It is not an exaggeration to say that Dr. Darold A. Treffert`s life took a profound turn when Leslie Lemke entered it. After meeting him eight years ago, Treffert, a psychiatrist who practices in Fond du Lac, Wis., rediscovered the most intriguing medical phenomenon he had ever encountered and in the process became its leading expert.
Leslie Lemke is a kind of genius. Despite his blindness, mental retardation and cerebral palsy, he makes music as easily as most people draw breath. He can reproduce any piece of music on the piano after hearing it only once. He also sings and does impersonations. Yet he has had no formal musical training and indeed no formal schooling or therapy of any kind.
He is a member of a very rare group of people called idiot savants, or literally ”wise idiots.” They have a serious mental handicap-either mental retardation or severe mental illness such as schizophrenia or autism-but they also possess what Treffert calls an ”island of intelligence,” a special ability that stands in stark contrast to their handicap.
In June, 1980, Leslie came to Fond du Lac with his foster mother, May, to give a concert at Goodrich High School honoring the foster parents of Fond du Lac County. Treffert`s daughter, Joni, attended it, and when she returned home that evening she told her father that she had witnessed a ”miracle.”
Treffert was able to explain the syndrome to her, having encountered it 20 years earlier. But the next day when a reporter from a local television station, fearing it was some sort of hoax, asked him to review a tape of Leslie`s concert, Treffert was astonished, too. ”I had no idea, based on the savants I had seen, that Leslie was that miraculous,” Treffert remembers.
Treffert encountered his first savants in 1959 in his first professional assignment, at Winnebago State Hospital near Oshkosh, Wis., where he was charged with developing and then directing a separate child-adolescent unit.
He met one boy who had memorized the bus system of Milwaukee. Given a time of day and a bus number, he could name the corner on which a passenger would be standing. Another boy was a ”basketball robot” who could make perfect free throws, almost as if he were a machine. And a third was virtually a talking almanac. He could recite a long list of events that had occurred on dates in history. All three boys were severely disturbed. Yet they had these strange islands of intelligence.
”It was a brand-new phenomenon to me at the time,” Treffert says. ”I began to wonder what we were dealing with, and I began to ponder whether anyone else had noticed it. And as I searched, I discovered that somebody had, but it was buried in the (medical) literature. It was not the kind of thing you would learn about in medical school or residency.”
The term ”idiot savant” was coined a century ago by Dr. J. Langdon Down, of London, England, who also was responsible for the classic description of mental retardation, Down`s syndrome. At the time, the term idiot was accepted medical terminology for someone with a low level of intellectual functioning. The term savant was derived from a French word savoir, meaning
”to know.”
Since the word idiot now carries a derisive, negative connotation, Treffert and others prefer to call the condition the savant syndrome and those who have it savants.
Soon after Leslie Lemke`s concert in Fond du Lac, Traffert called May and Joe Lemke, his foster parents, and arranged to meet their son. The family lived in Pewaukee, Wis., in a modest little cottage where they had converted a porch into a music room for Leslie.
”My introduction was as much to May as it was to Leslie,” Treffert remembers, ”because you couldn`t be with him at that time without being immersed in May. I was as intrigued with May as I was with Leslie because they both had a story to tell-May in terms of bringing someone along and Leslie as the person who`s been brought along. Of course, I had seen Leslie on tape, so I knew what he looked like, and almost as soon as I walked in I felt like I belonged there.”
Leslie was premature, weighing only 5 pounds and 3 ounces when he was born in Milwaukee on Jan. 31, 1952, and was immediately given up for adoption by his mother. He spent his first months of life in the Milwaukee County Children`s Home, where doctors noticed he did not open his eyes. Swollen and hard, they were diseased and had to be removed before he was 6 months old.
At that point, the Milwaukee County Social Services Department asked May Lemke to take the boy into her home. After raising five children of her own and working as a governess, she had set up her home to receive infants until they could be placed permanently. Leslie`s condition was fragile, and May was told that he might die. ”Not in my house,” she said defiantly.
May`s younger daughter Mary Larsen, who now is Leslie`s legal guardian, remembers that at first Leslie ”just lay there. He was like a vegetable. Never cried. Never responded to anything. His eyes had just been removed and they were very badly infected. My mother had to open up his eyelids and clean out the sockets every day.”
Leslie could not even swallow, so May would place gruel on the back of his tongue and stroke his throat to force him to swallow involuntarily until he learned. By age 2 1/2 Leslie was sitting up and crawling and he could speak and sing, but his development seemed slow, according to medical records. At age 3, a neurology consultant noted his cerebral palsy, thought to be caused by a birth injury, and his tendency to parrot phrases that were spoken to him, a condition called echolalia.
”Every time my mother would go to the doctor, she would be told that soon he will have to be institutionalized, that he was going to become too much of a problem,” Larsen recalls. And she said: `No, he`s never going to be institutionalized. My family will take care of him.` That`s right there in the doctor`s records.”
When Leslie`s left arm became paralyzed, doctors told May that nothing could be done. May massaged the arm and hand with oil, repeatedly extending it in a version of physical therapy. ”Mother didn`t believe there was nothing you could do, so she did the best she knew how,” says May`s older daughter Pat Smith. ”Some of the things she did weren`t accepted medically, but for her they worked.”
