1. Fortress and Frontier: Different but Not Less
  2. Fortress and Frontier: A Second Conversation with Temple Grandin
  3. Fortress and Frontier: What the Data Say About COVID-19
  4. Fortress and Frontier: The Narayana System and Innovations in Healthcare
  5. Fortress and Frontier: Healthcare’s Reluctant Revolution
  6. Fortress and Frontier: Price Transparency in Healthcare
  7. Fortress and Frontier: The Disruptive Innovator
  8. Fortress and Frontier: Healthcare Policymakers Should Worship Change, Not Stasis


In this first installment of the Fortress and Frontier series on the Discourse Magazine Podcast, Robert Graboyes, a senior research fellow at the Mercatus Center, speaks with Temple Grandin, a pioneer in the humane treatment of livestock and a well-known spokesperson on autism. Their discussion encompasses Grandin’s life and career, the overstandardization of today’s educational system, how to efficiently distribute COVID-19 vaccines, the importance of many different types of minds and more.

The second Fortress and Frontier podcast features another conversation with Temple Grandin. The third podcast with Pradheep Shanker focuses on COVID-19 data. The fourth with Devi Shetty is about innovations in healthcare. The fifth talk with Eric Topol is about medicine’s slow progress and machine learning in healthcare. The sixth with Keith Smith focuses on price transparency.

ROBERT GRABOYES: Welcome to Fortress and Frontier: Conversations on Healthcare and Innovation, a product of Discourse Magazine at the Mercatus Center at George Mason University. My name is Robert Graboyes, and I’m a senior research fellow at Mercatus. Today’s podcast is entitled “Different but Not Less: Temple Grandin and the Economic Virtues of Neurodiversity.” I’m not prone to superlatives, but frankly, my guest today, Dr. Temple Grandin, is one of the most fascinating and influential people on the face of the planet.

I’ve been riveted by her stories since around 1995, when the late Oliver Sacks, the greatest bard of neuroscience, described her in an essay entitled “An Anthropologist on Mars.” Temple’s story was also the subject of a magnificent HBO movie called, simply, Temple Grandin. Her story therefore will be well known to many listeners, so I’d like to turn today’s conversation in perhaps somewhat unfamiliar directions for a lot of listeners.

At Mercatus, our interests lie in markets, in technological and institutional innovation, in entrepreneurship and in public policy. I think Temple’s story tells us a great deal about all of those things. Today, we’ll explore the interplay between neurodiversity and the economics of innovation. Temple, let me welcome you to this podcast.

TEMPLE GRANDIN: It’s really great to be here.

GRABOYES: Delighted. Before Temple and I really begin our conversation, I’ll briefly describe her history for those who haven’t heard it or those who haven’t heard it in a while.

Temple is a professor of animal sciences at Colorado State University. She’s perhaps the single most important proponent of humane methods in the livestock industry. She essentially reinvented stockyards and slaughterhouses, making the lives of hundreds of millions of animals more pleasant and their deaths less painful, and she did so in ways that also benefited the meatpackers’ bottom lines.

Perhaps one-third to one-half of all cattle slaughtered in America are processed through plants that Temple designed, and she did all of this in an industry that was quite unwelcoming to women when she began. These accomplishments alone are enough to make Temple a legend, but it is the life that preceded her work that made her the worthy subject of a major film. Temple is probably the world’s most visible face of autism, and the life we celebrate in this podcast could easily have been derailed in early childhood.

At age four, Temple had not yet spoken, and she had grown emotionally remote and detached from those around her. Doctors diagnosed her as autistic and suggested that she be institutionalized for life and essentially forgotten. Her mother rejected the conventional wisdom offered, a theme that repeated itself over and over throughout Temple’s life.

In time, she learned to speak, went to school, earned a bachelor’s, master’s and doctorate, and did all of this with enormous help from family and educators, often in pitched battles against an array of naysayers who would have broken most of us. But Temple, with the support of family and mentors, ultimately persevered and triumphed. She changed the meat industry, and equally, she became a preeminent spokesperson for autism, helping to change how the world perceives neurodiversity.

In the HBO film, Temple’s mother insists that she is “different, but not less,” hence the title of today’s podcast. In the next hour or so, we’ll discuss her life, her work, the gifts her autism conferred upon her work. We’ll talk about the possible relationships between neurodiversity, innovation and entrepreneurship, and we’ll discuss whether public policy wastes some of the gifts that people like Temple possess. If we have time, we’ll talk a little bit about the Oliver Sacks essay, the HBO film and her writings.

With that, let’s begin the conversation. Temple, first of all, did I make any errors in my introduction? Or did I leave out anything important?

GRANDIN: Well, my mother was really important in my success. She had a really good sense of how to stretch me slightly to try new things, and she always gave me choices—you could do this, or you could do that.

And I had some excellent teachers as a young child, excellent speech teacher, excellent third-grade teacher. Also a really good science teacher in high school because I was not a good student, and I was not motivated to study, and he gave me interesting projects to do, and he got me motivated to study because now studying was a pathway to becoming a scientist. You see, now there was a reason to study. So then I got motivated to knuckle down and study.

Changing the Meatpacking Industry

GRABOYES: It seems to have worked very well. Tell us a little bit about your work in livestock and meatpacking industries. What was different about your vision and your designs?

GRANDIN: When I first started working with cattle in Arizona—I got introduced to the cattle industry when I was 15 at my aunt’s ranch. This brings up another really important thing: Students get interested in careers they get exposed to. If I hadn’t gone to my aunt’s ranch . . . I was a psych major—very, very interested in optical illusions. When I first started out with cattle, I noticed that they’d balk at a shadow—maybe there was a coat on a fence. Other people weren’t noticing this.

