A baby gets affected by autism due to an impairment in brain development while it is a fetus.

Parents might notice signs of autism only once their baby becomes a toddler. Autism’s presentation differs among children, and early signs can include the child not responding to or understanding their surroundings.  

Parents might worry if a three or four-year-old doesn’t watch TV, ignore sports, and avoid peers, suspecting something unusual. Autism is often diagnosed by age six or seven when the child struggles with basic skills like dressing or tying shoelaces.

A child with autism often struggles to communicate their needs using everyday language. This frustration can lead the child to run away from social situations, damage property, or hit their parents, and the medical community often finds it challenging to support them. Special schools exist to provide care for autistic children. Parents of autistic children deserve greater understanding and sympathy compared to those caring for children without such challenges. 

Maria, my client, has borne this heavy burden for years. Though I’ve heard many heartrending stories of families affected by autism, her story remains the most vivid in my memory.

Maria is approximately 50 years old and of Egyptian descent. I met her as a client at my clinic, where she often came accompanied by her cat, Amy, who weighed a substantial 10 kilograms. Maria belongs to the Christian Orthodox community, a minority religion in Egypt. Her tall stature, olive skin, and attractive features suggest she might have been a model in her youth.  

Over the last thirteen years, I observed that Maria never appeared happy, as shown by her constant lack of a smile. There might be a reason for her fading smile that I hadn’t thought of. I was always focused on my animal clients, since my livelihood depended on my expertise in pet care. As noted, Amy was overweight, which contributed to the many health issues she experienced. 

Amy would lie on the examination table as if she were guarding an egg. I had often recommended various weight-loss diets, but Maria would usually say, with little enthusiasm, that the cat refused to eat any of them. People often try to soothe their guilt about overfeeding their pets by sharing numerous stories. To help Maria understand my frustration with these pet owners, I told her one day that, among all the cats I’ve seen at my clinic, hers was the heaviest.

Maria understood my perspective, so she stopped visiting my clinic and went to another veterinary practice, which didn’t bother me. A few years prior, she had come with her daughter—who was a medical student—and I blessed her. I explained that Amy hadn’t lost weight again, which meant she was at risk of diabetes. Months later, Maria called worried because Amy was drinking a lot and suspected she might have diabetes.

I asked, “Bring the cat in without breakfast, and we’ll take a blood sample for testing.” The next day, Maria arrived with Amy, and as explained, a blood sample was to be taken from the jugular vein in the neck. I found it quite challenging to find the vein beneath the layers of fat. After several attempts to pierce the skin incorrectly, Maria’s expression, previously blank, became tense. I tried again, alternating my gaze between Maria, who was still serious, and Amy, who lacked a neck. We took a break when both Amy and I grew tired. When Maria innocently asked if my difficulty was because Amy was chubby, I became irritated but chose not to respond.  

A cat deemed the plumpest by a worldwide veterinarian so far lived in Scotland and weighed thirty-two kilograms. Its owner, a butcher, remarked, “Amy’s weight is not even one third of that Scottish cat’s,” with a hint of sadness, to which she replied, “That is true.”

I attempted to withdraw blood again by inserting a needle into the vein. This time, blood was successfully extracted, and a smile appeared on Maria’s face as she left the room. Although I remained in the office, I could hear the conversation between Maria and my nurse.  

Maria explained that her son was diagnosed with autism at a young age, which led her to leave her job to care for him. Autism can include violent behaviours, such as attacking nearby people, running away, or breaking objects by striking them against the floor when something is disliked. Maria was able to cope with these behaviors when he was a young boy. After her daughter was born, her husband left her. 

Bringing up her daughter and looking after her son had become work, and she explained that she had been doing this for twenty-eight years. She explained that the one and only good thing that had happened to her family was her daughter, who had gained a place at university to become a doctor, and who was not with her at present.

While my nurse and Maria were talking, I chose not to interrupt and listened quietly in my room. Later, I understood why Maria’s smile had faded. Recently, she called me and asked, “Could you come to my place and check on Amy? The pain she was experiencing was in her shoulder, and I can’t carry her.” I agreed without hesitation and went to her house immediately, even though I usually avoid visiting clients’ homes. This is because examining animals at home is challenging without quick access to veterinary tools. Nevertheless, I visited since her house was near my clinic, and I felt sympathetic towards her. Her house was surrounded by walls, iron bars, and a gate, which I thought was suitable for caring for children with autism.

Once inside the house, I asked what had happened to her shoulder as she tilted it, and she thanked me for visiting her at home. “Yesterday I sent Andrew to a Centre to care for him, and after that I cleaned the house, and my hand was injured,” she said. “Is that so?” I replied, and did not press the matter.

She showed me her hand, saying, “Look at this hand.” I noticed a serious injury below her elbow, which looked like a dog bite. I asked what had happened. She explained that Andrew had bitten her after she kept a coffee cup on his table, something she couldn’t tolerate. Despite being twenty-eight, she cleaned up his excrement and showered him. She said he’s very strong and that she can handle his beating and kicking. She emphasized the need to clean his surroundings immediately and mentioned that his main problem is breaking objects impulsively.

“I feel so sorry,” I said. “Have a look at Amy,” she said, and I asked what the problem was with Amy, who was sitting quietly on the couch. “She has some pain and is limping on the front leg,” she explained. I examined the cat, palpated the suspected injured leg, and explained that it seemed to be muscle pain and that there was no need to worry at this stage.

I took a wander around the house and said, “The house is beautiful and looks spic and span.” “I have been accustomed to these practices because of Andrew,” she said, and I replied, “Now the house should be vacant.” With a slight smile, she waved me off and said, “For twenty-eight years I have lived for Andrew; now I want to live for myself, if only for a little while. I wish to live alone, even for some time.”