For many, Tourette syndrome is synonymous with spastic yelling and expletives. But beneath this reductive, albeit often humorous, stereotype, Tourette’s tells a more complex, sympathetic and sometimes beautiful story of social outcasts burdened with the gift of compulsive expression. From demon possession to cable television, this map explores some key instances of Tourette’s in popular culture and what our relationship with the neurological disorder reveals.
In 1885 neurologist Gilles de la Tourette formally described the neurological syndrome that has come to bear his name. He called it maladie des tics (disease of tics) referring to the involuntary and compulsive vocalizations and body movements that are the disorder’s signature symptoms. But historians agree that the first record of Tourette’s appeared centuries earlier, in the Malleus Maleficarum, an unscientific text by Heinrich Kramer and Jacob Sprenger, Inquisitors of the Catholic Church hailing from Germany. Translated as Hammer of Witches, the book instructs Catholics on how to rid the world of the demonically possessed, and it outlines some telltale signs of possession, many of which we now know are symptoms of Tourette’s. Kramer and Sprenger describe spasms of the voice and body—most notably in an account of a young Bohemian priest who yelled obscenities when passing churches. “I cannot help myself at all,” the priest explains, for the devil “uses all my limbs and organs, my neck, my tongue, and my lungs, whenever he pleases, causing me to speak or to cry out; and I hear the words as if they were spoken by myself, but I am altogether unable to restrain them.”
Though Tourette syndrome wasn’t formally described until more than a century after his death, the influential writer and lexicographer Samuel Johnson was posthumously diagnosed with the condition. No wonder the aptly named neurologist Russell Brain called Dr. Johnson “The Great Convulsionary.”
“When he walked,” describes Johnson’s authoritative biographer, James Boswell, “it was like the struggling gait of one in fetters.” Johnson held his head “to one side towards his right shoulder, and shook it in a tremulous manner, moving his body backwards and forwards, and rubbing his left knee in the same direction, with the palm of his hand.” Johnson’s friend, novelist Fanny Burney, remembered, “His mouth is continually opening and shutting, as if he were chewing something; he has a singular method of twirling his fingers, and twisting his hands: his vast body is in constant agitation...his feet never a moment quiet.” Though little proof exists, historians agree that Johnson likely shouted Tourette’s-like expletives as well. To this last point, medical scholar J.M.S. Pearce has suggested Johnson’s colleagues “concealed this trait for fear of impugning his formidable reputation.”
In Jonathan Lethem’s postmodern detective novel Motherless Brooklyn, the narrator, Lionel Essrog, is a small-time assistant private investigator who suffers from Tourette syndrome. In creating this protagonist, Lethem diverged from the widely held assumption that Tourette’s patients must exhibit coprolalia, or compulsive cursing, and instead gives Lionel several other scientifically accurate behaviors, such as obsessive counting and repetitive touching, echolalia (pathological repetition of what others say) and the compulsion to shout nonsensical phrases in midconversation. (Alfred Hitchcock becomes “Altered Houseclock,” while Lionel Essrog’s own name becomes a telling clue: “Unreliable Chessgrub.”)
More than a gimmick to spice up a work of genre fiction, Lethem’s treatment of Tourette’s lends depth to both his story and the disorder, with each informing the other. Lionel’s interior narration on the page, for example, is unencumbered by his affliction. He refers to it as “Tourette,” something apart from himself, which ultimately becomes a character just as important to the story as Lionel. In fact, “Tourette” plays a key role in solving the novel’s central mystery. “Let Tourette be the suspect,” Lionel says at one point, “and maybe I’d get off the hook.”
Though coprolalia, the involuntary utterance of obscenities, is most widely associated with Tourette’s, only 10 to 15 percent of patients exhibit the symptom. But it’s no surprise that when South Park creators Matt Stone and Trey Parker developed an episode titled “Le Petit Tourette,” they milked coprolalia for all it was worth.
At the beginning of “Le Petit Tourette,” Stone and Parker go straight for the low-hanging fruit: A school-age boy with Tourette’s swears explosively, piquing the interest of Eric Cartman, the show’s young Machiavellian antihero and frequently antagonistic protagonist. True to form, Cartman sees the affliction merely as an excuse to “say whatever you want all the time and never get in trouble” and proceeds to convince the entire town that he too has Tourette’s.
As the episode progresses, however, a more accurate portrait of the disorder emerges. Cartman’s friend Kyle, as punishment for (accurately) claiming that Cartman is in control of his actions, attends a Tourette’s support group whose members demonstrate a wide variety of involuntary vocal and motor tics. Cartman eventually learns his lesson only when he becomes overly accustomed to ignoring his impulse control and begins blurting humiliating sexually charged secrets about himself along with his rehearsed profanities.