In my early 20s, I thought everybody was a visual thinker like me. The HBO movie showed very clearly how I think in pictures. I didn’t know that my thinking was different at the time. It was a shock to me to learn that some people don’t think in pictures. It was obvious for me to look at what the cattle were seeing as they were going through chutes to get vaccinated, and no one else had thought of looking at that.

This is where someone who is a visual thinker excels. I’m talking right now about these feed yards. I’m now seeing feed yards from the ’70s, different cattle-handling facilities that I worked in when I was in my early 20s. They’re popping up like PowerPoint slides just like it shows in the movie.

GRABOYES: Interesting. I imagine the advent of Google Images made it a lot easier to describe what you were seeing and how you were thinking.

GRANDIN: Well, the difference with it—it’s like Google Images, but the pictures come up sequentially. Google Images displays them in gallery format or Lightbox format, where I see it—a picture comes up. Now if I hold a picture, I can make a little video of it, and then I’ll go to another picture in another place, but then sometimes it can get off the subject, like a restaurant, like the feed yards, for example, but there’s always an associative link.

GRABOYES: I’ll have to say, I’ve learned one thing about my own animals from watching your film and reading your writings. I’ve had in my life five cattle-herding dogs, four of them Welsh Corgis, and I’d always wondered, how is it that this tiny little animal can spook an entire herd of cattle and get it to move in a direction? Seeing what you said about chains and a coat hanging over it, I understand a little bit better that they are very sensitive to objects. You’ve helped me to learn about my dogs.

GRANDIN: Especially something that moves, and something that suddenly moves—it’s going to make a prey species animal, like cattle and horses, want to run away, and it makes the animal like your dogs want to chase.

GRABOYES: Yes, absolutely.

GRANDIN: It’s the rapid movement.

GRABOYES: Tell us a little bit of the specifics about your vision and the designs of the slaughterhouses—the way you changed the way they look.

GRANDIN: The first thing I did is, I went and I worked cattle in every feed yard in Arizona, and I picked out design features that worked and design features that did not work. It was a bottom-up approach, in other words: study the state of the art and find things that work, but I also don’t want to be reinventing bad things that don’t work, and from that, I came up with new designs. Both the design of the facility and the management is really important. You’ve also got to have the management to go with it.

The thing that probably revolutionized the industry the most was a very simple scoring system I thought up for assessing the meat plant. How many cattle do you stun and make them unconscious and dead on the first shot? How many animals aren’t falling down? How many animals did you poke with the electric prod? How many animals—a bell rang when you’re handling them? That’s a really good measurement of detecting problems. Very, very straightforward, just like traffic rules for meat plants.

I was hired in 1999 to train the McDonald’s auditors how to do this, and then Wendy’s came in six months later with a really great program. In that year, I saw more change than I’d seen in my entire career prior to that because now they actually had to repair equipment and manage it. You know what the biggest problem with the stunning was? Broken equipment—simply weren’t done, management.

Most of the plants I could fix with a lot of simple changes like non-slip flooring, change the lighting. Cows are afraid of the dark, so you put a lamp on the entrance to a chute—makes a big difference. Move some lighting to get rid of some reflections. Put up a piece of metal so they don’t see people walking by. Real, real simple things. Moving in smaller groups. Get electric prods out of their hands.

There were 75 plants on that McDonald’s approved supplier list. Only three had to buy really expensive equipment. A number of the plants already had things I had designed, but they weren’t being maintained and managed very well. We took some shabby old ones and we made them work with a little bit of non-slip flooring in the right place.

Bring up 10 cattle, not 25 cattle at a time. And three other plants had to have a manager-ectomy. In other words, nothing changed until we got rid of the plant manager. Then overnight, the place changed.

GRABOYES: Interesting. I know that philosophically, you’ve said, “Nature is cruel, but we don’t have to be.” And I’ve been fascinated by the way that your designs have put that into motion. Talk a little bit about that.

GRANDIN: I get asked all the time, do cattle know they’re going to get slaughtered? I had to answer that question when I first started. I go over to the Swift plant, Tucson, Arizona, and then I go out to the feed yard and watch cattle go up the chute to get vaccinated. They behaved exactly the same way in both places. If they knew they were going to get slaughtered, they should be wilder and harder to get into the slaughterhouse, but it was the same.

Also, I’ve since looked up a lot of data on stress hormones in the blood. They range from high to low, but it’s the same range for handling on a ranch, the vaccinations, as it was at the slaughter plant. If they knew they were going to get slaughtered, you wouldn’t have been able to get them in there.

Neurodiversity and Design

GRABOYES: Right. You have spoken and written extensively about the ways in which your autism conferred a distinct advantage on you over other designers, other people thinking about the design. Could you talk a little bit about that? What was the virtue of autism in your case?

GRANDIN: I can visualize the whole system. When I’m drawing a drawing, I can visualize the entire system built, and I test-run it in my mind. When I first started, I didn’t know other people weren’t able to do this. I didn’t fully learn this until I was in my early 40s. I found that other engineers calculate things more mathematically. There’s now been research where there’s different kinds of thinking. I’m an object visualizer; that’s the scientific name for what I am.

The more mathematical mind is the visual-spatial. For example, when designing something, they’ll calculate the loads on something, where I just see it. We actually need both kinds of engineering because when I was out working on installing these big systems, about 20 percent of the really smart equipment designers—they designed the drive units we’d have to run these conveyors—design entire factories, build anything, be really clever on invention and building things, hold multiple patents.

I’m going to estimate that 20 percent of these people would be special ed kids today, either autistic, dyslexic or ADHD. The thing that saved them was having a shop class in school.

