The Literalist: A case of Adult ADHD

Edward worked alongside me as co-founder and senior engineer at two high-tech ventures. He was a classical musician and had performed as a timpanist for the Minneapolis Symphony Orchestra. Yet, Edward had no problem slipping into the role of senior software test engineer—and later—as operations manager for our computer network start up. He entered the venture knowing nothing about computer networks or the HVAC market that we planned to service. Yet, whatever the role—and no matter how technical—Edward made up for the background that he lacked.

Suffice it to say that Edward was one sharp business manager.

But Edward was a literalist and occasionally a procrastinator. At first, his colleagues and subordinates dismissed these traits as endearing eccentricities. Upon coming across Edward many years later, I learned that his peculiar way of processing information and an inability to communicate with those who are less precise not only lost him a job, it had a profound impact on his life. Ultimately, his symptoms—and events they provoked—led Edward to a diagnosis and treatment. But first, he had to acknowledge that he had a problem.

Let me illustrate one of Edward’s idiosyncrasies…


Edward in mid-thought

One morning, I was standing in line at McDonald’s. As I waited my turn, I heard a voice in the line ahead of me:

“I’ll have the Scrambled Egg Breakfast
—with the eggs ba-a-r-r-r-e-ly cooked”

 A wagging finger rose high above the crowd—to emphasize the syllable: ba-a-r-r-r-e. A trill hung in the air for several seconds. I recognized the phrase and the voice instantly. It was one of Edward’s lovable affectations. I knew exactly what was coming next. Well, at least I thought I did…

I had occasionally met Edward at other breakfast restaurants. He always asked for nearly-raw eggs in that same voice and with a wagging finger. Often, the order taker would explain that the restaurant cannot serve under cooked eggs. At a few franchise outlets, Edward was offered a liability waiver. This allowed them to serve under cooked food, but it explained that raw eggs may contain high levels of bacteria—and that compared with a supermarket supply chain, restaurants have diminished capacity to ensure continuous refrigeration. (I have always felt that the second method of dealing with this request is more reasonable and, certainly, more accommodating!)

But the counter clerk did not object to the preparation request nor did he produce a legal form. Instead, he simply pointed to a portable clock on top of a coffee machine and explained that breakfast had ended five minutes ago. “Is there anything I can get you from the lunch menu?”

Edward stared at the clock. He was stunned! He glanced alternatively at his watch and then back at the clock. For a long moment—he was speechless. Finally, he put together a very earnest and coherent question. In fact Edward was always precise in his choice of words. He said:

“In the future, can I assume that your switch-over will invariably be triggered
by a clock that is 7 minutes ahead of local time, as determined by a recog-
nized time standard? Or is it possible that your clock is accurate, but that
you adhere to something other than Universal Coordinated Time?”

This time, it was the order taker who was stunned. He stared at Edward trying to figure out if he was encountering humor, insolence or anger. Actually, he was encountering none of these emotions. Quite simply, Edward is a literalist. He is given to being punctual and precise. He is exceptionally bright, and—at the time—in constant need of reminding that not everyone else is so literal, demanding or bright.

I felt sympathy for both Edward and the order taker. Although I was several steps back in line, I inserted myself into the conversation, speaking loudly so that both could hear. I said “Look Edward! At some time in the minutes before 10:30, the restaurant stops the setup of breakfast ingredients. When they can no longer make a variety of items on the breakfast menu, they shut down the grills and switch over the cash registers and overhead menus!”

I really didn’t know if this is how McDonald’s works, but I wanted to move the conversation away from a discussion of clock precision. After all, no one could maintain a clock as carefully as Edward. Not the phone company. Not Big Ben. Heck—not even the folks who run the atomic clocks in Greenwich and Colorado. They probably take their cue from Edward!

Not surprisingly, the counter clerk considered me to be his new best friend. Suddenly excised from a predicament, he raised his eyebrows and flashed a big smile. He pointed to me and exclaimed “Yeah! Exactly what he said!”