May taught Leslie to walk by devising a sling that she tied around the back of her waist. She reasoned that if Leslie could hold onto the sling and pick up the rhythm of her own gait as she dragged him along, he would learn to walk. By age 5 1/2 he was walking. Although he did not volunteer conversation, medical records indicate he could repeat verbatim a whole day`s worth of overheard conversations, changing his voice to impersonate each speaker. One evening May found him under the bed, strumming the bedsprings as if they were a musical instrument.
Before Leslie turned 8 May got him a piano. She ran his fingers up and down the keyboard so that he could identify the notes. She played piano by ear and loved to sing. Leslie quickly learned to play the piano as well as the bongo drums, ukelele, concertina, xylophone and accordion. But May taught him only simple songs-nursery rhymes, ditties and a few hymns.
One evening when Leslie was about 14, something incredible happened. The family had watched the movie ”Sincerely Yours,” starring Dorothy Malone and Basil Rathbone, on television, then retired for the night. At 3 a.m. the sound of music awakened May. She went out to the living room and discovered that Leslie had crawled from his bed to the piano and was playing Tchaikovsky`s Piano Concerto No. 1, the theme from the movie that he had heard for the first time that evening.
When May was experiencing the first signs of Alzheimer`s disease, she often told the Tchaikovsky story more dramatically. She would say that when Leslie was 8 he suddenly rose from his bed in the middle of the night and spontaneously played Tchaikovsky, forgetting the part about Leslie`s previous exposure to music.
Still, it was the first time Leslie exhibited his savant characteristics, and Treffert has no doubt that without May`s belief, tutoring, makeshift therapy, persistence and enthusiasm Leslie Lemke would not be what he is today.
”May was crucial, like Vitamin B is to rickets,” he says. ”I think, frankly, there`s some question whether Leslie would have even lived without May. Even if he had lived, and if we had come across him, without May it would have been in an institution.”
Treffert, 55, a native of Fond du Lac, knew that he wanted to be a doctor as early as 4th grade. ”I just had it on my mind that that`s what I wanted to do,” he says. ”There were no physicians in my family. My father was a factory worker, and everyone kept saying you had to know somebody to get into medical school.” Treffert was accepted by the University of Wisconsin Medical School, interned at Sacred Heart General Hospital in Eugene, Ore., and returned to the University of Wisconsin hospitals for his residency in psychiatry.
”Probably the same reason that the savants intrigued me is the same reason I went into psychiatry,” Treffert says. ”During my internship, one patient in particular sticks in my memory. I was working in the emergency room, and a woman came in who had stabbed several of her children to death and had stabbed herself, but not to death. She must have had 200 stab wounds on her body. She was blatantly psychotic, just babbling.
”I wondered, `What in the world is going on?` (In contrast), I had some sense of what was going on with a urinary tract infection or some sense of a diabetic coma, but it seemed (in her case) as if we had no idea, and it was obvious to me that this was not just a psychological thing. I got bored looking in various eyes or ears, but the whole field of psychiatry and how little we know really attracted my attention.”
When Treffert received his training, the biological revolution in psychiatry was beginning. Even so, he found psychiatry dominated by Freudian psychology. ”I felt the field was on the wrong tangent. Trying to explain some of these biological things in psychological terms just didn`t square with what I saw or what I felt. Others felt that way, too, but I was certainly in a minority.
”I considered major mental illness a brain dysfunction, not a result of something that happened in childhood. Now there are people who do have problems because of (childhood incidents), but to try to explain schizophrenia or infantile autism in those terms seemed to me not only erroneous but sort of offensive in terms of implication.
”There was work by a doctor, Bruno Bettelheim, who wrote a number of books, and the pitch he was making was that these autistic youngters were psychologically damaged, the product of a `refrigerator mother.` I saw it as an organic disease, and I really became almost incensed that a trip was being laid on the parents.
”The treatment in those days was a psychological approach, and I didn`t see anything coming from it. I felt that autism represented circumstances of organic brain dysfunction that had to do with attention and with memory and with inability to focus, that the child who was shutting the world out and in a world of his own wasn`t doing that because he was trying to deal with early childhood rejection or anything like that.”
Although Treffert has always maintained his interest in autism, he stopped having clinical contact with patients when he became superintendent of Winnebago State Hospital where he remained until 1979. Since then, in addition to a private practice, he has been director of the 150-bed Fond du Lac County Health Care Center.
He did not intend to return to Fond du Lac, a town reminiscent of Booth Tarkington`s Middle West. But in exchange for a ”living wage” during his medical residency he agreed to work in a state hospital for two years as a payback, was assigned to nearby Winnebago and decided to settle down.
Through the years Treffert became interested in the nature of memory. He was one of a handful of psychiatrists who were doing sodium amytal (”truth serum”) interviews with patients.
”It was striking to me in the sodium-amytal interviews how often people were able to recollect things in great detail that they could not recollect as we sat and talked even though they had tried very hard to remember,” he says. ”I remember one patient who was trying to reconstruct an evening when a particularly traumatic event occurred in her life. Her memory sort of faded during certain points, and she wasn`t sure whether or not something had taken place. Under the amytal she reconstructed that night, even remembering which streets they`d driven down and which lights were yellow and which lights were red.
”It was obvious to me that there was a heck of a lot more being recorded and stored than we were able to retrieve.
