My older brother Mike doesn’t know he’s in trouble. Mike is low functioning, autistic and has never spoken. He is inwardly directed, if that concept even makes sense for him. I spent many years trying to understand my brother and, I don’t know him any better than I did 60 years ago. Mike breathes in and out with the help of a ventilator. He only responds to his name with a twitch of a finger and movement under his eye lids. I really hope he doesn’t know he’s in trouble.