We’re actually losing skills. We have two brand-new poultry processing plants—state-of-the-art—one that’s about three years old, one that was just finished, where every bit of equipment inside that plant was imported from Holland. A hundred shipping containers per plant. I cannot tell you where they’re at. I’ve got to keep some confidentiality. I’ve been in one of them, and I’ve been by the other one. My friends have been in the brand new one—absolutely gorgeous.

We’re paying the price for taking skilled trades out of schools 25 years ago. There’s two parts of engineering. There’s what I call the clever engineering department. Think of paper feed inside your printer. Think packaging machines. Then you have the more mathematical engineers. We still do the building. We did the building. We did the boilers. We did the refrigeration equipment.

But all the clever stuff that goes inside is coming from Holland. We are losing skills, and I’m very concerned about this. There’s a tendency to stick nose up at skilled trades. Now I’m talking of high-end skilled trades. I’m talking about a guy who took welding in high school. He’s now building factories, but he’s getting close to retirement age now. I’m very, very concerned about these people not getting replaced.

GRABOYES: When I was near the same age category, and certainly, I didn’t do shop, and sorry I didn’t, but it was an important part of the school when I was there. The people who went through it, I think, did very well out of it.

Neurodiversity and Innovation

Now, there’s a really interesting story about your grandfather. I have a long-standing interest in aviation. I’m doing some writing on it right now. Tell us a little bit about what your grandfather did. I’ve seen other people intimate that his story might have something to do with your story as well, and perhaps some neurodiversity there as well.

GRANDIN: That’s right. My grandfather on my mother’s side—MIT-trained engineer, co-inventor of the autopilot for airplanes. He worked on a device called the flux valve. The person he worked with is someone that probably would be Asperger’s. My mother’s written about that in her book. The partner, Antranikian—he had the idea of three little coils, where all the other engineers wanted to wire the autopilot up to the compass needle. He had the idea, but my grandfather knew what to do with it.

You see, this is the two kinds of minds working together. One person has the idea. There’s a very simple device, and somebody else has to make it work. They worked together in a loft over a place that fixed trolley cars. It was during the Depression.

The Bendix Corporation wanted to rent it from them, and this was really foolish. He rented it to Bendix. They ripped it off, put it in all the warplanes during World War II. Finally, when the war was ending, the Sperry Company brought it out. Flux valve is my grandfather’s. Flux gate is the rip-off.

My grandfather didn’t sue because we needed it in all the warplanes. He said it would be unpatriotic to sue. Now, in some ways, it’s similar to some of the stuff I did because I have a piece of equipment that I developed. It’s in all the big meatpacking plants. If you want to see it work, you can look up Beef Plant Video Tour with Temple Grandin. You’ll see this piece of equipment work.

GRABOYES: I have seen it.

GRANDIN: Now, this piece of equipment—the idea came from the University of Connecticut. A guy named Paul Belanger came up with the idea of an animal straddling a conveyor. It was a low-stress way to hold it. Then the degreed engineers built a model. Also, Paul was not the first author on the patent. I don’t think that was right.

Then, what the scientific researchers did is to do a scientific paper that showed that it was a low-stress way to hold them. Now, this thing was a plywood model, and the university was getting ready to throw it out. My job was to take this thing that was a plywood model—there’s no way it would work in a commercial plant—and make a real one.

I was like Grandfather on this. I took the thing, and I made it work. I had to design an inference design. I had to design a site. I had to design a way to adjust it for different size animals and make the thing work in real plants. That was my job. You see, this is an example of different minds working together.

In the ’80s, we did a calf version of it, which the Humane Society of the United States gave a bunch of money for it. The development was paid for. The original Connecticut research was paid by animal welfare groups. The development of the first commercial one was paid for by a consortium of animal welfare groups. You can read John Hoyt’s obituary in The New York Times. He was the head of the Humane Society of the United States. Then another donor paid for a lot of the development when I made the big cattle one, and then very quickly, it went to the industry.

I’m making sure I give the University of Connecticut people credit for the idea. My credit is I had to develop parts of it. I’m kicking myself, I didn’t get two parts patented on it because this was back in the ’80s, and this would have been the side adjustment and the entrance design. But I do have it published in my 1993 livestock handling textbook. I’ve got it in there. This is where you need different kinds of people doing things. This piece of equipment is in every large plant in North America.

GRABOYES: Yes, it’s interesting how many of the great inventions out there we identify with one name, but it really came from another name—the sewing machine, the vacuum cleaner. Some guy came up with an idea, went to someone else who knew what to do with it, and the someone else ran off with it and put his name on it. It’s a familiar story.

GRANDIN: I’ve made sure in everything I’ve written—especially academic stuff—I’ve made sure that the Connecticut group gets credit for the idea. But I saved that model that they made from the trash. They were going to take it to the dump. I got it, made it go throughout the industry.

After I got the first plant done for the big cattle, then I went to seven equipment startups after that because people would make modifications that would make it not work. The second plant shortened this metal shield that goes over the top of it, and the cattle went berserk in it. So I took a piece of cardboard and extended this metal shield with cardboard, and all of a sudden, they calmed down. We were running the rest of the shift with cardboard on it. You see, that’s an example of using behavior.

If I had not been at that second startup, it could have failed. People would make modifications, and I’ve had to go back into plants and remove modifications that did not work. The next seven startups I went to, I spent more time transferring that technology within industry successfully than I did on the initial project because I had to correct mistakes that people were making.

GRABOYES: We’ll talk a little bit later about the HBO film entitled Temple Grandin. There is a stunning scene in there where one of your designs has been tampered with to really ill effect. Explain that one if you could.

GRANDIN: That was shown very nicely in the HBO movie. There was a dipping vat. I had come up with a design where they’d walk down a non-slip ramp. They have to dip cattle to get rid of ticks, get rid of, I think, all scabies.

