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The Silence Only She Could Hear: A Pioneer of Autism Research

Růžena Nesnídalová, taken in Prague in 1937 (Photo: family archive)

For History Campus editor Karolína and her family she was “Aunt-Doctor”. For the age she lived in, she was Růžena Nesnídalová, a renowned psychiatrist and the first woman in Czechoslovakia to describe autism in children. Many years after her death, we have only a few photos and one book that she published. But who was this woman who pushed medicine much further and how does her family remember her?

Box of Photos

When I was 13, I visited my great-grandma almost every day. She lived in the retirement home at that time. Even though a lot of people around me feel uncomfortable being so close to old age and death, for me every moment with my great-grandma was a gift. She always sat in her rocking chair, a small smile on her gracious face as if she knew much more than me. Even though she had problems with her memory and she rarely knew who exactly I was, she knew much more about the past than anyone else.

On her chest of drawers was always a bowl with biscuits, the ones made of sponge pastry with jam and dark chocolate, their sweet scent filled the whole room. My great-grandma had a small box of old photos from her younger years. Whenever I visited her, we looked at them together and she talked about the people she used to know and the places she used to see.

Charming Young Lady

Among all the photos, I always waited for the one portrait that fascinated me. The picture showed a beautiful young lady not older than 17 years. She had curly hair and an old-fashioned dress. I could look at the portrait forever and never get bored. She had some strange light in her eyes as if she saw into the deepest part of my heart. I knew her under the name “Aunt-Doctor”. She was a cousin of my great-grandma and a respected psychiatrist. My mom had visited her a lot when she was younger and spoke about her as an old, serious lady with strong glasses and the sight of an owl.

A few years later, after my great-grandma died, we organized a huge meeting of all my relatives from my grandmother’s side. There I met my aunt, the niece of the lady from the portrait. From her and other relatives, I found out about her and listened to many stories that I didn’t know before.

How Růžena Becomes “Aunt-Doctor”

Růžena Nesnídalová was born in 1918 in Pilsen, where she lived throughout her whole childhood. She moved to Prague when she was admitted to the Faculty of Medicine at Charles University where she studied psychiatry.

Růžena finished school in 1950 and worked as a doctor in Pilsen for two years. From 1960 onwards, she lived permanently in Prague. She worked in the children’s and youth’s psychiatry department at one of Prague’s clinics. After 10 years, she managed to become the principal of this department.

Three Stories and What Is True

She never got married and decided to stay alone for her whole life. Nobody knows why she chose this way. Yet there are many stories told in our family that explain the strange loneliness of Růžena Nesnídalová. All the stories agree on one thing – there was some fatal man in Růženas life, whom she had loved so much that she never searched for someone else.

The first one was the “our family” version of the story. This one tells us about a man that Růžena fell in love with, but when the war began, he left her to fight in the Exil army in England. He supposedly fought in RAF and he died there. Růžena never stopped loving him so she stayed alone for the rest of her life.

The other stories are similar but with different circumstances. In one of the stories the guy was Jewish and her family hid him in their house. After the war, he left Czechoslovakia and stayed in West Germany, and Růžena never saw him again. According to another story, the man she loved was German, and Růžena hid him from expulsion in 1945. Then he ran away to West Germany and stayed there.

Between Medicine and Philosophy

As a woman, her role in medicine wasn’t easy. At that time there were almost 700 psychiatrists in Czechoslovakia and about half of them were women. Even though it was hard to assert oneself as a woman, Růžena had dived into a topic, that hadn’t been explored yet. Thus she opened a chapter that changed the view of medicine.

Soon her work began to be more and more significant. She wrote essays and articles about Kanner’s syndrome and organized many medical-philosophical seminars. There, she discussed this topic with many Czech experts who were thought to be some of best in our country at that time. Some of them were for example Prof. PhDr. Jan Vymětal or Prof. Jan Patočka. Jan Patočka was (among other things) signatory of Charta 77, a document about the violation of human rights in Czechoslovakia during the communism era. Because of her connection with anticommunists Růžena was forced to retire early even though many experts around the world respected her work.

The Results Are Reaching the People

The main task that she tried to solve was to explain how people with mental disorders behave in childhood and if we can recognize from that what disorder they have. Her most significant focus was on children with Kanner’s syndrome. Růžena worked with many children, observed and treated them, she sought knowledge to better understand their behaviour. In 1961, she wrote an article about Kanner’s syndrome in the magazine “Czechoslovakian psychiatry”, that was the first article about it in Czechoslovakia.

A few years later, in 1973, she published the book “Extreme Loneliness”, about children living alone in their own world that other people can’t understand. In this publication she wrote down all of her knowledge and results of her whole practice. She described a few of her patients and results of her observations. She described all the symptoms and her book was the only professional work about autism in Czechoslovakia till the 1990s.

Old Lady With the Sight of an Owl

When Růžena Nesnídalová was forced to retire early, she was still active in her field. She published other professional articles and essays, and she regularly gave professional consultations. Růžena lived in Prague, in a flat with only one room. In old age, she couldn’t even stand up from her bed and was dependent on help from her relatives. She didnt even lock her flat in fear that people wouldnt be able to get to her in case of need. Růžena died on 30th of August 2008 due to cancer that she refused to treat. She was almost 90 years old.

 

Kanner’s Syndrome

Leo Kanner was an Austrian-American doctor who in 1943 described a psychological disorder that is now known as Autism spectrum disorder. He described the behavior of 11 children who were extremely introverted and tended to specific rituals and habits. They seemed to live in their world, were fascinated by strange objects and often felt anxious.

The modern research on autism started in the 1970s. Scientists didn’t use the behavior method like Leo Kanner but focused on studying the brain and its connection to it. The research is still ongoing. Today we know that people with autism have some genetic predispositions but we are not able to say for sure what which gene causes it.