I was standing in my living room in Cambridge with Misha, my then-8-year-old son, and Larry, his behavior analyst. Larry was leading Misha through a session of Applied Behavior Analysis (ABA), his treatment model.

“What do you see?” Larry asked him, displaying a card with a photo of a duck.

Misha matched the card to the correct photo among an array on the table before him.

“Good job, Misha!”

Misha grabbed a gold star and added it to his “token board.”

Six days a week, Larry tried to train Misha not only to match photos but also to brush his teeth, pull on his socks, blow his nose, speak, read, draw, and calculate. Each session worked backward from an objective chosen for him, aiming to eliminate “problem” behaviors. Through trial and error, Larry searched for the “reinforcers” that prompted Misha to perform “correct” behaviors instead. Reinforcers could be “positive” (gold stars) or “negative” (such as withholding attention). The treatment’s ultimate ambition was deducing a precisely measured “schedule of reinforcement” that would enable adults to predict and control Misha’s behavior in any environment.

The apparent versatility of the ABA treatment gave me hope. The neurologist who diagnosed Misha with autism spectrum disorder described it as a lifelong condition with no known causes or cures. Additional diagnoses ensued, none entailing a clearer protocol: mixed receptive-expressive language disorder, sensory processing disorder, cerebral vision impairment, intellectual disability, chronic constipation. Molecular sequencing revealed a pair of genetic mutations never before reported in the scientific literature.

I borrowed confidence in ABA from the policy consensus around its potency. None of Misha’s doctors or teachers recommended any equivalent model, nor did our insurance cover any. Legislatures in most states, including Massachusetts, have responded to the rapid acceleration of autism diagnoses by mandating insurance coverage of ABA. Early Intervention, a federally funded program serving children from birth to 3 years, steers children diagnosed with autism into ABA programs.

The ease of access clinched my commitment to the treatment. Misha’s neurologist practiced in Newton. His developmental pediatrician and his speech pathologist were in Lexington and Waltham, respectively. His neuro-ophthalmologist, geneticist, gastroenterologist, and physical therapist had their clinics at different Boston locations. Only the ABA specialists, the behavior analysts, came to our door.

Hope, confidence, and access led me to give the treatment a fair chance to work. As I watched Larry and Misha, however, I reflected that behavior analysts had been breaking out work tables in our living room for six years, ever since Misha had enrolled in Early Intervention at 22 months of age. The service plan back then had exhorted me, a key variable in his environment, “to learn strategies as taught by clinicians.” They trained me to become a normal parent. They instructed me how to touch Misha, when to speak to Misha, what to feed Misha, which songs to sing to Misha, and where to push Misha’s stroller. To him they “modeled” how to act like a normal son, one who displayed “appropriate” behaviors. The service plan promised to teach him to speak 10 words. A year later, he had zero. “He is very strong-willed,” the early interveners lamented of the boy at 3.

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Now Misha was 8, and his ABA treatment consumed 20 hours every week at home, plus another 25 at school. The data showed no lasting progress in any behaviors targeted by the intervention. A session dedicated to “brushing teeth” comprised 16 steps, beginning with “grab toothbrush” and ending with “spit.” He remained stuck on step two: “Turn on the faucet with free hand and rinse the toothbrush.” He employed some modified signs and verbal approximations, and even said “meatball” once. But he never repeated the word, no matter how many times his behavior analysts showed him photos of meatballs. He looked distracted, irked, or plain bored by the ABA sessions, his attention wandering from their demand to demonstrate positive powers. Prompted to “blow your nose,” he stuck out his tongue.

The pith of his personality surfaced during his leisure time, when he sought out novel experiences. Handed a screwdriver, he embarked on a self-appointed mission to remove knobs from our doors and light switch plates from the walls in our apartment. He wanted no part of a session designed to train him how to throw a ball. He preferred to balance it on his head. A sly smile often crawled across his face, hinting at a store of private jokes. Why this jocular boy, brimming with mirth and curiosity, failed the one treatment prescribed to him baffled me.

Was Misha failing ABA, or was ABA failing Misha? Oddly, I couldn’t answer the question empirically with any degree of certainty. ABA is marketed as “evidence-based,” but no state agency collects performance data, assesses outcomes, or controls quality. If no standards existed to place Misha’s scores in context, then maybe the theory behind ABA could shed some light. Where, I wondered, did ABA’s scientific principles come from?

“Skinner,” Larry replied.

“B.F. Skinner? The Harvard psychologist who trained pigeons to play Ping-Pong?”

“Yes.”

Surprised, I opened Applied Behavior Analysis, the textbook used for licensing behavior analysts. Voilà! A photograph of Skinner, with his prestigious forehead, appeared in chapter one. A hundred pages expounded the savant’s doctrine of “behaviorism,” which he derived from laboratory experiments on pigeons and rats in the 1930s and 1940s. From other reading I knew this much more: Skinner’s signature conceit, reducing behavior to systems of interlocking “reinforcers,” had ignited a roiling controversy in the midcentury decades. But the firestorm around his work had burned out long ago. Behaviorism was a fossil.

A twinge of sadness pierced me. Disabled kids have been herded into makeshift classrooms, seated before surplus desks, and outfitted in yesteryear’s clothing. Apparently, they are given the obsolete ideas, too. They are, to stretch an epigram by John Maynard Keynes, slaves to a defunct psychologist.

Behaviorism coalesced as a school of thought in revolt against the traditional subject matter and methods of psychology. The inner life of motivation and sensation, will and judgment, thought and feeling, “lack the dimensions of physical science,” Skinner wrote in Science and Human Behavior (1953), widening a trail blazed by John Watson and Ivan Pavlov. Traditional psychologists interpreted dreams and engaged in talk therapy. Behaviorists rejected introspection, contending that “antecedents” in the environment wholly determined an organism’s constitution. Careful observation could measure these environmental factors. A schedule of rewards, or, in Skinner’s parlance, “reinforcers,” could intervene to reform the patterns for the better. Despite what journalists continue to claim, Skinner never taught pigeons to play Ping-Pong. But he did get them to peck Ping-Pong balls in unnatural ways, and his success in reinforcing the behavior of hungry rats suggested the ingenuity of his technique of conditioned response.

A disregard for life “under the skin” marked behaviorism’s aspirations to be a predictive science. The same principle made Misha’s intervention appear so versatile. His behavior analysts restricted themselves to observing his physical operations, devoid of subjective or personal meaning, so that they could be measured with the same tape, as it were. Misha trying to speak and Misha trying to blow his nose fell into the same abstract category of “behavior.” A nonverbal boy who couldn’t give ready evidence of his inner life could be trained by presuming he had none. How clever! Change the environment, change the boy.

But sidestepping Misha’s sense of himself as a conscious agent diverged from my approach as a parent. His squealing and flapping I took as a kind of song and dance, fun rather than functional. His meltdowns I interpreted as frustration over his struggle to discriminate among his desires. When he cheated at the card game Uno and chortled, I caught his sense of humor and cheered his assertion of freedom. I reckoned his outward behavior, in other words, not as a domain unto itself, to be manipulated to conform to objectives imposed on him, but as a clue to his inner feelings, beliefs, and thoughts. That’s common-sense parenting.

It’s also sound reasoning. “There is no such thing as ‘behavior,’ to be identified prior to and independently of intentions, beliefs, and settings,” the philosopher Alasdair MacIntyre once wrote in a critique of behaviorism’s mindless form of scientific investigation. “In a serious field,” Noam Chomsky wrote, “you wouldn’t identify the subject with the study of the data. That’s like calling physics ‘meter-readings science’ because meter readings are the data.”

Skinner boasted of his refusal to read his critics. Instead, he upped the ante, extrapolating results from the laboratory behavior of rats and pigeons to every aspect of human behavior in society. Crude analogies, underlined by peremptory assertion, marked his pronouncements. Coining the term “behavior therapy” (a.k.a. “behavior modification”), he published a novel and a series of books that discarded the distinction between scientific prediction and utopian prophesy. Mass doses of behavior therapy could solve the world’s political, ethical, and religious problems, he held. If only hidebound society shed the illusions of freedom and dignity — ghosts of “the so-called ‘democratic philosophy’ of human behavior” — then a vanguard of his disciples could get on with the job of redesigning the environment for salvation.

Skinner’s contempt for democracy appealed to governments beleaguered by dissension and fiscal crisis. In the 1960s, a national movement to shutter asylums, reformatories, and prisons coincided with mass civil disobedience. Rather than endorsing expensive, time-consuming therapies that integrated behavior into personality, governments funded behavior therapy for gamblers, homosexuals, alcoholics, child molesters, juvenile delinquents, and disabled children and adults. Behavior analysts formed their first professional associations and entered schools, families, and communities with smartly packaged, scalable interventions. In 1969, the President’s Committee on Mental Retardation blessed their objective as “the normalization principle.”

Twilight, alas, soon fell over behaviorism’s heyday. The animal science experiments on which the field staked its most ambitious claims fell apart. The dawning of cognitive science cast light on the aspect of volition intrinsic to the mind. An ethic of recognition returned to psychology as the values of agency, choice, and diversity spread through society.

In a speech in Boston to the American Psychological Association a week before he died in 1990, Skinner acknowledged that the wheel of intellectual history had turned his behaviorism to dust. But he held fast to the renunciation that distinguished it. So far as science is concerned, the “creative self or mind,” he said in his orotund manner, “simply does not exist.” He likened himself to Charles Darwin and cognitive scientists to creationists.

Not long after, state governments began investing his phantom science with near-monopoly power over the one remaining group that society still construes as less than human.

After flunking Early Intervention, Misha began preschool in a “substantially separate” ABA classroom in Cambridge. Autistic students in the district nearly tripled in number between 2010 and 2020. Given the district’s choice to use ABA exclusively for them, segregation made pedagogic sense. The fewer independent variables in the environment, the more the classroom resembles a laboratory. (Forty-five percent of Massachusetts students with autism are placed in some form of “substantially separate” setting, according to the state Department of Elementary and Secondary Education.)

Every week in school, Misha underwent two 30-minute sessions of physical therapy; three 30-minute sessions of speech therapy; and three 30-minute sessions of occupational therapy. The remainder, 1,380 minutes, belonged to behavior interventions. ABA commandeered the measurement of the lesser therapies. “By the end of the year,” his speech pathologist predicted in his Individualized Education Program (IEP), “Misha will increase his communication skills by requesting 3 needed items and identifying 5 novel targets from a 3-word description with 80 percent accuracy as averaged across 5 consecutive sessions.”

I sat in hours-long meetings squinting at bar graphs and line charts presented by a team as large as a hockey squad. Misha was never invited to attend. I served as his proxy, his voice. But behaviorism’s assumptions relegated me to a spectator. No theory of autism, philosophy of education, or conjecture of Misha’s flourishing informed his IEP. Theory and philosophy are anathema to behaviorism. Education is engineering, Skinner said. A student is a “vortex of stimuli” controlled by the environment. Only that which can be measured in metric time matters. The results of quantification are considered self-evidently true. Either Misha met his objectives, or he did not.

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He did not. Misha’s sister graduated from fourth, fifth, and sixth grades, bridges over which she crossed from elementary to middle school. Misha remained in “pre-academic” time. When he was biologically 5 years, 5 months old, he was alleged to be 1 year, 6 months old behaviorally — a stopped clock, placed in an existential penalty box. His teachers copied and pasted the same “vision statement” into his IEP for six consecutive years.

Misha could not speak up. But he did act out. He rose from his seat and moved around his classrooms, orienting his body in space. “We have created a new token board for Misha that targets ready hands and looking eyes,” read one of the “compliance strategies” devised to rope him into his prescribed place.

At age 8, he evinced an intense curiosity about hair. He picked out hair from among the wood chips on the playground, held single strands to his ear, and played them like a violin, grinning with delight. At school, he began touching the heads of his teachers and classmates. He did so 5.25 times a day when the tabulations began. His average rose to 74.75 times a day and then spiked to 116.45 times a day. Why? “Through the course of multiple observations,” his behavior analyst wrote in summarizing a half-dozen “functional analyses” undertaken in school and at home.

Misha engaged in hair pulling across staff. He has pulled hair of peers across settings. He has pulled hair during structured and unstructured activities. He has engaged in hair pulling when he has been engaged in preferred and non-preferred activities. It is hypothesized that hair pulling is a synthesis of functions, not reliably dependent on the setting, situation, or regulation.

Another possibility, namely that feeling hair enchanted Misha’s budding aesthetic imagination, fell outside behaviorism’s exclusively “functional” template of value. A behavior is either “adaptive” (correct) or “maladaptive” (problem). It either reduces or increases tension between the organism and the environment. About the pursuit of pleasure for its own sake, ABA had nothing to say.

The impasse exposed a conceptual bind. Misha couldn’t learn the normal academic curriculum of math, science, history, and English until he functioned like a normal student. His physiology wouldn’t permit him to keep his hands and feet still, like a normal student. ABA misconceived his sensory wants and needs as “problem behaviors” and intervened, which only generated more “problem behaviors.” The data outputted by ABA’s fetish for measurement fed back into itself as input, reinforcing a consensus that succeeded mainly in producing a feeling of pointlessness.

At the Lurie Center for Autism, an educational consultant told me ABA couldn’t possibly be the impediment. Misha just needed a better, stricter, more comprehensive intervention plan in a private school out of the district. Off he went to Melmark New England, an ABA school 40 minutes away in Andover.

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Melmark clamped a vise grip around him. In an observation room, behind a one-way mirror, an “educational coordinator” monitored his compliance with “appropriate social interactions” in class. Rules of maneuver screwed him into meticulous formations of space and time. “Any instance that he comes within six inches of another person without permission” his teacher docketed as an “invasion of space.” “Bolting” occurred when he wandered “more than four feet away from the designated area without permission” — to touch an elevator button in the hall, for example. To extinguish his interest in hair, the behavior that prompted his transfer out of Cambridge, Melmark deployed physical intervention.