Everybody thought you have to slide cattle in, so they put a sheet of metal over my non-slip floor, and I walk in there, and there are some dead cattle there that had drowned in it. They show it in the movie—that actually happened. Then I went back in, and I took the piece of metal out, and then it worked. But again, I had to be there because that non-slip floor—just the precise angle—was very critical in making it work.

One of my original drawings is in the movie. I really, really liked that. Then I’ve got a number of professional papers I’ve done in Journal of the American Veterinary Medical Association and Journal of Applied Animal Behavior Science that describe all of these different things. Details of design matter. They put that metal plate in there, and it just wrecked it. I took the metal plate out, and then it worked fine. And the cowboy foreman did that. He just didn’t think it would work.

Neurodiversity, Innovation and Entrepreneurship

GRABOYES: Interesting. Let’s see how we can take your story and generalize it to enterprises or the economy in general. You and I talked last time a little bit about a research thesis I’ve been thinking about. Now, the name Mercatus is Latin for market. We study markets. We study how they work, how they don’t work, how public policy helps them, how it hurts them. I like to explain to people that we’re not anti-government, or certainly not anti–large corporation, but we tend to have a fondness for entrepreneurship.

My research focuses on innovation. I wrote a piece back in 2014 called “Fortress and Frontier,” which gave the name to this podcast series, in which I compare the large enterprises to a big fortress that’s trying to keep new ideas and new people out. The frontier, which is more like the information technology industry has been in the last 30 years—anybody could come in and contribute to it.

My thought is that revolutionary innovation—the question is, why does this happen in small upstart enterprises and not so much in government or large, well-established companies? You think of Bill Gates or Steve Jobs or Jeff Bezos developing world-changing innovations in their garages.

I suspect that part of the explanation lies in neurodiversity, that governments and large corporations are less likely to hire neurodiverse employees, and when they do hire such people, they’re less inclined to allow them to take full advantage of their strengths and to avoid their weaknesses.

I imagine a lot of the big meatpacking plants probably wouldn’t have hired Temple Grandin in the first place, and if they had hired you, they might not have let you do the sort of things that you have done. I don’t know, go on that. I’ve read some of the things, I’ve listened to some of your lectures on Bill Gates and Steve Jobs and others. Why don’t you carry it from there?

GRANDIN: Well, all of those companies started out small. Little companies innovate. I don’t care what the field is. One of the problems you get in the big corporations is they get very guarded of their intellectual property. I have found that the companies—and I’ve worked for every major meat company, where I’ve got to sign five nondisclosure documents and turn in drawings after the job. I’ll tell you what the secret is. They’re obsolete.

They just got a pile of junk there because they haven’t communicated enough with other people to find out that they’re no longer ahead, and so people lost time to guarding a bunch of obsolescence. I’m saying that absolutely seriously. There’s a tendency to get the not-invented-here syndrome. That’s what I call it.

Then somebody comes along and invents something in a garage, and this has happened over and over again. When I started my business out, one of the things that helped me get started and why people would hire me—I wrote about my projects. When I wrote about the dip vat in Beef Magazine, I did not talk about the metal plate that had been put in that made it mess up. I wrote about the things in the trade magazines.

A lot of this was all done before there was internet. The center track restrainers were all done pretty much pre-internet, and they’re still in the plants. They’re still using them. Now, they’ve replaced them because they’re worn out, but it’s still the same piece of equipment.

But I wrote about the things I did. I also explained to people exactly how to do it. These are not the kind of systems where you’re going to make piles and piles of money on it because it might be only 30 of the systems in the whole world. You’re talking about these pieces of equipment in a very, very large client. It isn’t something where you’re going to sell hundreds of computers or thousands of computers or something like that.

But also in the industry, there’s a lot of small innovators that make specialty equipment in the meat industry. Most of them have retired now, and some of these definitely were autistic. I know two guys I’m pretty sure were autistic—20 patents each, per person. Their stuff used all around the world. They’re close to retirement now, or they have retired. You need the neurodiversity to do some of the invention. It’s really important.

I want to talk about another thing: there’s been a lot of problems in scientific journal articles right now with replication of research, especially in biomedical. It gets down to methods. As a visual thinker, the part of the paper I look at to try to figure out why one scientific study is different from another scientific study is, I look at the methods section. There’s a famous case in cancer studies where all that was different was the way they stirred their cancer cells, and it totally changed the result.

I see that, so I’m talking about it now. There’re different types of stirring equipment. I am seeing that equipment right now as I talk about it. A beaker with a little magnet that spins around is one of them. Another one is a big box full of water that rocked. I am seeing it. Right now, we’re equating scientific rigor with statistics. Yes, statistics is important, but then I read the paper and I go, “You didn’t tell me what breed of pig you used. That can totally change it. You didn’t tell me how the chickens were housed. That can totally change things.”

Great Achievers and Education

GRABOYES: Interesting. I just read a wonderful book, and I would recommend it to anybody: your Thinking in Pictures, Expanded Edition from, I guess it was 2006.

GRANDIN: Thinking in Pictures, yes.

GRABOYES: Magnificent book for any listeners there. It discusses Temple’s life, her work, her philosophy, her views on religion, lots on autism. If you have autistic children, enormous amount of advice. I thought it was a gripping, mesmerizing book. I’d recommend it to anyone.

I think it was in there or in some of the videos I’ve seen—you’ve spoken about Einstein and Steve Jobs and others that you assume—or that people widely assume—were somewhere on the spectrum. Could you talk about that? Of some of the great achievers who pretty clearly were like Mozart?

