August 4, 2008
Tourette’s On The Trolley
Consider What a Saturnalia Should We All Have Coprolalia

John R. Guthrie
(Image from Wikipedia)

I sat on a bench outside of San Diego’s historic Santa Fe depot waiting for the trolley to the Mexican border crossing at San Ysidro. A woman, a stranger, approached me. As if we were acquaintances of long standing she said, “I’ve lost my identification.” I wondered if she was about to ask for a donation. She wasn’t. She was a woman of late middle years, her slightly decrepit outfit accented by a mirror finish equestrian riding helmet. The helmet struck me as somewhat unusual, we being in the middle of San Diego without a horse in sight. But we were, after all, in Southern California, the land where Scientologists thrive, The Terminator is governor, and where the death of the Heaven’s Gate suicide cult is but a fleeting memory.

“Even my birth certificate, they took it too,” she continued.

“I’m terribly sorry. I hope you’re able to replace everything,” I said.

Looking directly at me, she replied, quite emphatically, "Motherfuckersonofabitch. Goddamshit-motherfucker!”

She continued with string of phrases impressive in their emphasis and scatological intensity, included many repetitions of the phrase that implies carnal knowledge of one’s female parent.

I said, “Tourette’s?”

She nodded, smiling amiably enough and said, “Yes.”

Tourette’s Syndrome, actually a group of related neurological maladies or “tics.” About a third have symptoms that include coprolalia (Gk, kopros, “dung,” + lalia “babble”). Tourette’s may vary in intensity from benign to disabling. A French medical resident, a colorful and brilliant Parisian with the impressive name of Georges Albert Eduardo Brutus Gilles de la Tourette (1859-1904) published a research paper on nine patients with this malady in 1885. Thus the disorder was named after him. 

The first patient I saw with Tourette’s Syndrome also manifested a full blown coprolalia. She was an elderly woman. I had known her and her family since my childhood. She was a nursing home resident by then, a diminutive, gray and withered woman I’ll call Nelly. Bifocals on the bridge of her nose, she sat in a rocker and knitted aimlessly and endlessly, producing only an elongate band of fabric lacking substance or meaning, swearing dreadfully all the while. She had developed Tourette’s Syndrome late in life after a series of strokes.

Later I encountered another, more typical Tourette’s sufferer, a man of early middle years who was born with the malady. He was soft spoken, neat in his appearance, meticulously polite and remarkably industrious. Intermittently Henry (not his real name), would involuntarily stamp his feet vigorously, fling his right arm outward, all this accompanied by an emphatic vocalization, a sort of emphatic, high-pitched “EEYIP!” sound.

He had close-knit family, a wife and young son who had boundless affection for him. Once one got by spasms and the, “EEYIP!” their love for Henry wasn’t surprising.  Henry was a sweet person in the most complimentary sense. He had a goodness about him, an emotional intelligence that comes from a personal knowledge and a visceral understanding of suffering.

Society can be cruel to those who are different. As a child he had suffered at the hands of teachers, some of whom considered him intentionally disruptive. He was taunted endlessly by his class mates. In spite of it all, he finished high school. He eventually got a job as a prison guard.

“The inmates,” Henry explained, “were not a problem. I explained my problem up front. The other correctional officers and my watch captain, though, were something else. Every day when I came to work, they gave me such grief that I even had to eat by myself. Finally one day, no warning, the captain called me into his office. He told me I was making a laughingstock of the whole security unit. He fired me. Man, I felt so bad. I’d gone to work every day, knowing I’d catch crap, but I just sucked it up because I had the wife and kid to support. I was so ashamed…”

Sweet soul or not, Henry retained a plaintiff’s attorney with the temperament of a spitting cobra. It is a tribute to our torts system that he recovered handsomely.

Though late night comedians have had a field day with Tourette’s Syndrome, Henry’s story is a reminder that this malady, even in its lesser manifestations, is no laughing matter. When accompanied by uncontrollable coprolalia, what does it do to one’s social interactions? What congregation, no matter how welcoming, what minister no matter how compassionate, would welcome one who interrupts  sermons of hope and redemption with a string of obscenities such as to blister the paint on the sanctuary walls? 

In San Diego that day, the trolley came rolling in, its bell clanging insistently. Lady Tourette and I climbed aboard. She sat across the aisle from me, again releasing a string of sexually explicit obscenities of an intensity that could curdle milk. Though severe Tourette’s Syndrome is no laughing matter, the response of a naïve audience is pure theater. I peered sideways at the two Mexican grandmothers seated across from Lady Tourette. The abuelas shifted so that they stared fixedly out the window, studiously not acknowledging the cloud of profanity that enveloped them. It was as if they were refusing to acknowledge a grizzly in the car. Two stops later, shopping bags in hand, they detrained. Once their feet were again on solid ground, as if to make sure she wasn’t following, they both glanced back, narrow-eyed and frowning at Lady Tourette.

A slender black man, graying at the temples boarded several stops later. He was dressed in gray flannel slacks, a white shirt and tie beneath his sweater vest. Scholarly half glasses perched on his nose. His bearing, his manner, the computer technology magazine he carried all cried out, I am a striver, a professional, a gentleman. He said, “Excuse me, please,” ever so politely as he slid carefully past Lady Tourette into a corner seat. As he sat, Lady Tourette’s let it rip; a series of imprecations such as might make birds fall dead from the sky. The black gentleman’s mouth dropped open slightly as he looked over his reading glasses at the apparition across from him. Then he recovered his composure, pursed his lips in indignation, and turned away, studying computer technology with determined intensity until his departure three stops later.

There the black gentleman was then replaced by a white couple; two stoners. A skinny man with a terrible vacancy in his eyes that announced to the world that no one was home. His significant other followed him. She was a woman for whom it was one minute until midnight on the last evening of the summer of her life. The tattoo across her neck said, cryptically enough, “Leathers” in one-inch high block letters. Her name scripted on her forearm, crawled along amidst the needle tracks. Lady Tourette’s back pack was on the floor poking out into the aisle. The female stoner stumbled on it.

“Excuse me, Ma’am,” she said.


Though one had the impression that Leather may have been has heard coarse language before, she was disconcerted. “How rude,” she says loudly, peering woefully about to gauge the reaction of others. “How very rude.”

While Tourette’s Syndrome is usually hereditary, it can occur from other causes, including carbon monoxide poisoning, stroke, encephalitis and head trauma. It can also be mimicked by other maladies including schizophrenia. People from all walks of life are found among those who suffer from Tourette’s. The great lexicographer Samuel Johnson had from this syndrome. Many historians feel that Mozart did also.

The trolley squealed into the station at its final destination at the colorful and storied town of San Ysidro. Lady Tourette and I stepped down from the trolley car. The intensely busy border crossing into Tijuana loomed ahead. As out paths were about to diverge, She caught my eye.

I nodded goodbye.

“’Bye,” she said, and soon disappeared into the babble and hustle of the milling crowd.

John R. Guthrie is a former Marine infantry rifleman. He then garnered a formal education to include medical school and became the commanding officer of a U.S. Navy Reserve Shock Surgical Group before going into private practice in the Smoky Mountain foothills of Appalachia. He is the editor and publisher of the monthly webzine The Chickasaw Plum: Politics and the Arts Online. (Link)


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