Misha responded with bouts of crying and episodes of tearing hair out of his scalp and eyebrows. I visited the observation room one day to see for myself. My eyes landed on a copy of Skinner’s Science and Human Behavior, which stood among other books and papers on the educational coordinator’s bookshelf. We watched Misha rise from his desk and move about the classroom, slapping his hands together and stomping his feet. “See that,” I implored. “His sensory wants and needs should be respected.” The coordinator, paraphrasing Skinner’s book, remonstrated that Misha’s sensory wants and needs, “if real,” constituted no useful “evidence.”

The assertion of dogma focused my concern. Twice a day, Misha’s teacher subjected him to Melmark’s school-wide “well body checks.” A “body tracker system” stored photographs on a central server. I objected to an adult woman inspecting my son’s body — sometimes in a closed bathroom stall — without his consent or my foreknowledge. Melmark appeared surprised by my objection. The possibility that Misha could harbor unarticulated feelings about compulsory inspections of his body seemed not to have occurred to them. Privacy, after all, obstructs the gaze of behaviorism. Dignity, which can’t be measured, must not exist. I gave Melmark notice of his withdrawal and began searching for his third school in less than two years.

No treatment model works for everyone. For whom does ABA work? To what degree? For how long? The absence of longitudinal data spoils our capacity to answer these questions with integrity. The natural changefulness of young children, not to mention the role of chance, are unaccounted variables. Yet refuting any treatment definitively is impossible. Parents like me need to believe something can help our children.

So, when I read in Melmark’s Family Handbook that “ABA is an objective discipline” and “there is nothing to substantiate” complaints that “behavioral programs produce robotic children,” I suspended my critical faculties. Queried for this essay about the science behind ABA, Melmark pointed to “a large body of valid scientific evidence” ascertained by fellow behavior analysts, past and present. I spent some time reading around in that “evidence.” This time, though, I also took in the growing criticism about it. Education scholars independent of the ABA industry find its published research riddled with conflicts of interest, resistant to interdisciplinary cooperation, and hampered by “rock-bottom” standards.

To my knowledge, only one large-scale outcomes analysis has been undertaken by government. That is the U.S. Department of Defense’s ongoing “Autism Care Demonstration,” a multiyear assessment of claims made in the military’s insurance program. “The Department remains very concerned,” the 2021 report concluded, as “almost half of the participants are experiencing no change or worsening symptoms after two years of ABA services.” The data showed no correlation between treatment intensity and outcomes. Of the improvements that were imputed to ABA, the Pentagon’s report questioned whether they were “clinically significant.” ABA’s own research standards, the report said, “do not meet our hierarchy of evidence standard for medical and proven care.”

In The Measure of Man (1953), the writer and naturalist Joseph Wood Krutch perceived that behaviorism’s midcentury power and prestige surpassed its scientific discoveries. Behaviorism spread to the extent that individuals forfeited their presumption of free will and became automata, “conditioned to like being conditioned.” I think the same paradox explains ABA’s current expansion better than the “evidence” alleged by the industry.

Over the two decades that state legislatures have endorsed ABA for children with autism, a vanguard of behavioral technologists have been reengineering the environment of culture for everyone. Skinner’s technique of reinforcement has shaped the design of video games, dating apps, slot machines, social media, and product marketing. The digital architecture of mass behavior modification, busy with prompts, notifications, and nudges, mostly just aims to herd us into goals chosen for us.

The automation of life is plain to see in the unfolding future of ABA. Seventy ABA classrooms in New England already use robots for autism instruction. I telephoned the manufacturer in Connecticut to pose a question missing from the excited newspaper stories. No, a spokesperson avowed, the company hasn’t collected any data to justify its claims for robot-assisted ABA.

The evidence is beside the point, but the irony is rich. Trained to disregard the inner lives of their clients, behavior analysts themselves may be replaced by robots.

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At 11 years old, Misha still didn’t brush his teeth, speak, read, draw, or calculate, at least not like most children his age. But he received no ABA at home, and his educational plan no longer rubbed his nose in his impairments. In March 2021, he started at the Perkins School for the Blind, in Watertown, the only school in Massachusetts willing to honor my demand to scrub every trace of ABA from his IEP. Perkins manages to teach Misha without injuring his distinctive modes of building and fortifying his identity.

If not for a chance disruption to the environment, I might not have gained the confidence to gamble on such a radical departure.

The outbreak of COVID, of all things, did the trick. Melmark closed for some months. The behavior analysts stopped knocking on our door. Time and again I’d been warned that halting ABA treatment could jeopardize Misha’s well-being. According to behaviorism’s iron laws, the abrupt withdrawal of reinforcers, the collapse of hierarchies of time and space, risked regression — or even a state of vegetation.

Misha greeted the opportunity as though bounding out of the opening of a clenched fist. One warm day that summer, he charged down the street to the community swimming pool with me in tow. He drew a breath, sealed his lips, and dunked himself in the water. In swells of exuberance that lasted all afternoon, he taught himself how to swim — and set himself free.

Then something surprising happened to him. “Mothers were coming and saying, ‘my child was injured by the vaccine,’’’ Kennedy testified. “These were many hundreds of mothers of children with intellectual disabilities. And they said ‘nobody’s listening to us. The Democrats aren’t listening to us. The Republicans aren’t listening to us,’ and I felt that I should listen to them.” Kennedy listened. In 2015, he joined the World Mercury Foundation, an activist organization that rebranded itself as Children’s Health Defense, and embraced the mothers’ cause.

At the same time that Kennedy, Jr., woke up to the injury theory of autism, I also began to listen. My son was diagnosed in 2014, at age three. Over the next 18 months, I tested the possibility of recovering my son through alternative or “holistic” remedies prescribed by a trio of healers.

Defenders of conventional medicine paint such experiments as the product of an irrational transaction between the charlatan and the sucker—the former, like Kennedy, Jr., an opportunist beyond shame, the latter, like me, curable by a sober presentation of The Facts. If that were so, then why do holistic remedies fly off the shelves at pharmacies without evidence of their efficacy, alongside an array of alleged immunity-boosting, anti-inflammatory vitamins and herbal supplements? America has been awash, as it were, in “de-tox” and wellness nostrums for a half-century.

The beginning of the holistic health movement was about the time when the theory of autism as a toxin-induced chronic illness first sent up shoots in the grassroots. Did generations of Americans suddenly lose their marbles? Are the autism mothers—or, as in the story I tell in this essay, one father—simply lacking in critical intelligence?

A pediatric neurologist at Boston Children’s Hospital diagnosed Misha with autism spectrum disorder at age three. At Massachusetts General Hospital, another pediatric neurologist answered my call for a second opinion, only to rebuff my hope for a different one. “I did not find him to be very receptive to testing,” the expert sighed. Both neurologists observed that Misha didn’t respond to their request to identify colors, body parts, or animals, that he averted his eyes from theirs, that he pawed their examination table when he didn’t flap his arms. Autism, the doctors said, constituted a lifelong condition. Medical science didn’t understand its causes or cures, and scarcely comprehended the limit of its woes.

I wondered how the neurologists could deduce such a bleak judgment from 90 minutes in the bell jar of their examination rooms. If they knew so little about autism, then how could they gavel down a life sentence? I remembered reading somewhere that a properly trained neurologist ought to be able to argue both for and against any single diagnosis in a stepwise process of elimination. I opened the Diagnostic and Statistical Manual of Mental Disorders (DSM), leafed to the entry under autism, and plucked out of its basket several inculpating symptoms. Aggrieved, I sought out the Handbook of Differential Diagnosis, a companion volume, and underlined an admonitory passage: “Clinicians typically decide on the diagnosis within the first five minutes of meeting the patient and then spend th rest of the time during their evaluation interpreting (and often misinterpreting) elicited information through this diagnostic bias.” Now what?

As an educated citizen of liberal Cambridge, Massachusetts, I felt that I could and believed that I should develop my own, independent judgment about Misha’s condition. I would do my own, alternative research. I would draw my own conclusions and plot my course of action based on what I learned.

According to “holistic” attitudes and “alternative” ideas about medicine and health, autism was neither the psychopathology listed in the DSM nor the organic twist of disease inferred by neurologists. Autism, the alternative sources taught me, was one among an epidemic of preventable chronic illnesses that American children contracted from toxins in the environment. Holistic therapy, fortunately, contained resources disregarded by credentialed experts. Vitamin therapy, homeopathy, and antifungal treatment could heal children like Misha of their injuries.

A family friend and fellow autism parent who had helped to start The Thinking Mom’s Revolution introduced me to Mary Coyle, a homeopath at the Real Child Center in New York. Coyle claimed that Misha had likely contracted autism from contaminants in the environment. Was I aware of the epidemic of chronic illnesses afflicting children like him? Some of them, Coyle explained, received diagnoses of asthma, chronic fatigue, or dermatitis. Others were diagnosed with fibromyalgia, Lyme disease, or PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections).

The pathogens lying at the nexus between the body and the environment typically fooled medical specialists at places like Boston Children’s Hospital and Massachusetts General Hospital. Coyle urged me to abandon their dead-end query, “Is your child on the autism spectrum?” To help Misha, I needed to switch the predicate and ask a different question: “How toxic is your child?”

Why not find out? I had never heard of homeopathy or “homotoxicology,” Coyle’s specialty. But I believed that with some study I could probably draw the necessary distinction between evidence and interpretation in the test results. Coyle herself had been trained by conventional physicians before seeking out instruction in holistic medicine. She hosted a radio program, Fearless Parent, spoke at conferences, and articulated her rationale in a book that I obtained, Cutting Edge Therapies for Autism. Holism sounded harmless.

We started out with an “Energetic Assessment.” Measuring Misha’s rates of “galvanic skin response,” Coyle said, would weigh the balance of electrical vibrations conducted through his pores. She deployed an electrodermal screening device that deciphered imbalances in his “meridians,” or “pathways.” Toxic metals, alas, appeared to be obstructing his “flow” of energy.

With Coyle’s theory confirmed, she referred me to Lawrence Caprio to canvass for food and environmental allergens. Caprio, like Coyle, had defected from conventional to alternative medicine. I learned that while attending medical school at the University of Rome he had befriended a homeopath in the Italian countryside and lived “a very natural lifestyle.” The experience led him to a conversion to naturopathy.

Misha, Caprio reported, turned out to be “intolerant” of bread, butter, eggplant, oatmeal, peanuts, potatoes, and tomatoes. Misha also displayed a “sensitivity” to bananas, car exhaust, cheese, chlorine, chocolate, cow milk, dust mites, garlic, onions, oranges, soy beans, and strawberries. Caprio flagged “phenolics” such as malvin (in corn sweeteners) and piperin (in nightshade vegetables and animal proteins).

Next, I mailed urine and stool samples to the Great Plains Laboratory in Kansas. The director there, William Shaw, had worked as a researcher in biochemistry, endocrinology, and immunology at the U.S. Centers for Disease Control before he quit and set up his own laboratory. Shaw suspected lithium in “the bottled water craze” and fluoridation in the public water supply as causes of autism and came to believe that government scientists woefully misunderstood such sources. He compared their dereliction to the Red Cross’s failure to intervene in the Holocaust. Shaw, to be sure, found toxic levels of yeast flooding Misha’s intestines.

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Homeopathy, naturopathy, and renegade biochemistry cast me outside the institutions of science where Misha’s neurologists practiced. But to grasp how these new realms could be objective correlates of Misha’s condition—and how toxins, foods, and yeast could be the culprits—I had only to remind myself of the progressive demonology that made the claims of alternative medicine seem plausible.

Industrial corporations, after all, have been chewing up the land, choking the air, and despoiling the water, turning the whole country into a hazardous materials zone. I’d read Silent Spring, in which ecologist Rachel Carson claimed that our bodies weren’t shields, but permeable organisms that absorbed particulates. I’d heard Ralph Nader liken air and water pollution to “domestic chemical and biological warfare.” I’d finished Bill McKibben’s The End of Nature with dread. Listening to progressive news media about “forever chemicals” evoked moods that swung between indignation and paranoia. I paid for eco-friendly cribs, de-leaded the windows in our apartment, and tried to shop organic.

As Coyle, Caprio, and Shaw whispered in my ear, my imagination boggled with an overwhelming catalogue of possible pathogens. Our food contained more pesticides, hormones, and insecticides than I had suspected. Our air is filled with methanol and carbon monoxide. Chlorine, herbicides, and parasites degraded our tap water. Mold festered in our walls, floors, and ceilings. Formaldehyde lurked in our furniture. Heavy metals hid in our lotions, shampoos, and antiperspirants. Synthetic chemical compounds—polychlorinated biphenyls, phthalates, bisphenol A, polybrominated diphenyl ethers— seeped into our toys, diapers, bottles, soaps, and appliances. Even our Wi-Fi, cell phones, refrigerator, light bulbs, and microwave oven emitted radiation through electromagnetic fields.

Had the dystopia of the contemporary world poisoned my son under my nose? Then why hadn't his pediatrician alerted me? The alternative treaters who had my ear defined autism as a preventable, “biomedical” illness, meaning, as Shaw explained, “that the therapies are directed at the underlying causes of autism rather than a pharmaceutical approach directed toward controlling symptoms.” The critique of pharmaceuticals led me to the horrifying possibility that the mechanism of harm had originated with Misha’s pediatrician.

He had received three-in-one vaccines against diphtheria, tetanus, and pertussis (DTP) and measles, mumps, and rubella (MMR) according to the recommended schedule. Coyle claimed that these vaccines contained dangerous metals, including mercury and aluminum. They could have spread from Misha’s arm to his gut and persisted long enough to perforate an intestinal wall. Mercury, a neurotoxin, could have leaked into his bloodstream and surreptitiously addled his brain.

His pediatrician’s pharmaceuticals could have set off a chain reaction that had the same effect. The antibiotics she gave him for petty infections could have reduced the diversity of natural flora that controlled yeast in his gastrointestinal tract. An overabundance of yeast could have generated enzyme that perforated his intestines even if live-virus vaccines had not done so directly.

Either way, undigested food molecules such as gluten (in wheat) and casein (in dairy) could have joined forces with environmental toxins and heavy metals and attached to Misha’s opiate receptors, disrupting his neurotransmitters and triggering allergic reactions. The ballooning inflammation would have thwarted his immune responses. If so, then his “toxic load” could be starving his cells of nutrients. Escalating levels of “oxidative stress” could be congesting his metabolism. No wonder he lacked muscle tone, coordination, and balance!

