Good Doctor: The manipulation of autism (Episode 5 Review)

by: Raine

Writer Park Jae-bum has started to use Si-on’s autism as a story tool rather than represent the disability sincerely. This is because there is no other way for the plotline to advance in the manner that Jae-bum ssi wishes it to. He wants people to start to see Si-on for who he is rather than just “that autistic guy”. But, he’s trying to make Si-on himself convince them without any outside help and does so by seriously manipulating autistic traits that were established in earlier episodes.

In terms of the development of other characters aside from the autism, this episode was much more exciting. Do-han and Yoon-seo and a few of the residents have to cope with the death of a patient. They, in and of themselves, have some really nice character development, but in regards to Si-on, it’s a little skewed.

And the bad guys, they’re pulling funding from the pediatric program to be evil. I don’t really care about it. Basically, they’re just using Si-on as a pawn in their political game and are trying to push around Do-han and Woo-seok. Do-han’s board of directors girlfriend, Chae-kyung, is also just a cold business-type and is pretty boring. She did get a little jealous of Yoon-seo this episode because Do-han came back to help her. That was the most interesting thing Chae-kyung did. Yeah, she’s useless.

Si-on’s mom also made a reappearance as a hospital worker. I think she’s his mom? I’m not sure. But there will be some mommy issues coming in soon. I’m really not looking forward to it. I doubt they’ll handle abandonment issues well.

The patient who was brought in at the end of the last episode died on the table. She was Yoon-seo’s first solo surgery patient and Yoon-seo has a hard time accepting the death – Si-on does as well. I expected that from him. For much of the episode, he sits outside the morgue to keep the little girl company before the funeral. It’s what he did for his rabbit and his brother when they died. That behavior is very realistic and is also very sweet. He also mends the child’s ripped so she can wear them to heaven and he silently offers them to the parents. D’aw!

Yoon-seo is trying to act like nothing happened while inside she is reeling from the death and her responsibility in it. The parents blamed her and she had to watch them sob. It was a really powerful experience to watch her go through and, unlike with the NICU infant, the writer didn’t manipulate it too badly. She struggles through her day and Do-han decides to push her into doing another surgery immediately. This method is not one I’d agree or disagree with. Sometimes people CAN do well immediately after suffering such acute grief and guilt. Sometimes they can’t. It’s Do-han’s job to judge. He judged Yoon-seo correctly. She rose to the challenge, even though she thought that he was a total jerk for challenging her in the first place. His method could have backfired, but it didn’t so I won’t harp on that.

One of my favorite parts of the episode is that the parents later forgive Yoon-seo. They have cried their hearts out and are accepting guests at the funeral. Do-han has forbidden Yoon-seo from attending, mostly to protect her against the parents’ fury, but goes to try and make amends. Turns out their fury has run its course. They tell him they know Yoon-seo tried her best to save their child and that Yoon-seo is hurting as well. They also thank Si-on for giving them the clothes. It’s actually a beautiful scene where we see Do-han acting like a human and Yoon-seo getting some of the guilt ablution that she needed.

When Yoon-seo visits the morgue, she finds Si-on guarding the door. There is some talk of heaven. This is a huge point of contention between Si-on and Do-han this episode, the existence of heaven. Do-han thinks that Si-on is an idiot. Si-on is surprised Do-han doesn’t believe. I won’t dwell on this issue because I have my own personal beliefs on the subject. But basically, Si-on tries to comfort and assure her by telling her something Woo-seok once told him. The child is in a better place and that the child appreciates the effort that Yoon-seo made. She tried to give the child a chance at life. When he says it, Yoon-seo doesn’t believe him. But when she has time to think about it, she really starts to appreciate his words.

Although the repetition of words is very much what a person with autism would do in this situation. There are a few other situations in the episode that are very un-autistic.

1) Si-on thinks to himself that it’s okay if people see him strangely. – No, it wouldn’t even occur to him to think something like that. He would just receive their words and their ill feelings and be hurt by them.

2) Si-on explains heaven to a little girl in a story that he made up. – A person with autism would not do that unless the story was told to him previously. It’s too abstract a concept. They are concrete thinkers. It was very, very strange to watch.