GRANDIN: Well, Einstein did not talk until age three. That’s been documented. A child in that situation, no matter what label you put on, may be in special ed today. Where would he have ended up? I’m a big proponent of developing strengths. I had really good ability in art—showed up when I was seven and eight years old. I was always encouraged to do lots and lots of different kinds of art. Or you might have a kid who’s good at math. Well, then, somebody needs to encourage them to do the more advanced math.

What would happen to Einstein today? I think it’s interesting that he had a job in a patent office because that would have exposed him to a lot of new ideas, and they gave him all the electrical patents to look at. Think of all the ideas he would have gotten, going over patent applications in the patent office. I also read that he wore green corduroy slippers to work, with pink roses on them. It’s a patent office. That’s a little bit different.

GRABOYES: He was different in many ways. I think you’ve talked about Steve Jobs, maybe in that book or in one of your conversations.

GRANDIN: He was bullied in school, but he also had a lot of access to hands-on stuff that his father had in a shop. All of these big companies started out small in garages, dorm rooms, scavenged computer equipment. I think I remember reading something about one of the companies got computers out of recycled trash to start some of their stuff—starting out very, very, very small and gradually building it up and having a vision to do it. You see, you get in a big company—it’s like the Star Trek fan—you get assimilated by the Borg, if you’re a Star Trek fan.

GRABOYES: Yes, I am.

GRANDIN: And they don’t end up doing anything.

GRABOYES: You touched on education. Again, Mercatus—we tend to focus on how public policy affects all of these things. I’d like to start with public policy in education at the federal level, at the state level, at the local level. What do you think schools and universities are doing right or wrong with respect to students on the autism spectrum or otherwise atypical thinkers? And let’s include in that directives from the government telling the education system how to do what they do.

GRANDIN: I think the biggest mistake the schools have made is taking out all the hands-on classes. We’ve got some states where, in high school, you can learn English, algebra and sports, and that’s about it. They’ve just taken out so many other things. How can a student find out he likes music or she likes music if you don’t try it? Or likes theater, or likes to build things.

If I hadn’t had shop, art and sewing when I was in elementary school . . . I hated school. Then you’ve got some kids—they don’t get a chance to do any of these things. We need people that can do these things. When I started designing cattle facilities, it was just the same as designing things out of poster board when I was a child. It’s just grown-up cardboard, is all steel is. It’s the same kind of thing.

We need to value that there are different ways people think. There’s scientific evidence now, and I’ve covered some of it in my book, The Autistic Brain, on the object visualizers and then the more mathematical visual-spatial . . . Object visualizer thinks like a photo. Then the word thinkers . . . But these different kinds of minds can complement each other.

Let’s look at a mess like Fukushima. I’ve talked about that before. When I found out why that reactor burned up, I’m going, “How could you do this?” I can’t design a nuclear reactor, but maybe I need to be working on safety systems. How can you put your electrically operated emergency cooling pump in a non-waterproof basement?

You see, I see the water coming over the seawall, and that electric pump’s not going to work underwater. You see, I see that, and this is where we need a visual thinker to, “Hey, we better put in watertight doors.” They’re not exactly a new technology. That would have saved it.

The thing is, it’s that simple. You see, sometimes what you can do with visual thinking is greatly simplify something. Electrically run pumps do not run underwater. I have to protect them from that. That’s all I have to know about that reactor, and if that pump doesn’t run when I need it, I’m in a lot of trouble.

Problems with COVID-19 Vaccine Distribution

GRABOYES: Yes. We talked last time about the current logistical problems in distributing and administering the vaccine this year. In many ways, it’s been admirable. It came out far more rapidly than any vaccine has ever done, but on the other hand, getting it into people’s arms has been problematic. I still don’t have mine yet. You told me that you immediately had some thoughts on things that they might be doing wrong. Why don’t you share those?

GRANDIN: Let’s say we want to set up a drive-through at a fairgrounds. After you have the Moderna or the Pfizer, you’ve got to do a 15-minute wait for a possible allergic reaction.

So, I’m already figuring out in my head, how I can design my car flow so that I’ve got to time them as they go out the exit. I hold them there for at least 15 minutes, and I’ve got people checking the people, but then I have to have a way to pull a car out of the line really quickly and drive it back to the emergency place. I would just simply lay it out same way I would a cattle handling system. I’d Google Earth the facility.

Then you’ve got other ones that are walk-throughs. You do them inside a convention center, which is just a great big huge room. I’ve looked at some of the pictures of this stuff. You’ve got a bunch of chairs spaced out for them to sit in for that waiting period. Then you just got to time your line. It takes this much.

Okay, they check in, they do the shot, take the arm out of the car. As I’m talking about it, I’m seeing it. But I’ve got them out of a giant parking mess. This is a situation where you need to have different kinds of minds. Visual thinkers like me just to help design the logistics. How do I get them through there easily and safely? I can’t have lines of cars backed up down a freeway entrance. That would be a very bad thing. I’ve got to figure all that stuff out, and when you visualize it, it’s really, really easy.

Right now, to get into medical school, for example, you’ve got to be really good in math. Well, the mathematician isn’t the one that’s going to figure out just how to do the logistics, whether it’s a walk-through in a convention center or a drive-through where I’ve got to deal with all the car logistics.

I can just see it. It’s not complicated. I have to have some input, like, if an arm gets stuck out of a car, how long does it take to vaccinate them? Okay, I have a check-in station. Then I’ve got an injection station, and I have to have some times for that.

Then I’ve got the thing I’ve really got to deal with in cars—my exit because I’ve got to hold them for that 15 minutes or more, possibly. And then if somebody gets a reaction, I’ve got to have a way to pull out a car, so I don’t have the input back down some freeway ramp somewhere with a big mess, and I’m seeing that right now on some facilities I’m familiar with. I’m already seeing our fairgrounds and our equine center right now.