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How could I dismiss out of hand the re-diagnosis of “autism enterocolitis,” AKA “leaky gut?” In 1998, a midlevel British lab researcher named Andrew Wakefield published a study warranting the diagnosis in The Lancet, one of the world’s most prestigious medical journals. National politicians echoed the implications. “The science right now is inconclusive,” Barack Obama said in 2008. Thousands of media outlets around the world reported a controversy between two legitimate sides. “Fears raised over preservative in vaccines,” a front-page headline in the Boston Globe announced. Wakefield appeared on television with articulate parents by his side. “You have to listen to the story the parents tell,” he said on CBS’s 60 Minutes. ABC’s Nightline, Good Morning America and 20/20, NBC’s Dateline, and The Oprah Winfrey Show all broadcast the gravamen of the indictment out of the mouths of weepy, well-educated parents.

The accusation against antibiotics resonated with definite misgivings that I held over the dispensation of American medicine. As Lynn Payer demonstrated to me in her Medicine and Culture, doctors in the United States order more excessive diagnostic tests, perform more needless caesarean sections, and prescribe more superfluous antibiotics than any of their counterparts around the world. A prepossessing dependence on technology encourages American medicine to treat symptoms rather than people. From this truth, Coyle, Caprio, and Shaw drew an uncommon inference that aggressive medical care had sabotaged Misha’s birthright immunity.

Misha, so endowed, could have repaired the damage done, no matter whether vaccines or antibiotics had upset his “primary pathways.” His body would have availed “secondary pathways” such as his skin and mucous membrane. Coyle said his innate capacity for adaptation had been telegraphing itself in his fevers, his eczema, his ear infections, even his runny noses. Yet his pediatrician had stood blind before the hidden meaning of these irruptions. Reaching into her chamber of magic bullets, she prescribed steroid creams for his eczema, acetaminophen for his headaches, amoxicillin for his ear an sinus infections, antihistamines for his coughs and runny noses, and ibuprofen for his fevers. This “Whac-a-Mole mentality,” Coyle despaired, had plugged his “secondary pathways” as well.

Thus, a vicious cycle set in. Vaccines and/or antibiotics had predisposed Misha’s microbiome to harbor viruses, bacteria, and fungi. Turning toxic, they invaded his cells, tissues, and fluids. The foreign occupation precipitated allergies. The allergies provoked inflammation, which arrested metabolic energy, which led to anemia, which invited recurring infections. His pediatrician perpetuated those with cascading doses of foreign chemicals. “Rather than freak out and take medication and look to suppress,” Coyle counseled, “we should celebrate that the body is working and go and look at the primary pathways and clear out the blockages.” Up to 103 degrees Fahrenheit, “the fever might be a good thing.”

If I could just accept that “allopathic” medicine did not stand apart and speak objectively, but instead reflected the sickness of American society, then the trio of virtuoso healers would help me sidestep the adulterated dialectic of science and health. A holistic treatment protocol would charm Misha’s autism out of its chronic condition and turn it into a treatable medical illness. “The body’s infinite wisdom,” Coyle said, “would take care of the rest.” As the protocol purged and flushed his toxins, the fawn of nature would close the holes in his intestines. His allergies would ebb, reducing inflammation, reviving cellular respiration, and reconnecting his neurotransmitters. The realignment of his meridians would reflow his energy. “Once you clear,” Caprio said during an interview on Fearless Parent with Coyle, “the whole thing just changes dramatically.”

The logic unfolded with Platonic beauty. Misha need not be “cured” of some dreadful disease born into him. No, I could restore his immunity and “recover” his prelapsarian state of nature. Holism’s steady hand would remove the machine from the garden.

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Autism parents began gravitating toward holistic treatments in the 1960s and 1970s, when emphatic personal testimonials, printed and distributed in underground newsletters, led to the formation of grassroots groups such as Defeat Autism Now! (DAN!) and ushered in the “leaky gut” theory. DAN! grew out of the psychologist Bernard Rimland’s Autism Research Institute. Rimland’s 1964 book Infantile Autism blew up the prevailing, psychogenetic thesis of autism’s origins, which blamed mothers for failing to love their children enough.

The Today Show and The Dick Cavett Show had given psychologist Bruno Bettelheim, the chief exponent of the “refrigerator mothers” thesis, free rein to liken them to concentration camp guards. Rimland’s Infantile Autism refuted that thesis and reoriented the understanding of autism away from psychiatry and toward biological medicine. Letters poured into his Autism Research Institute from “refrigerator mothers” complaining of having been insulted by pediatricians. Pharmaceutical companies began rolling out new childhood vaccines for measles (1963), mumps (1967), and rubella (1969) and combining immunizations against pertussis, diphtheria, and tetanus into one injection. Rimland began distributing an annual survey that queried parents about the baleful effects and asking about the efficacy of the holistic approach: vitamin therapy, detoxification, and elimination dieting.

The etiology variously called “leaky gut,” “autism enterocolitis,” or “toxic psychosis” awkwardly amalgamated elements from both ancient and modern medical philosophy. The old idea of disease as sign of disharmony with nature queued behind the modern concept of infection through invasion by microorganisms. But no theory needs to be complete for a treatment to work. “Help the child first,” Rimland urged, “worry later about exactly what it is that’s helping the child.”

Like anti-psychiatry activists, breast cancer patients, and AIDS activists, autism parents confronted physicians with the backlash doctrine of “consumer choice” in specialist medical care. “The parent who reads this book should assume that their family doctor, or even their neurologist or other specialist, may not know nearly as much as they do about autism,” William Shaw wrote in Biological Treatments for Autism.

The first television program to elevate parental intuitions, Vaccine Roulette, aired in 1982 on an NBC affiliate in Washington, DC. The show promoted the vaccine injury theory and won an Emmy Award. Accelerating rates of the diagnosis over the next decades brought the injury theory from a simmer to a boil. In the 1960s, one out of every 2,500 children received the diagnosis. By the first decade of the 21st century, the prevalence rose to one out of every 88, an increase of 2,500 percent. Up to three-quarters of autism parents admitted using some form of holistic treatment on their children.

A Congressional hearing in 2012 featured their cause, heaping suspicion on vaccines, speculating on gut flora, and praising the efficacy of vitamins, homeopathy, and elimination dieting. Dennis Kucinich, a Democrat from Ohio and one-time Presidential candidate, expressed outrage over the spectacle of“children all over the country turning up with autism.” Kucinich blamed “neurotoxic chemicals in the environment,” particularly emissions from coal-burning power plants. Kucinich did his own research and drew his own conclusions.

“There’s no such thing as ‘conventional’ or ‘alternative’ or ‘complementary’ or ‘integrative’ or ‘holistic’ medicine,” skeptic Paul Offit complained the next year in his book, Do You Believe in Magic? “There’s only medicine that works and medicine that doesn’t.” Clever and concise, Offit’s polemic begged the relevant questions. Who decides what works? Fundamental science is one thing, therapeutic interventions quite another. “Evidence-based medicine,” introduced in 1991, supplies criteria to translate medical science into clinical medicine. Atop its hierarchy sits the “randomized control trial.” But as the philosopher of science Jacob Stegenga has painstakingly demonstrated in Medical Nihilism, the randomized control trial is loaded with social and financial biases and severe methodological limitations on its own terms. Even when a therapy works incontrovertibly, that doesn’t free its applications of ambiguity. Antibiotics work. We’ve known that since the 1930s. But which of their benefits are worth which of their costs?

In 1992, ABC’s 20/20 exposed a cluster of autism cases in Leominster, Massachusetts. A sunglasses’ manufacturer had long treated the city as a dumping ground for its chemical waste. After the company shuttered, a group of mothers counted 43 autistic children born to parents who had worked at the plant or resided near it. Commenting on the Leominster case, the neurologist Oliver Sacks voiced a curious sentiment in An Anthropologist on Mars. “The question of whether autism can be caused by exposure to toxic agents has yet to be fully studied,” Sacks wrote, three years after epidemiologists from the Massachusetts Department of Public Health determined that no unusual cluster of cases had ever existed in that city in the first place. Who gets to decide the meaning of “fully studied”?

Bernard Rimland and the autism parents in his movement answered the question for themselves. “There are thousands of children who have recovered from autism as a result of the biomedical interventions pioneered by the innovative scientists and physicians in the DAN! movement,” Rimland insisted in the group’s 2005 treatment manual, Autism: Effective Biomedical Treatments.

William Shaw and Mary Coyle, both DAN! clinicians, adapted Rimland’s manual for Misha. Coyle vouched personally for the safety and efficacy of the holistic treatment therein. She swore she used it to “recover” her own son.

Interdicting toxins marked the first step on our “healing journey.” Taking it obliged me to decline Misha’s pneumococcal conjugate vaccine (for pneumonia) and his varicella vaccine (for chickenpox). Meanwhile, I eliminated from our cupboard and refrigerator the foods for which Caprio had proved Misha sensitive and intolerant. I prepared a course of “optimal dose sub-lingual immunotherapy” to “de-sensitize” him. Coyle drew up a monthly schedule to detoxify him with homeopathic remedies from a manufacturer in Belgium. Shaw itemized vitamins and minerals to supplement Misha’s intake of nutrients, plus probiotics and anti-fungals to control his yeast and rehabilitate his intestinal tract. My kitchen turned into an ersatz pharmacy of unguents, powders, drops, and tablets.

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Every morning, I inserted two tablets of a Chinese herbal supplement, Huang Lian Su, into an apple in order to crank-start his digestion. I added half a capsule of methylfolate into his breakfast in order to juice his metabolism. Ten minutes after he finished breakfast, I stirred Nystatin powder into warm coconut water, drew two ounces into a dropper, irrigated his mouth, and ensured that he abstained from eating or drinking for ten more minutes. Fifteen minutes before his midday snack, I squeezed six drops of a B12 vitamin under his tongue. Every evening, I slipped him two more Huang Lian Su tablets.

To fortify his glucose levels, I could elect to give him two vials of raisin water every other hour. To normalize his alkaline levels, I added a quarter-cup of baking soda to his baths. The “de-sensitizing drops,” however, had to be dribbled onto his wrists twice every day. Misha also needed regular, carefully calibrated doses of boron, chromium, folic acid, glutathione, iodine, magnesium, manganese, milk thistle, selenium, vitamins A, C, D, E, and zinc.

Homotoxicology, the core modality, entailed his daily ingestion of homeopathic “drainage remedies” to purge toxins and open pathways. The bottles arrived in the mail. Coyle provided a table of equivalencies, linking particular remedies to organs. This compound for his small intestines. That one for his large intestine. This one for his kidney. That one for his mucous membrane.

Homeopathy’s whole-body scope of intervention claimed to relieve a range of other illnesses as well. William Shaw said it could cure sensory integration disorder, central auditory processing disorder, speech and language problems, fine motor and gross motor problems, oppositional defiance disorder, obsessive compulsive disorder, eating disorders, headaches, eczema, and irritable bowel syndrome. The marketing materials that accompanied Misha’s compounds claimed to treat bloating, constipation, cramps, flatulence, nausea, night sweats, and sneezing.

I learned the shorthand rationale as part of my self-education. Homeopaths stake their claim on a manufacturing process that distinguishes their remedies from pharmaceutical medicaments. It’s called “succussion.” A label that reads “4X,” for example, indicates that the original ingredient has been diluted four times by a factor of 10—the manufacturer has succussed it 10,000 times. “12X” indicated that the original ingredient has been succussed one trillion times.

The compounds prescribed for Misha said they contained asparagus, bark, boldo leaf, goldenrod, goldenseal, horsetail, juniper, marigold, milk thistle, parsley, passionflower, Scottish pine root, and other herbs and plants of which I’d never heard. Having been succussed, though, the remedies actually contained no active ingredients. In the bottles remained “the mother tincture,” a special kind of water said to “remember” the original ingredient. The only other ingredient listed on the label was an organic compound that served as a solvent and preservative. Thirty-one percent of some of Misha’s remedies contained ethanol alcohol, a proof as strong as vodka or gin. Coyle said to “gas off the alcohol” on the stove before serving him.

Succussion confused me. Misha’s reaction worried me. He looked a fright. Black circles ringed his eyelids. Yeast blanketed his nostrils and lips. Rashes and red spots appeared all over his body. Pale and lethargic, he oscillated between diarrhea and constipation. He broke out with recurring fevers. He stopped gaining weight. Because he didn’t speak, or reliably communicate in any other manner, I couldn’t understand why his emotions seemed to be running at an unusually high pitch.

Coyle explained that different glands and organs in the body stored specific feelings. The kidneys stored fear, the pancreas frustration, the thyroid misunderstanding, the liver anger, the lungs grief, and so forth. Naturally, those emotions poured out as his body excreted toxins. I shouldn’t regard the worsening of his symptoms as a side effect, but rather as a necessary condition of his recovery—“aggravations,” in homeopathy’s parlance. A Table of Homotoxicosis charted the correspondences with the precision and predictability of biochemistry. Nor should I abandon the treatment. To do so would be to “re-toxify” him. I must allow the treatment to fully fledge. I must keep my nerve. If the treatment failed, it would be my fault.

I lost my nerve. It took 18 months of gnawing doubt and thousands of dollars out the door. Then one day I swept all the vitamins, antigens, probiotics, antifungals, and homeopathic remedies into the trash bin. I restored Misha to a regular diet and caught him up on his vaccines. When I paired my demand to Mary Coyle for a full refund with a suggestion that I might retain an attorney, she returned all my money immediately.

I had blundered into a non sequitur. The environment is toxic. Conventional medicine does reflect the sickness of our culture. Yet that doesn’t logically make holism any better. The supplement industry, I came to understand, has pumped hundreds of millions of dollars into thousands of clinical studies without demonstrating that vitamins, herbal products, or mineral compounds are either safe or effective, much less necessary. The Food & Drug Administration (FDA) neither tests the industry’s marketing claims nor regulates its product standards.

