this. You must think I'm pretty weird."
Frank turned to face Mel properly, grasping her hand in his and squeezing in what he hoped was a reassuring way.
"Not weird, Mel. Amazing. I think you're really fucking amazing."
—
Frank's phone buzzed loudly on his night stand. He put down his book and smiled at Mel's name flashing on the screen. He clocked the time as 04:14 before swiping to answer.
"Hey," he murmered, "I wondered if you'd call today. How did it go?"
"They said yes. They said I'm autistic."
"Mel that's -" Frank interrupted himself. "Wow. How are you feeling?"
"A bit worried."
He'd been expecting shock, or relief, or validation. Worried wasn't something he'd prepared for.
"What are you worried about?"
"What if I lied? What if I made it up?"
"Did you?"
"No. But maybe I exaggerated things? Or misled them?"
"Mel. Did you show them the spreadsheet?"
"Yes."
"And was what you showed me on the spreadsheet true?"
"Yes."
Frank waited.
"…It's just a lot to take in."
"I know."
"Why didn't anyone notice till now?" Mel's voice cracked, and Frank heard her start to cry.
"I don't know, Mel," he whispered softly. "I'm really sorry that no one did."
Mel's ragged breaths carried down the line and caught in his throat.
"You noticed… You knew from the start."
He took a second to process that.
"Mel?"
"Yeah?"
"Do you need a hug? Do you need me to come over?"
There was a long silence punctuated by intermittent sniffles.
"Yes please, Frank."