Turn 209 of 233

Turn to Kimo and make him laugh, then ask Dr. Okafor about empathy development

Lena turns to Kimo on the exam table and the turning is the thing that is the full-body pivot, 790 pounds shifting on the reinforced chair. She looks at him and the looking is the thing that is the setup. She scrunches her face — eyes squished, nose wrinkled, lips pushed out — and the face is the thing she has never made in public because the public is the thing she used to care about. She doesn't care now. She makes the face and holds it.

Kimo looks at her and the looking is the thing that is the two seconds of processing. Then the processing breaks. The break is the thing that is the laugh — a full, open, chest-shaking laugh that fills the exam room and bounces off the drywall and the growth chart and the hand-drawn grid lines. His whole body moves with it. His 206 pounds shakes on the exam table. His feet stop swinging because the swinging is the thing that can't happen when the laughing is the thing that is the taking over.

"Mama face is broken," he says between laughs. "Mama face is not matching. Mama inside is happy but Mama outside is — that. That is not happy face. That is broken face. Crack face. Mama has crack face."

He laughs again and the laughing is the thing that makes Lena laugh and Lena's laughing is the thing that makes the chair creak and the creaking is the thing that makes Dr. Okafor smile behind her hand. The room is the thing that is the full — full of the sound and the sound is the thing that is the not-clinical and the not-clinical is the thing this room needs.

"Mama crack face is the funniest face," Kimo says. He is winding down. The laughing is the thing that is the becoming the breathing and the breathing is the thing that is the heavy. He wipes his eyes with the back of his hand.

"Mama should make crack face more. Crack face fixes sad. Crack face is the medicine."

Lena lets her face relax and the relaxing is the thing that is the return to her own face — the tattooed, bare, 790-pound face that is the thing that is the matching. She turns to Dr. Okafor and the turning is the thing that is the question.

"You said you want to watch for affective empathy," Lena says. "The felt version. What does that look like when it starts? How do I know it's happening?"

Dr. Okafor leans forward and the leaning is the thing that says the question is the thing she has been wanting someone to ask.

"Affective empathy is different from what he just did," she says. "What he just did was read your face and respond with joy because your face was funny. That's social responsiveness — he's very good at it. Affective empathy is when he sees someone who is genuinely hurting and his body responds. Not his mind — his body. His chest tightens. His stomach drops. He feels the distress physically before he has a word for it. It's involuntary. It's the thing that happens before the thinking."

She looks at Kimo, who is now examining his own hand, turning it over, studying the lines on his palm with the focus he gives to everything.

"Right now he observes distress and names it and diagnoses it. That's cognitive empathy — extremely advanced for his age. The felt empathy, the kind where someone else's pain becomes his pain, that's developmental. It will come when his nervous system is ready. You can't teach it. You can only expose him to people feeling real things and let his body learn what to do with that information."

"So I just wait," Lena says.

"You wait and you watch," Dr. Okafor says.

"And when it happens, you'll know. Because he'll stop being the understander for a moment and he'll just be a boy who feels what someone else feels. It won't be a definition. It won't be elegant. It will be messy and physical and it might frighten him because he's never not understood something before. The first time he feels without understanding why, that's the milestone."

Kimo looks up from his palm. "Everything has lines," he says. "Hand has lines. Wood has grain. Concrete has cracks. River has branches. Lines are the pattern. Lines go everywhere. Mama, do you have lines?"

"I have lines, buddy. I have lots of lines."

"Lines are the inside showing on the outside," Kimo says. "That is matching. Lines are matching."

Dr. Okafor writes this down and the writing is the thing that fills another line in the file that is the thing that is the growing and the growing is the thing that is the profile and the profile is the thing that is the Kimo.