Longreads

From the beginning, their physical relationship was governed by the peculiar ways their respective brains processed sensory messages. Like many people with autism, each had uncomfortable sensitivities to types of touch or texture, and they came in different combinations.

Jack recoiled when Kirsten tried to give him a back massage, pushing deeply with her palms.

“Pet me,” he said, showing her, his fingers grazing her skin. But Kirsten, who had always hated the feeling of light touch, shrank from his caress.

“Only deep pressure,” she showed him, hugging herself.

He tried to kiss her, but it was hard for her to enjoy it, so obvious was his aversion. To him, kissing felt like what it was, he told her: mashing your face against someone else’s. Neither did he like the sweaty feeling of hand-holding, a sensation that seemed to dominate all others whenever they tried it.

Justin is among the first generation of autistic youths who have benefited throughout childhood from more effective therapies and hard-won educational opportunities. And Ms. Stanton-Paule’s program here is based on the somewhat radical premise that with intensive coaching in the workplace and community — and some stretching by others to include them — students like Justin can achieve a level of lifelong independence that has eluded their predecessors. “There’s a prevailing philosophy that certain people can never function in the community,” Ms. Stanton-Paule told skeptics. “I just don’t think that’s true.”

A few months later, Buddy traded $800 and bartered time and equipment for a 51-foot boat that needed, among other things, a new layer of fiberglass. When the Deepwater Horizon oil rig exploded 41 miles offshore last April, they were almost done with the seemingly endless repairs. Their goal had been to finish before the young brown shrimp, at their sweetest and most succulent, began to move in May from the marshes to spawn in the salty gulf. And when the oil company’s efforts to cap its leaking well fell short, Aaron recorded it on his Facebook wall. “BP fails.... AGAIN!!!” he posted on May 29. Then, on June 15: “Sleepless night, lots of thinkin goin on.”

When two cousins each learned that a lethal skin cancer called melanoma was spreading rapidly through his body, the young men found themselves with the shared chance of benefiting from a recent medical breakthrough.

Even if some combination of targeted drugs could put melanoma into a long hibernation — and that was still not clear, he knew — it might take a cocktail of five or more such drugs to treat any given case. And it can take 10 years for even one drug to reach the market.

The trial of a melanoma drug offers a glimpse at a new kind of therapy tailored to the genetic profile of a cancer.

At what may be a watershed moment in understanding genetic changes that cause cancer, a small band of doctors is doggedly testing a drug known as PLX4032.