Dr Linda Nathanson-Lippitt of Children’s Habilitation Center in Atlanta, has kindly agreed to talk to our magazine about autism, its causes and treatments. The interview took place between Michael Shengaout and Dr. Nathanson-Lipitton August 23, 2012.

MR. MICHAEL SHENGAOUT: Hello Linda! Thank you for taking time out of your busy day to answer some questions about autism and the types of therapies that exist for autism.

DR. LINDA NATHANSON-LIPPITT: My pleasure.

MR. SHENGAOUT: My first question has to do with the term Autistic Spectrum Disorder. Is it accurate to talk about autism as a single disease or is autism a category that includes a variety of conditions?

DR. NATHANSON-LIPPITT: It’s more accurate to think of autism as an end point, a clinical picture you can arrive at from a number of different paths. It’s not one condition at all.

MR. SHENGAOUT: Which factors have been identified as causes of autism?

DR. NATHANSON-LIPPITT: First of all, we know that there are number of genetic disorders which result in a very high incidence of autism. The most common one that we see is Fragile X Syndrome which is a disorder of some of the genes on the X chromosome. Interestingly, many of these genes are involved with the process called methylation. A methyl group is a carbon atom with three hydrogen atoms attached to it. You can think of it as Mother Nature’s switch for turning on and off different genes. The methyl group also makes things like Vitamin B12 functional inside the neurons. If you aren’t a good methylator you’ll have problems in many areas, including a problem with brain function, which can lead to autistic symptoms. This means that a very high percentage of people with Fragile X Syndrome are autistic. [Also] Fragile X Syndrome is common in people with Down Syndrome. Although many of them are absolutely not autistic, again, statistically the presence of Fragile X syndrome increases the risk of autism. We know from studies that if there is one autistic person in a family, there is an increased risk that other children in that family will exhibit autistic symptoms. If you look at family clusters, you’ll see that close relatives have a statistically higher risk. So we know that there is the clearly genetic factor, and probably more than one genetic factor. We also know that there is a subgroup of kids with autism who don’t detoxify well. We live in a very dirty world where sucking on batteries can get you a load of cadmium, playing on pressure treated wood can get you a load of arsenic. We are all, I think, familiar with the risks of lead in brightly colored paints on the things that kids chew on and eat, with mercury pollution from coal plants and other areas. Most of us are fairly good at getting this stuff out of our body. But many people also have problems with getting rid of these toxic elements and, once again, we see a much higher level of toxic accumulation in people in the autistic spectrum. There are also problems with inflammation. For example, people in the autistic spectrum have a much higher incidence of elevated titers to the herpes virus called Herpes 6, which is not the genital kind that is more well-known by the public, and we often see many of these kids who have been fully immunized. Overall, these individuals don’t have protective titers to, for example Whooping Cough, which is another of the illnesses that they often seem to have trouble making good titers for.

MR. SHENGAOUT: Could you explain what protective titers are?

DR. NATHANSON-LIPPITT: When you get immunizations, your body makes antibodies against that particular pathogen. And you are protected from that pathogen from those antibodies. So we talk about the amount of antibody you have in your blood as the titer. If that particular pathogen tries to get into your body again, your white cells immediately recognize an enemy and you’re got all your immunity troops line up to kill the pathogen.

MR. SHENGAOUT: And your immunity wipes out the pathogen?

DR. NATHANSON-LIPPITT: Exactly. We know that we have multiple indicators that many of the kids in the autism spectrum have high levels of oxidative stress in their bodies as well as signs of inflammation. So, there are different pathways that can lead to you having a person who is having trouble with language, with socialization, with a need for sameness, which we put together and call autism.

MR. SHENGAOUT: That’s a great overview. So, you mentioned that there are certain family clusters and, in some ways, you can observe a certain proximity between siblings or sometimes a certain dependency between what the parents have and what their children have. One of the factors, like inflammation, clearly directs the doctor to investigate the immune system. Do you find that there is a certain set of factors with the parents of autistic kids? Let’s say some immune issues or similar types of things?

DR. NATHANSON-LIPPITT: Yes, once again we are talking sub-groups. But yes, families with children with autism seem to have a higher incidence of autoimmune diseases in blood relatives. We find illnesses like Lupus or childhood onset diabetes. We seem to see more thyroid problems in these families and we see more history of emotional problems in the families, very often bi-polar disorder, depression, and obsessive compulsive disorder. The tic disorders seem to be more frequent in family clusters where kids with autism pop up. I just want to emphasize that of the presence of these other disorders in a family automatically means that you are going to have a child with autism. But on a statistical basis, we see an increase of risk factors.

MR. SHENGAOUT: Would you say that with autism we seem to have a combination of nature and nurture, so to speak, meaning genetic and environmental factors work together in these families?

DR. NATHANSON-LIPPITT: Absolutely. My understanding is that we are dealing with genetic vulnerability and an environmental stress source. When you put the two of them together – that’s what is giving us the epidemic which is really what we have.

MR. SHENGAOUT: When you talk about an epidemic, do you mean that the numbers of autism cases is growing. You have been at this for at least thirty years, am I right?

DR. NATHANSON-LIPPITT: Yes.

MR. SHENGAOUT: You have had a chance to observe the population with autism for a long period of time?

DR. NATHANSON-LIPPITT: Absolutely.

MR. SHENGAOUT: Do you think that the growing number of autism cases is due to better diagnosis or do you think that we are really having an epidemic?

DR. NATHANSON-LIPPITT: The answer to both is yes. I think both things are happening, yes. When I was in training thirty some odd years ago, seeing autistic kids was “Wow, what an interesting thing”, you know? And generally, having been trained in New York, there’d be one school that would have an autism class for a group of schools and now there isn’t a school that doesn’t have classes for autistic children. We were seeing an incidence of autism at one in ten thousand and now we are up to one in seventy eight, from the latest numbers that I have seen.

On top of that though, we’ve expanded the diagnosis as well. So you’ve got both factors. We absolutely were not missing children who were non-verbal, who were sitting and rocking back and forth and holding their fingers in front of their , what we call stimming on their fingers. We weren’t missing those kids, but what we are seeing now is a sub-group of kids who go under the heading of a degree of high functioning autism or Asperger’s Syndrome.

By the way, both of these diagnoses are about to disappear from the DSM 5 (Diagnostic and Statistic Manual) that is coming out. It’s all going to be replaced with the term autistic spectrum disorder, which I think is more honest. Although in some ways, it’s nice to be able to parse things out a little bit more. So, there has been a lot of controversy about how DSM 5 is going to look. The DSM is the “Diagnosis and Statistic Manual” which we use to give official number-related diagnosis.
But yes, we do understand that there are many very bright people who may have some early delays in language development, who are a little bit quirky, who may have a little bit more trouble in terms of connecting with other people, but are highly functional in the world who now, when we stretch the boundaries do get included in the diagnosis.

So I think you’ve got both things going on. Many of these kids had what we just used to call developmental language disorder and found that as the language got better, which it invariably did, much of the quirkiness disappeared as the communication skills got better. We still see kids like this, so I think we have had a little bit of both. But there is no question that we are seeing far more, even when you figure that you have this milder group, which is now being included. That’s why I say that this is an epidemic.

MR. SHENGAOUT: So would you say that even the hard core cases have increased severalfold?

DR. NATHANSON-LIPPITT: Those have increased a hundred times.

MR. SHENGAOUT: The severe cases?

DR. NATHANSON-LIPPITT: Yes.

MR. SHENGAOUT: Amazing.

DR. NATHANSON-LIPPITT: Oh yeah. Oh yeah. The reaction of a doctor used to be, “Wow, I just saw an autistic kid. Isn’t that interesting that since it’s so rare.” And now, frankly, probably seventy percent of my practice is kids in the autistic spectrum. When I started thirty years ago it was, maybe, fifteen percent of my practice.

MR. SHENGAOUT: Wow. On the other hand it looks like everyone who is a bit introverted or just lacks social skills a bit and taps his food seems to be labeled as autistic. Do you think that the term autistic is a little over used?

DR. NATHANSON-LIPPITT: Yes I do. I think that it’s really, really tricky. Frankly, sometimes using the term autistic gets you services that you wouldn’t get without that diagnosis. I think some people stretch the diagnosis to help people who could use some help building social skills or who could use some help with language impairment, or with anxiety or the like, and I definitely think that there is some over-diagnosis that tends to go on. Sometimes there are good ulterior motives for over-applying the diagnosis, like the ones that I just described and sometimes because it’s kind of the diagnosis de jure and it’s so common. Well very often if you are not sure what is going on, it’s the easiest thing to slot people into.

MR. SHENGAOUT: I have kind of read quite a few articles where anyone with a bit of eccentricity would be described as autistic and I was thinking that it’s same as describing anyone with a good imagination as schizophrenic! Just because they imagine things doesn’t mean that they are out of touch with reality.

DR. NATHANSON-LIPPITT: Yeah, well on the edges of virtually any psychiatric diagnosis you have borders that are fuzzy and whether to lump them inside the border or outside the border when you are over in the milder area is very often a judgment call. There isn’t a blood test you can do that gives a definite answer of autism or no.

MR. SHENGAOUT: Talking about blood tests, could you tell me about some of the most promising, in your opinion, autism research that you know about? What University is leading the way? Which researchers of doctors are working on these questions? What are they doing? Where are they looking to find new treatments and diagnoses?

DR. NATHANSON-LIPPITT: The Child Mind Institute in California is certainly doing some very exciting research. They’re looking at functional EEG’s, functional MRI scans, looking at what parts of the brain are lighting up or not lighting up with different kinds of function, trying to see whether we can use some of this data to be more refined in picking medications or supplements to help rather than using the trial and error method that we really still use as we select treatment.

At the University of Arizona, Jill James is doing some very exciting basic research (see Jill James video here). A lot of her work is looking at issues of methylation and sulfation. Jim Adams who is a very bright, interesting guy, also out in Arizona/Colorado area does a lot of work with Jill. He started out as many people do: he was in the field because he has a daughter who is severely autistic. He wasn’t a scientist but he believed that we need to do some good research and not just have anecdotal information. Jim is the author of the few really good papers documenting heavy metal toxicity and improvements in the kids with using DMSA Chelation (expelling heavy metals and other toxic elements). John Hopkins is doing some interesting work on methylation. Martha Herbert is a neurologist up at Massachussetts General at Harvard who has been doing some very interesting and exciting work looking at brain inflammation. She is a crusader for the fact that our environmental deterioration is a major factor in the poisoning of a lot of our most genetically vulnerable kids. There is a map of mercury pollution in the air in Texas, and when you overlap incidence of case of autism, it virtually overlaps exactly with where the mercury, the air pollution with mercury is.