GRABOYES: Well, I hope you’ll share your thoughts with them.

GRANDIN: That’s the only way you can get a ton of people vaccinated. Of course, the other thing that’s a problem is supply. Okay, let’s say I set up for great big, huge day. We’re going to do quite a few thousand, and I don’t get the vaccine shipment. Well, that’s a big mess. How do you plan? Then I’ve got angry people. I’ve got a mess on a freeway ramp that I don’t want to have. I’m seeing those sorts of things.

You see, the different minds are good at different things. You see, that’s the thing—the different minds are complementary, going back to the scientific papers. Yes, we need to have statistics but right now, we’re equating statistics with scientific rigor, and we’ve got papers where the most basic method stuff is left out. Like how were mice used in an experiment? That can totally change the results, and it is a behavior experiment.

Overstandardization in Education

GRABOYES: Right. We talked a bit about, last time, overstandardization. I was sharing a little bit about my own history. In my early years, like anyone else, I had plenty of weaknesses. I won’t rattle those off today, but one of the strengths I had was that, for whatever reason, I began reading very early, at age three, age four. By four, I could read anything. I was quite a number of years ahead in reading.

But in school, I was always told, “Now, you need to read at your grade level, and we’re not letting you check out books that are ahead of your grade.” It was very frustrating. Like you, I had a great mother who said, “No, I’m not going to put up with that.” She would get me the books that I wanted. But I see that as this drive for standardization, that everyone should learn in exactly the same way and at exactly the same pace and exactly the same methods.

A great scholar of healthcare, Clayton Christensen, wrote that medical schools have this problem, that they’re structured, well, because of things that were written in 1910, all medical students were expected to proceed at precisely the same pace through precisely every course. You have different kinds of learners, and you waste time, and some people never actually learned pieces of it. What about this idea of overstandardization?

GRANDIN: I think it’s really bad. I’ve heard of this. “Well, you can’t read those books above that grade level.” I said, “If he can read high school books, let him read high school books if he’s in the third grade, or do more advanced math.”

The other problem you have with a lot of kids that have an autism label or some other special ed label is uneven skills—extremely good at one subject, such as math, for example. Then we need to move them ahead. A lot of these kids that are really good at math—they want the pure numbers. Get them the old-fashioned algebra book, the old-fashioned geometry book. Just move them ahead, move them ahead in the reading.

Now, I never could do algebra. That screened me out of a lot of engineering stuff because it’s too abstract. You can’t visualize it, and I’ve never passed an algebra course. Thank goodness in ’67, when I was a freshman in college, it was not required, but I had to have gazillions, tons of tutoring to wobble through statistics with a C.

Then I learned that the man that makes the very best devices for launching satellites out of rockets barely got through engineering school. He’s a visual thinker. He made one device that was similar to when you push the key, your trunk door opens, and he used a similar thing to get the satellites out of the nose cone. I looked at his client list. It’s a who’s who of everybody.

We’re screening out people that we need. This is the problem. I didn’t realize how bad it was until I started seeing some of the stuff in the meat industry, starting out with a state-of-the-art pork processing plant, and then the two chicken plants. That’s a really serious loss of skills.

You’re not talking about importing clothing from a foreign country that’s cheaply made clothing. The high-end equipment here—that’s very expensive because we’ve lost the skills to make it. We need the different kinds of minds, and they do different parts of projects.

GRABOYES: Years ago, I heard a talk by Burt Rutan, who is a famous aviation designer. He was telling a story of how a third-year engineering student came to him wanting an internship, and he said, “Well, why don’t you just come work for me?” He said, “I have one more year of engineering school.” He said, “What have you taken so far? And what are you going to take next year?”

He showed him, and he said, “I’ll hire you right now. If you finish that year, I’m not going to hire you because I know all those courses. In the fourth year, they’re going to teach you all the things you cannot do in engineering. I’m not the slightest bit interested in hiring someone who has learned what he can’t do. I’d rather you not know those things.” I think he said he came and became the head of research and development for the company, but it was this out-of-the-box thinking.

In your story, your mother defied what was considered the best medical expertise at the time when you were a child. Most of my writing, or let’s say an awful lot of my writing, has to do with people who have defied conventional wisdom in healthcare and said, “This is something we believed. It happens to be wrong. There are better ways of doing it.”

Could you share a little bit about that? You’ve certainly had and written about healthcare, the treatment of autism and autistic students, the medications. What do you see there about conventional—

Career Influencers

GRANDIN: Let’s just start with one thing I’ve been observing recently is, a lot of grandfathers coming up to me, a few grandmothers coming up to me that find out they’re on the autism spectrum when the kids get diagnosed, but this grandfather was a NASA engineer or this grandfather was a computer programmer out in Silicon Valley. I met him last year. They got good jobs. They had paper routes when they were young. A lot of these kids are not learning how to work. That is a really big problem.

Now, I had a speech therapist that was very good when I was young and a really important person. That was two ladies, older ladies that had a little school in their house, and there were a couple of Down syndrome kids in the class. I had a great third-grade teacher, this regular third-grade teacher. Then there was Mr. Carlock, my science teacher.

But let’s look at who got my career started because I’m seeing a lot of kids with an autism label—really smart ones—getting through school just fine, getting through college, lose it in the workplace. So let’s look at who helped me as an adult and as an older teenager. It wasn’t the medical profession. It was my aunt out on the ranch. She was an English literary major in college. She helped me when I was having a lot of problems and would counsel me.

Then getting my business started, there was a wonderful superintendent at the Swift plant, former military officer. I did not know that until I read his obituary about two years ago—Norb. He was very, very supportive. There were feed yard managers that let me come to their feed yards.

