Best Boy is a novel about Todd Aaron, a 54-year-old autistic man who has lived for 40 years in a Payton LivingCenter (sic); he was involuntarily committed to this facility. Todd has been in five previous places for congregate living, but Payton seems to be the best for him, thanks in part to a loving caregiver, Raykene. Todd has accepted the institutional “Law” of Payton and takes his drugs right on schedule, including Risperdal, an antipsychotic that slows him down, making a “roof” over him and muffling, he says, “the voice in my brain.”  The story is told from Todd’s point of view, often with startling imagery:  he pictures his dead parents turning into giant cigars, a raindrop “explodes,” and, when upset, he rocks back and forth and feels “volts.”  Now and then he recalls that his mother called him her “best boy.”
Into this stable setting come three personified disruptions. The first two are fellow patients, Terry Doon (a pun on “doom”?), a brain-injured roommate who teases, torments, and bullies Todd, and Martine Calhoun. While Terry disrupts Todd’s living space, Martine is a siren who lures him to different parts of Payton’s campus; she is also a rebel who urges him to stop taking Risperdal and shows him how to hide the drug in his hand and get rid of it later.   

The third is Mike Hinton, a day staffer who lies, manipulates, and in general mistreats Todd. Todd understands Hinton as evil and entertains violence against him—but does not act. Hinton has sex with a female patient who dies, apparently a suicide, although the language of Payton’s staff, as reported by Todd, euphemistically hides the truth.

Todd has the “Idea” of escape and sets out, on foot, to go 744 miles to “home.” A state policeman soon returns him to Payton.

Now and then Todd’s younger brother Nate calls, often while drinking. Near the end of the book, Nate and his wife Beth take Todd to his childhood home, where he had been abused physically and mentally. In a moving scene, Todd enters the only unchanged area, a crawl space and feels the return he yearned for.            

All three tormentors leave Payton, and there is a surprising resolution for Todd.  The balance and harmony of Payton’s LivingCenter are restored, and Todd, reminded by Raykene, affirms that “Somebody always loved me.” 


As a work of fiction, Best Boy is engaging, compelling, and startling. Todd’s point of view provides many fresh perceptions of reality. He sees dogs this way: “They were people with distorted long ears and long noses and pointed big teeth in their mouths who had been crushed in strange bodies and forced to bark horribly instead of talking but they were still people” (p. 205). Besides his imaginative perceptions and expression, Todd’s personality is engaging because he is direct, honest, and moral.
In an age of realism, irony, and absurdity, the story may seem too neat (three characters disrupt and are expelled; the ending takes care of Todd), but I think it should be read as a moral fable, an allegory of sorts that illustrates the poor care for mentally ill in this society.  Hinton should never have been hired.  Drugs are misused, even by staff. Administrators gloss over difficulties and tragedies; one speaks of the villainous Hinton as “a less-than-optimal situation.” The book includes angry satire on behalf of persons such as Todd.  At the same time, realistic details about mental health care seem authentic. 

This novel is a work of “engaged literature,” in Sartre’s phrase, urging us to grasp moral and political issues, in this case, America’s poor care of mentally ill patients.            

Background information about autism and various treatments is presented by the concept that Todd, who is reporting, reads the Encyclopedia Britannica and searches on the Web.  I’ll leave to mental health professionals how to judge the likelihood of this device, but the information is useful and gives context to the story.

In Best Boy, Gottlieb has returned to the subject of autism that he explored in his debut novel The Boy Who Went Away (1997), apparently also inspired by his older brother Joshua. (Best Boy is specifically dedicated to Joshua Gottlieb.) 

Gottlieb’s opinion piece in The New York Times, “Adult, Autistic and Ignored,” makes clear the impact of a mentally ill person on a family and the failures of a society to care for such people, especially as they become older.          

Best Boy provides a compelling contribution to disability studies because it presents the lived experience of an older, autistic man as well as his relatives as they encounter many difficulties—legal, economic, and moral—in current mental health treatment. 


Liveright Publishing Company

Place Published

New York

Page Count