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On Being a Patient |

Elevators on His Mind

Peter S. Stack, MD
[+] Article and Author Information

From Dallas Diagnostic Association, Dallas, TX 75230.


Requests for Single Reprints: Peter S. Stack, MD, Dallas Diagnostic Association, 7777 Forest Lane, Suite C-300, Dallas, TX 75230; e-mail, ps.stack@bhcs.com.


Ann Intern Med. 2004;141(4):319-320. doi:10.7326/0003-4819-141-4-200408170-00014
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“Alex rides elevators on his mind” was written by my 10-year-old autistic son and taped to the wall next to his bed. Elevators are the central focus of Alex's attention at this point in his life. His form of autism is described as high-functioning, since his intelligence measures in the normal range. However, he has many typical features of autism, the most dramatic being an obsessive interest in narrowly defined topics. This bizarre and mystifying behavior is a daily reminder of his brain's remarkable capabilities and its frustrating limitations, reinforcing the notion of some critical derangement in the scaffolding that organizes and processes his thoughts. Alex, like others with autism, can't see the forest when standing in front of a tree. Rather, he is inexplicably drawn to minute details of one specific tree, a fixation that defies rational explanation. In Alex's case, the fixation is on elevators.

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Elevators are universal
Posted on September 16, 2004
Ashish Goel
AIIMS, New Delhi 110058
Conflict of Interest: None Declared

I completely agree that the capacity of the human mind is only limited by thought. There is immense capacity with subtle limitations. The essence of human life is to recognize and accept ones limitations and then go beyond them. Every one of us is autistic to an extent. That can actually be said for any psychiatric disorder. It exists to a certain degree in each one of us normal individuals. Each one of us is obsessive and each one of us is having symptoms, it is only when one understands these symptoms that we live with them and when they start troubling us that these symptoms take the shape of psychiatric disorders. Dr Stack has rightly said that we are all comforted by ritual, structure and detail in our daily life, some more than others. In fact we all ride elevators on our mind. The elevators are merely different in shape and form, but they are there.

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