Then there was a guy—very, very helpful in starting my business—named Jim Uhl. He had a tiny construction company that he was just starting. Former Marine Corps captain. I seem to get along with the military people because when I was in college and having a lot of problems, the wife of the dean, who was also a military officer, was really helpful with a no-nonsense, let’s-get-things-done view.

Jim sought me out because he had seen some of my drawings. He had this little tiny company, and it was just starting, and he wanted to get someone that could design stuff for him. We worked together, and he was the person who built those dip vats. He also was somebody very helpful, a helpful mentor, former Marine Corps captain.

Somebody that helped me—there was another construction guy that hired me to do work at a construction company. I’m pretty sure he was on the spectrum. Jim was definitely not on a spectrum. Norb was definitely not on the spectrum, but they were both former military officers. They were people that really helped me, helped get my business started. Thank you, Jim. He then grew his company, his gigantic big construction company, and he’s retired now, but I can remember when it started, and we’d worked on these jobs together.

At this point I wasn’t getting any assistance from medical profession, but then as I went through my 20s, my anxiety worsened. Worsened and worsened and worsened. I’ve been taking one little tiny medication for 40 years. I think it was essential because anxiety was tearing my body apart with colitis. I resisted the idea of taking a medication. I describe it in detail in Thinking in Pictures.

I’d read journal articles. Mr. Carlock had taught me how to use the scientific library. I’d read an article in Psychology Today called “The Promise of Biological Psychiatry.” This would have been in my late 20s. But I resisted taking the medication. I laid the article aside. It had the names of two drugs in it. I actually went and looked up the original medical article.

Boy, I can tell you in those days that was a pain because you had to look them up in this big gigantic book called the Index Medicus. I read the symptoms, and I go, “It sounds like me.” But then after I had a very stressful eye operation, I decided I’ve got to get the medication. I talked my family doctor into giving me this low dose of this ancient old tricyclic drug, Imipramine.

Then a couple of years later, I switched to Desipramine, and it worked like magic. I don’t dare go off it. I think it’s made by some factory in India. I said, “Please, factory in India, please shipping containers and everything else I can visualize, keep bringing this stuff over here.” Because I’ve seen other super creative people—had to take a little medication, go off of it with disastrous consequences. That I don’t plan to do. I wrote in my book, “Better living through chemistry,” the old DuPont slogan.

But there’s way too many kids drugged up on way too many drugs. I’ve talked to parent after parent. You’ve got a ten-year-old on five drugs. That’s rubbish. That’s absolute rubbish. I find out no thought went into it. For an older person, maybe a little bit of just the right thing. It can work wonders. I’ve seen it work wonders.

They get just a little bit of the right thing and then they go off of it, and it’s a mess of all messes. No, I will take it for the rest of my life. If they stop making it, I’ll have to switch to another drug. I’m not looking forward to that. Please, factory in India—I think it’s all generic now—please, wherever it comes from, keep making it.

GRABOYES: Keep it up.

I’ll just recount a funny little story from my life on the standardization and trying to mainstream everything. Fifteen years into my career as an economist, I applied for a job, and I was surprised they brought out a psychologist who administered the Myers-Briggs test. He was absolutely humorless.

He called me in afterwards and said, “You can’t possibly be an economist.” I said, “I am. Actually, I think I’m a pretty good one, and I’ve been one for 15 years.” He said, “No, no one with your Myers-Briggs profile can be an economist.” I said, “Well, I am.” This went on. As far as I know, he vetoed my getting the job—which was fine, I didn’t really want it that much—but it was such a funny thing that because I did not fit into the pigeon hole that he wanted, I couldn’t possibly be doing my job. I see a lot of that in large organizations.

Literature and Film

GRABOYES: You first came to my attention in Oliver Sacks’s essay. For those who don’t know Oliver Sacks, he died a few years ago. He was a neurologist and just a magnificent literary character as well—beautiful. He wrote stories. I’ve read dozens, maybe a hundred stories he’s written about interesting people like Temple and other interesting neurological patients he had met with. I always said that every time I read one of his essays, afterward I knew less about the human brain than I knew before I read it, because he just impressed on what a magnificent mystery the human mind is.

Temple’s essay, which was also the name of the book, was “An Anthropologist on Mars.” Could you tell a little bit about the origin of the title of that essay and what that essay—how it impacted your life and career?

GRANDIN: Well, I got a lot more busy after the Oliver Sacks essay was published in The New Yorker magazine. An agent named Pat Breinin approached me about doing Thinking in Pictures. It made me a whole lot busier, and then the HBO movie made me even busier. I have people walk up to me in the airport and say, “Well, what do you think of all this attention?” I say, “It’s a responsibility.”

I got a lot of kids that look up to me, and I want to see these kids that are different get out and be really successful because I’m seeing too much of them getting stuck totally in the autism box, where that’s becoming their whole sense of being, and they’re not getting out and doing enough stuff. I was just on a call yesterday and there’s a guy, a real attractive-looking guy about 20 years old, sitting at home, and I just said, “Get a job. You’ve got to get out and do something. Right here in my town, our grocery store is hiring right now. Get a job.”

Now we have to be a little bit careful about multitasking. That’s something I’m not very good at. If I have to do a job that involves a sequence, I need to make a little pilot’s checklist because I have a very poor working memory. If I’m a computer, I’ve got the cloud’s super warehouses full of servers back here for graphics memory, but I’m accessing it on a phone with only one bar of service. I like that visual analogy. There are certain multitasking things that I have a problem with. Those kids just need to get out and just get a job.

GRABOYES: Your book was filled with fascinating quotes. One that I just keep thinking about and thinking about and thinking about was, you quoted some fellow as saying, “I have an interface problem, I don’t have a core processor problem”—that the problem was, he can think anything, but getting information in and getting it out is his problem.

