Innocentia and the Autistic Boy



By Anthony Kovatch, M.D., Pediatric  Alliance — Arcadia Division



Part I:  Evacuation from the Lesser House of God

(Note:  This story is completely fictional; any resemblance to actual persons or places is accidental.)



“The world is a comedy to those that think, and a tragedy to those that feel”  — Horace Walpole.


As I pulled into the crowded, pot-hole-ridden parking lot adjacent to the Center for Children with Autism and Other Developmental Disorders on that cold, blustery, overcast day in late February, it became immediately apparent that the administration had unwittingly chosen a foul day for the evacuation from the failing, run-down building.  No snow to beatify the affair either.  Need for a better bottom line had necessitated a relocation of the entity to a more modern venue in the suburbs.  Harried movers were carrying out through the narrow front entrance whatever furniture had not been defaced beyond use by the residents; I had to excuse my interference several times as I entered the Center where I had been Pediatrician-in-Chief for 25 years.  Not a bad deal, this job, I thought — endanger your well-being for several hours every Wednesday on your day off and pay your own kids’ way through private elementary schools, then college, then graduate school, then weddings, then maybe THEIR kids’ private elementary schools, etc.  Plus, it sometimes warmed up what was left of my burnt-out spirit when I passed under the center’s slogan posted on a sign above the entrance:  We Create Miracles in this House.

The Lesser House of God

The Lesser House of God


I could feel the emission of negative energy long before I stepped into the medical clinic in the basement of what had long ago been an old schoolhouse.  “You will have to be fast today, doc; we have to be out of here by sunset,” said the compulsive nurse Evelyn before I could put down my ancient scuffed black doctor’s bag.

“I will surely abide,” I responded, trying to improve the mood.  “Don’t you guys who have worked here for so long feel sentimental about leaving?” I asked with sincerity.

“Not at all!” responded the cynical nurse Rita. “They make you so mad here — with this abrupt move and all — that you can’t feel any sentiment at all.”  The compulsive nurse nodded in agreement.  I laughed because many times I had felt the same way.

“The hell with sentiment,” remarked the cynical nurse.  “Let get moving before Nogence” —  the staff had Americanized the oldest nurse Innocentia’s unwieldy name over the years —   “gets here and slows us down.  And, Evelyn, hurry up and throw out those old pictures she keeps in that  bottom drawer — those kids are history.  If she insists on saving that old photo of Justus, I will resign!”  Following suit with me, the compulsive nurse abided.  Twenty-five years of history in the dumpster. (All inmates had a photograph taken for identification purposes when they were admitted to the Center, much like a prisoner, except that the kids were made to smile — whatever it took.)

Innocentia made her customary late entry appearing hassled and in a state worse than the weather outside.  She breathed heavily with any exertion because of her overweight, big-boned Polish body.  The rosy color that suffused her cheeks offered a hint of a singular beauty that had long-ago expired.  “I had to park way down the street”, she explained plaintively as if on a witness stand.  She had worked the four-to-twelve shift for almost twenty-five years entirely by herself, without complaint, because admittedly, she had “no life.”  No husband, no children, no pets, no close friends other than the nightcap she regularly took as a sleep aid.

I noticed as the clinic proceeded that she became aware of the absence of the photographs in her bottom desk drawer and their demise in the bowels of the dumpster.  Her mood saddened but she said nothing, maybe realizing that it was time to dispose of the memories and give closure to her long-lost relationship with Justus.

With Justus!  Was a relationship possible?  The autistic boy with half a brain.  His left hemisphere had suffered a stroke in the womb of his beautiful but cocaine-addicted mother, leaving it severely shrunken and dysfunctional.  No language, except for two words which he bellowed almost unceasingly: chocolate milk!  So steadfast and tenacious was his demand for this drink that he was only allowed one cup per day for “behavioral rehabilitation.”  Needless to say the strategy was ineffective and only worsened his never-ending self-abusive behavior, stimming, and aggression towards nurses, staff, and myself.  But most of all, towards Innocentia!  The more anti-psychotic drugs that were prescribed, the more emergency room visits for the staff for hematomas, black eyes, and open bites.    However, on rare occasions, there was redemption.


“Once there were twenty-five soldiers, all brothers, because they were all made out of the same old tin spoon.  They stood up straight with their muskets on their shoulders, very proud in their red and blue uniforms….All the soldiers were exactly alike, except one.  He’d only got one leg, because he was made last, and the tin had run out. It was said that to make up for this, the tinsmith had promised the last tin soldier the strongest heart….and he’s the one this story is about.”     — From  The Steadfast Tin Soldier by Hans Christian Anderson.

The Steadfast Tin Soldier

The Steadfast Tin Soldier


I became secretly aware of this redeeming behavior late one evening when I was forced to make late rounds after regular office hours.  Justus had developed high fever and more violent behavior, and I felt compelled to check on him.  Now, in spite of his distasteful aura,  Justus was truly a handsome boy; to Innocentia, he was the most handsome boy in the world.  He had a large crown (reminiscent of Fred Flintstone), but the long, slinky  hair that covered it — haircuts and grooming were prohibited by his tactile defensiveness and  aggression — wavered between red, auburn, and blond depending on the lighting and the degree of his rage.  I called him “the boy with kaleidoscope head” to beguile the staff.  His eyes were the same: chameleon-like and capable of transmitting sadness, ecstasy, and vulnerability all at the same time — much like a circus clown.  He had been abandoned by his family at three years of age, made a ward of the state, and institutionalized ever since.  Sadly, he was the first boy born to forty-four year old parents after five girls.  Nobody risked an adoption — his heart was known to none: he was thought incapable of loving and of being loved

At any rate, I found him gently nestled in the lap of Innocentia, restrained in her arms.  “Watch what you’re doing!” I warned. “He will…”

“Calm down doctor. He’s OK  now,” she interrupted.  “If  I  squeeze his head over and over like this, he will always smile and then sleep.  I call this therapy ‘squeegee’ for fun.”   She was right: it was almost miraculous — certainly more effective than “behavioral rehabilitation.”

I performed a perfunctory exam of his heart and lungs only, so as not to disrupt the miracle.  “Good work, good night to you both,”  I smiled as I exited with my black bag in tow, noticing at least four open cartons of chocolate milk on the counter behind them.  I reported the infraction to no one, permanently ablating it from my memory.

After five years at the Center,  Justus was “upgraded” to a chronic care facility with a lower cost to taxpayers;  his photograph joined Innocentia’s drawer of memories — at least until the evacuation.  Innocentia’s greatest sorrow after the boy’s discharge was that, nightcap or not, she could never dream of him.

But back to the evening of the evacuation.  “It’s time to blow out of here forever” declared the compulsive nurse, so we picked up our personal effects and exited the old schoolhouse for the final time.  “Here is your key to the new joint.  They say it is palatial compared to this old dump,” she added.

“Where is Nogence?” I asked in a panic.

“Probably can’t  find her pathetic way out of the building after all these years,” joked the cynical nurse.

“Maybe she’s searching the rubbish for souvenirs,” quipped the compulsive nurse.  I laughed along with them, at least on the outside.  We all tired of waiting for her, so the three of us, like Elvis, just left the building.

The evacuation from the Lesser House of God was complete — except for the ghosts of twenty-five long years and an old woman who could not bear to leave them.


To be continued tomorrow: Part II:  The Bells of Saint Kunegunda