3) Yoon-seo hugs Si-on in thanks for showing her how to be a real doctor and not just a technician. (Her worry was that she’d stop caring for her patients and Si-on’s devotion to the dead little girl showed her otherwise.) – He doesn’t flinch when she hugs him! I found that so bizarre. He hiccups at her proximity, but he didn’t flinch at the contact. Even if he accepted the hug, he’d still flinch. People with autism do NOT do well with contact. She touches his shoulder a few other times and he accepts the touch without flinching. That’s just…no. People with autism are hypersensitive to human contact. Therapists have to gradually acclimate them to accepting touches and hugs. I remember at my school, we’d always greet the kids with some sort of firm touch or hug and kisses. (My school was in Miami, a place where kisses on the cheek are an accepted form of greeting.) We would ask the kids for “besitos” (kisses) in return. So precious. I love those kids.

4) Yoon-seo wakes Si-on up in the morning to go on an adventure and he covers up. – He doesn’t have that sense of self-awareness. Nakedness wouldn’t affect him like that unless someone instructed specifically to cover up in front of other people. Based on his behavior in the first episode, he was not instructed in modesty. So this behavior is incongruous.

5) He asks Yoon-seo to go to the zoo for their adventure and he wear a headband with bear ears. – Again, people with autism have sensitivity to pressure and touch. He would NOT like the pressure of a headband on his head unless he was trained to TOLERATE it. Or, he would LOVE the pressure on it head and would therefore always be wearing something that provided that input. But most people with autism have an aversion to that pressure.

6) There is a “feral” child in the ER at the end of the episode. Si-on approaches her and gets bitten. – He wouldn’t approach her unless he was asked. Especially because she is giving off angry, negative energy.

Now let’s talk about this “feral” child. How is not one person in that hospital trained in restraint and seclusion? Why is there a CROWD of people watching her and why did they let Si-on approach her like that? Violent patients are not uncommon and it’s required to have the training. Speaking from personal experience, some people with autism (and other disorders and conditions) are violent (mostly out of frustration) and almost half the staff in my school were trained in restraint techniques. Kids are strong when they are displaying no physical self-control. This scene just wouldn’t happen unless there were no doctors or nurses present.

Basically, the episode was an improvement on the interpersonal front, but the autism was just “there’. It existed. I was really hoping that they’d show the physical manifestations of Si-on’s feelings and maybe have someone like Woo-seok or Nurse Jo explain what was going on. Like, they’d see him rocking and ask, “You are very sad that the little girl died?” “No.” “Are you sad that she is alone in the morgue?” “Yes.” That would’ve been much more realistic.

I suppose I’m hoping that the autistic aspects of the show don’t get totally warped and misused and misrepresented. This is a chance to teach and educate. Miseducation is worse than not knowing at all.

Edit: I realize that I didn’t say something I feel is important. The story is trying to have Si-on prove his worth by himself, on his own merit and behavior. But what really needs to happen is that the understanding of Si-on has to come from something outside of Si-on; it needs to be externally motivated by Woo-seok, or Nurse Jo or perhaps even a psychologist who makes an entrance. Si-on is not capable of garnering empathy for himself in the way that the show wants him to. They want his actions and words to move people. That’s not how autism works. If they had just ONE character who would dedicate himself to opening up the world to Si-on and opening up Si-on to the world, that would solve a lot.

Reviews:

Episode 1: First Impressions

Episode 2: the Autism Perspective

Episode 3: How to create a good doctor

Episode 4: How to explain autism

Episode 5: The manipulation of autism

27 thoughts on “Good Doctor: The manipulation of autism (Episode 5 Review)

    • Raine says:

      Thanks for the reading. I love reading. My points in this post are to highlight Si-on in particular. Next post will be to address the variety in the manifestations of autism.

