The Man Who Mistook His Wife For A Hat and Other Clinical Tales by Oliver Wolf Sacks

Author:Oliver Wolf Sacks
Language: eng
Format: mobi, epub
Publisher: Harper Collins
Published: 1969-12-31T16:00:00+00:00

14. The Possessed

In Witty Ticcy Ray (Chapter Ten), I described a relatively mild form of Tourette’s syndrome, but hinted that there were severer forms ‘of quite terrible grotesqueness and violence’. I suggested that some people could accommodate Tourette’s within a commodious personality, while others ‘might indeed be “possessed”, and scarcely able to achieve real identity amid the tremendous pressure and chaos of Tourettic impulses’.

Tourette himself, and many of the older clinicians, used to recognise a malignant form of Tourette’s, which might disintegrate the personality, and lead to a bizarre, phantasmagoric, pantomimic and often impersonatory form of ‘psychosis’ or frenzy. This form of Tourette’s—‘super-Tourette’s’—is quite rare, perhaps fifty times rarer than ordinary Tourette’s syndrome, and it may be qualitatively different, as well as far more intense than any of the ordinary forms of the disorder. This ‘Tourette psychosis’, this singular identity-frenzy, is quite different from ordinary psychosis, because of its underlying, and unique, physiology and phenomenology. None the less, it has affinities, on the one hand, to the frenzied motor psychoses sometimes induced by L-Dopa and, on the other, to the confabulatory frenzies of Korsakov’s psychosis (see above, Chapter Twelve). And like these it can almost overwhelm the person.

The day after I saw Ray, my first Touretter, my eyes and mind opened, as I mentioned earlier, when, in the streets of New York, I saw no less than three Touretters—all as characteristic as Ray, though more florid. It was a day of visions for the neurological eye. In swift vignettes I witnessed what it might mean to have

Tourette’s syndrome of ultimate severity, not only tics and convulsions of movement, but tics and convulsions of perception, imagination, the passions—of the entire personality.

Ray himself had shown what might happen in the street. But it is not enough to be told. You must see for yourself. And a doctor’s clinic or ward is not always the best place for observing disease—at least, not for observing a disorder which, if organic in origin, is expressed in impulse, imitation, impersonation, reaction, interaction, raised to an extreme and almost incredible degree. The clinic, the laboratory, the ward are all designed to restrain and focus behaviour, if not indeed to exclude it altogether. They are for a systematic and scientific neurology, reduced to fixed tests and tasks, not for an open, naturalistic neurology. For this one must see the patient unselfconscious, unobserved, in the real world, wholly given over to the spur and play of every impulse, and one must oneself, the observer, be unobserved. What could be better, for this purpose, than a street in New York—an anonymous public street in a vast city—where the subject of extravagant, impulsive disorders can enjoy and exhibit to the full the monstrous liberty, or slavery, of their condition.

‘Street-neurology’, indeed, has respectable antecedents. James Parkinson, as inveterate a walker of the streets of London as Charles Dickens was to be, forty years later, delineated the disease that bears his name, not in his office, but in the teeming streets of London.

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.