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Caprio and Coyle regard Traditional Chinese Medicine (TCM) as a reproach to modern, Western medicine. TCM, they pointed out, is 5,000 years old. Actually, I learned, Chairman Mao Zedong contrived TCM after 1950 as a means of controlling China’s rural population and burnishing the regime’s reputation abroad. In 1972, during Richard Nixon’s tour of Chinese hospitals, his guides stage-managed a demonstration of TCM’s miracles. American media reported the healing event at face value and launched the holistic health movement stateside. Several years later, the FDA sought to regulate the vitamin and supplement industry. Manufacturers fought back with a marketing campaign centered on “freedom of choice” and convinced Americans to stand up for their right not to know which ingredients are in their daily vitamins.

I formed my new perspective with the aid of a handful of indispensable books, including Robert Park’s Voodoo Science, Edzard Ernst’s Homeopathy: The Undiluted Facts, Simon Singh and Edzard Ernst’s Trick or Treatment: The Undeniable Facts About Alternative Medicine, Rose Shapiro’s Suckers, Dan Hurly’s Natural Causes, Paul Offit’s Autism’s False Prophets, and Alan Levinovitz’s Natural, a book whose subtitle summed up the theme: “How Faith in Nature’e Goodness Leads to Harmful Fads, Unjust Laws, and Flawed Science.”

But I needed to file a public records request with the Connecticut Department of Public Health to discover that Lawrence Caprio had been censured and fined for improperly labeling medication, for practicing without a license, and for passing himself off as a medical doctor. I also learned that Caprio’s naturopathy license had been suspended for two years after the FDA determined his bogus “sensitivity tests” violated its regulations. Misha, an actual immunologist confirmed, had no food allergies in the first place.

Was Misha ever burdened by toxins? Coyle said the results of the “energetic assessments” revealed that he carried quantities of heavy metals. Degrees of dangerousness were measured against a standard range credited to “Dr. Richard L. Cowden.” I sent Misha’s results to Cowden. I stated my belated impression that meaningful ranges for heavy metals don’t exist—we all have traces— and my belief that autism cannot be reversed. “I have reversed advanced autism in many children,” Dr. Cowden snapped. “I saw reversal of more than a dozen cases of full-blown autism, including my own grandson. So I am pretty sure the parents of those dozen+ children would debate you on your IMPRESSION/BELIEF.” Cowden advised me to repeat Misha’s energetic assessment through the Internet and to place him into an “infrared sauna” to detoxify him. I declined.

Even before Misha’s first energetic assessment, the FDA had accused the manufacturer of the device of making unapproved claims. The FDA had approved it only for measuring “galvanic skin response.” But the company’s marketing materials had crossed over into unapproved diagnostic and predictive territory when they claimed that the “software indicates what is referred to as Biological Preference and Biological Aversion.” The software was recalled. “Dr. Cowden,” I also learned too late, was not the “Board Certified cardiologist and internist” that he advertises. He surrendered his medical license in 2008 after the Texas Board of Medical Examiners twice reprimanded him for endangering his patients. According to the American Board of Internal Medicine, Cowden’s certifications are “inactive.”

The “homotoxicology” that Coyle practiced had sounded to me like a branch of toxicology. But the two fields turn out to have nothing in common. An analysis of clinical trials of homotoxicology established that it is “not a method based on accepted scientific principles or biological plausibility.” Actual toxicologists pass a rigorous examination for their board certifications and adhere to a code of ethics. Homotoxicologists become so simply by declaring themselves homotoxicologists.

As for vitamins, supplements, and homeopathic remedies: an exception in federal law places them outside the FDA’s approval process. Only their manufacturers know what these dummy drugs contain. In 2022, upon fielding numerous reports of “toxic” reactions, finding “many serious violations” of manufacturing controls, and recording “significant harm” to children, the FDA warned the consuming public.

Homeopathy, of course, possesses no detectable mechanism of action, nor gives any reason to believe that “aggravating” the primary symptoms of an illness is necessary to cure it. Water does not “remember,” at least not if the laws of molecular physics hold true. The tinier the dosage, homeopaths maintain, the more potent the therapeutic effect the mother tincture will deliver. By this logic, a patient who misses a day might die of an overdose.

I came away from my encounters with Mary Coyle, William Shaw, and Lawrence Caprio convinced of their sincerity. I also realized that my liberal virtues—skepticism, independence, open-mindedness, self-help—had become constituent features of my error. A liberal education, as the French philosopher Jacques Ellul pointed out in his neglected Propaganda, is the first requisite for sophisticated credulity. In societies with high levels of formal schooling and advanced communications technology, vast quantities of second-hand, semi-digested, unverified information circulate among media consumers conditioned to give every half-baked proposition the benefit of the doubt. Society’s intellectuals, Ellul concluded, are its greatest purveyors of propaganda.

Thus, it is no surprise that autism’s cult of redemption has been led by trained researchers, practicing clinicians, and highly educated parents espousing their cause in the nation’s self-serious news programs. The internet, rather than introducing novel forms of credulity, has merely intensified the phenomenon of ersatz expertise. Some say childhood vaccines could cause autism. Others say vaccines do not cause autism. You decide. How?

As I steered Misha back toward conventional medical science, I rediscovered the disappointment that had drawn me to holism in the first place. I took him to a “neuro-biologist,” a “neuro-psychologist,” and a “neuro-immunologist. His “neuro-ophthalmologist” ordered an MRI. His “neuro-radiologist” read the images with an algorithm that implausibly measured his brain as “normal,” due to the absence of indications of damage.

That determination proved only the vacuity of scientific materialism. As Anne Harrington writes in Mind Fixers, the “biological revolution” that seized psychiatry in the 1980s aspired to network the anatomical, electrical, and chemical functions of the brain. A procession of neuroimaging technologies held out the promise of progress: electroencephalography (EEG); computerized axial tomography (CAT); positron emission tomograph (PET); magnetic resonance spectroscopy (MRS); magnetic resonance imaging (MRI). But the resulting studies have always fallen pitifully short of a credible evidentiary threshold and have never done anything to expand treatment options in autism. Mainly, neuro-imaging has furnished opportunities to market the autism research industry, a breakthrough culture that has never broken through.

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Holism, by contrast, purports to answer prayers in the immaterial world, bidding to restore harmony through an aesthetically elegant fusion of mind, body, and spirit. As Coyle explained on her website: “Homotoxicology utilizes complex homeopathic remedies designed to restore the child’s vital force an balance the biological flow system.” The vital force is neither a discoverable fact nor a logical inference. It’s an image of a fact superimposed on the body’s only actual conduits of energy, the cardiovascular and nervous systems. Why did Misha lack of the power of speech? His neurologists didn’t know why they didn’t know. Coyle turned the question back on me. Some autistic children, she said, possessed clairvoyance. Others cried for our help in telepathic dreams. “They’re in there,” she insisted. So why couldn’t I hear my son from behind the pane of his injury?

A part of me still craves holism’s beautiful notions. The more sensible and responsible parts of me recognize in this desiccated spiritualism the return of a repressed pagan unconscious. As Misha recovered from its false and harmful claims and grew in ways that his neurologists could not predict, I realized that I could not force myself to believe either in goblets of magic water or in neuro-radiology’s algorithm.

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Scientists have falsified the “leaky gut” theory of autism time and again since Andrew Wakefield’s 1998 paper in The Lancet, which has “entered his profession’s annals of shame as among the most unethical, dishonest, and damaging medical research to be unmasked in living memory,” according to Brian Deer’s The Doctor Who Fooled the World.

After all this time, you have to wonder who is really fooling whom. Autism parents agitated for the likes of Wakefield and Robert F. Kennedy, Jr., to come along and validate their conclusions for decades. Nor does the cottage industry of holistic practitioners and alternative medicine gurus require a man in Donald Trump’s Cabinet to carry on their proselytizing. Many advocacy shops lost access to social media platforms during the COVID-19 pandemic. But William Shaw managed to publish a paper in 2020 purporting to demonstrate “rapid complete recovery from autism” through anti-fungal therapy. And in 2022, Mary Coyle podcasted her claim to have healed her son’s chickenpox through “natural” remedies. Podcasts distributed by Google, Apple, and Spotify have become a preferred medium to expand the bill of indictment against autism’s causes to Tylenol, electromagnetic fields, “toxic baby food,” “geo-engineering,” and genetically modified foods. Nevertheless, vaccine skepticism, focused on COVID-19 and HPV inoculation, remains the irreducible core within the holistic circle, a goad to reject the false revelations of cold, mechanical instrumentalism.

Kennedy, Jr., merely represents another phase in the narcissism ingrained in this theodicy of misfortune, which is bound to spread. Biological facts are powerless to throttle a spiritual war against invisible enemies. The paranoid imagination elevates grievances to the status of a historical event. Re-baptized in nature’s holy immunity by ascetic protocols of abstinence and purification, the convert turns over a new leaf, as it were, and craves personal vindication above all else. “This book offers you two messages,” Bernard Rimland said of the testimonials collected in Recovering Autistic Children: “You are not alone in your fight, and you can win.”

Win? Children need love and respect for who they are, not how their parents prefer them to be. In Mirage of Health, the great French microbiologist René Dubos underscored the truth that matters: “As far as life is concerned, there is no such thing as ‘Nature.’ There are only homes.”

Boston Children’s Hospital stands two miles from our home in Cambridge, Massachusetts. Congestion on the Longfellow Bridge turns our drive to the hospital into an hour-long ordeal. We’re stuck in place, boxed in. Misha, my son, loafs in the back seat, his gaze fixed on glades of light rippling on the Charles River. I feel his mood tense. What’s eating him?

The traffic uncoils. I turn onto Charles Street and descend into an underground garage. We have waited months to see Misha’s neuro-ophthalmologist. Now we’re late, liable to return to the back of the queue.

On the sidewalk, we fall in with a morning crowd fleet of foot and thread our way among a maze of streets emblazoned with shafts of light and shade, reflections from the towering buildings. Reaching a crosswalk, we’re dashing across a busy street when Misha throws away my hand, stops and freezes. All expression drains from his face.

“C’mon Misha, watch out for the cars.”

“Misha, let’s go. On to the sidewalk. Now!”

He’s blocking both lanes of traffic.

“It’s okay, sweetie, you can do it.”

He’s not budging.

“Misha, what’s wrong?”

I don’t know how to respond to his sudden inertia, and he’s not about to tell me. Misha doesn’t talk. I step toward him, grab his hand and tug. I’ve never felt his body to be so rigid. Sometimes, my nudge in the small of his back resumes his body’s forward momentum; alternatively, my intervention prompts him to kick off his shoes, pull down his pants and shriek. I wonder how long the drivers will forebear the human statue in their path.

A honk alerts me to their gathering impatience. I bear him to the sidewalk. Ten years old and one hundred pounds, he’s tall and slender, not impossible for me to manhandle, as it were. But now his body has reawakened into a diffuse panic. At the revolving door fronting the hospital, he pivots and runs away.

Chase, capture, return. I am resolute. I believe he will regain his elasticity when we reach the cabinet of curiosities awaiting him in the doctor’s office.

The door whisks us into a lobby of strangers in a hurry. A colorful spectrum of signs hangs from the ceiling. A greeter sits in an open chair before an information desk. Misha breaks away from me and rushes toward her.

“Hi there, young man, and how are you today?” she chirps. He grabs her hair, squeezes and yanks. That’s how he is today.

“Ouch, ouch,” she winces.

“Hold still,” I instruct, “hold still, give me a minute; he’s having a hard time.”

I pry loose his grip, disentangling one finger at a time. With his free hand, he swats at a man to his left, but misses.

“Ma’am, I’m very sorry. Are you okay?” She is stricken.

Bystanders fall back, creating a circle of empty space around us. A security guard arrives on the scene. “Sir, can you help us get upstairs to our appointment?” He clears a path. I march Misha into the elevators while he snatches hair from the heads around us. He’s wailing inconsolably.

The elevator opens on the appointed floor. The guard leaves to give the ophthalmology department advance warning. Ducking into a lavatory with Misha, I kneel down and hug him, steadying his heaving shoulders. His heart is thumping. His palms are sweating. I plaster his wet eyes with kisses and taste the salt in his tears.

“What’s wrong? What can I do? Please, stop. Calm down! Tell me. Please tell me why. What can I do??”

“Waaaaaaaaaaah!!!!” Spittle flies into my face. His jaw looks poised to unhinge itself.

A receptionist waves us past the waiting area and ushers us into an exam room. The neuro-ophthalmologist enters ten minutes later to find our hair mussed, our shoulders slumped and our jackets and shoes strewn. Her computer is unplugged. Her instruments are tweaked, and her swivel chair is unscrewed. Another half an hour elapses before Misha consents to rest his chin on the perch of her binoculars and to peep through its holes.

I believed he would recuperate when we reached the exam room. I was wrong. Back home, he trembles and whimpers all afternoon.

I’m often wrong. As Misha’s single parent, I’m solely responsible for washing, dressing, nourishing, entertaining and providing for him. He sticks to me like wet paper. Even so, revelations of his vulnerability sneak up and disconcert me. Episodes of his freezing on sidewalks and crosswalks began a year ago. His stationary state arrives with swift fixity, like a curvature in spacetime stooping down a gravitational beam. I have no inkling when he’s on the verge. He freezes when stressed, but also when relaxed. Sometimes he freezes and sits down on the sidewalk. I sit alongside him and wait. Let the pedestrians stutter-step around us.

No such insouciance can slough off his thwarting traffic in a busy intersection. Nor does the typical structure of memoir frame our predicament. The motif of “the journey,” after all, narrates a dialectic of experience. Beginning with an awareness of confusion and danger, the progression of time binds with the confessions of memory on an adventure that discovers wisdom, perhaps even redemption.

But Misha and I live in a plotless picaresque, pervaded by an ethics of ambiguity. His staccato style of self-expression is indelible. He hums, giggles and blisters the atmosphere with high-decibel sounds that would crack concrete, if sound could crack concrete. A thrum of body noise conveys the tenor of his moods. He flaps his arms, snaps his wrists, stomps his feet, slaps his hands, drums his fingers, rocks his hips. Sublime feeling flashes across his mien with the arch of an eyebrow. Without language, however, I can’t readily grasp what it’s like for him to be seized on that crosswalk. A stalemate in the confrontation between existential need and social necessity leaves me nonplussed.

