What should you say when you’ve just sprayed blood into someone’s face?

As an autistic guy, I have a number of rehearsed responses to virtually every question and situation. I don’t think I’m alone in that – much of society have pre-programmed sets of words they drop into sentences to convey meaning without having to engage their brains and thus slow down the communication.

When we meet a casual acquaintance, for example, we don’t choose every word to create a sentence – we select a block of meaning, as from a drop-down menu, and send it to the mouth:

‘Hi, how’re you?’

The unthinking response is invariably, ‘Fine, thanks, how’re you?’

We do this all the time. It’s the reason idioms are so divorced from their literal meanings – catch you later, how’s tricks, I’ll take a rain check, a piece of cake, shitting bricks. Instead of thinking of each individual word, we select the meaning we want, and the particular register (formal, informal), and our brains arrange the chunks and make the sentences for us.

If we didn’t operate like this, it would take too long to say anything and too long to interpret what other people are saying. It’s as though society has consented to ignore the individual words and ascribe meaning to blocks of words – they’ve agreed that ‘once in a blue moon’ means ‘rarely’ and ‘over the moon’ means ‘pleased’, for example.

This can be a good thing for those of us on the spectrum, as it means we can fake empathy and not have to struggle to figure out what someone’s thinking or feeling. So long as we learn the rules – which can admittedly be difficult in itself – we can fit in.

For example, I’ve had to learn that when people ask, ‘How are you?’ it’s merely a means of facilitating conversation and not an earnest enquiry after your health, so you’re not meant to tell the truth (for a time, I answered with, ‘Entering the inner sanctum of the seventh circle of Hell, and you?’ just to see the reactions).

Where a context-specific response is required and I can’t tell whether a comment is serious or sarcastic (‘Lovely day, isn’t it?’) I normally reply with ‘Indeed’ or ‘Absolutely’ so that it fits both. Unless I’m tired and slip into Aspie mode, where I’ll take everything literally, overthink everything I say and consequently fail to communicate, I can normally mask my difficulties.

However, there are three situations I keep encountering that I’ve never figured out how to deal with.

There’s a lady at the school gate who keeps slipping into small talk that her eldest daughter died as a toddler. Every time she does it, it’s so matter-of-fact that it knocks me off track.

‘How was your Christmas?’

‘It was really good. We lost a child at Christmas, so we make the most of it every year. How was yours?’

‘Er, er, yeah, fine,’ but all I can think is, Should I be saying, ‘oh dear’, or ‘that’s terrible’, or ‘poor you’, or ‘what happened’?

Another difficulty is when old people look at you, groan wearily, and say, ‘Don’t get old.’ Since I live in a village full of elderly people, this happens more often than you’d think. How the hell are you meant to respond to that?

‘I won’t,’ or ‘I’m not planning to,’ sounds like you’re going to kill yourself. Saying, ‘It happens to us all,’ is a bit patronising because they’re old and in pain and I’m not, as is minimising their experience with, ‘It can’t be that bad’ or ‘It could be worse’. And giving some philosophical statement like, ‘Youth is wasted on the young,’ or ‘Any day there’s air in your lungs is a good day,’ is a little too in-depth when you’re standing in a queue at the local shop.

But the worst, the absolute worst, is when I spray people with blood.

I’ve mentioned before that I donate platelets. The way they do it is to put a blood-pressure cuff on your upper arm, inflate it, then stick a needle in your arm. Despite having normal blood pressure, for some reason I have a tendency to squirt. It’s like popping a balloon – the second the needle touches my arm, boom! Blood spattered all over their hands.

So I warn them every time. And every time they’re like, ‘Ah, I’m better than the other nurses, it won’t happen to me,’ and every time – pop – I get them.

There’s something incredibly intimate about blood, so it makes me feel embarrassed and kind of dirty when I spray it over some poor girl’s hand, or neck, or face. The girl yesterday got it all over her bare hand and up her arm, and was clearly horrified, and in those situations I have no idea what to say.

I muttered, ‘Sorry,’ but that seems on the one hand inadequate (I’ve just squirted my bodily fluids over her, after all) and on the other pointless (I can’t exactly control it, can I?). I once tried, ‘See? Told you so,’ but decided that’s rubbing salt in the wound. Likewise, ‘Gotcha!’ makes me seem like a sicko who enjoys the sight of his blood on someone’s cheek.

So I just sit there uncomfortably and squirm. Every time.

If anybody has some advice for how I can respond, I’m all ears!