Edward acknowledged my presence in the line behind him, but quickly froze again. He slowly raised a crooked finger to his lips and reflected for awhile—too long for a person holding up a line of hungry patrons. Then he looked at the clerk with a serious but welcoming gaze and warmly said “Suppose I were to visit at 10:15 or earlier—according to my clock which is synchronized with my mobile phone service. If I visited earlier, could I reasonably expect that you will still offer me breakfast?”

As before, the question was phrased with über-precision. Not the precision of a nerd or Geek, but the precision of someone who relates only to those who communicate in the syntax of a peer-reviewed, technical journal. But this time, the clerk understood the question: Edward just wanted a breakfast routine that he could count on. He wanted to know how early he had to arrive, so that he wouldn’t miss the morning menu.

The clerk beamed with a smile. “Yes, Sir!” He exclaimed. “If you arrive fifteen minutes early [according to any reasonable clock, I presumed], I am certain that we can serve you eggs!”

Crisis resolved. At least regarding the change of restaurant menus…

Calamities Brewing

Back at our computer company, Edward’s professional relationship with the executive team was deteriorating. We admired his skill and liked him personally. But, our venture was small, underfunded and trying to cover 3 jobs for every manager. Edward’s difficulty in thinking quickly and his need for precise and literal language made it too difficult for any of us to make progress. During the next quarter, the board voted Edward out of our computer start up. Because he was also a board member, we stood on shaky legal ground. But we simply lacked the funds and the patience to be stuck in a looping-thought every time we needed a meeting of the executive staff.

There was a brief legal battle over Edward’s severance. No animosity; just a quick exchange of papers, a group conference and a resolution that everyone could live with.

I lost touch with Edward. The last time we saw each other was 17 years ago. I never learned that he lost his home and his girlfriend over the same peculiar idiosyncrasies. Perhaps the events surrounding our professional separation made each of us too timid to look up the other. Occasionally, I reflected on our former friendship with melancholy. I missed Edward’s wit, his smile and especially, his sense of humor. In many ways, we were kindred spirits. I wondered if he ever heard that I met and married a wonderful girl, that I now have a child, and that I still think of him occasionally.

The Present  [17 years later]

During the time that I lost contact with Edward, he was diagnosed with adult ADHD and treated by pioneer in the field. It’s not schizophrenia and it’s not a sign of bipolar disorder. In adults, it is the inability to deal with organizing thought and action, especially in advance of the last minute. It is not a problem with knowledge or learning. Those functions take place in the back of the brain, but they must later be accessed by the fore brain to execute effectively.

Edward’s inability to accept imprecise language is just one of the symptoms that can lead to a diagnosis of ADHD. It is more often expressed by procrastination, an inability to focus—and sometimes—unreasonable demands for rapid answers from others.

Over the years, I have encountered others like Edward. At first, it never occurred to me that these traits are anything other than endearing eccentricities. But those who study these things consider it to be a disorder. And to their credit, they have developed effective treatments.

Certainly, it seems a stretch to call it a ‘disorder’ for individuals who are successful in both their career and their family life. For these individuals, I think of ADHD as a symptomatic label rather than a disorder. But, what if the difficulty in communicating with others—or the inability to organize thought and execute on a deadline—interferes with earning a living? What if an individual demands answers from loved ones with the precision and rapidity at which their mind functions?

In such a case, might these interfering traits be a “condition” that warrants evaluation and treatment? If it is not treatable, I would think that something about their environment needs to be adjusted to suit an unalterable condition.

What Can be Done?

Today, adult ADHD is highly researched. Pioneering, academic and clinical research from Massachusetts and South Carolina have resulted in enormous strides in treatment. These methods are being adopted by clinics all over the world.

Fortunately, Edward connected with one of these pioneers even before the clinics began adopting their methods. He credits that relationship to cognitive improvements that have percolated throughout his personal and business affairs.

But don’t take it from me. I’m just a columnist. For information about adult ADHD, click on the video below and get it from the proverbial horse’s mouth. That would be Dr. Barkley.