MR. SHENGAOUT: That I didn’t know.

DR. NATHANSON-LIPPITT: Oh yeah. Oh yeah and so Martha has been doing some fabulous work. It is such a pervasive problem that the work is going on all over the country. Clearly a great deal and there is still a divide between the people interested in toxins and the really smart, dedicated, honest people who are insisting that this is a brain disease as opposed to a biologic intruder affecting the brain and other parts of the body. So you do have honest disagreement with people who feel that the biologic approach is not necessary, that all you really need to do is lots and lots of ABA therapy or Floor Time Therapy or incidental learning. Those are terribly important because reprogramming the brain is absolutely important, but if you don’t take care of the biologic underpinnings, even those who are insisting that this is still a brain disease (which obviously is not me), do admit that the incidence for example of intestinal problems, whether it’s chronic diarrhea, or constipation alternating with diarrhea, or highly self-restricted diets is far more common in the autistic population than the general population. So the behavioral stuff terribly important and the use of medication to help with some of the symptoms – absolutely! But looking at the biologic underpinnings is absolutely mandatory if we are going to recover these kids and help them do as best as they can.

MR. SHENGAOUT: Basically what you are saying is that you need to look not only into fixing the software, but also fixing underlying hardware.

DR. NATHANSON-LIPPITT: Well put.

MR. SHENGAOUT: Well, I think we have covered basically everything that I wanted to ask. Is there anything else that you would like to add or any message of hope to people who woke up today realizing that they have a child who afflicted with this?

DR. NATHANSON-LIPPITT: The first thing is to recognize that that the child has a challenge with autism. That is a huge challenge for the child and for the family. I have given this lecture multiple times to my colleagues – any kid in the spectrum deserves a therapeutic trial on methylated Vitamin B12 and you can’t give this orally. The gold standard is giving it as a small injection every three days and giving it a five week trial. I would urge everyone who has a child in the spectrum to try this, because, as I was saying, most of these kids don’t methylate well. If you can’t methylate Vitamin B-12, it doesn’t matter how high your blood level of Vitamin B-12 is, it’s not going to help and, frankly, 80% of the kids I put on methylated B-12 show improvement in eye contact, language and attention. The down sides are so minor: a little bit of hyperactivity in a small number of kids, the possibility of some sleep problems. For me any kid in the spectrum deserves a five week trial.

MR. SHENGAOUT: So there is a silver bullet you should try before you go anywhere else.

DR. NATHANSON-LIPPITT: Yeah. You know you are still going to have to do the ABA or the Floor Time, but this may give you a much more accessible child’s brain to work with.
The second thing that I think is so important is to remember as parents: don’t lose your humanity and your needs, because you have a special needs child. Your children who are not affected still have all of the needs that any child has for support, attention, play, fun with their parents, so it is so important to make sure that you, parents, give yourselves time to play, to have R & R, to have time together, to have time for yourself. There is a tremendous pull to say, “Well I am okay and my child isn’t, so all of my needs have to go on the back burner”.
If you don’t take care of yourself, you’re not going to be as effective in taking care of your more needy child and the neurotypical children in your family will start having issues because they don’t lose their needs for the wonderful support of the family, because they have a sibling is more needy. I think an incredibly important thing for every family who is battling autism is to take to heart.

MR. SHENGAOUT: What are the best ways of supporting Autism related research?

DR. NATHANSON-LIPPITT: I think there are two very good organizations. #1 is the Autism Research Institute, ARI, which is based out in California and this is one of the oldest organizations that Doctor Bernie Rimland started almost fifty years ago. Sadly, we lost Doctor Rimland a couple of years ago. He was one of the first people who corrected the ideas of the fifties when we had people like Bruno Bettelheim, saying that autism is the “result of refrigerator mothers”, and God knows how many wonderful caring women carried this incredible burden of guilt, that they were not loving enough to their child and that’s why their child had autism until this went by the wayside. But, in the context of that and the initial thing, that autism was just a brain disease and the rest of the body didn’t have any issues — all you could do is treat the symptoms, and you couldn’t cure the condition. Bernie who was a Ph.D. was a voice in the wilderness saying there has got to be something more here and gathered scientists and people around him, and started the Autism Research Institute. Some of the first things, like using Vitamin B-6 and magnesium which does help many of the kids, were started by Bernie back then and the Autism Research Institute still sponsors them. Jill James research, Jim Adams research is sponsored by them and so that is a huge good organization. Autism One O-N-E is another wonderful organization so those are two places I would definitely be looking at to support.

MR. SHENGAOUT: I mean if you have funds to support?

DR. NATHANSON-LIPPITT: If you have funds to support, those would be two wonderful places to endow.

MR. SHENGAOUT: Linda, thank you very much for your time and for such an informative lecture and overview of Autism and what is going on with it.

DR. NATHANSON-LIPPITT: My pleasure.

The first time I heard the word “autism” was while watching the movie “Rain Man.” I was only seventeen, so the tragedy of autism didn’t really sink in. Yes, I saw how Dustin Hoffman’s hero was shackled from within, unable to cope with the outside world, but his savant qualities stole the limelight. Counting spilled matches in a restaurant or cards in Vegas, remembering all kind of obscure statistics – that was a fascinating demonstration of the limitless grandeur of the human mind, even if it was limited in many other ways.

Autism wasn’t the only thing my self-consumed, sex-crazed seventeen-year-old self couldn’t understand at the time. Some things can not be explained by movies – you must live them to understand. Maybe some day, mankind will discover how to teach life’s painful lessons by giving a quick and relatively painless shot, but until then we are stuck learning through the School of Hard Knocks. The harder things get, the more we change, and if we don’t break – usually to the better. Maybe the job of our guardian angels is not to keep us out of trouble? Maybe, like good fitness trainers, they make sure that we learn all we can during our short span on this Earth without getting broken? It was this belief that kept me afloat, when twenty years after watching “Rain Man,” I discovered that my son had autism. It came very close to breaking me – I suppose my guardian angel used to be a particularly tough football coach…

Most autistic children share the same tale. At a certain age (usually 2 or 3 years old) normal development suddenly stops, often followed by regression. Symptoms include serious language delays, no eye contact, shrieking, strange behavior (like walking in circles or rocking), and so on. This often happens right after the MMR vaccine, which is why many parents blame the vaccination. Parents usually go through the denial phase (“he is just a little bit behind”), followed by a desperate search for a cure, from physicians and developmental therapists down to quacks and healing patches. There’s lot of explicit and implicit blame (“it is in your genes” or “it is because you took that medication”). Then come years of tears, the draining of family finances and the constant terrifying, nightmarish thought that your child may be non-verbal and peeing his pants at the age of 17. Normal children learn by emulating, mimicking others, but the autistic child won’t even attempt to hold a spoon or repeat any sounds without hours of therapy. If there is one thing worse than death, it is having existed without quite having lived. And that’s just what severe autism does to a child.

Some form of autism affects 1 child out of 88, a hundredfold (!) increase from two generations ago. Yes, there are many “different autisms,” and this number includes both the severe, nonfunctional patients (who cannot even talk), as well as the highly functioning patients. You may have an interesting conversation with someone labeled as “autistic” and then wonder “why is everyone so scared?” The scary thing is that the number of severe cases with nonverbal, nonfunctional kids has also gone up many times (more than tenfold). We are not at the top of the pandemic, we are only at its beginning; the cases we have today, both severe and borderline, are just the people who seem to be more vulnerable than others to some environmental factor (or factors). Back in the old days, miners used to take caged canaries to the mines because birds are more sensitive to poisonous gases (like carbon monoxide and methane). If the birds started dropping dead, miners knew they should run for dear life. Many people believe that people with autism are “the canaries in the coal mine,” showing that there is something deeply wrong in the environment. And unless we find out what it is, in a couple of decades we may very well be looking at tens of millions of disabled children who will live into their 80s. Not only will they be missing out on their own lives and wrecking the lives of those around them, but they will also cost society hundreds of billions of dollars and break the system of social care, which is already busting at the seams. Does this sounds scarier than climate change, West Nile virus and Jerry Sandusky combined? Well, I hope it does, because it is!

So, what can be done about autism, considering that we don’t know all the causes behind this affliction? Quite a lot, actually, including prevention, treatment and research. Some of these things can be done on the individual level, some at the state level, and some we can do only as a country.

Prevention

An ounce of prevention is worth a pound of cure, and parents can do a lot to reduce the risk of autism in their children. Anecdotal evidence shows that autism happens when genetic vulnerability (usually related to the immune system) is triggered by one or more environmental factors. If one or both of the spouses have allergies, psoriasis, asthma or other immune issues and if the child is a boy (risk for girls is several times lower), they are in the risk group. I hope that sounds scary, because it usually takes fear to make the necessary lifestyle changes that eliminate these “environmental factors” out of a child’s life.

First comes eliminating factors related to the immune system. Try not to get sick during pregnancy; antibiotics may increase the risk. That may be achieved with surprising ease by washing hands obsessively, every 30 minutes (the most effective prevention method!). Also wear a mask at work if there are people sneezing around you. It’s better for them to laugh than for you to cry. Your child should be breastfed until he is at least 6 months of age or even longer. Breastfeeding has been shown to help build a strong immune system. Also, do only those immunization shots that you must, and do them as late as possible. Many doctors will probably crucify me for saying this, but immunization shots remain on the list of possible contributing factors to autism. Despite the discredited Wakefield’s study, which tried to link the MMR vaccine to autism, there are other studies that show that the volume of immunization shots (not just MMR) and their timing may still be a contributing factor. You will definitely want tetanus and diphtheria shots, but maybe at 8 months instead of 2 months when the child’s immune system is a bit stronger and he is more likely to need protection from the pathogens. The Hepatitis-B shot needs to be done in the hospital only if you carry the virus, otherwise you may put it off till later, (perhaps even years later). At any rate, until the CDC does the definitive study on vaccines and autism, it is up to you to balance the risk from not receiving some immunization shots with the risk from receiving them.