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The paradox of Misha’s remoteness in proximity suggests a counter-genre. “I have called this book Anti-Memoirs,” André Malraux wrote in his 1967 masterpiece, “because it answers a question which memoirs do not pose, and does not answer those which they do; and also because it is haunted, often in the midst of tragedy, by a presence as elusive and unmistakable as a cat slipping by in the dark.” Malraux, the French novelist, historian and statesman, eschewed the drama of confession and discovery in the passage of the self to its appointed destination. The private knowledge excavated with the memoirist’s inward searchlight interested him less than the flash of the uncanny, the unsayable or the ineffable—the intrigue “slipping by in the dark” of “the human condition.” “The most significant moments of my life do not live in me,” Malraux wrote in his Anti-Memoirs. “They haunt me and flee from me alternately.” Mine, too.

I drive Misha to Boston Children’s Hospital or Massachusetts General Hospital several times a month for observation and evaluation. Two of the world’s most sophisticated institutions of medical science, these hospitals abound with expertise in the diagnosis and treatment of the most wayward journeys and refractory cases. Here, the medical plot surveys the realm, compasses the landmarks, measures the contours and provides unity and coherence to stories of altered lives.

Misha sees a cardiovascular geneticist, developmental geneticist, developmental optometrist, developmental pediatrician, neurologist, neuro-ophthalmologist, neuropsychologist, pediatric gastroenterologist and speech-and-language pathologist. What do they see? A reflection of their specializations. The neurologist diagnoses autism spectrum disorder. The speech-and-language pathologist diagnoses mixed receptive-expressive language disorder. The developmental pediatrician finds intellectual disability. The occupational therapist discovers sensory processing disorder, the gastroenterologist chronic constipation, the neuro-ophthalmologist and developmental optometrist cerebral vision impairment. Molecular sequencing by the geneticists reveals an extra chromosome in one region and a misspelling in another. No geneticist has ever seen either variant before.

No causes have been discovered. No cures have been propounded. No treatments have been effective. The doctors, without a hypothesis, aren’t even wrong. The data outputted by medical measurement loops back into itself as input, reinforcing a clinical consensus from which nothing follows.

The human sciences don’t recognize Misha at all. The linguists up the street from our home at the Massachusetts Institute of Technology, for example, believe that the birthright possession of language signifies the human distinction. “Within the first year or so after birth,” Noam Chomsky and Robert Berwick write in Why Only Us: Language and Evolution, “infants master the sound system of their language; then, after another few years have passed, they are engaging their caretakers in conversation. This remarkable, species-specific ability to acquire any human language—the ‘faculty of language’—has long raised important biological questions, including the following: What is the nature of language? How does it function? How has it evolved?”

Language does not evolve in Misha. Why not? I ask Dr. Howard Shane, his speech and language pathologist. Dr. Shane directs the Autism Language Program at Boston Children’s Hospital. Eminent in his field, he has examined, diagnosed and treated thousands of children over more than forty years. He answers my question, following Chomsky’s innateness theory, by saying that Misha’s “language processor” is broken.

“That is an interesting metaphor,” I remonstrate, “but where is that located in the brain, and how do you know it’s broken?”

“You have to infer it,” Dr. Shane counters. “I think it’s a pretty good assumption. I didn’t say it was missing, I said it was broken, not completely broken.”

“But are there neurobiological origins of the breakage? That’s what I’m asking.”

“You mean, what’s causing it?” Dr. Shane asks.

“Yes, some kids with a diagnosis of autism speak and others do not. Why? The differential must be due to a brain-based problem if language is innate.”

“There’s nothing that medical science can detect right now,” Dr. Shane avows. “To really understand his brain, we don’t have the capacity. We don’t have the capacity to understand speech problems neurophysiologically. We don’t even have a good definition or terms to describe children who are ‘minimally verbal,’ ‘nonverbal,’ ‘aphonic,’ et cetera.”

If language furnishes the distinction between humans and other animals, then what does the difference imply about people without language? Is Misha a hiccup of evolution, estranged from our species, a refugee exiled from the story of humanity? Cognition is said to require a brain capable of turning symbols into propositions, and then representing the meaning of those propositions in sentences governed by rules of logic. Does this paradigm mean Misha, without a functioning “language processor” that enables him to speak, read and write, is literally thoughtless?

I write to Chomsky and propose a refinement of his book’s title: Why Only (Nearly All of) Us? Surely, I implore, there must be a method to take the measure of our predicament, or, if not, then some speculative theory I could consult.

“It’s a very important matter,” Chomsky replies. “I wish I could recommend something. Not much seems to be understood.”

Humans more garrulous than Misha have plunged me into deeper abysses of despair. Still, trying to articulate what passes between my son and myself often feels like I’m groping after Malraux’s “cat slipping by in the dark,” chasing farragoes of meaning at once elusive and unmistakable. I open his bedroom door in the morning to find him lying on his back, his knees bent like tent poles under the covers. He rolls out of bed and runs past me to stare through the windows, frantic to bathe his eyes in the sunrays. In the winter evenings, he sits in a corner chair and stares through the window at a street lamp. The lamp is nested in electrical wires and set in the neck of a telephone pole. As the natural light wanes, the unfolding chiaroscuro engrosses his attention.

“Hey, you aren’t going to just sit there, are you?” Even as the words leave me, I realize my rhetorical question is semiconsciously devised to hammer home a point rather than to elicit an answer. Let me try again.

“C’mon, bubba, let’s go for a walk.”

“En-ne-ne.”

“Do you want me to do a puzzle with you?”

“En-ne-ne.”

“Can I sit next to you and read my book?”

“En-ne-ne.”

“Are you okay?”

“En-ne-ne.”

“You’re going to answer ‘no’ to everything I ask, aren’t you?”

“Yayesh.”

Very funny, kiddo.

He said his first word, “meatball,” at age five. Hearing him excited an assumption: if I applaud every utterance, then I can bring a grammar to the fore. “Misha, say ‘meatball?’ Misha, do you want a meatball? Okay, then say, ‘meat-ball.’ If you want to eat a meat-ball, say ‘meeet-ball.’ Misha, c’mon, say ‘meatball.’” He scarfed down plates of meatballs but said “meatball” never again.

Eight days before his seventh birthday, while assembling a puzzle, he addressed its pieces: “I see you, I see you, I see you, I see you.” First person, singular pronoun plus transitive verb plus direct object. His first sentence! He never repeated it.

A year later, we stood in the foyer of our home in Cambridge. “Misha, do you want to go to the park?” A nod is the acme of my expectation for his answer. “Not today,” he says with perfect fluency, expressing a preference and making a distinction. The words tumbled from the side of his mouth. He gave no sign of regarding them, and he never repeated them, no matter how often I goaded him.

What does he hear yet fail to comprehend? What does he comprehend yet choose to ignore? I’ve never been able to adduce a pattern from his mutter of verbal approximations. Toast started out as “toe-toe” and then became “t-t.” Yes at age five became “ssssssss” at age seven and then returned as “yaysh” at age nine. Many times, I have celebrated the embryo of a new word carried by his reedy voice, only to mark its recession into a pocket of unrecoverable time. “Nn” once meant phone, which turned into “gi-za-za.” One summer, boardwalk was “tee-pa.” The next, it was “de-wa.” Tee-pa to de-wa?

Our context, tight as shared skin, both traps and releases the gist as if by emanation. He looks up at me plaintively, brow furrowed, head cocked. I grasp his meaning and accompany him to the bathroom. Another day, he’s repeating a sequence of sounds I haven’t heard and don’t comprehend. “Pee. Aye. See.” “Pee. Aye. See.” What in the world? Unlike his syllabic blasts, this sequence contains distinct pauses. Clearly, he has something specific on his mind. He takes my face between his hands and looks at me gravely. “Pee. Aye. See.” The clever boy, I finally ascertain, has switched his mode. He’s not approximating the sound of a noun, like toast, phone or boardwalk. He’s spelling out the word. “Pee, Aye, See,” phonetically, is “P A C”—as in, Dad, I can’t find the Pac-Man pocket player game we brought home from the store last evening.

The habit of loving takes care of basic needs, even when he doesn’t discriminate among his desires. The last word in a sequence is the one he seems to hear first.

“What’s wrong, honey? Are you hungry?”

“Eee-eee.”

“Aha, I forgot your snack. I’m sorry. For dinner, how about pizza?”

“P.”

“Can you say ‘pizza?’”

“Z-p.”

“Very good. I will make some pizza.”

“G-p.” (He prefers that I get a pizza from the corner pizzeria, rather than make one).

“Now, how many slices do you want to eat?”

“Eee-eee.”

“Misha, do you want . . . one slice . . . or . . . two slices . . . of pizza?”

“P.”

“Misha, tell me, do you want one . . . or . . . two? Do you want . . . three?”

“Wee.”

“You want three slices of pizza?”

“P.”

“Misha, you want three slices of pizza? No or yes?”

“Yaysh.”

“Three slices, yes or no?”

“En-ne-ne.”

“What else do you want to eat?”

“Eee-eee.”

“Yes, I know you want to eat.”

“Eee-eee.”

“But do you want an apple or grapes for your dessert? Misha: grapes or apple?”

“A-ba.”

“Do you want me to cut your apple?”

“A-ba.”

“Okay, but do you want your apple cut?”

“Kuh.”

Meanwhile, my conversation with his sister, Niusha, brims with idioms, dependent clauses and double negatives. The dissonance exasperates him. He approaches and places two fingers across my lips, enjoining me to shut up and cook.

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Autism constitutes “a whole mode of being” and “touches on the deepest questions of ontology,” the neurologist Oliver Sacks wrote. The arrow of Sacks’s insight, earned by his rapport with patients outside of the exam room, bounces off the castles where the scientists of human development toil on schematics. Entrenched, they erect distinctions between facts and values, adopt postures of detachment and carve the gestalt into a set of discrete, interlocking functions.

Sacks envisioned for persons like Misha a science of “radical ontology” that jettisons the etiolated metaphysics of the concept. Rather than itemizing deficits in function, radical ontology plumbs modes of being, honors the novel entities from which concrete realities are constructed, building and preserving identity. The richness and tenacity of human perception, Sacks contended, bear no necessary relationship to propositional thinking—or any other “intellectual differences.” In his patients he witnessed a testimony synonymous with poetry. To show how life reaches past science, he turned to the genre of the “strange tale,” distinguished by “a quality of the fabulous.”

Misha, so understood, stands not behind his developmental norms but apart from them. He accesses the flux of experience from a dimension of perception that awakens hidden meanings. He pauses before the entrance to a grocery store in a downpour, laughing hysterically at the opening and closing of the pneumatic electric doors. Sopping wet, I realize that to him their metronomic cadence is a pair of hands clapping.

I relish the moments when I muster the wit and imagination to cross the threshold into his phenomenal reality, being instead of knowing. Misha climbs into his bed for the night’s sleep. I take my place lying beside him, cooing in his ear. Niusha sits at the end of the bed and kneads the bottoms of his feet. He asks for a “h-sh”: a hair shower. Leaning over, Niusha tosses locks of her hair across his face. He folds his arms across his chest and bats his eyelashes. A light from the hall shines weakly into the room. He radiates existential poise. He turns his head toward me with eyes open wide, his irises flush with color, and gazes into mine. The intimacy awes me. He is me and not-me. I am him and not-him. Father and son.

The pressure of daily rites returns our impassioned moments to the atmosphere of ambiguity. It is 8:50 p.m. on a Sunday in November, soon after he turns ten. He has spent his evening on a self-appointed mission to remove all the knobs from the doors and unscrew all the light switch plates from the walls. Now he’s chewing on the curtains in the living room.

“Misha, time for bed, it’s almost 9. Let’s go brush your teeth.”

“Wohn!” he exclaims, extending an index finger.

“Okay, one more minute.”

“He-he-he-he-he.”

“One more minute, and then you go to bed, okay?”

“K.” He sets a digital timer to count down from sixty seconds.

Beep, beep.

“Okay, bedtime. Let’s go.”

“Wohn!” he exclaims again.

“Misha, we did one minute. It’s time to go to bed.”

“Wohn!”

“Misha, let’s go!”

He darts around the corner into his bedroom and returns with a board game, Sorry, tucked under his arm. He is not sorry. He dumps the pieces onto the carpet and slams them down on the board’s colorful geometry. Bam, bam, bam.

Niusha, too, protests before bedtime. We negotiate without compromising her need to rest. If Misha could explain, then I could countenance his dawdling as well. Why is he playing for time? Is he too wound up to commence his bedtime ritual? Then I should indulge him with a half hour more. Or is he fatigued from a fitful weekend? Then I should have directed him to bed already. Truth be told, I want to go to bed. I’m exhausted.

“C’mon, friend,” I exhort, “let’s go brush your teeth and get to bed. You have school tomorrow morning.”

Storming into the kitchen, he reaches across a counter and snares a carving knife from its scabbard. He looks at me, brandishing the weapon. Your move, Dad. I grab his wrist and ease the knife from his hand.

Niusha, or “yah-yah,” is listening through the walls of her bedroom. She’s hoping I don’t summon her to the brewing siege.

“Misha,” I offer upon summoning her, “do you want yah-yah to put you to bed tonight?”

“Misha,” she chimes in, “I can put you to bed. Okay?”

“En-ne-ne.”

“C’mon. Let’s go,” she says sweetly.

“En-ne-ne.”

Off he scampers into the bathroom. He pumps the faucet over the sink and flushes the toilet again and again. Why is he supplicating the plumbing? He steps into the bathtub, twists the spigot and douses his socked feet. Why? Why not? He steps out, slipping on the hardwood in the kitchen, squawking and flapping like a cross-eyed goose. At last, he flies into his bedroom. Niusha joins me at his door. He is cornered.

The hopelessness of his position impels him to a last act. He climbs a wall of shelving with surprising agility. He leans across the corner space to the window and tosses the curtain open with his free hand. The bare window—the eye in the wall—stares at us. This is new.

