and uttering obscenities, often related to feces (coprolalia). This last word translates in Greek literally to shit talker. Though only about one in ten people with Tourette’s exhibit coprolalia, there’s a widespread misconception that everyone with Tourette’s is subject to uncontrollable outbursts of profanity. This is also the de facto misimpression one gets from TV and other media (e.g., the South Park Tourette’s episode and the ranting “Tourette Guy” on YouTube).7
Little is known about what causes Tourette’s. In the fifteenth-century book Malleus Maleficarum, considered the first written account of what’s now called Tourette’s, a priest’s tics were believed to be “related to possession by the devil.” When it first entered the medical lexicon in the late nineteenth century, it was considered a “moral” social infirmity resulting from roguishness and a debilitated will. From the early- to midtwentieth century, it was characterized as a psychiatric illness requiring psychotherapy. Now that neuroscience has taken epistemological center stage, it’s seen as involving abnormalities in the brain and its circuitry, which affect the production and/or reception of dopamine,8 the neurotransmitter involved in initiating movement.
Although the exact cause of Tourette’s isn’t known, recent findings suggest the condition can confer advantages as well as impediments. Tourette’s can result in increased attention to detail and heightened awareness. Neurologist Oliver Sacks has noted that, while Tourette’s is often destructive in its effects, it “can also be constructive, add speed and spontaneity, and a capacity for unusual and sometimes startling performance.” In timed neurological tests for motor coordination, children with Tourette’s were faster than their peers. In other neuropsychological studies, they showed higher cognitive control: all those childhood hours spent trying to suppress tics served as a form of mental training. One can only guess at how this cognitive advantage and nervy sensitivity might play out when applied to a complex and sensory-rich environment like water, where feel and proprioception—the awareness of one’s body movement and position—are so crucial.
A 2014 20/20 piece exploring the possible relationship between Tourette’s and athletic excellence referenced two athletes. The first was the US soccer goalkeeper Tim Howard, whose performance in the 2014 World Cup was so impressive that Americans actually started watching soccer. The second athlete was Anthony Ervin.
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The day after the pool incident, Anthony’s mother took him to the pediatrician, who suspected Tourette’s and referred him to a neurologist. After several visits that included sleep-pattern tests and a CAT scan to rule out a brain tumor, the neurologist diagnosed Anthony with Tourette’s. By now his blinking fits had escalated and would commence as soon as he woke up. Concerned about the stigma surrounding Tourette’s, Sherry asked that Anthony’s condition be listed in his school records as a “nonspecific neurological disorder.” As the family learned more about the condition, some of Anthony’s elementary school behaviors made more sense. Tourette’s is a complex struggle between the self and what feels like an outside force besieging it with physical and mental compulsions. This accounts for the variety of neurobehavioral conditions that can accompany Tourette’s like OCD and ADHD. Anthony exhibited tendencies of the former: washing his hands repeatedly; spending minutes on end before a mirror to make sure his hair’s part and curl were exact; lining up books in ascending order; grouping colors.
His mother suspects that much of the waywardness during his early years could be attributed to “Anthony dealing with things neurologically that nobody realized.” And though vocal and physical tics tend to subside with age, the depression, anxiety, panic attacks, and mood swings that can accompany Tourette’s often persist through one’s adult life. Anthony’s cognitive ability in later years to train and race with the undistracted tunnel-like focus of a racehorse with blinders also had a destructive counterpart: a tendency to obsess single-mindedly over disaster scenarios and then paralyze with anxiety over a sense of impending calamity.
A chronic but nondegenerative disease, Tourette’s has no cure, though it can be treated. Anthony was prescribed clonidine, a hypertension medication also effective in suppressing tics. They started him on a quarter of a pill. Five days later they increased the dosage to half a pill, but he was still subject to frequent blinking fits. Only when they increased the dose to a full pill did he wake up without blinking or twitching.
Not until later in high school, at higher doses of medication, did the tics fully come under control. In junior high, he was still subject to convulsive episodes. But aside from excessive swearing during emotional moments (which he admits he often indulged in simply because he had the medical excuse), his tics were more physical than verbal. Ervin likens the experience of a Tourette’s fit to watching an online video with slow connectivity where the clip keeps pausing to buffer.
Jackie recalls Anthony in junior high sitting on his bed, struggling to read: “It would take him forever to get through one page. His eyes would close, and he would lose track over and over again. It was heartbreaking.”
Lorac insane, dying . . .
“Raist!” he moaned, clutching his brother tightly.
Raistlin’s head moved feebly. His eyelids fluttered, and he opened his mouth.
What?” Caramon bent low, his brother’s breath **** Caramon bent low, his brother’s breath ****** head moved fee *** fluttered, and he **** eyelids fluttered, and he ** he opened **** fluttered **** opened his mouth *** his mou ** mo ** mouth *******
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I can’t. I put down the book and wait for it to pass.
Here in my room, at least I don’t have to control it. I can just let it happen. At least here no one is staring at me and avoiding me like at school or like my old neighborhood friends. Everybody avoids me now. Only at swim practice do they act the same around me, probably because swimming is hard and we all do it and what we go through together and have in common is more important than what we don’t.
Yesterday I watched a nature show about animals living high up in the tall mountains. In one part there was a crazy snowstorm and nothing but snow and ice and darkness and freezing wind. It was the last place in the world you’d want to be. Most of the show was about nature and animals, but for one part during the snowstorm it showed the people who filmed it inside their tent, with a little light hanging over them. It was cramped inside and they could barely sit up in the tents and they were laughing and joking about having not showered for ages and didn’t seem to care at all about being crammed into that tiny space because they were warm and had each other. I remember that.
I remember the one bird stuck in the storm. It didn’t have a tent. It didn’t even have a tree. Just the ledge on the mountain. It ruffled its feathers and shut its little eyes and shrunk down into itself. It looked like a tiny statue someone had left on the mountain. It went quiet and deep inside its own body, so deep that it was safe and warm even if its feathers were covered in snow.
They showed lots of other stuff too, like mountain goats charging each other and slamming heads together and a wild cat with her baby. But mostly I remember those men with smelly socks laughing in their tents. And the bird all alone out there with its eyes shut in the storm, not moving because there was no other place to go.
If April is the cruelest month, then adolescence