Second – environmental factors. Kids put toys into their mouth, and these toys may contain chemicals. The only thing my son ever chewed was a Fisher Price toy with lead in its paint. He ended up with elevated levels of lead in his system – clearly one of the contributing factors to autism. Don’t buy cheap toys. Buy expensive toys manufactured in places where people are much more conscious of what goes into their products (like Japan, Europe and the U.S.). It is better not to buy a toy rather than buy something that will make your child sick. In fact, that goes for everything you buy, from pens and pencils to food! Talking about food – try to eat organic meat and milk during pregnancy and breastfeeding. Hormones and antibiotics that are fed to cows and chickens end up in you and in your child. It will definitely not make your child healthier and may be the contributing factor in overwhelming your child’s body. Check yourself for heavy metals – if your levels are elevated, probably your child’s are too. Also, your grandma’s advice about eating vegetables and cutting down on snacks and sweets may be more important than we think. High-fructose corn syrup has been shown to reduce the body’s ability to expel heavy metals from the body and to be a factor in inflammatory processes in the body – both long-known factors for autism.

To add to the list of environmental factors, there have been some studies linking autism and industrial pollution (like mercury from coal-firing power plants). Maybe those crazy environmentalists are onto something? According to some studies, the yearly cost of autism in the U.S. is around 126 billion dollars, so being cautious about the environment makes not only moral, but also economic sense. At the very least, it deserves some serious studies with some serious funding. After all, neither you nor I can conduct such studies on our own.

Treatment

Dr. Linda Nathanson-Lippitt, one of the leading autism specialists in Atlanta, said that “There are many different autisms.” There are several known biomedical problems that are linked to autism. Thus, if the child falls behind in language development, doesn’t play with toys, rocks back and forth or walks in circles – act quickly. You cannot afford to be complacent, even if your physician is. There are many good places that list known conditions and treatments with links to autism, e.g. Autism Society (http://www.autism-society.org/living-with-autism/treatment-options/summary-of-biomedical.html) and so on. These biomedical conditions may include sensitivity to certain foods, intestinal yeast infections, metabolic problems which require certain supplements (e.g. certain forms of vitamin B6 and B12), elevated levels of heavy metals, and so on. Most researchers think that autism is a problem of the body, not just the mind.

Whether or not the problem with the body is identified and treated, the most effective treatment for the autistic mind remains behavioral therapy (ABA, Floor Time and so on). In many cases, this therapy has been successful in reducing (or even eliminating) symptoms of autism even when used just by itself, without any other therapies. The earlier and more intensive this therapy is, the more chances the child has for a normal life. The good news is that early intensive behavioral therapy does work. The bad news is that this therapy is expensive (at least $20/hr, usually much more), the child needs a lot of it (30 hr/week for at least a year, usually more) and most parents are poorly suited to conduct this therapy themselves (I know, I have tried!). The typical cost is 40-80 thousand dollars per year, which most families cannot afford. More bad news – many states don’t include this type of therapy in insurance coverage. As we know, unless it is regulated, most insurance companies are unlikely to include coverage voluntarily. Even when we put aside the moral side of this equation, there remains the pure economics of it: the cost that an autistic patient may incur over his lifetime could reach 3 million dollars. Thus, the therapy that may significantly reduce this cost to society, or possibly eliminate it completely, is definitely worth the up-front investment.

The Affordable Care Act of 2010 had its share of negativity, but I will risk saying something positive here. This law lists behavioral therapy as a mandatory part of the insurance coverage (thanks to the amendment by Senator Bob Menendez of New Jersey, see section 1302 of the law). Many states that started covering this therapy started doing so only after or just before passage of this law. You may find more information about the costs of coverage to the states and the list of states providing it from the presentation by Stuart Spielman of Autism Speaks. You may also find our interview with Stuart in this issue of our magazine. Autism Speaks is the biggest organization lobbying for insurance coverage both on the state and federal level, among many other things they do.

Research

Autism is a severe disability. If it is not a disability, it is not autism. Children with autism may be pretty happy – it is everyone around them who suffers. These children often grow into 17 year olds who are 6’ 2’’, 200+ pounds, whose tantrums become dangerous to everyone around them, including their parents and siblings. They often have to spend decades locked up in institutions, and then no one is happy.

We already know that some things work with autism, but we don’t really know what the culprit is. It is important to understand that autism is as serious as a heart attack and requires as much research. It needs a fundamental understanding and a fundamental cure. In addition to the moral reason, there is also a clear economic one. The heart attack is over in several minutes (one way or another); autism lasts for decades.

Unfortunately neither you nor I can find the cause or cure for autism. It requires significant joint (and very expensive) effort from many private and public institutions. At this time, federal spending on autism research is driven by the Combating Autism Reauthorization Act (CARA) signed by President Obama in 2011, which is itself an extension of a 2006 law. This law allocates $22 million per year for research programs, $48 million per year for early detection programs, and $161 million for “certain other programs” directed by the Interagency Autism Coordinating Committee. This brings the total to $231 million. This amount is three times less than the amount spent on Alzheimer’s research ($600+ million in 2013 per the National Alzheimer’s Project Act), four times less than obesity research ($823 million in 2011) and thirty times less than research on cancer ($6+ billion plus additional funding per each specific cancer type).

By comparison, a private organization, Simon Foundation, has provided $200+ million dollars in grants for autism research since 2007. Autism Speaks is another serious contributor towards the research, as well as many other organizations. The cause of autism is one of the rare areas of bi-partisan work, where republicans and democrats have come together. Congress has an Autism Caucus, founded by a Republican from New Jersey, Chris Smith, and Democrat from Pennsylvania, Mike Doyle. It is interesting that out of 20 physicians in Congress, only Republicans Michael Burgess of Texas, Phil Gingrey of Georgia and Democrat Donna Christensen of Virginia are participating. I imagined that doctors would be more interested in solving one of the most serious long-term medical problems in our country.

There are some problems that cannot be resolved by the individual and must be resolved by society as a whole. The only way any one of us can help to cure autism is by supporting one of these serious research foundations and asking our Congress and Senate representatives to join the Autism Caucus and increase the funding for Autism research.

In conclusion of this overview, I would like to repeat that autism is pandemic. Unless checked, it will get much, much worse. What we do now, both as individuals and as a society, will define all of our lives for decades to come (considering the rate of growth of autism cases). Some of us are already dealing with this tragedy, but none of us who think of ever having children or grandchildren can afford to look away and do nothing. Autism may soon be at everyone’s gates.

MR. SHENGAOUT: Peter Bell (Executive VP of Autism Speaks) told in his report to the Interagency Autism Coordinating Committee (Transcript of the meeting on July 10, 2012, see page 283) that the Affordable Care Act (see section 1302 on page 164 for “Essential Health benefits Requirements”)includes provisions for the behavioral therapies. As most parents with kids with autism know, this is what works the best. If no diet has worked, if other biomedical therapies haven’t worked, this actually may get your kid at least half way down to the finish line. In that report to this committee, he has mentioned that the guidance (for these provisions) which has been given thus far “has been somewhat challenging and troubling and not terribly clear”. My first question is: Who would issue the guidance to the state for this behavioral provision, and what can we expect?

MR. SPIELMAN: Well, let’s start with what the guidance is. The Affordable Care Act was enacted into law by Congress, and the Department of Health and Human Services is responsible for implementing the provisions of the Affordable Care Act. So the answer to your question would be the Department of Health and Human Services. Now, they have put out informal guidance so far, and that guidance allows considerable discretion in the states in how the states set up health care exchanges. So the primary obligation here, responsibility here, is with the Department of Health and Human Services. They are the ones who are charged with providing information and guidance on the implementation of the Affordable Care Act. The states have a significant role but HHS is the primary Federal Agency.

MR. SHENGAOUT: So we may look at the states and laws on behavioral therapies and gauge what kind of benefit is children with autism are expected to receive? A commonly quoted number that would make the difference is thirty hours a week of ABA or similar behavioral therapy. Would you give some feedback as to what type of coverage generally exists across the states where behavioral therapy is part of medical insurance coverage?

MR. SPIELMAN: I can say that there are thirty-two states that provide significant coverage for Applied Behavior Analysis as well as other autism therapies. There are some state laws that vary somewhat in coverage. Some states have unlimited coverage. Some states impose some limitations, but I think all the laws have in common are recognition that the healthcare needs of individuals with autism are important and need to be met.

MR. SHENGAOUT: So most of the laws that you have seen do approach, at least, this magical number, thirty hours? Is that a fair statement?

MR. SPIELMAN: Well, they’re not framed. None of the laws that I am familiar with is framed in terms of child gets X number of hours a week. The way that some of these laws are framed is in terms of dollar limitations and other limitations on services such as the age of the child. If you were going to characterize these laws in a very broad general way, you would say that the laws represent an acknowledgement by states around the country that there are significant healthcare needs for children with autism, and that behavioral health treatment, ABA specifically, is very, very important to many of these kids.

MR. SHENGAOUT: I saw your report to the Institute of Medicine back a year and a half ago. What’s the cost to society? What will be the cost of this coverage of behavioral therapy? What is the cost/benefit analysis of this? We know the moral side of this issue. Kids have to be as healthy as they can be, but if we look purely from the financial point of view, what is the situation here?

MR. SPIELMAN: Well, actually, I think you’re raising an important issue here, and that is, how do you measure cost? I am in a car dealership now, so I apologize for the background noise. Let me use a car analogy. I, in fact, am here to get an oil change for my car, and there is a price for the oil change, and it does cost money. It’s not free, but another way of looking at that is, what’s the value of the expenditure? And there are certain costs that are associated with not changing the oil, with not taking proper care of the car. And those costs, in fact, may be far greater than the costs of actually doing a relatively inexpensive service. I think that analogy is actually apt here for kids with autism. If you provide the care, the cost is low in absolute terms, but especially in relative terms. Kids with autism have significant healthcare issues. If those issues are not addressed early, then it’s not as if the kids will magically get better. The kid’s needs may get greater, so I would say that, in both an absolute and especially in a relative term, these costs are very, very inexpensive.