“Hey, Misha, what’cha doing?” I see what he is doing. He is fiddling with the latch, straining to open it.

“Dad, what’s he doing?” Worry not, Niusha. He lacks the dexterity to solve that latch. He solves the latch, thrusts open the window, and punches out the screen with a flourish.

“Dad!” Niusha yells.

“Ou-si,” he shouts. Night air gusts into the room.

“Ou-si! Ou-si!! Ou-si!!!”

Niusha and I gape at each other. Outside?

He puts his arm through the open window.

“Ou-si!!!!”

He is threatening to jump. His eloquence is magnificent.

In Pain and Shock in America: Politics, Advocacy, and the Controversial Treatment of People with Disabilities, Jan Nisbet chronicled the history of this school, which deploys the “Graduated Electronic Decelerator” (GED). From a battery pack strapped around students’ shoulders, the decelerator’s wires travel under the clothing to the arms, legs, and torso. The shock, triggered by remote control, pulses through cathodes fastened to the skin. This is an entirely different treatment than electroconvulsive therapy for severe depression. The sole purpose of electric skin shock is to inflict pain.

The Judge Rotenberg Center opened under its original name, the Behavior Research Institute, in Providence, Rhode Island in 1971. A sister school opened in the San Fernando Valley of Los Angeles, California in 1976. Since the 1990s, after problems in Rhode Island and California forced the schools’ closure in those states, it has operated exclusively in Massachusetts, running a day school and approximately forty group homes for developmentally disabled students sent by school districts across the country. Autism has always been the school’s focus, although Nisbet reports that in recent years it has admitted increasing numbers of misbehaving transfers from juvenile court and foster care. Annual tuition—paid by public school districts and, thus, taxpayers—is $277,915.

The one constant in the school’s history, Nisbet found, is its use of punishment to modify students’ behavior. Before introducing the decelerator in 1990, teachers and clinicians programmatically handcuffed students, pinched their feet, squeezed their muscles, dumped buckets of cold water on their heads, sprayed ammonia vapor in their faces, and withheld food. Nisbet quotes from an internal 1979 memorandum by Dr. William Bronston, medical director of the California Department of Developmental Services, depicting the school’s “unrelenting pursuit of traumatic aversive interventions” against its most “powerless and undefended” students as central to its value system. “The insistence and pride in using aversive interventions as a mainstay in the BRI program results in the most diabolical and preposterous propositions,” Bronston added.

Parents and ex-staffers filed child abuse complaints. Medical examiners autopsied the bodies of students who died under suspicious circumstances. But no criminal liability was attached to the school until 2011, when a grand jury convened by the Massachusetts attorney general returned indictments against founder Matthew Israel on charges of obstructing justice. A deferred prosecution agreement secured his resignation.

By then the school operated under a consent decree that continues to allow Massachusetts to use electric shocks on disabled people—it is the only state where this is the case. Rhode Island permanently withdrew all its students in 1976; California brought the school to heel through regulatory hearings, licensing battles, and attrition as more parents refused to send their children there; and a settlement in 1989 prohibited its further use of punishments. In Massachusetts, however, the school dug in.

The state’s Office for Children issued an emergency license suspension in 1985 in response to the death of twenty-two-year-old student Vincent Milletich. During a punishment procedure that placed Vincent’s hands and feet in handcuffs and lowered a White Noise Visual Screen Helmet over his head, the young man went limp. He was pronounced dead an hour later at a local hospital. The school lost a class action appeal of the emergency order in U.S. District Court but found a way to sidestep it by seeking a restraining order and preliminary injunction in the lower, county probate court where its group homes were located. After years of fighting over jurisdiction, a consent decree permitted punishments on a case-by-case basis, subject to the approval of the probate court. In 1994, the school consolidated its operations in Massachusetts and changed its name from the Behavior Research Institute to the Judge Rotenberg Educational Center in honor of Ernest Rotenberg, the county judge who saved it.

Critics also dug into the school. U.S. Senator Lowell Weicker of Connecticut asked the Civil Rights Division of the Department of Justice to investigate the school in 1986; no investigation appears to have been undertaken. A second appeal ended in a puzzle: “Although the Department of Justice announced an investigation of JRC in February 2010 in response to a letter signed by thirty-one disability organizations and the investigation was conducted,” according to Nisbet, “no reports or outcomes from the investigation were ever made public, and no action was taken to restrict the use of painful procedures.”

In 2013, a Special Rapporteur concluded that the GED violates the UN Convention Against Torture. According to Nisbet, the device is a tool of institutional violence and intimidation. Former students subjected to the device believe it represents society’s contempt for them. Resident Andre McCollins received thirty-one shocks over seven hours in 2002, initially for failing to obey a command to remove his jacket, and then for screaming in pain from the shocks. A judge in a civil suit released the video footage, which spread widely on YouTube. In 2007 two teenagers received shocks for no reason at all.

In 2020—at the urging of six U.S. senators, a dozen members of the U.S. House of Representatives, and scores of disability rights groups—the Food and Drug Administration (FDA) banned electrical stimulation devices intended to change behavior. The school sued the agency, lost in the trial court, and then appealed. On July 6 of this year, the D.C. Circuit of the U.S. Court of Appeals overturned the ban. The FDA filed a petition for reconsideration in September. The case remains unresolved.

Nisbet reports this back-and-forth surefootedly and fair-mindedly. Parents of some of the students at the school, she writes, have long attested that the device is indispensable for treating self-injurious, life-threatening behaviors. Nisbet feels for their plight. “Most of these families have children excluded from educational and treatment programs because of the severe nature of their behaviors and have challenged or exhausted the existing systems of education and human services,” she writes. Placement at the Rotenberg Center is often “a last resort.”

Yet Nisbet was sure that this option would not be available without the school’s cunning. She narrated the school’s use of the law during the uncertain era of newly de-institutionalized systems of schooling and residential care for autism. The school sidestepped licensure requirements, stiff-armed building inspectors, menaced ex-staffers, and muscled state legislators with lobbying by the firms of Rudolph Giuliani in New York and former Governor Pat Brown in California.

On the core question of the behavioral science, Nisbet contextualized the history in a similar way. In the 1970s, she agrees, punishment was a signal feature of Applied Behavior Analysis (ABA), an industry-wide model for autism treatment that the school still employs and cites in its defense. In the 1980s, a splinter group proposed Positive Behavior Supports (PBS). Rather than punishing failure, PBS rewarded success. A proponent of PBS, Nisbet suggested that parents and judges have been fooled by obsolete science.

The Rotenberg Center, so understood, is a product of a unique set of circumstances, its reign of punishments an egregious exception to the progress made by self-correcting behavioral scientists and educators in remediating autistic behaviors. This same tragic narrative has framed television specials on ABC’s Nightline (1984), The Oprah Winfrey Show (1993), and CBS’s Eye-to-Eye (1994), as well as CNN’s coverage today by Anderson Cooper. The two-sided controversy feeds debate or, as has happened more than once, a shouting match. Audiences tolerate the ugliness at the heart of the story because it is positioned as remote from their own experience: look at the methods used on this one group of unfamiliar children at this singular school—what a shame.

A quieter possibility is squeezed out of the binary narrative of positive versus negative approaches. Professional behavior analysts today hold a monopoly on service models at U.S. schools and centers for autistic people. Their education means, first and foremost, behaving correctly in an institutional environment. In pursuit of the mission of social control, leaders in the profession have been reluctant to wholly remove the iron fist from the velvet glove that they present to the public.

The most recent National Institutes of Health Consensus Development Conference “on destructive behaviors” took place in 1989. Experts in behavioral disabilities refused to exclude punishments from their standard of care—“a major setback,” Nisbet conceded. Nobody knows the extent of punishment in contemporary autistic schools and centers. But if, as Nisbet insisted, the Rotenberg Center does not represent professional behavior analysis today, then why do professional behavior analysts routinely entertain presentations by the school’s clinicians at professional conferences? Why has the effort to mount a persuasive critique of punishment from within behaviorism proved so difficult?

Maybe it is because the impediment has always been behaviorism itself. Founder Matthew Israel received his PhD under behaviorism’s originator, Harvard psychologist B.F. Skinner. Israel set out to perform an experiment to test Skinner’s theory, and Skinner repeatedly defended the results amid the outcry. He told the Boston Globe in 1981:

You can be opposed to punishment but you can’t just give it up until you’ve got something to replace it. There may be a point beyond which you give up on miscarriages of nature.

Behaviorism transforms persons into objects of scientific inquiry by recording observable cues elicited from conditioned responses. Skinner insisted that subjective states of mind could have no bearing on changes in behavior. Israel was not alone in seeing the relevance for the treatment of nonverbal and autistic children. Their inner lives, apparently inaccessible, could be presumed to be scientifically valueless. All that mattered was changing the contingencies in the environment until they produced a preferred behavior.

The Rotenberg Center’s zeal for punishment has always been consistent with these premises, as Skinner himself warranted. If you conceive of disabled children as malfunctioning machines, then their behaviors are unintegrated data, not clues to their thoughts and feelings. A remote-controlled electrical device strapped to their bodies is an ingenious hack, a professional obligation. Outside critics ascribe an inherent humiliation to the GED and try to shame behaviorists for using it, but moralism misses the point. The empathy that comes from perspective-taking or reality-sharing between human persons is, to the behaviorist, a clinical distraction. That is as true for reward-based interventions as it is for punishments. The profession as a whole is united against relationship-based education for children with autism.

“It seems almost unbelievable that anyone could ever have taken a theory like behaviorism seriously,” philosopher Charles Taylor opined in the 1980s, while rival camps of Skinnerian behaviorists split hairs over the finer points of punishment. “It takes a very powerful metaphysical set of preconceptions for one to ignore or override so much that is so intuitively obvious about human life, for no valid scientific or explanatory reason.”

Behaviorist theory and research, no less crude today, is an embarrassing reminder of the poverty and stagnation of “special” education that does not attempt to support the emotional lives of disabled students or divulge their individuality.

Applied behaviorism, meanwhile, is ubiquitous. Having returned through the cultural side-door of autism, the science of coercion is expanding on the global scale of digital apps and social media. Shoshana Zuboff’s The Age of Surveillance Capitalism attributes the emergence of mass online behavioral engineering to Skinner’s writings and compares it with twentieth-century totalitarianism.

“Likes” and “follows” are a far cry from the GED. But as Alfie Kohn shows in his book, Punished by Rewards, reward-based algorithms, too, can be toxic, inducing mistrust, anxiety, and depression. That’s what happens when people are mistaken for machines and turned into spectators of their own lives. How a discredited Harvard psychologist has become the unofficial ideologist of both Silicon Valley and disability treatment is a problem beyond the intramural scope of Pain and Shock in America. The book, even so, indexes the post-human society that is cornering us all.

“Tomorrow’s Child,” a story by Ray Bradbury, opens with Peter and Polly Horn traveling to a hospital for the birth of their first child. In their technological utopia, a helicopter conveys them across a sky spangled with rocket ships. An advance birthing machine awaits, promising to eliminate Polly’s labor. At the moment of truth, however, the hospital’s machine malfunctions. She has delivered a healthy male infant. He weighs seven pounds, eight ounces, and sports a normal nervous system. There’s just one problem: the boy has been delivered into the fourth dimension. From outside the three-dimensional structure of human perception, he appears in the shape of a tiny blue pyramid, with three darting eyes and six wriggling limbs. The obstetrician says that the boy himself apprehends the phenomenal world around him cubically.

The Horns name their discarnate issue Py and take him home. But the existential limbo fills them with anguish and repulses their friends and neighbors. Desperate from isolation, Peter and Polly return to the hospital intending to abandon Py to medical science. The obstetrician surprises them once more. He hasn’t figured out how to retrieve Py, but reverse-engineering the birthing machine could place them in the fourth dimension with him. They could perceive him as he really is. The price, of course, would be their own geometrical transfiguration. Peter would take the shape of a hexagon. Polly would look oblong. With heavy hearts they assent to the bargain, trading expulsion from membership in the human community for the joy of sharing in their child’s perception of reality.

For parents and children wrestling with neurodevelopmental conditions today, Bradbury’s allegory has lost none of its poignancy. Autism, my son Misha’s primary diagnosis, constitutes “a whole mode of being” and “touches on the deepest questions of ontology,” as the neurologist Oliver Sacks wrote in 1995. If this is so, then the question is how people like Misha perceive the fundamental entities and properties of reality. “The ultimate understanding of autism may demand both technical advance and conceptual ones beyond anything we can now dream of,” Sacks wrote. He urged neurologists to limn the boundaries of “radical ontology” by shucking off their habits of detachment and accompanying their subjects in society. “If we hope to understand the autistic individual, nothing less than a total biography will do,” Sacks maintained.

Thirty years later, one in every thirty-six children receive the diagnosis. Neurologists still confine their perception to the bell jars of the consulting room, while autism advocates promote “neurodiversity.” No advances, conceptual or technical, have struck up a symmetry between medical understanding and social belonging. “Tomorrow’s Child” today subsists in a permanent realm of uncertainty.

Misha is now eleven and lives with his sister and me in the very progressive city of Cambridge, Massachusetts. In photographs, his aspect betrays no abominations. He passes for any normal child his age (although, in my estimation, he’s handsomer than most). Tall and lithe, his hazel eyes are hooded by long lashes and framed by an oval visage. What his eyes perceive is anybody’s guess. His acuity rates 20/20. The signals that his brain gives to his ocular muscles, however, could be showing him a kaleidoscope everywhere he looks. He doesn’t say, as he has never uttered more than a handful of verbal approximations. Nor does he seem to reliably process speech directed to him.

“What’s your name?”

“Me.”

“Can you say, ‘Misha’?”

“Mi-ta.”

“Excellent. How old are you?”

—

“Misha, are you eleven?”

“T.”

“Where you do live?”

—

“Misha, who am I?”

“D.”

“Very good. What is your sister’s name?”

—

“Do you have a sister?”

—

“Misha, can you say the name of your sister, Niusha?”

“Yah-yah.”

