I have known Daniel for 20 years. I think of him as a 27-year-old, the age he was when he started seeing me. I cannot get my head around the fact, that he and I have watched each other age for two decades. Daniel has had many diagnoses in his day, but suffice it to say that Daniel is in the “spectrum”, the autistic spectrum. I see Daniel once a month and we have a ritual. We sit down together, with his mom, and he asks me how to spell my last name, as he diligently pulls out his checkbook to pay me. He says “one l or two?” I say “two”. Every couple of months, I want blood work, so periodically we discuss this. I say it is time to get some labs. He says “uh-oh, do I have to fast?” I say no.
Once a month, for twenty years is a long time to have the same conversation, and yet for some reason, each interaction feels fresh. I think that we have both come to count on the fact that we will connect in this way. The routine is comfortable for both of us. I think about my friends that I see from time to time. I often have the same conversation with them each time I see them. There is something very nice about knowing what the other person is going to say. I also think about how much children like to watch the same movie over and over and over. They like that they know what is coming. They like re-living the joy in the experience.
In electrical engineering, the term ground or earth is used for the reference point in an electrical circuit from which other voltages are measured, or a common return path for electric current, or a direct physical connection to the Earth. I think about my ritual with Daniel as a grounding experience. By that I mean, that our ritual provides a connection for him to the Earth, in the same way that the electric current is grounded to provide a way to measure other currents.
We all love routine, and we all love novelty. The difference between people lies in how much consistency they need versus how much adventure they need in order to feel satisfied. Those on the “spectrum” tilt more towards needing routine, in the same way that those with Alzheimer’s Disease also require consistency to cope. It appears as though those with compromised brains, of varying etiology, need more rituals.
I feel privileged to be part of Daniels’ routine. The words exchanged are predictable, but the feelings associated with those words are not. There is still a freshness amidst the predictability. Each encounter, like each breath, comes with different associations and different experiences. Daniel has taught me a lot.