MR. SHENGAOUTS: So we’re talking about the fact that, even from a financial standpoint, just to continue the car analogy, if you don’t change the oil for twelve thousand miles, you will end up with a hole in your engine. In a similar way, the cost of not treating autism and not developing the child at least to the point where he or she is self-sufficient would result in lifelong need for lodging and other care that, in many cases, does fall not only to the parents, but also, at some point, to society.

MR. SPIELMAN: There have been a couple of studies that are done and have been done about lifetime costs, and one is by Michael Ganz from Harvard University. There was another study that you can see on our website—

MR. SHENGAOUT: David Mandell, University of Pennsylvania.

MR. SPIELMAN: …where the findings at this point are preliminary, but in both the Ganz study and the study that you mentioned (University of Pennsylvania, David Mandell), what we see are very significant lifetime costs. And you know the costs can be framed in terms of lost opportunity as well as actual expenditures. You know costs to look after someone who has a disability, as well as the loss in terms of what that individual may be able to accomplish in terms of working, paying taxes—and these are very significant expenses. So I think that one of the actuarial issues that comes up is that often costs are framed in a way that I think isn’t the most helpful way. The absolute cost of autism care is low; it’s the relative care that we should be thinking about. Children with autism live long lives and the cost of disability over seventy years is great. If we can address these issues early on, if we can change the trajectory of kids, if we can take a kid who might otherwise go to special education and put that kid in regular education or have any other fundamental change like this, then we really are making the soundest of investments possible. I am putting aside for the moment the humanistic issues here, which of course are great, and I also haven’t even mentioned the ancillary effects of providing care, because children are members of families, and the lives of family members who have to deal with the disability of a child are affected, their economic potential is affected. So, it is, I would say, the soundest of investments. This is where the car analogy fails, because you as an individual are really not affected by whether my car is properly serviced. But in a sense, and in a very real way, you’re affected if my child or some other child doesn’t receive the care he or she needs. We all share a community, whether community is defined locally or more broadly. We all are part of society, so it’s really important to get these kids care—and get these kids care as soon as possible.

MR. SHENGAOUT: I am painfully aware of all those things, having a child with autism myself, non-verbal at seven years old. I also could see what a difference the behavioral therapy has made. We literally have run out of our retirement savings, and we cannot continue it. It even occurred to me that there was a fitting expression from Reagan years that I heard, which was the “trickle-down effect”, that once this thing would be addressed, then the trickle-down financial effect would last for decades to come.

MR. SPIELMAN: Well, you know our children are going to be part of society. The question is, what part of society will they be a part of? Will they be part of the workforce? Will they be shunted into a type of life where their potential isn’t fully realized? It is not a question of whether or not kids will grow into adulthood and be part of the greater society. It’s a question of where they are going to wind up and so, again, I can never overstate the human part of this condition.

MR. SHENGAOUT: Yes.

MR. SPIELMAN: But even if one were to be rather detached from this, this is a very expensive condition, and to reach kids at the earliest possible moment is a sound strategy. So I feel very strongly about this.

MR. SHENGAOUT: That makes two of us. I have another question. A couple of years ago, there was declared a “war on Alzheimer’s, and there was set a goal of resolving this condition, coming up with treatment for this condition by year 2025. Correspondingly, there was investment from the top into the research and similar type of actions. I was wondering, how does Alzheimer research funding correlate with autism research funding from CARA (Combating Autism Reauthorization Act of 2011), and can we expect an increase in autism research, considering that autism is pandemic now?

MR. SPIELMAN: Well, Autism Speaks has argued for the need for increased investment in autism research. It’s interesting you mention Alzheimer’s, because Alzheimer’s is a brain condition, and autism is a condition that affects the brain as well. We think that more research needs to be done on brain conditions, and we really think there is a tremendous opportunity with autism and a great need for investment. So I’ll even tell you that these are tough economic times and that all parts of government are under scrutiny and under some strain, but, consistent with what I said before about investment and payoff, there is a real significant return here on the kind of investment that we can make. Understanding this condition, understanding autism is important for thousands and thousands of children and adults. It also has ancillary benefits, because, again, we’re talking about the brain and understanding what, in some ways, is the most challenging part of the human body, where our knowledge is gaining but, still, we have a long way to go. So, we should be spending more money on research. We have to recognize that a condition that affects one in eighty-eight children (and that’s probably an underestimate) is a condition that deserves a maximum federal effort.

MR. SHENGAOUT: I am curious if the question has ever been framed from the standpoint of economic opportunity. Back in 1991, I remember there was this Telecommunications Act (also called the Al Gore Act) where that Act invested two or three billion dollars into communications infrastructure. Those funds were used for writing the first Internet browser, Mosaic, and, in essence, it created trillions of dollars of revenue; we are not talking about billions here, but trillions, and as a result, it was probably the best money invested by the federal government ever, because I am sure the tax revenues have exceeded the investment many times over. Has it ever been proposed that medicine and medical research is the Internet of the 21st Century, and that investing in it may create and continue the economic growth of the United States, because you have to be in the technological advantage in order to compensate for more expensive labor in this country?

MR. SPIELMAN: I think that some have framed this that way, and there are countering views. Some look at the financial straits that our government is in and look at cutting, while others see opportunities for investment and for generating more economic activity. There is a point when I talk about these things when I feel that the cost discussion frankly makes me a little uncomfortable, because I never really want to stray too far from the humanistic side. And aside from that, I too am a father of a child with autism, I too am a father of a non-verbal child with autism, and there are any number of reasons why more should be done here, but to me the greatest reason is the reason that we provide care for those who need any kind of assistance, and it’s our sense of community. It’s our sense of who we are as people. But I do have to agree that there are real opportunities here. It’s not as if autism is a condition that affects an isolated species of plankton in a tiny little remote part of the world. This is a condition that affects people all over the world, and the technologies that we bring to bear here, the approaches we bring to bear here will create opportunities. There will be people who are providing services. There will be a new effort. It really is a matter of seizing a chance to do the right thing and do the right thing in the broadest way.

MR. SHENGAOUT: I hear you. I do tend to ask lots of questions about the costs, because the moral and humanistic aspect of this [issue] is so clear. But, because we are in this type of an economic situation, I hoped to shed some light on the economic aspect of this problem that no one has looked at, But, from any angle—humanistic, financial—from any point of view, tackling it with everything we’ve got would make the best sense.

MR. SPIELMAN: I think that it should be recognized that there are many reasons why we should do this, and all of us look at things from a little different view point, and sometimes we are forced to look at it from a little different view point. But it’s the right thing to do. I mean it’s just the right thing to do, and any kind of savings that could be realized by spending less are full savings.

MR. SHENGAOUT: You mentioned that your family is stricken by this affliction, and I know that Peter Bell (Executive VP of Autism Speaks) also has a son who has this problem. Michael Strautmanis from that administration also has a son with this problem. It looks like lots of people who are part of Autism Speaks became part of this movement because they are personally affected by this? Would you say that is a correct statement?

MR. SPIELMAN: I think that that’s a correct statement. I think you know that many of our lives took a bit of a turn because of our experience having a child with disability. I think that’s the way it should be. Forgive me for speaking in a philosophical sense here, but our lives should take a turn, and our lives should be integrated, and my personal experience can perhaps inform other people, and it’s appropriate for me to use my experience in a professional manner. If I can do something that helps people become more aware of autism and makes this society a better place for people who are affected by autism, then I’ve done something that is good in the work place. I’ve done something that is good at home. If I can help my child by helping other children with autism, then I think I’ve done two good things, not one good thing.

MR. SHENGAOUT: I understand. If it’s not too personal of a question, do you mind sharing with the readers or our magazine your story, what’s happened and what have you done? I think that might be very helpful to lots of us if you told.

MR. SPIELMAN: I am an attorney and, when my child was diagnosed, I was struck and thinking—what do I do? I’m not a doctor. I can’t go into a laboratory and do some experiments. What do I know? As an attorney I had received certain training in advocacy, and I understood a little bit about public policy, so I tried to set about using the little skill I had for the best effect. So that’s how autism affected me and continues to affect me, because every day I go home to a young man who has autism. It’s my continuing responsibility to help him, but I feel that one way I can help him is to try to help others with autism. This is what I have been trained to do. You with your literary magazine and each of us in our own way affected by autism, we try to take the sum of our experience and channel those experiences into something that is both personal and something that goes beyond the personal. What is the relevance of this story? We would all like to help and do as much as we can for people, so this is a continuing challenge. How do I take my experience and make it useful for someone else? First and foremost, I want to help my son, but how do I make my experiences work for others as well? Can I do that? That’s a wonderful thing if I can do it.

MR. SHENGAOUT: In many ways, you cannot help just one individual. It just has to be broader than that. So you became part of Autism Speaks after this situation happened to you?

MR. SPIELMAN: Well, my child is 18 now, so, yes. Autism Speaks is much younger than 18. but it’s true.

MR. SHENGAOUT: I guess we have similar experience in this sense. Stuart, thank you so much for your time. I wish you luck and thank you for this interview and all the great work you have been doing with Autism Speaks. I thank you, not only as a member of society, but also as the father of a child with autism.

MR. SPIELMAN: Well, thank you, Misha. I appreciate your interest. The one thing that strikes me is, when I talk with fellow dads, it’s always an interesting experience, because it’s a challenge to think about how to fulfill the role of being a father. It’s something that I keep grappling with as I grow older—am I doing the right thing? What’s the right thing? How do you do the right thing? But I think, if we all work together in our own capabilities, we can make this a better place for our children and for other people’s children. And I hope, at some point, some family somewhere is going to find that it’s not a struggle to get services, that the research is being done, and they won’t even think about this. They’ll just think that this happened very easily. I’m hoping that, at some point, there will be families what just sort of think, “oh, this is what happens, it is easy to get services, they just happen” just like the cell phone happened. So good luck to you and good luck to your son, well, good luck to your child and—

MR. SHENGAOUT: It’s a son, yes. When we talk about autism, it’s a very safe assumption to say “son”.

MR. SPIELMAN: It is. It’s a statistically appropriate leap. But good luck to you and your son and thank you for your interest and your perspective on autism and, maybe ten years from now, we can talk again, and we’ll look at autism as something where society met the challenge, and that services are being provided and that we’ve come a long way. Let’s hope so.

MR. SHENGAOUT: Let’s hope.

