What 'The Good Doctor' Can Teach Us About Autism and Sarcasm

“The Good Doctor” is a medical drama set in a California hospital. The star of the show is a genius surgical resident on the autism spectrum, Shaun Murphy, who is played by actor Freddie Highmore. The show contains some great illustrations of how life can be for people on the autism spectrum. In this article I will look at the difficulties many people with autism and Asperger’s have when it comes to understanding sarcasm.

Early on in the series there is clear tension tension between Dr. Murphy and his boss Dr. Melendez, a cardio-thoracic surgeon played by Nicholas Gonzalez. Melendez is a hotshot surgeon with a major ego to match, and he’s skeptical, to say the least, about what Dr. Murphy can bring to his team. He believes that while Dr. Murphy is clearly very bright, he doesn’t have the qualities to be a successful surgeon.

Dr. Melendez likes to use sarcasm in his role as supervisor for Dr. Murphy and several other surgical residents. When Dr. Murphy is late on his very first day on the job, he tells Dr. Melendez it was not his fault. The bus was late, so it was the fault of the driver. Melendez turns to him and sarcastically says, “We made a real good choice hiring you.”

Dr. Murphy simply replies, “Thank you.” The sarcasm was totally wasted on Dr. Murphy as he missed it completely. He took the words of Dr. Melendez literally, as people on the autism spectrum often do, so he thought he was being complimented. He didn’t perceive the sarcastic tone and way it was being said.

It’s a great example of the literal thinking of people with Asperger’s. Autistic people often take the words said to them at face value and don’t take context into account. Other examples of this problem are metaphors (e.g. “as cold as ice”) words with double meaning (e.g. “channel”) and jokes (e.g. “why did the chicken cross the road?”) These can be all tough for people with Asperger’s to interpret.

But it’s not impossible. A later scene in that first episode of “The Good Doctor” shows this well. In the scene, Dr. Murphy turns up for work on time. He says good morning to Dr. Melendez and his colleagues.

Dr. Melendez sarcastically replies, “Right on time. What, did you sleep here or use a teleportation device?”

Dr. Murphy responded with a deadpan expression, “I used a teleportation device. Nonsensical questions usually imply sarcasm, which I’ve found people often answer sarcastically.”

Dr. Murphy had learned from previous encounters of sarcasm, and put a rule in place that would serve him well — nonsense questions often imply sarcasm. He picked this up quickly, maybe quicker than real life. Sometimes this can take a lot more work — but autism is a spectrum, so everyone’s different in their abilities.

The point is that sarcasm is often a tricky issue for children with ASD, as are double meanings, metaphors and jokes. But they can be helped to recognize and understand them. It’s just another issue you need to be aware of as a parent, so you can help your child moving forward. And when I say “just another issue” I’m not being sarcastic! It’s a real recognition that you have a lot more on your plate than the average parent. Things like teaching your child about the social world, coping with difficult behaviors, attending all manner of appointments, battling with the school, balancing your family’s needs, worrying about the future, cooking a limited palate, picking up the pieces when your child is sad and distraught, spending a good amount of your time sleep deprived and exhausted, and so much more.

I hope this article has given you a little insight into the mind of your son or daughter with autism and how you can help them.