Oliver Sacks on echolalia in Tourette’s syndrome

July 8, 2015

One of the neurological case studies in Oliver Sacks’s remarkable book An Anthropologist on Mars (1995) involves Dr Carl Bennett, a surgeon in British Columbia who has Tourette’s syndrome. Sacks spends a lot of time with Bennett at home, work, and play, to learn more about the condition and how it affects his daily life.

Oliver Sacks - an anthropologist on mars - seven paradoxical tales - book coverPeople with Tourette’s are often depicted stereotypically as beset by elaborate physical twitching and involuntary swearing and the like, but this oversimplifies a very complex condition. In Bennett’s case the Tourette’s never affects his surgery, but outside of such contexts the compulsions of touching and vocalising do present to a striking degree.

Bennett’s Tourette vocalisations are not so much swears and other taboo expressions as ‘juicy’ phrases devoid of real meaning (at least in his use of them), uttered over and over again. To satisfy this urge, Bennett systematically collects odd names. One passage in the book describes how, after a calm bout of morning exercise – half an hour on an exercise bike, smoking a pipe, reading a medical book – Bennett’s echolalia returns in force:

he kept digging at his belly, which was trim, and muttering, ‘Fat, fat, fat . . . fat, fat, fat . . . fat, fat, fat,’ and then, puzzlingly, ‘Fat and a quarter tit.’ (Sometimes the ‘tit’ was left out.)

‘What does it mean?’ I asked.

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