Once upon a time there was a boy. He lived at the edge of the forest with his grandmother, who happened to be a kind old turtle. Everyone called him ‘Towheaded^[1] Boy’ because of the fine flaxen hair upon his round head.

Once Towheaded Boy woke up in the middle of the night. He thought that he heard a sweet, clear voice calling to him “Follow me! Hurry!”

Towheaded Boy was just about to run outside, as dark and scary as it was, when Grandma Turtle stopped him: “Be patient,” she said, “That’s just the South Wind flying to the Southern Land. You’re too little to go that far from home yet. Now go back to sleep.” So the boy went back to bed and fell sound asleep.

Some time passed and again, in the middle of the night, the boy seemed to hear someone calling to him, “Fly with us! Hurry!”

The boy ran out of the house and there, high in the sky, he saw birds flying by, flock after flock. Towheaded Boy began flapping his arms but that didn’t get him off the ground. Not all boys can fly.

And that’s exactly where Grandma Turtle found him – standing on the edge of the forest, watching the birds fly away. So she took him back home and put him into his warm bed.

“Sleep tight—you’re still too little. The time will come for you to see the lands where the wind was flying, where the birds were going, and the lands where even the wind and birds never go.

“But when will it come, this time of mine?” Towheaded Boy asked impatiently.

“Soon!” answered Grandma Turtle. “The dwarves will call you. Just grow up a little bit more and they will call you.”

And that’s exactly what happened. One night Grandma Turtle woke him up.

“Do you hear it?” she asked.

At first the boy thought that everything was quiet, but then he listened more closely and heard a silvery chime.

“Be sure to dress warm and don’t forget to put on your scarf,” said Grandma as she rushed him along.

They left the house and started walking across the glade, with Grandma leading the way and the boy following her.

The silvery chime was getting closer and closer as the dark glade opened up into a meadow. Among all the flowers in the meadow—the bluebells swaying on their long stalks that looked like a stork’s legs, the lilies, the tulips, the daisies—shone yellow, blue, and pink lights.

“Grandma! Grandma! Look at the stars in the flowers!” shouted Towheaded Boy in excitement.

“Those aren’t stars,” replied Grandma Turtle.

Her turtle feet rustled in the grass, her breathing was labored and the reflections of the colored lights in her shell were blurred by its deep, wrinkled cracks.

“Those aren’t stars, they’re fireflies. They shine their light to help the dwarves forge their keys.”

The fireflies glowed brighter and brighter. And the silvery sounds that he thought were chimes coming from the meadow weren’t chimes at all. It was now apparent that this was the sound of hammers on anvils. The first hammer was making a thin sound—ding-diddly-ding-ding. The second one was beating just a little louder and less frequently—bing-bong-bing-bong. The third one struck only once in a while and was the loudest of all—Bam-Bam-Bam!

The dwarves were singing to the sound of their hammers:

The dwarf upon his anvil—Boom!
“Now Spring has sprung, the Earth’s in bloom!”
So say the ones who fly and crawl,
The ants and beetles and butterflies all!
And those who slept, now they do sing
“It’s Spring! It’s Spring! It’s Spring! It’s Spring!”

It’s Spring: the cat, he lurks about,
While hoping that a mouse comes out.
He waits, but what a clever mouse!
She safely stays inside her house!

And last of all the blind old mole,
He pokes his head out from his hole.
Get up! Get up! Come hear the song!
Come one and all and sing along!

In the meantime, Grandma Turtle had finally made it to the creek in the middle of the meadow. “Look!” she said to the boy when she had finally managed to catch her breath.

On the other side of the creek, among the bluebells, there were three anvils: the first one was small and green, the second one, which was a little bigger, was red, and the third one, the biggest, was made out of diamond.

A tiny dwarf in a green apron crouched over the green anvil. On his head he had a green knitted cap with a long tassel hanging all the way down to the ground. In front of him on the green anvil lay a green key. He was striking it rapidly with a green hammer that was so tiny it almost looked like a toy.

To the “Ding-ding-diddly-ding” of his hammer, he sang with his thin voice:

The dwarf upon his anvil—Boom!
“Now Spring has sprung, the Earth’s in bloom!”
So say the ones who fly and crawl,
The ants and beetles and butterflies all!

Right next to the anvil stood a green pine tree with fireflies twinkling on every branch like lights on a Christmas tree. However, unlike Christmas lights, the fireflies jumped from one branch to another, singing along with the green dwarf:

And those who slept, now they do sing
“It’s Spring! It’s Spring! It’s Spring! It’s Spring!”
The babbling brook, the crawling ants,
The birds, they warble, the butterflies dance,

“It’s Spring! It’s Spring! It’s Spring!”
Whether you crawl or fly or sing,
For you, for you, it’s Spring!

At the red anvil stood a larger dwarf in a red apron, who was the green dwarf’s brother. With his red hammer he beat on a red key, which sparkled like a ruby. The red dwarf was wearing a red knitted cap with a tassel hanging all the way down to the ground, and he had a red beard. His red hammer was beating out a forceful “Bing-bong-bing-bong” on the red key, and he was singing to the sound of his hammer:

Even the mole no longer sleeps,
And from his hole he softly creeps.
And once a year, on this dark night,
He looks about and sees our light.

As for the cat, who’s lurking still,
He’ll never get to eat his fill.
And will he catch the mouse today?
No, no, she always gets away!

And while you wait, Spring says goodbye,
And your whole life, it passes by,
Why do you wait, Cat, tell me why?
Perhaps you’re really not so sly!

What will we have to show for our fun
When life as we’ve lived it is over and done?

His anvil stood under a maple tree and an oak tree with their red and green leaves. Red fireflies dangled on these trees like Christmas lights. But unlike Christmas lights, they were flying back and forth and singing along with the dwarf in their high-pitched voices:

Upon this night, so dark and clear,
The only time in all the year,
Upon this night, so dark and late.
To you shall be revealed your fate.
A distant journey awaits the birds
For boys as well are true these words.
A distant journey, a wondrous way,
From which you may not turn away!

You’ll face the doors upon your walk,
Be wise and choose the proper lock!

Every choice that you make
Leaves something in its wake.
When the star burns bright
A wise man follows its light.

At the diamond anvil stood an old dwarf in a white apron and a white cap with a tassel to the ground. He had a long white beard and was the oldest of the three brothers. He was striking his hammer slowly and forcefully on the diamond key lying on his diamond anvil—Bam-Bam-Bam!

There were no trees next his anvil and no fireflies in the grass or flowers around him. But there were stars twinkling in the sky above his head.

As he was banging his hammer, the dwarf with the white beard did not sing, but rather recited in a hollow voice:

Upon this single fateful night,
Beneath the wondrous starry light,
Your guiding star you shall behold,
And your true path, it will be told.
And you must follow this guiding light,
And never lose it from your sight,
For he who from this path doth stray,
Will never find the star’s true way.

“Catch!” shouted the youngest green dwarf in his thin voice as he threw the green key across the creek. After the boy caught the key, the green dwarf called out again, “Whatever you do, don’t open the crystal trunk with the green jewels in it!”

“Catch!” shouted the middle brother, the red dwarf with the red beard. He threw the red key across the creek and then added, “Watch out and don’t try opening the crystal trunk with the red jewels!”

“Catch!” quietly said the oldest, white-haired brother-dwarf in his low, deep voice as he threw his diamond key across the creek. And then he added, “Make sure you don’t open the crystal trunk with the diamonds in it.”

No sooner had the old dwarf uttered these words, than the meadow disappeared right before his eyes. The night was over, gone were the fireflies and the dwarves, and only the field with the bluebells remained. And a path through the field. And a star above the path.

“Grandma!” called out the boy, but she had vanished too. He started crying, but then wiped away his tears—he was a boy, after all.

Even though it was already daytime and the sun was out, the star still burned with a bright green light.

The boy followed the path toward the star. He kept walking and walking until the sun started beating down on him. “It’s getting hot,” he thought.

No sooner had he thought this, than right in front of him appeared a green forest with mighty oaks, firs, and birches. The trees were so old and their branches were so tangled that it was impossible to enter the forest.

Although it was already noon, the green star kept on shining just like before. In fact it was shining right over the top of one of the oaks. The boy looked very closely and saw that there was a hollow in the oak tree. The hollow had a little door that was all covered with moss and on the door was a little green lock. Towheaded Boy pulled the green key out of his pocket, put it in the lock, and turned it. The door opened.

Out of the hollow scampered a squirrel with a long fluffy tail. “Let’s go play!” she called out to him. The forest parted to let them in, which doesn’t happen all that often!

The squirrel ran along a mossy trail from one tree to another, and the boy ran right after her. When he was tired of playing, he said, “I’m thirsty!”

The squirrel tapped a mossy mound with her long tail. She tapped it very lightly, so that the mound wouldn’t get hurt. Next to the mound, a clear spring burst forth out of the ground.

“I’m hungry!” said the boy, when he had his fill of water. No sooner did he say these words, than a loud voice rang out from under an oak tree: “If you please! If you please!”

The brush under the oak moved and a huge old bear climbed out of his lair. The boy got scared, but the bear was grinning from ear to ear and he held honeycombs full of honey in his paws. And the boy’s fear immediately disappeared.

After he had eaten his fill of honey, Towheaded Boy said, “I’m tired and would like to take a nap.” A finch jumped out of her nest and chirped, “Lie down on the grass in the shade next to the creek and I’ll sing you a lullaby.”

The boy made himself comfortable and the finch started to sing. It had a beautiful voice. But before the boy closed his eyes and fell asleep, he saw a crystal trunk in the grass just on the other side of the creek. It had a green lock and was filled with green jewels.

Forgetting everything, he jumped up and ran to the trunk.

The key broke off in the lock, but Towheaded Boy didn’t get upset. In fact, he didn’t even notice. He threw back the lid of the crystal trunk and started stuffing his pockets with fistfuls of the shiny, emerald-green gemstones.

But when he turned back around to brag to Squirrel, to Finch with her beautiful voice, to Creek and to Bear, especially to Bear, of course—when he turned around, the forest was parted no more, and the branches of the old pines, oaks and firs were tangled again.

There was still a hollow in the oak tree, and the hollow still had a little door with a green lock, but he couldn’t open it because his key was broken. And there was no spare key.