  1. 2pm&JoowonBias4ever (@2pmBias4ever) says:

    hai there. thanks for your insight. however, i agree on you points for autism. note that in the first episode, it was mentioned that ShiOn has undergone treatment for his autistic characteristics. therefore, he is deemed normal, albeit on certain extreme tense situations where his autism tendencies come out. like on occasions in surgery room where he panics, or thinking the child died, etc. minor autistic behavior are such like his hands shaking when he’s nervous. but his major characteristics have been treated.

    also note that ShiOn is fine with touches since he was little. that is not part of his autistic characteristics. bear in mind that autistic people behaves differently EACH person; no two autistic person is the same. ShiOn’s major syndrome is savant, whereas his autistic is minor. his brother and Dr.Choi has been touching him since he was little. he often strokes his rabbit too, which indicates to me that he is alright with touches. ShiOn sees the wild child similarly like seeing a small animal. he is interested by them, thus he wants to touch them.

    being a grown autistic-savant man, i believe he behaves differently compared to children with autism who does not have control over their behavior or mindset of thinking. Joowon mentioned that for several months, he met up with a lot of autistic people and specialists regarding his character. i have also conducted a lot of research and discussions on this matter. so far, i think what he has done is significant and sufficient in portraying an autistic man who has undergone treatment, but still does exhibit some characteristics in difficult times.

    • Raine says:

      It seems you hold a different belief than I do about autism. I do not believe that once you are ‘treated’ for autism, you are ‘cured’. That is what I seemed to get from your comment so forgive me if I am wrong. I have worked with both children and adults with autism although most of my experience IS with children.

      They said he was treated as a child, but that does not mean he is cured or doesn’t’ manifest traits of autism anymore. It means he was taught how to deal with the world. Being put in a hospital setting is different than what he was taught which is why he is floundering quite a bit. Although they DID mention he had hospital experience before, so I’m wondering what happened there. Deemed “normal” is such a misnomer that I really hate to use that term. Autism is a disability. It’s persistent and lifelong. He won’t ever be “normal” if normal means a life without autism. And he doesnt’ NEED to be normal.

      He knows how to control his traits in social setting and it is true that they would manifest MORE under stress but they are by no means gone. Just controlled. This is why I don’t believe in a “cure”.

      I disagree about the savant syndrome being ‘major’ and the autism being ‘minor’. The autism that this character shows is severe. And while I do acknowledge that it manifests in each person differently, there are persistent characteristics that I have come to be familiar with. Again, I am NOT an expert. This is based on my work and observations as a para and a teacher and co-operation with therapists.

      Stroking a rabbit is GIVING touch. Wanting to touch. That is quite different than receiving touch without warning. I’m not saying he will have a fit when he’s touched or not accept it, rather, I expect a small flinch or at least a look of begrudging acknowledgement of the touch. He may like it even. Just based upon how the character has been formed, I don’t think it’s an accurate portrayal on the writer’s part.

      I think Joo Won is doing an EXCELLENT job in his portrayal. It’s the reason I watch. It’s very accurate. And it’s true adults with autism are different than children. Time is a great teacher. But I don’t agree that he’s ‘treated’ and therefore he’s fine. I’m not sure if you’re saying that or not, though. I feel like his treatment did NOT encompass hospital behaviors. That’s why I think he needs a guide/aide. Someone to teach him again.

      I KNOW this is a show and I’m making a LOT of assumptions here. But the writer is also taking a lot of liberties with the disability to make his writing work and that makes me MAD!

      That was a really long response…please let me know what you think!

      • 2pm&JunhoBias4ever (@2pmBias4ever) says:

        again, very interesting insights. this drama has made me want to volunteer or donate to the autistic foundation. 🙂 also, being a Joowon bias does not mean i am willing to give away his faults. i look forward to criticisms and feedback on his acting. i hope you do not think i am defending Joowon. 🙂

        i actually agree with you that the autism is slightly tone down a bit. not being an expert or have ever worked with autistic children before, i am portraying my opinion based on the past few months’ of reading, so please excuse my knowledge. moving on, this being a drama, it is quite difficult to portray certain emotion or way of thinking. especially for disability like autistic. (therefore, the use of monologues is highly necessary.) in your first point about ShiOn noting that people sees him strangely, i disagree on this. i think he is just acknowledging that he does not have any friends. even in episode 3 he mentioned to Dr.Choi that he knows people dislike him. what made you think that he should not think this way? i am really curious. having grown up with people hating him everywhere he goes, is it not alright for him to have that way of thinking?

