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What 'The Good Doctor' Missed About Developmental Disability Services

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Please note: This article contains spoilers for the television show “The Good Doctor.”

ABC’s “The Good Doctor” has been a delightful source of binge-streaming entertainment for me and my family over the past several days. The show follows Dr. Shaun Murphy who is autistic and has savant syndrome while he works as a surgeon at (fictional) St. Bonaventure Hospital in San Jose, CA.

I am autistic too and I and work in the field of developmental disabilities; as such, I am often on the lookout for various representations of disability in the media and whether they treat the subject matter mindfully. “The Good Doctor” excels where other media portrayals of autistic individuals have had a tendency to miss the mark.

The show has covered a decent variety of medical maladies and injuries, typically using two surgical teams each working on an individual in nearly every episode. Woven in between these two concurrent surgical team exploits, we get to see a piece of Dr. Murphy in various roles.  We see his work side, his  personal life at home with his daily routines, navigating friendship and relationships, and we get to delve alongside him into his childhood memories. What I enjoy most is how Dr. Murphy’s autism is not portrayed as something to be cured, but it’s also not downplayed or overlooked. It is a part of who he is. We unabashedly accept and embrace Dr. Murphy’s strengths and challenges, and his character is portrayed with a depth that I believe is not only fair representation, but necessary.

Both neurodiverse and neurotypical people can relate to “The Good Doctor,” and the show can be quite educational as well. Which is why I was surprised, given how well this show does at educating viewers, that “The Good Doctor” missed
some key resource information in one of their most recent episodes.

In season 2 episode 4, “Tough Titmouse,” we meet a patient named Mac who has fragile X syndrome. He arrives at the hospital with a splintered fence piece embedded into his shoulder. After the successful surgery removing the debris, doctors inform (Mac’s mother) that Mac can return home that day. They also say to her, “this is all really good news,” to which Nicole responds “I know, I was just hoping to have one day without him.” Later, the doctors mention to her that she can get help and she says “You mean like IEPs, speech therapy, or a behavioral mod?”and the doctor asks her if she has considered a residential facility or a group home for him.

Whoa, slow down there buddy. Let me explain something really quickly.

Throughout this conversation, and throughout the episode, not once does anyone on the surgical team ask Nicole this very important question: “Is Mac served by a Regional Center?” This question would have only taken approximately five seconds of screen time, after which the surgical team would have been free to go about their day.  Better yet, the hospital’s social worker should have been present to ask such a question of Mac’s mom and we still could have followed the side plot, just in a different way.

For reference, the 21 Regional Centers throughout the state of California are non-profits funded through a combination of federal funds through Medicaid waivers along with the CA state general budget to provide vendored services and supports to individuals with developmental disabilities throughout their lifespans.  Those served by Regional Centers are assigned their own Service Coordinator who provides to them either an Individual Family Service Plan (IFSP) if the child is aged 0-3 years old, or an Individual Program Plan (IPP) for ages 3 and up. Outlined in those plans, if eligible, are services that can meet that child or adult’s needs. Although Regional Centers are Californian in design, other states have comparable organizations aimed at supporting individuals with developmental disabilities.

Something that was missing from the dialogue in this episode was reaching out to the local Regional Center where Mac lives and either making a referral to the organization, or encouraging his mother to get in touch with his Service Coordinator. It is possible that Mac could have been eligible for respite services, which would have given his mother the day off she wanted from time to time, or even personal assistant (PA) services that could have helped him at home or
in the community with completing tasks.

As the state of CA continues to move further away from institutional living to individual living arrangements in the community, it is important to note that Mac’s mother, like many other parents throughout the state, have options that can enable their children to live successfully in the same home as their parents or other family members.  These children and families are not alone, and help can be just a phone call away.

However, sometimes raising a child with a disability can be too much for a parent, just as raising a child without a disability.  Parents are not all superheroes and they have their limitations too. In those cases, finding alternative living
environments may be the last-case option.

The episode did poignantly illustrate the reality some children and adults can find themselves in when living in residential facility settings. Later in the episode, Dr. Neil Melendez visits his developmentally disabled sister Gabi at a residential facility. She was seated by herself at a table playing with a puzzle. The two of them talk and Gabi asks him “are mom and dad coming for me today?” He tells her no and insists that while her family loves her, she has more fun there (at the facility) than at her parents’ house anyway. Her smile fades and her brother distracts her by playing together with her on her puzzle.  The scene is a sad one, but is also an accurate portrayal of the loneliness that can accompany segregated living. I hope we will see more of Gabi’s character in future episodes. I would love to see and hear more of her story.

This week’s episode certainly contained a dramatic jump from discussing “behavioral mods” to discussing a residential facility or “group home” for Mac to live, without considering services that are meant to be more “in-between” such as respite or personal assistance. The fact that there was no mention made of Regional Centers, which provide a significant bulk of services to individuals with developmental disabilities, demonstrates that this show still has a lot to learn about the topic of disability and support.

“The Good Doctor” is indeed good, but it could be even better!

Originally published: November 27, 2018
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