A field full of bluebells stretched out in front of him. A little path cut through the field. A red star was shining above the path.

The boy sighed and even cried a little. It’s no fun to be left all alone. First his grandma had disappeared, and now Creek, Squirrel, Finch, and Bear were suddenly all gone. After he was done crying, he wiped his eyes and started walking down the path.

Back in the forest, Creek said, “What a strange boy! He didn’t even notice how good my water tastes!”

“And he didn’t even thank me for the honey, and it’s really good honey!” Bear growled and licked his lips.

Squirrel added quietly, “He played with me for a while and then forgot all about me.”

“He didn’t even finish listening to my song, and I was really trying my best!” said Finch, “What a strange boy!”

“He is not strange, really. It’s just that he is ordinary, with nothing miraculous in him”, quacked Wise Duck, who had gained her wisdom by flying around the world many times and visiting many lands. She had been swimming in the creek quietly and preening her feathers without taking part in the conversation.

“My babies were also just ordinary. They didn’t listen to me and kept on falling out of the nest. But I loved them more than anything else in the world,” sighed Finch.

“So were my little squirrels…”, added Squirrel.

The wise old duck interrupted fiercely, “No! No! There must be at least something miraculous in everyone!” Usually nothing could upset her unless she saw a hawk flying above her ducklings.

“Last year our flock flew over the house where that boy lived with his Grandma Turtle, who happened to be a very kind and worthy individual. The boy ran out into the meadow and flapped and flapped and flapped his arms. No matter how hard he tried, he couldn’t get off the ground to come with us.”

“Grr-rrr!” growled Bear. He began to flap his huge bear paws around and around as if they were windmill blades. He flapped them so hard that he stirred up a great wind in the forest. The young trees bowed down and their tender new leaves were torn from their branches.

He kept jumping up and flapping his huge paws, running short of breath. Now and then he asked Duck, “Grr-rr, what about me? Am I getting off the ground? Even just a little bit?”

“No, you are not getting off the ground”, replied Duck. She just didn’t know how to lie.

Once Bear had settled down, Duck said, “Still, there is something miraculous in you. Look, you gave that boy your honey, even though you love honey more than anything in the world!”

“Grr-rrr!” growled Bear, licking his lips.

“And you, Creek, gave the boy such delicious water to drink,” Duck continued, “And you, Finch, thought up a song for him. And you, Squirrel, you dropped everything, as busy as you were, just to play with him.”

“Yes, yes, I am so busy!” exclaimed Squirrel in a panic as she darted back to her nest.

“There is something miraculous in everyone,” quacked Duck as Squirrel rushed away.

“Let me fly to Grandma Turtle and let her know that her grandson is alive and well,” thought Duck as she flew up above the forest. “She must have cried her eyes out worrying about her Towheaded Boy.”

And all this time the star continued shining in the midday sky, although not as bright as before.

Towheaded Boy followed the path toward the star, but he was feeling a little down. What good is it to be alone, with a pocket full of the most amazing, sparkling green stones and no one to show them off to?

He was busy feeling sorry for himself when suddenly he saw a girl right in front of him. She had a long golden braid and blue eyes, and she was wearing a red chain with a tiny red lock around her long white neck.

But the boy didn’t give her a second look – blue eyes, a braid, big deal! He pulled two handfuls of emeralds out of his pocket and held them out in his upturned palms, taking a step back to make sure the girl couldn’t snatch them from him.

“Who knows? All girls have a weakness for shiny things, just like crows,” he thought to himself, and then said:

“Look what I’ve got! And there’s plenty more where they came from!”

“Yuck! Frogs! How disgusting!”

“You’re a frog yourself!” he shouted. But when he looked in his hands all he saw, indeed, were baby frogs. They were crawling about and hopping off his palms down to the ground. They were coming out of his pockets too.

“For someone so big, you’re pretty silly,” the girl said. “You aren’t a boy any more. You’re a young man now. It’s time to start using your brain.”

He got mad and shouted, “Silly, you say?! I’ll show you!”

He could clearly see the tiny red lock in the chain around her neck. He ran up to her, key in hand, and with a single turn he opened the lock. The chain dropped to the ground, but the girl didn’t even notice.

“No, you aren’t silly at all,” she said slowly. She smiled, and it made her look so stunningly beautiful that it took boy’s breath away.

Right then Duck (that very same Wise Duck) was flying over the two of them, thinking, “It looks like something good might come from that knucklehead after all. I’ll just fly over to see Grandma Turtle and tell her what good fortune has befallen her grandson. A few hundred miles isn’t that far out of my way. And his grandmother, such a worthy individual, will be so happy she’ll feel a hundred years younger!” So Duck flew off to give Grandma Turtle the news.

Down below, the girl was still standing there and smiling. Her eyes were glued to the young man as she said, “No, you’re very smart, and kind, and strong. It’s not easy to move frogs from one swamp to another. That other swamp must have dried up and you took pity on them. You’re just wonderful! If you want, we can be friends for the rest of our lives.”

She stretched out her hand and said, “I know they used to call you ‘Towheaded Boy’ at home. See, I know all about you. Hello, Towheaded Boy!”

He wanted to take her hand, but, as luck would have it…

Yes, as luck would have it, at that very moment he noticed a crystal trunk full of sparkling red rubies. And off he went.

“Hold that thought,” he said to the girl.

Perhaps he wanted to give her rare and beautiful gemstones as a present. Perhaps. Or maybe the sight of the jewels made him forget about her altogether. Just like before when he’d forgotten about Grandma Turtle . And Squirrel. And Creek. And Finch. And Bear. Otherwise, why didn’t he look back as he was running to the trunk, not even once? If only he had looked back, everything might have turned out differently.

Oh, if only he had looked back…

He ran over to the trunk and opened it. And wouldn’t you know it, as he was opening it, the key broke off in the lock. But this time he didn’t even get any jewels! All he saw under the lid were red bugs, not gemstones!

The bugs crawled out of the trunk and scurried off into the grass. Soon all of them were gone. Only then did Towheaded Boy look back. But the girl was no longer there. The field was empty. The sun was beating down. The star he’d been following was still visible, but now it shone with a dim white light.

How did Towheaded Boy feel? He felt older. Maybe by ten years, maybe by a hundred.

Meanwhile Duck had reached Grandma Turtle’s house. Grandma Turtle was still sitting on the porch and gazing off into the distance. “Phew! I’m tired!” Duck quacked out, “It looks like things are looking up for your grandson. Pretty soon you’ll be playing with great-grandchildren!”

“Really?!” Grandma Turtle brightened up, “Oh, I always knew that he’d meet his princess and she’d fall in love with him. After all, who deserves love more than he does?”

Duck politely said good-bye, but she was thinking to herself, “I don’t know about a princess—somehow you just don’t meet too many of them among us ducks. But if you ask me, I’d fly as far from that boy of hers as possible. Anyway, that’s none of my business. Those things are for the young—my life has already been lived.”

Towheaded Boy walked along the dusty road under the hot sun that just wouldn’t set. He kept checking in his pocket for the only key he had left, the diamond one.

He felt sad, lonely, and miserable. Maybe he wasn’t that bad after all…

The only thing around was the dry, brittle grass and the white star shining in the sky.

Towheaded Boy looked up and beneath the star he saw a long, high, white wall that seemed to stretch out forever. The wall was covered with barbed wire. Right in the middle of it was a diamond gate that sparkled so brightly it was hard to look at. The gate was locked with a diamond lock. On the inside, old people and women and children were clambering up the walls and begging, “Open the gate, stranger! You have the diamond key. We’ve been dying for years with no food or water. Open, please!”

Next to the gate stood a crystal trunk. It was filled with beautiful diamonds, the likes of which no one had ever seen.

Again and again the women, the children, and the old people cried out, “Open, please!” while clambering up the wall. They would fall down and then start climbing up again, their hands covered with bloody cuts from the barbed wire. “Open, please!”

Towheaded Boy took a step toward the gate. Of course he took a step. But just then he saw guards with axes darting toward the trunk. He thought to himself, “They’ll snatch the trunk away and then I can kiss it goodbye forever. Oh, no, they don’t!”

And that’s why he didn’t open the gate in that endless white wall.

“Wait!” he kept on shouting while opening the trunk hastily. “Wait just a little longer.” He was in such a rush that, needless to say, the diamond key broke off too.

He opened the lid of the trunk wearily, almost reluctantly, and when he did, he saw that it was filled not with diamonds, but with beautiful sparkling dewdrops… Or could they be tears? Who knows…?

These dewdrops—or tears—quickly dried up. After all, the sweltering sun was burning very brightly. And then the trunk was empty.

When the boy looked around, he saw that there was nothing in sight: no guards with axes, no diamond gate with a diamond lock, no endless white wall covered in barbed wire. Only withered yellow grass remained.

And the star was no longer shining in the sky.

The echo of the screams “Open, please! Open, please!” rolled over the dry grass. Or was that just the crickets chirping? Who knows?

He stood for a while and then started backtracking along his own trail. Where else could he go? He slowly trudged along, dragging his feet. He walked for a long, long time. He went around the forest, and finally the night fell upon him. In the distance he saw a meadow with fireflies that glowed like stars.

He was so thrilled to see it that he picked up his pace. He walked up to the creek and saw the three dwarves—the youngest brother, the green one, the red-bearded middle brother, and the oldest brother with the long white beard hanging all the way to the ground.

“Dear dwarves!” said Towheaded Boy in a weak and wavering voice. “Give me the keys one more time. This time I’ll be wiser and I won’t break them.”

Ding-diddly-ding-ding. Bing-bong-bing-bong. Bam-Bam-Bam! The dwarves pounded on their anvils, forging their keys.

“We only give keys to little boys,” the little dwarf said without taking his eyes off the anvil.

“But I am a boy. Don’t you recognize me?”

“Take a good look at yourself!” quacked Wise Duck, who was swimming in the creek.

Towheaded Boy looked in the water, at his reflection surrounded by fireflies, and saw an old man with a wrinkled face, sunken eyes and a gray beard.

He turned his back to the creek and started walking aimlessly, wherever the glade would take him.

What’s done is done. As they say: “A bell, once rung, can’t be unrung”.

And Duck, as tired as she was after returning from Africa, dragged herself into the air and flew off to see Grandma Turtle. “You’ve got to do what you’ve got to do,” she thought to herself.