        by the use of word ‘treated’, i am not saying that he is ‘cured’. you misunderstood me there. i am saying that he learns how to control it, thus he is able to receive touch. when the little boy in the train in episode 1 touches him, he seems to only exhibit the slightest flinch, but to me, he seems more expectant than surprised. i notice that he seems to like touches, despite not getting much of it since he was little. when YoonSeo approached him, he may not be surprised at getting that touch for he sees her looking at him and walking towards him. but he does get hiccups, which may be another form of showing his surprise. (may i please note how adorable his hiccups are!)

        i also notice that ShiOn’s way of showing surprise is by blinking a lot, or slight flinching. there is a lot more touching in episode 6, have you watched it? we can discuss more on it once you have. 🙂 i would also like to raise an issue with the ending of episode 6 which has been bugging me since last night. i am not happy with it.

        looking forward to your reply. 🙂

        • dewaanifordrama says:

          Raine is right about the touch. It is a very common thing with autistic children to use animals for therapy. One of my friends who has an autistic son has a dog that is trained to be a therapy dog for him, and she has helped him to cope much better in the world.

          Joo Won is doing an excellent job portraying his character, the problem is that the writer doesn’t know what Savant Syndrome or autism, so they are not always writing the parts well enough. Well, I am assuming that the writer or at least the director is not as experienced.

          Someone who has autism, or even something more high functioning on the spectrum such as Asperger’s really struggles to see why their behaviours are not normal or why people find them strange. So when Si-on has that moment where he says that he knows that other people think he is strange, it doesn’t fit with the thinking processes of people with autism.

          • 2pm&JunhoBias4ever (@2pmBias4ever) says:

            thanks for sharing your experience here. my only argument about this matter is that no two autism cases are similar. each person is different. ShiOn may be based on a person in real life with similar autistic characteristics, so Joowon tries to portray those characteristic as realistically as possible. we cannot simply say “this portrayal is not similar to the autistic person i know” because the autistic person you know is different than ShiOn’s characteristic.

            you are right, the director is indeed inexperienced. but the writer is a very good medical drama writer. he has written very unique medical cases in his previous dramas. 🙂

            • Raine says:

              2pm – dewaani explained it very well. I will copy and paste the words that I wish I had said so well!

              “Someone who has autism, or even something more high functioning on the spectrum such as Asperger’s really struggles to see why their behaviours are not normal or why people find them strange. So when Si-on has that moment where he says that he knows that other people think he is strange, it doesn’t fit with the thinking processes of people with autism.”

              People with autism have a very different way of thinking and looking at the world. They have trouble putting themselves in other peoples’ shoes. So for him to “Understand” people making fun of him, it is not very autistic. Also, as for what you said about no two cases of autism being alike, you are very correct. No two people are alike. However, there are some VERY basic traits of autism and those are what are being portrayed incorrectly in the show.

              Thank you SO much for you very clever questions. These are what I LOVE to talk about.

  2. SaSam says:

    Thank you for the brilliant recap! I am not liking the hospital politics at all and really wish that at least some healthcare professionals will understand autism and guide Si On along. He needs guardian angels! He needs someone to befriend him, give him a safe and structured space with unconditional positive regard (my counselling training is speaking here). He’s got a good heart and so much to offer and not just in terms of medical knowledge (that scene of keeping the child company at the morgue was so sweet!)

    A note on touch though. I’d have to agree that some people with autism can learn to be okay with touch. Remember in the first episode when Woo Seok held his hand gently after he shouted at him for being late? Si On must have associated touch with comfort as that calmed him down quickly. Interestingly I have a few kids with autism who are quite comfortable with touch as well and in fact do seek cuddles as a source of comfort. Si On may have just been one of those who are less hypersensitive towards contact.