Heinrich Kramer and Jacob Sprenger wrote Malleus Maleficarum to catalog and help identify characteristics of witches and individuals possessed by the devil. One key passage almost certainly describes Tourette’s, a syndrome that wouldn’t be named formally for four centuries: “He who forms the voice…successively strik[es] his teeth with his tongue.”
Cut to 18th-century London: Samuel Johnson struggles with disruptive symptoms of an as yet unnamed syndrome, “sometimes making his tongue play backwards from the roof of his mouth, as if clucking like a hen, and sometimes protruding it against his upper gums in front,” according to his contemporary and biographer James Boswell. Although we don’t know for certain if Johnson had read Malleus Maleficarum, we know he was a religious man—he carried around a copy of Hugo Grotius’s De Veritate Religionis Christinae (1627), a didactic poem arguing the truth of Christianity. Further, Dr. Johnson’s vocal tics were riddled with “pious ejaculations” and snatches of the Lord’s Prayer. Considering Johnson’s expansive knowledge of classical and religious texts, he likely would have known all about the Catholic Church’s association of his symptoms with demonic possession, especially where misbehavior of the tongue was concerned.
Samuel Johnson was a profoundly influential scholar who suffered from Tourette syndrome. Though the disorder is popularly characterized by physical and verbal tics, it also produces “imaginative outbursts of inventiveness and creativity” as well as obsessive-compulsive behaviors, without both of which, Dr. J.M.S. Pearce suggests, “Johnson’s remarkable literary achievements, the great dictionary, his philosophical deliberations and his conversations may never have happened.” Jonathan Lethem, another prolific author and wordsmith, bestowed these same creative, linguistic and obsessive-compulsive Tourette’s traits on the narrator of Motherless Brooklyn, Lionel Essrog. In fact, Lionel reaches his full potential precisely because of his erratic behaviors.
Similar to how Dr. Johnson’s affliction seemed to drive him to a life of lexicography, Lethem’s character lives in a world of words. Lionel’s “Tourette’s Brain” illumines new truths simply by renaming elements of the world around him: “My words begin plucking at the threads nervously,” he says at a critical point in the tale, “seeking purchase, a weak point.”
The compulsive behaviors associated with Tourette syndrome cause feelings of guilt, especially among patients whose tics include obscene vocalizations or gestures. Not even Samuel Johnson’s status as the preeminent authority on the English tongue exempted him from this shame. Neurologist and medical historian J.M.S. Pearce asserts Johnson spent a great deal of time “harping...on his former sins, on the sensuality of his thoughts,” while Johnson scholar James L. Clifford ascribes Johnson’s shame “to sexual guilt, strong sexual desires...and possibly masturbation.” The 18th-century artist Frances Reynolds recalled of Johnson, “Copralalia and scatological comments are very probable.”
As if a case study itself, the South Park episode “Le Petit Tourette” follows young Eric Cartman as he pretends to have Tourette’s for the express purpose of being allowed to yell obscenities and insults without getting in trouble. But the guilt and shame catches up with him when he begins involuntarily shouting his secret sexual experiences and desires. Ultimately the episode sends up the notion that Tourette syndrome, because of its common association with expletives, is a sensationalist issue. To wit: Cartman nearly appears on Chris Hansen’s To Catch a Predator, a TV show that ensnares internet sex predators on camera.
Tourette syndrome seems to have multiple levels. The way the young priest in the Catholic witch-hunter’s handbook Malleus Maleficarum laments his affliction—thought at the time to be demonic possession but almost certainly was Tourette’s—bears this out: “I hear the words as though they were spoken by myself.” The literary work of Samuel Johnson shares a similar perspective—for him, no single word is just the word, but rather a palimpsest with layers of historical context.
In this tradition of language deconstruction, both Motherless Brooklyn and South Park present Tourettean fables with all due postmodernity. Lionel Essrog, the protagonist in Jonathan Lethem’s mystery, tends to “relate everything to my Tourette’s,” which creates, as he describes it, a “meta-Tourette’s.” The same term could be applied to Eric Cartman’s situation in the South Park episode “Le Petit Tourette”: Through pretending to have Tourette’s, Cartman effectively loses his ability to control his natural impulses, accidentally giving himself a post-Tourette’s Tourette’s. The “meta” issue appears to be common among Tourette’s patients. While the world assumes they have no regard for social mores, they are often hyperaware of their problematic behavior and are forced to watch themselves from the outside in.