When she reached the house, she quacked out to Grandma Turtle, “Your boy is coming home. Go out to meet him—he won’t find the way on his own.”

Grandma Turtle was very old. Her shell had turned completely gray and was all covered with deep wrinkles and cracks, so that it no longer reflected the sun, or the stars, or the fireflies. She was almost blind with age, but she perked up and asked, “Is he bringing his princess and their little princes?”

“I’m sorry to say so, but no,” Duck quacked hesitantly. This time she really wanted to tell a fib, but what can you do if you just don’t know how to lie? “No, he has neither a princess nor little princess with him.”

“It doesn’t matter. It’s still a blessing that he’s coming home.”

Wise Duck thought to herself, “That must mean that there is, or there was, something miraculous in him. If someone loves a duckling or a boy this much, he just has to have something miraculous in him, even if just a little bit.” She took off flying, wearily flapping her old wings in the darkness.

Grandma Turtle stepped out of her crooked old house, which had sunk into the ground almost up to its windows, and trudged across the glade toward dwarves’ lights and the sound of their song.

She was old and weak, and with each step she took she wasn’t sure whether she’d have the strength for another. She could barely see anything, and yet she still managed to find her grandson in the middle of the huge dark glade. She recognized the sound of his footsteps, even though he was dragging his feet. She also knew the sound of his breathing, although it was heavy and wheezing. Who knows how she recognized him? But it doesn’t really matter.

In any case, she did recognize him and, just like before, called him by his childhood nickname, “Towheaded Boy! Come on. Let’s go home. It’s already late! You stayed out so long today!”

Once they got home, she gave him some hot milk and put him to bed, the very bed that he’d left the night the dwarves had called him. It was actually too small for him now, but when his grandma tucked him in, he curled up, all warm and cozy, and soon fell asleep. He was smiling in his sleep. He dreamed that he was the Towheaded Boy again, a little boy with fuzzy blonde hair playing in the meadow in front of Grandma’s house.

When he had fallen asleep, Grandma Turtle stroked his face gently with her shriveled old turtle hands, tracing them along the wrinkles on his forehead, his cheeks and around his eyes. In these wrinkles she could read the story of his whole life as if they were the lines of a book. She saw how the forest first parted for him and then closed back up. She saw how the princess almost fell head over heels in love with him, but then disappeared. She saw how the diamond gate remained shut, the gate to the city with the dying people surrounded by the endless white wall and the barbed wire.

The boy slept.

“It’s all my fault,” his grandmother thought bitterly, “If I had told him more fairy tales, he would have recognized the miracles along his way and wouldn’t have paid any attention to those stupid trunks.”

Towheaded Boy was breathing peacefully and quietly in his sleep.

“It’s all my fault,” his grandmother thought bitterly, “I should have told him more true stories about real life.”

Towheaded Boy slept.

* * *

I told this story to my own little boy. He was blond then, with beautiful golden curls that made him look rather like a little girl. He was beautiful, but also a little bit naughty. We had a standing deal that I would tell him a story and he would go right to sleep.

But when I was done, he opened his huge green eyes, which were just like his mother’s, and said to me, “That’s not a fairy tale at all! I’m not asleep, I’m not going to sleep tonight and I’m never ever going to sleep again!”

Well, I could see that he was having a hard time keeping his eyes open, so I wasn’t really concerned about his little outburst.

“Why isn’t it a fairy tale?” I asked him.

“Fairy tales always have a happy ending,” he replied.

“This one also has a happy ending, doesn’t it? Everything turns out just fine. Well, almost everything,” I objected. “Grandma Turtle is alive—that’s the most important thing, isn’t it? And in her mind her grandson is still the same Towheaded Boy. She can’t see very well because she’s so old, but she remembers everything pretty well.”

“But … the keys … they still … they still got broken!” said my boy.

“So what? You, however, will be wiser. After all, soon the dwarves will be calling you too.”

He didn’t answer. He was already fast asleep.

I went outside into the yard. The crows were returning and getting settled in their old nest.

In my mind, I kept on asking my little boy, “What about you? You aren’t going to break those keys, are you? If you keep them intact, then everything will turn out fine. It may be hard and it may take a while, but, in the end, everything will be okay. You won’t break the keys, will you?”

You know, when you listen to crows, it sounds as if they’re arguing, but that’s just because they have such loud voices. They’re really just talking about everyday things. That night, when I was out in the yard, one crow was complaining, “Our nest started leaking over the winter. But that’s no bother—look at the thick branch I’ve found to fix it with! God willing, I’ll be able to drag it over there. I’m not getting any younger, you know!”

The younger crow replied, “I came across such an amazing goose feather—it’s all fluffy and fuzzy. You know, they say that in the old days people used to write fairy tales for their babies with feathers like that. When my baby is born, he’ll sleep tight in the bed I make from those feathers and he’ll dream sweet dreams!”

But just as she finished saying this, all the noise from the birds and the wind ceased and I heard the distant sound of the dwarves’ song:

“The dwarf upon his anvil—BOOM!”

“The dwarves are calling my boy,” I thought as my heart anxiously trembled with a mixed feeling of joy and fear. “What will he be like when he returns home?” No sooner had I thought this, than my boy came out onto the porch. He had washed up—even though he didn’t really like to wash—and he was already dressed for the road.

He looked at me and asked, “Is it time?”

A thought occurred to me: “It’s good that you have your mother’s kind, honest, green eyes. And it’s good that you know the story of the three keys—a story doesn’t take up any space and doesn’t add any weight onto your shoulders.”

“Well, is it time?!” He asked again impatiently.

I looked at him intently, trying to fix in my memory exactly how he looked at the very moment when he was starting out on his own path. I also tried to dig up vague memories of my own path, which is now approaching its conclusion.

“Umphf! I’ve finally managed to drag that huge branch over here,” said the old crow hoarsely. “I thought I was going to have a heart attack. But now my nest will have a decent roof!”

The younger crow chimed back, “And look at this little goose-feather bed! The only thing I have left is to lay my egg and wait for it to hatch—that’s all there is to it!”

My boy and I walked through the gate out into the glade.

Far off in the distance we could see a meadow. There were hundreds and hundreds of fireflies in the grass, on the flowers, and in the branches of the trees, all glowing in different colors. The dwarves were at their anvils, pounding out “Ding-diddly-ding-ding. Bing-bong-bing-bong. Bam-Bam-Bam!” and singing their song:

“Now Spring has sprung, the Earth’s in bloom!”
So say the ones who fly and crawl,
The ants and beetles and butterflies all!
And those who slept, now they do sing
“It’s Spring! It’s Spring! It’s Spring! It’s Spring!”

It’s Spring: the cat, he lurks about,
While hoping that a mouse comes out,
He waits, but what a clever mouse!
She safely stays inside her house!

And last of all, the blind old mole,
He pokes his head out from his hole.
Get up! Get up! Come hear the song!
Come one and all and sing along!

And on this single starry night,
You’ll have your fate within your sight.
And all through life take heed – to wit,
Your fate is what you make of it.

I thought, “Have I told you everything?” I could barely keep up with my boy who was galloping ahead of me on the trail through the glade.

All the while the dwarves were singing their song, and this was all that my boy could hear.

What will you be like when you come back home, my boy?

Copyright © 1957 Александр Шаров
This Translation Copyright © 2012 Tower of Harmony, LLC
All Rights Reserved, used by permission

My mother told the same story about her brother Mac so many times she made him a legend in his own time. Legend or loser, sometimes I can’t make up my own mind which letter “L” fits him best.

In the 1940s, my Uncle Mac studied ballroom dancing. If you’ve ever watched Dancing with the Stars, Mac could have been any one of those slender men with picture-perfect posture, slicked-back shiny hair, tight butt, gliding a skimpily-clad woman onto the dance floor. The precision of his movement, his grace and ease, his muscular torso could make a woman do crazy things. And Rachael McKenna had been driven insane with her desire for him.

Rachael’s encounter with Mac took place on an East Village street corner, Christopher Street and Broadway, directly beneath the dance studio where Mac practiced every Saturday. The story goes that Rachael McKenna strutted up to Mac in a most demure way, like Greta Garbo, sashaying over to where he stood that balmy summer afternoon.

My mother swears that Rachael McKenna lured her brother back to her apartment on the lower East side of Manhattan. It seems Mac never made it up the long flight of steps to the dance studio for practice that day with his regular partner, and somewhat sweetheart Gina. He seems he never even gave Gina the benefit of a cancellation.

Rachael, knowing that this might be her only chance to lure Mac away from his star-studded dance partner, thrust her arm into Mac’s and walked joyfully away from Christopher Street.

At her apartment, and I can’t even image how my mother knows all of his, Rachael hiked up her satin black skirt up over her knees, and crossed her legs. She teased Mac sitting comfortably on her white leather couch, to come hither using her index finger to beckon him. Mac, like a man hypnotized by a rare perfume, rose from his seat opposite Rachael from the parlor chair, walked across the room and sat alongside the provocative beauty.

Rachael’s body possessed smooth fine lines and defining curves in all the right places. Her hair was as thick and as black as a raven; ringlets framed her porcelain face. Her eyes were a deep brown with yellow flecks in the irises. They peered into Mac’s eyes looking like two rare gems.

Rachael reached for a bottle on the cocktail table in front of her and poured out two golden thimble-sized portions of single-malt scotch. She handed Mac the small glass. Their eyes connected in a silent toast while Rachael smiled coyly at Mac flapping her big bedroom eyes. Mac put the shot glass to his lips and just sipped at first. He had never tasted scotch as smooth as velvet before. He tossed the golden liquid back and swallowed, the fire in his belly went straight to his head. Mac looked into Rachael’s stunning eyes and her beautiful face. She certainly knew how to intoxicate a man. And Mac, a sweet innocent boy, just barely eighteen, couldn’t help but give into her prowess. Before Mac knew what happened, the sun went down over the East River as tug boats blasts woke him to his senses in none other than Rachel’s bed.

It was seven o’clock in the evening. His mother, my matronly grandmother, and old-fashioned busy body, hid beneath the drawn drapes on the second floor landing hoping neighbors wouldn’t see Mac stroll in after the dinner hour. Everyone in the Italian ghetto knew the house rules, very similar to their own. And tonight Mac broke one of the oldest of the house rules; everyone must be seated at the dining room table when Papa comes in from a day’s work at the factory.