    • Raine says:

      Sasam – you are right. There are a few who do seek the input, but based on the rest of Si-on’s behaviors and responses to things, I think it’s bizarre. Plus, that’s a rarer trait. He doesn’t seek any of that kind of stimulation in the show at all. He wears no long tight long sleeves and doesn’t give himself the input or does ask for it (either directly or indirectly). I also blame the lack of reaction to Woo-seok’s touch on either a) familiarity with a very hard press on the shoulder, ie Woo-seok’s, or b) writing inconsistency. I suppose I’m coming from the viewpoint that Si-on has a very low threshold. It’s how he was portrayed in the beginning and modifying it now is not consistent. Also, despite needing that input, it is still jarring to be touched ‘randomly’. I’ve had a lot of high-threshold kids who needed full body squeezes a lot but still did not like like randomly being touched. The body squeezes are ASKED for. Or at the least, we tell them we’re doing it.

      What do you think? What kind of therapist are you? I am NOT one. So this is based on my learning, studies, and experience. It’s also based on discussions with therapists in my life.

      • SaSam says:

        Raine, I am a creative arts therapist who works with a wide range of client populations, autism being one of them. So while I study the condition and work with individuals with the condition, I don’t profess to be an expert as well, more from experience of working therapeutically with them. From the standpoint of a creative arts therapist though I believe that when a trusting relationship is established children with autism do learn to tolerate some form of physical contact. That said, you are right though, random touching would usually be on a different level and I now see what you mean about Si On being unusually comfortable with being hugged. I guess inconsistent writing is to be blamed since as you said this aspect wasn’t set up in the beginning. Thank you for all the insights! You have brought up several good points of discussions and I am glad this has generated lots of learning on this thread!

  3. allison says:

    It is very possible that Si-on’s adoptive father (the head of the hospital guy) had taught him about the door to heaven. Maybe we should be giving a little slack to the writer because it is difficult to account for every action an autistic person would do. I’m sure Si-on would have had gotten used to touch especially to people he likes because of his brother and the head of the hospital guy.

    • Raine says:

      Allison, I think you may be right that someone may have taught him about the door to heaven. It’s highly plausible. But I must disagree about the touching. Even with training and practice, it is still difficult to receive touch. My brother finds it difficult still, he is on the ASD spectrum and many of my students after years of therapy still have issues with it. It’s a life long thing. My goal in these posts is more to educate about autism than to disagree with the show. I want people who watch the show to know what’s fact and what is fiction so that they better understand.

  4. dewaanifordrama says:

    I couldn’t agree more with you Raine. I think that the writer is trying to do too many things all at once, and so we’ll end up with resultant crappy drama.

    I have been worried about the autism aspect since the beginning of the drama because no one seems to know how to deal with it. They keep on talking about (the doctors that is) about how to cure him like he has a cold or something. It really frustrates me that as medical professionals they seem to have no idea about what autism really is. I get it that not every medical professional is a trained expert in autism, but really, the sheer ignorance in the drama is starting to get on my nerves. The scene where Si-on reachers out to Yoon-seo and then retracts his hand could have been realistic if the autistic person was very high-functioning, but yeah, the whole hug thing…blegh. It’s the “romance” storyline being pushed, which I find is not being done very well. I would much rather that the Yoon-seo/Do-han loveline be explored if we have to have one.

    And boy oh boy I really wish that they hadn’t introduced the mom drama.

    And really, the politics are just silly and about as bad as the politics backstory in Rooftop Prince. It’s like the writer has no sense of ingenuity.

    All that said, there were large portions of this episode that I really enjoyed, especially the surgery fallout (I was hoping that somewhere along the line they would actually lose a patient – though I think it was hard/sad that it had to be Yoo-seo’s first surgery patient). And I really loved how Do-han is the one who received that feedback from the parents. He’s obviously all caught up in guilt somehow at not being able to save his brother, and it’s why Si-on is pushing his buttons. I am interested to see how that storyline develops.

    And I really don’t know why they are pushing the Heaven/not Heaven storyline so much. Plenty of scientific/medical professionals are believing, and plenty of “simpler” people aren’t. It seems like just another thing that the writer is ineffectually trying to attempt.

    And sorry for writing a novel here 🙂

    • Raine says:

      I like long responses. And you as an ESL teacher have a unique perspective on a lot of things. Did you ever study autistic speech patterns? I really enjoyed the surgery fallout as well. Hated introing the mom.