His body is bandy, strung together by a physiology that mismeasures stimuli from his environment. A meek style of movement during his infancy suggested that he was never in possession of his body. Crawling in the yard, he trembled before a quarter-inch decline from the sidewalk to the grass. He hung his head over the side of his stroller in the neighborhood and fixed his gaze on the spinning spokes. Arriving at playgrounds, he refused to dismount. He didn’t stand up until his eighteenth month, and then he toddled on his toes. He clung to the inner edges of sidewalks and dragged his palm across the streetscape, refashioning walls, doors, and fences into an extended guardrail.

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A neurologist diagnosed Misha with autism at age four. Additional diagnoses piled up over the next years: mixed expressive-receptive speech disorder; sensory processing disorder; cerebral vision impairment. Of causes and treatments, his specialists have never developed so much as a working hypothesis. Molecular sequencing has revealed two genetic mutations, neither previously reported. “Your son,” his geneticist avowed, “is on the far edge of science.”

Misha is both profoundly disabled and benignly different. He doesn’t appear sick. He doesn’t appear well, either. The antinomies of his social being discharge their tension in a stigma that emerges during unrehearsed appearances in our community. He blisters the air with shrieks and squeals, huffing and hissing, pealing with laughter out of nowhere. A sublinguistic rhapsody, unclassifiable as well as unignorable, sets the soundtrack: “We-we-we-we-we-we-we”; “me-me-me-me-me-me-me”; “uh uh uh uh uh uh uh.” The signals that draw his stigma are both embodied and undecodable.

I am resolved not to hide away Misha’s fugitive aspects. Only through contact with his given environment can he make a safe home for himself. Isolation within his sensorium would cause the anxiety that he bears on a good day to expand into a total loss of trust in his own being. “Loneliness,” as Hannah Arendt once observed, constitutes “the experience of not belonging to the world at all, which is among the most radical and desperate experiences of man.”

In a city of heavy objects constantly in motion, Misha exhibits no capacity for self-preservation. We were crossing Beacon Street in Inman Square one weekday afternoon. He flew to the passenger door of a car as it slowed before the yellow of the traffic light. He tugged on his door handle. The forward motion of the car jerked his arm. Another day, on a different corner, a man puffed a pipe. A breeze tossed the smoke. Misha chased the billows into the street. A car skidded to a stop a dozen feet in front of him.

At age seven, he made a half-hearted attempt to leave home unannounced, unlocking and unchaining the front door. I purchased an identification bracelet, a tracking device, and a harness. He sloughed off the device and chewed through the bracelet. I couldn’t bear to tether him to the harness. A police officer came to take his photograph and copy out his vital statistics, lest I should lose him.

When I want him to stay close, he wanders away. When I want him to depart, he stays put. He stopped once in the middle of a crosswalk in Harvard Square. My nudge in the small of his back restarted his body. He screamed and yanked down his pants. Inside a grocery store on another occasion, he took our cart on a wide ride that ended with him knocking over a stack of soup cans and losing his grip on a carton of produce. A shopper tripped over the cans. She shot me a dirty look as she picked blueberries off the bottoms of her shoes.

On our strolls, he runs his fingers through hedgerows and drops shrubs in his wake. He flips open gas tank doors on rows of parked cars. He runs into the foyers of apartment buildings, presses all the buttons on the elevators, and scampers away with a chortle. In the bathrooms of neighborhood restaurants, he conducts boffo symphonies. He turns off the lights and triggers the automatic hand dryers while men fart and tinkle in their pits. In the local mall, he feels up mannequins and hooks his thumb to jewelry stands, toppling bracelets, rings, and necklaces. In the checkout line of department stores, he thrusts himself upon shoppers queued behind us and tries to untie their shoelaces. He fixates on such interaction rituals for months at a time. If you sneezed near him in the autumn of his eighth year, he instantly grabbed your hair.

Some encounters have been less than amusing. At the library once, he tugged on a thin and greyed ponytail that turned out to be attached to an elderly woman bound to a wheelchair. Her neck bent backward like a PEZ dispenser. I knew he didn’t intend to hurt her. That doesn’t mean she wasn’t hurt. I apologized for his particular offense. But I never apologize for the kind of person he is.

What kind of person is he? A more recognizable phenotype — Down Syndrome, for example — would provide an easement for strangers in the path of his sensibility. A disability like blindness would afford strangers a tacit medical context for tolerable inferences. The five senses reflect anatomically in our noses, ears, eyes, skins, and tongues. But it turns out that we have two more senses hidden from view. The vestibular sense, attaching to inner ear fibers, registers our internal balance during movement. The proprioceptive sense, registering external stimuli, provides us with assurance of our body’s position in space.

The secret senses flow unconsciously through receptors in our muscles, tendons, and joints, making adjustments to the rhyme and reason of the body’s ego. “If there is defective or distorted sensation in our overlooked secret senses,” Oliver Sacks pointed out, “what we then experience is profoundly strange, an almost incommunicable equivalent to being blind or being deaf.”

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What part of Misha’s lack of poise is compensation for his scrambled secret senses? What part is clowning? As he doesn’t speak, so he doesn’t convey his perception of the reality of his body. Voluble rather than verbal, he vibrates sounds from the back of his teeth and throat without modulating his volume — probably because he cannot feel his phonatory organs without increasing vocal pressure. Maybe I have to remind him to swing his leg before striking a soccer ball because when his leg retracts, he can’t be sure it remains attached to his trunk. Slips of time seem to lodge in his perceptual memory. We dropped by our neighborhood coffee shop. When we walked in the previous week, he sidled up to a jug of water on the countertop, drew a cup, and whet his whistle. On this occasion, the jug had been replaced on the countertop by a napkin dispenser. Yet Misha took an empty cup in hand and repeatedly pressed it against the dispenser, expecting water. He gazed upward at me quizzically.

Through a surreal world, he moves as if inhabiting a waking dream. One November we visited a friend’s home in seaside Hull for a birthday party. We ducked out a side door and stepped onto the cold sands. The ocean’s waves roared in a stiff crosswind. This was no day for beachcombing. Back inside, slinking away from partygoers, he led me up a spiral staircase. The passageway was enclosed and carpeted. Even so, it disoriented him. Reaching the landing on all fours, he peeked at the ocean through the windows. He froze with fear, as if the house were a sandcastle bound to be sucked into a violent Massachusetts Bay at any moment.

At house parties and barbeques, Misha ensconces himself inside bathrooms for eternities. He rifles through bedroom closets, tampers with toys, strikes discordant piano chords, and swipes and swills beverages. I incant a mantra to guide me through. Patience on top of patience. But we are not ideal guests. During lunch at a prospective friend’s home, Misha bellied-up to her kitchen table and stuffed his mouth with cheese, grapes, and crackers. Twice he fell off his stool and tumbled to the floor. Setting down his glass cup, he misjudged the edge of the countertop. The cup smashed to pieces on the floor. We were never invited to return.

Public spaces are freer of turbulence. I escort Misha to the Frog Pond at Boston Common in the summer and to Fenway Park in the spring. He loves a neighborhood block party as much as the next boy. Holidays I am determined to celebrate, even as he remakes their rituals. One Halloween, costumed as Mr. Incredible, he blew out the candles in every doorstep pumpkin he could reach. Invited to share a traditional Thanksgiving dinner in Somerville, we sat down with friends for turkey, stuffing, mashed potatoes, and gravy. Misha got up on his haunches and leaned toward the candles. Huffing a wet breath, he extinguished them with gusto. Wax spattered across the turkey. Then he unplugged the chandelier and stopped me from relighting it. My feeble attempt at humor failed to bestir the table to solidarity. What’s a little wax in our bird? Thanksgiving had been dipped in the shadows of the counterlife.

On vacation at the Jersey shore, the roar of the crashing waves, the commotion of the boardwalk buskers, and the cawing of the seagulls replaced the city’s frenzy of buses, leaf blowers, and fire trucks. Misha adored the carnival atmosphere of the beach. As the ocean waves petered out toward his ankles, he jumped half too low and a beat too soon. Strolling past the encampments of the sunbathers, he trampled their sandcastles. The haunted houses on the boardwalk wasted their spooks on him. A ride that lifted him to a modest height caused his palms to sweat. But he mounted the Merry-Go-Round’s carousal of plaster steeds with the aplomb of a little Lord Byron. After, he romped through pinball, air hockey, and Skee-ball, none the worse for defaulting at each station, and got his kicks by reaching behind the arcade games that others played and unplugging their machines.

“He’s the king,” his sister Niusha once quipped about the retinue of attention that Misha receives at home. With hilariously exaggerated deference, she bowed before “His Majesty” on the domestic pedestal. Our parlays in public bewildered her. “He’s invisible,” she said, “it’s like he’s not here.” He is, and he is not. When Niusha was nine, and her brother was six, she sat with me for an interview about autism on a program broadcast by Cambridge Community Television. “Maybe when you go into a restaurant, people look at you funny or try to avoid looking at you,” the interviewer rightly observed. Niusha, chiming in, recalled an incident that had recently taken place in a Porter Square luncheonette. Seconds after I had left our booth to fetch our drinks, Misha had climbed atop the table and swatted the pendant lights hanging from the ceiling. No harm, no foul. From a booth adjacent, however, a shriek of fear had rung out as if the end times were nigh. A manager quickened to the scene and waved a finger of reproach in Misha’s direction.

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“What do you want us to know about people like your brother?” the interviewer asked Niusha. “I want people to know not to be embarrassed of them,” she replied, “not to keep them into hiding. I want them to be out in the open, actually, and trying to make the world a better difference, because people might not know that they have a lot more intelligence than people think, and they should be more appreciated because of that. They should be more noticed. And I bet they would like that, of course.”

I bet they would. The question is how people would perceive them. Autism is experienced cognitively and felt existentially but diagnosed and treated behaviorally—from the outside in, as it were. In the corner luncheonette no less than in the neurologist’s consulting room, how you behave is who you are supposed to be. But the prevailing concept of the self as an information processor, its integrity revealed in problem-solving or pattern-seeking, shuts out feeling and judgment. Science dismembers persons into discrete domains and reduces their parts to functional values. Society rigs up a phenomenology restricted to observable surfaces.

No such system of reasoning can understand the web of memories, conjectures, and perceptions that human agents bring to their appreciation of particular situations. “What we call creativity is a characteristic that yields not merely something new or unlikely but something new that strikes us as meaningful and interesting,” Bernard Williams writes in Making Sense of Humanity, “and what makes it meaningful and interesting to us can lie in an indeterminately wide range of associations and connections built up in our existence, most of them unconscious. The associations are associations for us: the creative idea must strike a bell that we can hear.” Only the inner spaciousness furnished by art, literature, and history, Williams suggests, can overhear the chiming of certain bells.

Misha, so understood, is that rarest of creatures: A genuine individual. Improbable, inexplicable, and unimpeachable, he alights on the world like Peter Pan, bewixt and between, terrified and beguiled. When his eyebrows shoot up, I glimpse his curiosity radiating through his miasma of sensations. His blissed-out states sparkle with novelty. Once, amid a rainstorm outside the entrance to a grocery store, he stood spellbound before the opening and closing of the pneumatic electric doors. Their metronomic cadence was to him a pair of hands clapping for his private joke. He giggled uncontrollably. The shoppers had little patience for his attempts to choreograph their comings and goings. Amused and sodden, I obeyed Nabokov’s injunction: “I appeal to parents, never, never say ‘Hurry up,’ to a child.”

Sometimes, parents approach me with overtures of sympathy. They believe that they may have a cousin or a nephew of Misha’s dispensation. “But how did you know?” I returned one parent’s inquiry. She had plopped down next to me on a playground bench to chat about the wrongness tainting my son. “Oh, I could tell right away,” she answered brightly. “I can’t imagine,” she continued through a benevolent sigh. “I don’t know how you do it.” Her remark felt impertinent, as if his stigma had reassured her. There but for the grace of the genetic lottery… A rejoinder arched across my mind: Well, I don’t know how you do it, managing the banality of raising your carbon-copied child.

Cambridge, of course, is fully subscribed to the attitude of “neurodiversity.” Every April, the progressive potentates gather on the steps of city hall and celebrate “autism awareness.” Ceremonies of awareness yield a quotient of indulgence. No mishap or misdemeanor has damaged relations that I haven’t been able to repair with a nod, an apology, or a scowl. Strangers may startle or fluster. They swallow their grievance upon letting their eyes stray over his countenance. In this age of umbrage, I am grateful to avoid open conflict. But familiarity doesn’t reduce contempt. Our community steers clear precisely because it is aware of people like him.

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The paradox accompanied the birth of neurodiversity discourse. A young Australian sociologist, Judy Singer, coined the term in 1998 to denote a new category of personal identity alongside “the familiar political categories of class/gender/race.” Singer invested her coinage with sweeping ideological ambition. “The rise of Neurodiversity takes post-modern fragmentation one step further,” she wrote. “Just as the post-modern era sees every once-too-solid belief melt into air, our most taken-for-granted assumptions—that we all, more or less, see, feel, touch, hear, smell, and sort information in more or less the same way—are being dissolved.” A freelance writer, Harvey Blume, gave “neurodiversity” currency among journalists with an article in The Atlantic that same year. A couple of best-selling books, Andrew Solomon’s Far from the Tree: Parents, Children, and the Search for Identity (2012) and Steve Silberman’s NeuroTribes: The Legacy of Autism and the Future of Neurodiversity (2015), clinched the case.

Neurodiversity discourse is now ubiquitous. It takes protean forms— a meme, a critique, an ideal type, a virtue signal, a paradigm for restructuring autism research. The discourse in all its permutations identifies symptoms that science and society have deemed pathological and redescribes them as coping tactics or benign differences unworthy of invidious distinction. In this respect, neurodiversity discourse might be understood as an effort to do away with stigma, a concept traditionally rooted in shame over the body’s finitude.

But the leveling impulse that motivates neurodiversity’s loudest champions does not abolish stigma so much as remove it to the plane of language and throw it in the face of social institutions. Major institutions in the economy, government, and entertainment, on guard against accusations of insensitivity, have responded by editing marketing language and instrumentalizing neurodiverse forms of creativity in hiring practices. The Central Intelligence Agency, to cite one of the nation’s newly enlightened employers, is hip to the competitive advantages offered by neurodiverse job candidates.