My Mother recalls for me her mother’s clasped hands in prayer, behind that window, that Mac would get into the house before the Papa or he’d owe Mama big time for a cover-up. In the Romano family, you didn’t want to owe Mama nothing. She was worse than Shylock, the scorned Jew, in the Merchant of Venice.

Finally, Mac whipped through the front door only minutes before his Papa. Mama looked at him with blazing eyes, greener than the Caribbean, but deeper and darker than midnight. She tugged at his ear, her only boy, her prized possession, and marched him to the table at the snickers of my mother and three other sisters.

“Mama,” he apologized, “I’m so sorry, the lesson ran late. Gina introduced me to a Broadway producer,” he lied. “I danced for him, Mama. He really liked me, Mama. He said I was going places, Mama.”

She unhooked his ear, now the color of a newly picked strawberry, and Mac fumbled, quite ungraceful in his stance, and sat in his usual seat near the head of the table where Papa always sat.

“You’re in trouble,” his sisters chanted. “You’re in big trouble.”

“Sta zita,” Mama said in their county’s tongue, forbidden by Papa at the table, who wanted his children to speak only English. “I say if he’s in trouble,” Mama said staring at her daughters. “No!” she exclaimed, “your brother Mac has done well, and we will tell Papa of his good news after dinner.”

The four sisters made sour faces at Mac. And Mac, still not comfortable with the lie he had told, did not respond. He put his head down as if to pray for the good food they were about to eat and didn’t look up again until Papa walked through the door.

“My children,” Papa said smiling broadly from ear to ear while removing his cap. “Today was a good day for our family. Today I had a visit from an artist friend who will come and paint your portrait.” Papa held up a glass of wine Mama had already placed on the white linen tablecloth in front of him. “To my five precious American born who will do great things in this country, yes?”

“Yes, Papa,” they all answered.

“Good. Girls, go help your mother.” The girls rose in unison, assembly-lined the bowls filled with pasta and roasted pork to the table.

“Mac, pour a glass of wine,” Papa said, “and tell me about practice today.”

The lie now became embellished with a story of a producer who lived in the Village who after seeing Mac’s practice session with Gina had invited Mac to his apartment to see pictures of all the clients he represented on the stages of Broadway. Papa looked gratified at his only son, feeling satisfied that the money he spent on Mac’s instructions had been well placed.

As my Mother continued this tale of her younger brother Mac, I knew from past telling of stories, that my Grandfather Marco had indulged all of his children and not just Mac. The girls always had the latest in fashion and jewelry. I even possessed one of the cameo broaches he bought for his daughters to signify their wealth in America.

On the wall of my Grandparents’ dining room, still today, hangs the studio picture of Mac, with Gina in his arms, taken by a renowned newspaper photographer. The evening of the ‘big lie’ Papa pointed to the picture as he fetched a cigar out of his vest pocket.

“Is Gina excited that the two of you might collaborate on a Broadway stage?” Papa asked. Mac did not expect Papa to ask such a question, and did not have an answer at hand.

“What is it, Mac, did the producer say Gina was not good enough to dance on Broadway?” Mac thought for a few seconds that perhaps Papa had given him the answer.

“Papa, Mr. Ziegfeld did not say anything about Gina dancing in the follies. He only spoke of me as becoming a tap dance routine with a chorus. After all,” Mac continued boldly, “Gina is a dance instructor, not a celebrity.” Mac embellished the story so much that he’d have to write down all of these lies when he got into his bedroom in order to continue the charade.

But the charade would not last long, a couple of months at best, when Rachael would ultimately find Mac on Christopher Street puffing on a cigarette. Only this time not only would the weather turn cold.

Bundled up in a huge camel color coat, Rachael annoyed with Mac asked, “Why haven’t you returned my calls?” Mac looked stunned. “You called my house?” he asked.

“No,” she said, “I’ve spoken to your Papa at the pasta factory. Mac choked on the smoke he inhaled. “I didn’t give my name. I just said I had danced with you recently. I’m surprised no one told you.” Mac mulled this news over in his head momentarily, now spotting Gina walking toward them from Broadway.
That’s when Mac’s life got even more complicated. Gina obviously had seen Rachael in the studio watching Mac dance and now here’s Mac in a romantic huddle with this woman. Gina gave Mac a look of disgust and made her way into the studio.

“Rachael was a twenty-two year old woman, and Mac was a stupid eighteen-year old boy,” my Mother said, going over the story one more time. “Stupid boy,” my Mother reiterated, making her point. “My father,” she continued, “he thought Mac was his golden boy; the boy who would bring fame to the family. Do you know how your grandfather felt when he found out the truth?”

“No,” I said, “but I bet you’re going to tell me.”

“Don’t be fresh,” she said, giving me a nasty look. “These were painful times for our family.” I knew at this point of the story my mother would cry. She always did. I pulled out a wrinkled tissue from my pocket and handed it over to her. She wiped her face, blew her nose, and composed herself. Even though I had heard the story a hundred times, my mother always insisted on finishing it with this last zing.

“She wore a white dress and walked down the aisle of a church, that tramp of your aunt, and had me in the wedding party to boot. Doesn’t that beat everything you’ve ever heard in your life?”
“Yes, Ma,” I said. “Aunt Rachael has big ones,” I added, knowing it would make her feel better.
Poor Uncle Mac, his dance career ended abruptly and permanently. Papa said Mac would have to learn the hard ways of the world now that he was going to be a father himself. Mac would have to go to work and fend for his own family.

My mother now reminds me again that Papa lived only a few months after that blow to his heart. My mother says she’ll never believe what the Doctor Russo said about Papa having a damaged aorta. In her mind, she will always believe that her father died of a broken heart.

The way Aunt Rachael tells the story of my grandfather’s death is so different from my mother’s version. Aunt Rachael says, “Papa died before knowing he had a grandson.”

Of course, the baby was born seven months after the marriage with the white dress walking down the aisle of the church. Rachel said, “He was the tiniest of babies that I struggled to bring into the world. I named him Marco just for Grandpa.” I never repeat the words of Aunt Rachael’s side of the story to my mother, as I’m afraid for my life if she has a sharp object in her hand.

Fortunately, there are books with the opposite effect. Rather than taking you away from the reality, good fiction makes it more appealing. A good book of fiction uses colors that may not be available in real life’s palette, taking its hero into the situations not possible in the real world. Space ships and magic wands are but decorations to the bright and salient portrait of human character. When you close such a book, the spaceships or magic wands may go, but the yearning for a sense of purpose and the inspiration to become a better person will stay long after you finish the last page.

Deed Of Paksenarrion trilogy - book cover

“The Deed of Paksenarrion” is just such type of fiction. It is the story of a young girl (Paksenarrion) growing from the humble origins as a sheep farmer’s daughter all the way to a holy warrior, paladin, with the ability to recognize the good in the world and making it happen. The world in this book has magic in it; however Paksenarion’s doesn’t have any magical abilities. Neither does she kill dozens of enemies with the swipe of a sword. Paksenarrion’s strength comes from her character.

Sheepfarmer

The story is divided in three books. In the first book, “Sheepfarmers Daughter”, Paks (short for Paksenarrion) runs away from the arranged marriage to join one of the few military companies that take women soldiers. At this time there is nothing extraordinary about her except having enough courage to run away from home. Elizabeth Moon’s description of the military training is remarkably realistic. The details of the medieval weaponry, training and tactics are good enough to be used as a textbook. The author’s personal experience in the military has clearly helped her to depict the psychology of the recruits and conflicts within the military. Paks faces problems and makes difficult choices, loses friends and acquires enemies. She gradually changes from being a simple peasant girl into someone who is ready for her next station in life.

Divided Allegiance book cover

In the second book, “Divided Allegiance”, Paks is no longer a soldier doing her commanders’ bidding. She finds herself in a more independent role, having to face many more choices. It is impossible to mention her victories and defeats without spoilers. It is sufficient to say that Paksenarrion is pushed almost to the breaking point which, as it often goes, gets strengthened and transformed. This transformation is written out very skillfully, without looking artificial or contrived. In this book there is less emphasis on the detailed sword fighting and military action; magic and magical creatures make their entrance. There is even a religious conflict added to the mix.

Oath Of Gold book cover

In the third book, “The Oath of Gold”, Paks finally becomes the person who is ready for the divine guidance. This guidance is not something that is given, but something that is taken upon. Bringing goodness into the world is the only reward of becoming a paladin, and growing up to recognize that it is a reward is a prerequisite of becoming a paladin. Transformed Paks knows where her help is needed, but she influences events largely through the strength of her personality. Elizabeth Moon has managed a rare writer’s feat. She has produced a realistic and a colorful portrait of a saint – and did it without any religious context! In this sense Paks reminds heroes of “Narnia Chronicles” and “Out of the Silent Planet”, except here the author has shown not only the end result, but also how the person is transformed into such a hero through all the lessons, tests and trials that the life has to offer.

“The Deed of Paksenarrion” has been published both as a trilogy and as a single volume. But no matter what edition you read, it will inspire you to grow spiritually, transcend life travails and acquire a strong character. Oh, and have I said that you will also have lots of fun reading it?!

A BETTER WORLD

I look at my son. I see the hair,
The rebellious attitude, the strange set of values,
The unbending stand which says
I want none of your ways, I spit on your values.
Leave me be. And I am sad.

I see a disregard for life. The riots,
The contempt for law, the hatred
Which feeds on itself and grows
To become a way of life.
I see. I hear. I feel. And I am fearful.

If this were but the limit of my vision,
My life, my very being, would have no meaning.
But I see beyond the irritants, the noise, the confusion.
I see a desire. I hear a cry. I feel a need
For truth. And I am hopeful.

I look at my son as through a veil.
I see love – a love torn between what is and what should be.
I see that he as I may stray far afield.
But I see a concern, a searching mind, a troubled heart.
And I am proud.

I hear his voice above his noise and know
His life, not unlike mine, will be weighed in the
Balance of time. And man in his search for truth
Will sift the chaff from the wheat,
Knowing a better world. And I am thankful.

9/14/70

She stung Him — sapped His firm Advance –
But when Her Worst was done
And He — unmoved regarded Her –
Acknowledged Him a Man.