      I think Si-on reaching out to comfort her could have worked if it was an action he was told was appropriate to perform when people were crying. Again, it’s about he’s taught to socialize!

      • dewaanifordrama says:

        I am actually an ESL teacher of adults learning English for university purposes, more like English for academic and specific purposes – so it’s not something that generally we’ve been trained on. I also don’t work with children. I haven’t had any autistic students, or at least, if they were, they were incredibly high functioning.

        I just have a lot of friends who are on the spectrum, have Asperger’s or or who have children with autism. I also have several friends who have studied education for children with special needs, so we’ve talked a lot. I also read a lot. Or like in a comment I wrote above, about the friend whose son has a therapy dog.

        And as you’ve said in some other comments, the writing is really to blame. Joo Won can only do so much with what he’s been given. I find the character though that I get most irritated by is Moon Chae Won’s. Yoo Seo does not act towards Si On in any kind of consistent way. It is driving me crazy actually. I think the writer wanted to make the next “Rain Man” or something, but without good direction or writing, the characterizations and storyline of Si On coming into his own, are going to fall flat. I also don’t think that the writer seems to have as much familiarity with autism as one would hope when using it as a plot device and a major one at that.

        • Raine says:

          Dewaani – First off, your job sounds AWESOME. SEcond, you know a lot more than the average bear about autism. Third, I totally agree about the writer needing to read up more on autism before using it as a plot device. It’s starting to be VERY badly manipulated.

          • dewaanifordrama says:

            I do love my job 🙂 And it means I get to spend a lot of time with Koreans (who all think it’s super cool/funny that I love K-drama and K-pop as much as I do). I was worried about the autism/Savant syndrome when I first heard about the drama, and sadly my fears are being realized. So far there’s enough to keep me interested, but each episode makes me more and more frustrated. There’s just too much going on. Too much.

  5. alua says:

    First of all, I wanted to say I really appreciate your recaps for this series. You should be a consultant for the script writer of this drama!

    As for this episode: my favourite part was Si-on, the nurse and the little kid talking about heaven (even if you say it wasn’t realistic… but I thought it was very touching). Thought the little kid was really good, she could grow up to be a good and interesting actress (and with a unique kind of beauty, not a cookie cutter one, yay!). That said, I was a bit surprised about all the discussion about heaven. I’m as agnostic/atheist and we-die-and-that’s-it as it gets, but, whoooaaa, I didn’t expect the doctors to be so dismissive of other people’s beliefs. I mean, seriously, as doctors they will encounter death and people trying to cope with death all the time – and doing it in different ways. INCLUDING the doctors. It’s like they were trying to make a point that doctors never believe in heaven, which I really don’t think? I’m sure some are religious, and others aren’t – both of which is fine.

    Feral child: agree with you. There should be someone trained to deal with violent patients, adult-sized ones (drunkards, druggies, specific conditions, etc.), and even if there weren’t…. this is a pretty pint-sized patient! Surely two or three of them could tackle and restrain her together?

    Also thought that feral children are such rare occurrences that to have one in this series just seems a bit far-fetched…

    • Raine says:

      Thanks for saying all that. *blush*

      I’m guessing it’s a child with a psychotic break. She’s wearing clothes…but I could be wrong…

      About getting her under control, it’s very, very difficult. I’ve dealt with violent kids before and there is definitely a process. I’m not trained in it so I helped. But if you’re not careful, you can get seriously hurt. Even when you’re careful you get hurt. But yes, there IS training especially for violent patients. A manifestation of a lot of disorders and diseases is violence born of frustration.

      As for heaven, I thought it was weird that Do-han was so against it. Doctors, at least in the US, try to keep their beliefs to themselves and are encouraging. If they meet someone with like beliefs, they encourage that way. In any case, it’s not talk for the hospital.

      I agree that little girl was amazing. But Si-on would never do that…he just wouldn’t. It’s not within his scope to create a story as abstract as that. To be taught it and understand it is completely reasonable. So for my sanity, I assume his brother or someone he trusted told him that story.

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