In the institution of the family, the gravamen of the indictment hits home. The claim that neurodiversity denotes a personal identity, one that is rooted in ontological sovereignty, invites its unelected representatives to intervene with parents on behalf of their children. When, as in my case, a neurodiverse child is born to a parent labeled “neuro-typical,” the dialectic of love and authority is automatically held to be adulterated. I, too, am cast betwixt and between prescribed social parameters. “Inside us there is something that has no name,” José Saramago writes in Blindness, “that something is what we are.” That something this society cannot let be.

So far, neurodiversity has followed the path of vanguard movements organized around abstract and categorical postulates of identity. As cultural radicalism, neurodiversity perpetuates the assault on the conventional family. As ideology, it reaffirms an assumption that freedom lies in incommensurable acts of appropriation and consumption. As social criticism, it hardens the community’s distinction between them and us. As politics, it leaves distributions of power undisturbed. Every other autumn, candidates seeking election to Cambridge’s school committee or city council knock on my front door and make their pitches. I explain why I’m a single-issue municipal voter. I ask for their disability policy initiatives. My question invariably takes them by surprise. I haven’t met one who has given policy any forethought. But as they stammer over substance, they always carefully rephrase my description of my own son as “neurodiverse” or “differently abled.” I wouldn’t care, if the politicians of identity would actually do something.

The biggest social crisis of recent years let the hot air out of such lip-service. Covid-19 came. The mayor of Cambridge issued emergency communiques every day. She sought to reassure the “most vulnerable” members of the community by naming them in successive numbers — veterans, elderly, “unhoused people,” “undocumented people,” “people who are transgender and gender non-conforming,” and “people of color.” Two months into the city’s pandemic response, the mayor still ignored people like Misha. I wrote to insist on my son’s existence. She pledged to “do better.”

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The lockdown did all the work we needed. For years I had worried about testing our community’s elasticity. Now our community itself quarantined. I had always winced as our neighbors kept a wary distance from us. Now they stayed six feet away from one another. I had fought off dread of the future. Now everyone felt encumbered by an emergency without end. As social friction thinned, we slipped out of the liminal state all together.

One memorable day — July 13, 2020, to be exact — we dipped into the city’s public swimming pool. A facility with a capacity for a hundred entertained a dozen swimmers this day. Misha tap-danced toward the deep end. He was bolder than I had ever seen him in the water. He drew a breath, semi-sealed his lips, and dunked himself for the first time. A fit of spontaneity propelled him from one side of the pool to the other. He was teaching himself how to swim, repossessing his corporeal identity in the water’s pressure. As he clawed toward me, grinning ear to ear, I thought of Wordsworth savoring

that serene and blessed mood
In which the burden of the mystery,
In which the heavy and the weary weight
Of all this unintelligible word,
Is lightened.

That October, an indiscretion put us back in our place. On a Saturday afternoon at Riverside Park in Cambridge, families of diverse ages, genders, and colors were tossing frisbees, listening to music, riding bicycles, and sunbathing. Misha frolicked on a spray deck, flapping and squealing, as happy as his happy can be. I sat with Niusha on a bench nearby. We were admiring the pontoon boats and kayaks afloat on the Charles River when a woman staggered into our picture and began rubbernecking at Misha. By her ruddy appearance and her haphazard gait, she looked to be one of the “unhoused people.” Suddenly she let loose a bark about “your retaaarded son.”

“We’re not leaving,” I whispered to Niusha. “She’s drunk. She’s not driving us away.” Seconds later, the woman captured the attention of the park when she repeated the epithet at the very top of her lungs. We turned the other cheek and headed home.

That evening, Niusha sobbed with shame. I couldn’t find words to console her. Sitting on the edge of her bed, I stroked her hair and wiped away her tears in silence. My imagination drifted to the predicament of Peter and Polly Horn. I remember thinking that I would make the same choice in a heartbeat.

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It’s June 2019, and my son, Misha, has begun returning home from his summer school autism classroom in Cambridge in a bad mood. On some days, he is fidgety and riled up, and on others, he wears a hangdog look. One afternoon, a teacher’s aide addresses my expression of concern by informing me he’s been refusing to eat his lunch. Aha, he’s hungry. But why? Misha isn’t apt to say. At 7 years old, he doesn’t speak, or write, or read — at least not very much.

Maybe he doesn’t find the victuals delectable? It’s true, the aide agrees, a piece of stale pita bread with three cubes of cheddar cheese tucked inside doesn’t whet Misha’s appetite. But the vegetarian option is all that remains after he declines his cheeseburger wraps.

Now, that is odd. Misha carries seven medical diagnoses, but nothing between heaven and earth typically prevents him from scarfing cheeseburgers. The aide ushers me into the hallway and lowers her voice. Probably, she whispers, he doesn’t appreciate cheeseburgers served cold.

Cold?

The regular school cafeteria is closed for the summer. Every morning, the lunches arrive prepackaged in milk chests with instructions for reheating the cheeseburgers. The classroom contains a microwave. But the teachers have been forbidden to touch the appliance. Abashed, she divulges that none of Misha’s classmates have been eating lunch.

Her look of embarrassment reflects a secret truth. The predicament of autistic people like my son stems not principally from their challenges, real as those are, but from the failure of medical, educational, and human services institutions to provide for their actual needs. What explains the discrepancy?

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The rule enjoining the microwave, the aide went on to say, had issued out of the office of the Cambridge Summer Food Program. I walk over to that program’s office several blocks away and buttonhole the director at her desk. You see, my son attends summer school. He’s autistic. He doesn’t talk. He won’t eat the cheeseburgers you’re sending over cold. No, he isn’t in one of the summer camps; he’s in the autism classroom at the summer school. No, he hasn’t complained exactly; he doesn’t talk. Yes, the microwave functions fine; someone in this office apparently forbade the teachers from operating it.

Oh, yes, comes the blithe reply, the regular school cafeteria is closed for the summer. I know that. Well, the microwaves that remain in the classrooms belong to the Food and Nutrition Office, and the director issued a peremptory edict before she adjourned for vacation forbidding anyone to operate her department’s microwaves. Very sorry, there’s nothing that this program can do. You might contact the district’s administrator in charge of autism, if it means that much to you.

The district’s administrator in charge of autism confirms the microwave belongs to the Food and Nutrition Office. If that microwave can’t be used, I remonstrate, then permit me to donate one, so that Misha and his classmates can end their hunger strike. No, she replies. Massachusetts state regulations stipulate only certified food handlers may touch the appliances. None of the summer teachers are so certified; ergo, no microwaves may be used. This is for everyone’s safety.

Who issues these certifications of which you speak? A vendor, ServSafe, she answers. I telephone ServSafe. Yes, confirms the pleasant person who answers the phone, our company does offer training and certification in food handling. But she struggles to follow the preamble to my request for help in getting to the root of the matter. Let me transfer you to a supervisor, Mr. Summers.

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To the ServSafe supervisor I knock up a rough narrative of the situation, likening it — for reasons I can put down only to a mix of defensiveness and exasperation — to certain stories and novels by Franz Kafka. A long silence follows my exegesis of The Metamorphosis. “Your question is bizarre,” the irritated supervisor finally breaks in; ServSafe has nothing to do with microwaves. If it means that much to you, try the Massachusetts Department of Public Health.

I try the Massachusetts Department of Public Health. The department denies jurisdiction and refers me to the US Department of Agriculture, the funder of the Cambridge Summer Food Program. The US Department of Agriculture disclaims jurisdiction as well. Was I not aware of the difference between a federal funder and a local administrator of said funding? I was not. Several more days of calling around puts me on the phone with the state’s “point person” for the federal grant. She is the chief nutritionist of the Massachusetts Department of Elementary and Secondary Education. By now, having regaled eight or nine different officials from the top, I’ve honed my query. The chief nutritionist listens attentively through its inherent tedium. Our 25-minute colloquy concludes that no custom, practice, stipulation, statute, rule, or regulation forbids the use of microwaves in this circumstance.

Triumphant, I relay the news to the district’s administrator along with a request to promptly rescind the injunction. The administrator acknowledges the correction but puts my request on ice, as it were. She needs to sound out “upper administration.” A week later, I receive her email. “I have been informed that teachers will be able to heat up student lunches on the days that the delivered food should be served warm,” she writes, without explaining the turnabout. “I will email teachers now so that they know.” By this time, summer school has nearly ended.

Most of the time, such senselessness appears as a byproduct of modern life, a phenomenon at once banal, implacable, and ubiquitous. Repeating a simple question — Why? — tends to leave one feeling dumb. Only when bureaucracy emits disturbing undertones and some procedural howler turns up their volume does the mind concentrate on a strange disquiet. What, then, does the case of the cold cheeseburgers reveal about bureaucracy as a mode of power?

All bureaucracies operate according to the principle of jurisdiction. Rules, regulations, and laws underwrite the command authority of all duly placed officials. In this case, though, nobody knew who had jurisdiction, and the requisite policy didn’t exist. Yet there could be no special favors. The attitude of detachment — a principled indifference to the inner life of will, instinct, and emotion — constitutes bureaucracy’s special quality among social structures. It de-personalizes, as this case shows, the best-intentioned caregivers. Pretty much any unofficial person anywhere in the world would instantly know what to do upon encountering a group of hungry disabled 7-year-olds. Feed them! Misha’s teachers possessed the resources to do what their conscience would oblige in every other social situation. Yet the chain of authority confounded their most basic predilection.

My indignation could make no difference. Indignation draws counterparties into shared morality. Bureaucracies operate on the basis of written rules, not moral improvisation. The administrator reached for the retort of a state regulation she supposed must demarcate microwave authority to the domain of certificate holders. This supposition, ludicrous on its face, turned out to be untrue as well. But her genuflection shows that bureaucracy must be imagined before manifesting in material fact.

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Families like mine are requested to undertake this exercise all the time. Nonspeaking autistics like Misha must have familiar structures, standard routines, and stable reinforcers to “prevent regression,” we are told. But maybe this insistence reflects the abstract needs of officials, rather than the actual needs of the children. When I informed the administrator in charge that no written policy prevented the teachers from feeding the children edible food, she herself appeared to regress into a state of occupational sociopathy. She needed to defer to the celestial hierarchy of “upper administration” to tell her what to do.

Her complicity in a minor act of cruelty probably never occurred to her. Social relations founded on domination, the anthropologist David Graeber suggests, remain hidden until someone breaks in and asks the pertinent question: Which party bears the burden of the interpretative labor? Who is principally required to take the perspective of the other party? Why children like Misha must bear this burden, impelled to expend enormous amounts of energy attempting to understand the motivations and perceptions of dictating educators, is a question that hardly ever comes up for debate.

The reason, Graeber says, is due to bureaucracy, a social technology devised to bless the “lopsided structures of imagination” that keep institutions running efficiently. The production of norms absolves the official of any obligation to imagine the point of view of the subordinated party, which scrabbles for an interpretive foothold in an environment of organized stupidity. Radical inequalities of power combine laziness with ignorance to produce the idiotic stare of officialdom.

I myself expend a fair amount of interpretive labor entreating school authorities. Why not outflank them with my own, Misha-specific policy document? Now please turn to page 282. See there, serving temperature — cheeseburgers. Yes, that’s correct, initial the box; it’s just boilerplate. Policies are just factitious declarations of authority, interpretations of regulations that are themselves just interpretations of legislation. Bureaucracy isn’t natural or inexorable; it’s perpetuated by our failures to confront the tyranny of administrative power with human forms of knowledge and being.

Why do we usually surrender and lower our sights in the name of being realistic? The answer, Graeber contends, stems from our intuition that lopsided structures of imagination are ultimately enforced by the threat of violence. In the velvet glove, an iron fist awaits.

Graeber’s contention perhaps seems inapplicable to this case. A half century ago, findings from the social study of autism helped to close the state schools and asylums. A humanitarian movement assailed the pervasive violence in residential facilities, accusing them of functioning as “warehouses” and “total institutions.” Haven’t we moved beyond the violence of the bad old days? Anyway, Cambridge boasts a municipal mission explicitly committed to “diversity,” “social justice,” “intellectual freedom,” and other high-minded values. Graeber’s contention perhaps seems inapplicable to this case. A half century ago, findings from the social study of autism helped to close the state schools and asylums. A humanitarian movement assailed the pervasive violence in residential facilities, accusing them of functioning as “warehouses” and “total institutions.” Haven’t we moved beyond the violence of the bad old days? Anyway, Cambridge boasts a municipal mission explicitly committed to “diversity,” “social justice,” “intellectual freedom,” and other high-minded values.

Yet Cambridge is a perfect emblem of a bureaucratic society founded on the threat of violence. After all, even though violent crime rates in Cambridge are far below the average in like-sized cities around the country and have been trending downward for decades, the ranks of sworn officers in the Cambridge Police Department keep growing. How do they occupy their time? And why do they maintain a military-grade armory of tear gas, sniper rifles, and submachine guns? In 2021, one murder and 313 other violent crimes took place here. That same year, the police department took 112,000 calls for service, a number nearly equivalent to every man, woman, and child in the city. The denizens of the liberal city are constantly calling people with guns over bicycle theft, Internet scams, traffic accidents, and “loud arguments.”

Most police work, as Graeber observes, has very little to do with solving crime. Across the country, the overwhelming proportion of calls to which police respond are conflicts over the myriad rules that abridge personal freedom with the element of caprice. “Bureaucrats with guns,” he calls police.

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Recall the administrator’s justification for disallowing noncertified operation of the microwave: “This is for everyone’s safety.” This was obviously absurd. But what would have happened had I pushed past the absurdity with direct action rather than unctuous pleading?

Picture a man cradling a large electronic device outside the locked door of an elementary school around lunchtime. He has no appointment, no lanyard. He refuses to desist. He says he needs to . . . warm up cheeseburgers? No rule forbids it, he cries! Eventually, men with guns, sticks, and tasers would arrive. And when they did so, would they accept his representations of the situation as compelling, or plausible, or even coherent? Would Cambridge police command the school authorities to stand aside and open the door to the charity of a meal for a group of hungry disabled 7-year-olds? The question answers itself.