GRANDIN: Yes, and the thing is, see, when I do drawings, there’s no multitasking. There are certain things like, let’s say a guy’s programming computers. He’s coding. He’s just getting it all out of memory. There’s no multitasking. But the same brilliant coder—we put them on a really crazy busy McDonald’s takeout window. He’s going to probably get fired because that puts too much load on working memory. This is one of the things that tends to be there that can’t handle the load on working memory.

But some brilliant guy who’s inventing something in his shop—there’s no load on working memory because he’s just working on that one thing. This is a guy that’s got 20 patents, and half of them are actively being used. I can’t go into what the patents are. I’ve got to keep the confidentiality, but I’ve looked them up. I’ve gone through them, and I say, “Well, that piece of equipment’s still being used.” One owns a big metal fabrication company.

GRABOYES: Remembering correctly that you said, while you didn’t speak till after four, you knew what people were saying. You could comprehend around you.

GRANDIN: I could comprehend as long as the grown-ups weren’t talking too fast. I actually thought grown-ups had—I used to call it grown-up talk. Grown-up talk was “La la la la la la.” When they talked really fast, I could not hear the hard consonants, so when my speech teacher worked with me, she’d hold up a cup, and she’d say, “cup,” and then she’d say “cup-pa,” where she’d enunciate to teach me my words. Now, if they spoke directly to me and spoke reasonably not fast, then I heard them just fine.

The HBO Film

GRABOYES: I know that was done in the HBO film. They had your mother using the technique, sitting on the stairs with you. Talk a little bit about that. We’re almost out of time, but I will have to say the movie—I found it just stunning. I’ve been meaning to watch it for years. My wife and I watched it recently, which is what got me started on my conversation with you. I thought it was brilliant.

You’ve told me, and I’ve seen you say elsewhere, that they did a really strikingly good job of portraying you and your work and autism. I was just mesmerized by Claire Danes’ portrayal of you. I would recommend that anybody who hasn’t seen it should see it and would like to hear your thoughts on it.

GRANDIN: The most accurate thing in that movie is how they show my visual thinking. That is absolutely accurate. Claire Danes became me, and she was given all these old VHS tapes from the late ’80s and early ’90s. She practiced and practiced and practiced. All the projects are real—the dip vat project, the gates, the optical illusion room—I did those projects. And the main characters, like Mr. Carlock, my aunt, mother—they were shown really nicely.

Being a Spokesperson on Autism

GRABOYES: As a final question, I know that you—as I said earlier—you became one of the world’s leading spokespeople on autism. Just tell us a little bit about that experience and what you can accomplish and what you do.

GRANDIN: Well, I try to give people very, very practical information. I’ve been years involved with the construction industry, and construction is all about finishing projects. I want to see these kids get out and get successful careers, like some of the people that I worked with in construction and some of the people that helped me. I think this is really important.

Sensory issues, we’ve got to look at. There’s a real problem with certain people with lights flickering. I don’t have this problem, but now we have all these newfangled lights. I just spent half an hour talking to a lady about some LEDs flicker, some don’t. That can be debilitating. Problems with noise, problems with multitasking. Now, these people that had all these patents and stuff—well, they could have whatever lights they wanted in the shop, so they didn’t have to deal with these problems. They were not multitasking.

But I’m seeing too many kids that got a label, that need to get out and get a life. There’s a problem sometimes where some of the families and some of the professionals get so much into the disability mentality, they can’t imagine their child doing anything else. I’ve worked with two people that had metal fabrication companies, and they were definitely autistic—undiagnosed—and a pile of patents and stuff out there being used in the industries.

GRABOYES: Well, terrific. I don’t want to be obsequious, but you have been an inspiration to me for 25 years since I read that essay. Reading about you and watching you—it really, in some ways, changed the way I think about my own profession, about economics, about the way enterprises work, so I thank you for it.

Unless you have something additional to say, I’ll just say thank you, and it’s been such a pleasure to have you with us today.

GRANDIN: It’s been a real pleasure to be here, and we need to be going across disciplines, too, to get ideas. The first thing we need to be doing is cut the jargon out so that, then, the people can communicate—one of the things you need to do.

Look at where different skills fit together. Let’s go back to the food processing plant—the degreed engineer, the mathematician—boilers, refrigeration, roof trusses, soil compaction. And then the visual thinkers who failed algebra—they build all the clever machines that go inside. I call it the clever engineering department. You need to have both. I can’t emphasize that enough.

GRABOYES: There’s a book—I think it’s the most important book on healthcare innovation in the last 25 years—Clayton Christensen, Jerome Grossman and Jason Hwang, called The Innovator’s Prescription. Quite a bit of what you’re saying has crossover with that. I highly recommend it—wonderful descriptions of automated processes and where we go wrong in the design of them.

GRANDIN: Both kinds of minds are many, many, many things. Now, I’m using industrial examples because that’s stuff I’m the most familiar with, and I was out on these projects for extended periods of time.

GRABOYES: Well, with that, I think I shall say that’s about it for today. I look forward to having some more conversations with you. You’ve generously offered to help educate some of our students, and I’m going to take you up on that.

GRANDIN: I would very much like to do that. I have a TED talk I did. It’s called The World Needs All Kinds of Minds.

GRABOYES: I’ve seen it.

GRANDIN: We definitely do need. Let’s talk about Zoom. It’s easy to use because the visual thinker like me would have made the interface, but we need the mathematician to program it. You need to have both.

GRABOYES: That’s a wonderful closing statement. Temple Grandin, thank you so much for your time. It’s been such a pleasure.

GRANDIN: Thank you for having me on your podcast.

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