Tourette Syndrome in Contemporary Literature - Essay Example

 Tourette Syndrome in Contemporary Literature Introduction Tourette syndrome (TS) is defined as a “movement disorder” which is manifested in childhood and characterized by a “the presence of motor and phonic tics”.1 TS is also linked to symptoms of obsessive-compulsive behavior, poor attention spans, impulsive tendencies and “motor restlessness”.2 In recent times, a number of fictional works have portrayed characters suffering from a variety of neurological and mental pathologies. In some of these works protagonists are portrayed with Tourette’s syndrome. The narrative typically takes the form of an inspection of the core of humanity via the brain’s functions as opposed to a psychoanalytical approach. This new form of literature engages in a journey into the mind and emotions of mankind.3 This essay examines the representation of TS in contemporary fiction by reference to TS and duality and the relationship between cognitive disability and space. In this regard, duality is the way that the mind interacts with the external environment and thus can be referred to as “functional dualism”.4 Behavioral sciences often rely on the nexus between the mind and the body in that the mind records a feeling and the body responds in a way that informs an outsider. However, when the body responds in a way that does not reflect a sense or feeling of the mind, this is referred to as “dualistic contradiction”.5 The dualistic nature of TS is also described as “ambitendency or the behavioral expression of contradictory emotional states”.6 The functional dualism and/or dualistic contraction associated with TS has been used as a trope in contemporary fiction. Essentially, duality has emerged as a trope for the post-modern environment. The trope of duality as a characteristic of TS is used in contemporary fiction to underpin the difficulties associated with self-identity and finding one’s place in a chaotic and quite often contradictory world. Selected works of fiction and semi-fiction and non-fiction are used to demonstrate the manner in which the duality of TS is treated as a trope. TS and Duality in Contemporary Fiction TS as a Neurological Disorder TS is defined as neurological in nature and is attributed to a brain malfunction and is commonly believed to be genetic. The most common symptoms of TS are repetitious tics (stereotypies). Motor tics are involuntary and impact bodily movements especially in the face, legs, neck or head. Vocal/phonic tics are manifested by repetitious and involuntary sounds which can be grunting, coughing or the uttering of words and sentences.7 The symptoms are manifested by the time the patient is 18 years old.8 The stereotypies in TS are similar to the stereotypies in autism spectrum disorders and like autism can be triggered by stressful social situations.9 The reality is that children who suffer the physical symptoms of TS and Autism can have difficulty moving in social settings. Complicating matters, the constant concern expressed by loved ones and caregivers can only exacerbate the symptoms. Children in particular experience a great deal of stress and tension in social settings can cause responses that give way to more aggressive tics (TS) and stimming/self-stimulation (autism).10 Thus there is a clear understanding of how TS impacts the mind and the body and this sets a medical and psychological background for analyzing representations of TS in contemporary literature. Fictional Representations of TS This Alien Shore C. S. Friedman’s This Alien Shore does not specifically identify TS or autism, yet the symptoms are clearly manifested in two of the characters.11 This is not unusual in fiction where characters are typically described in a way that suggests that they are neurodiverse while omitting to identify them as such.12 Thus, This Alien Shore presents the symptoms of a neurodiversity and uses those symptoms and characters as a method of representing the struggles implicit in neurodiversity, but in a positive way as is characteristic of neurodiversity fiction. Friedman sets the stage for these struggles in a futuristic society in which alien encounters can be viewed as a method by which neurological disorders such as TS and autism can be understood from the perspective of the afflicted. As Ortego puts it, neurodiversity advocates take a position that neurological disorders must be understood as an identity issue and as an exercise in self-awareness and constant apprehensions about the external environment.13 Reid however, is more optimistic in her representation of neurodiversity in science fiction. According to Reid, neurodiversity is an ideology that promotes the belief that people are different in “the sense of perceptions and intellectual processing”.14 Neurodiversity promotes the idea that when people do not adhere to that which is perceived as normal, they ought to be celebrated as “part of the diversity of human experience” in the same way that we celebrate diversity in race and/or gender.15 Friedman’s Jamisia is portrayed as manifesting the symptoms and mind-body struggles implicit in neurodiversity. Early on, the narrative traverses the complex disconnection between the mind and the body. Jamisia describes her anxiety and confusion over the constant appearance of items she would not have chosen for herself, in her room overnight. From her perspective there is no explanation for how those items got into her room as she carefully locked her door before going to bed.16 This confusion is complicated by anxiety over the expectation that loved ones would appear to claim the items. When this doesn’t happen, another source of anxiety grips Jamisia. When Jamisia awakes and finds that no strange items are in her room, she is tormented by another source of anxiety. The narrative describes Jamisia’s state of mind even when she ought to have no reason to be anxious as follows: Her heart began to pound, triggering her wellseeker program: bright words scrolled across the corner of her visual field, assessing her emotional state in purely biological terms. ADRENALINE SURGE, it informed her. PULSE RACING, B-PRESSURE ENTERING RED ZONE, PHASE ONE MUSCULAR CONTRACTIONS NOTED. ACTION?17 Not only are the symptoms of both autism and TS evident in this narrative, but also the social and environmental factors that can intensify the symptoms. Jasimia’s mind and body are segregated. It is plausible that she unconsciously moves items throughout the night, and her family conveniently ignores these transgressions out of concern for her condition. None of these factors help, but instead only exacerbate matters for Jasimia. When nothing happens to alarm her, she is further confused and her symptoms are again intensified. In other words, the individual with autism or TS lives in a perpetual struggle of emotions which are manifested in physical ways such as motor tics. Yet, Jasimia is presented as heroic and her neurodiversity is deliberately unnamed so as to ensure that she comes across as just another part of a diverse universe. The Man Who Mistook his Wife for a Hat Neurologist Dr. Oliver Sacks, is world renown for his published renditions of unique cases of neurology and the film Awakenings in which Robin Williams played the role of the protagonist. For Sacks, the clinical perspectives on diseases are necessary, but by no means sufficient for helping us understand the pathology and human issues involved.18 Sack’s published material typically portrays a departure from conventional clinical treatment of TS patients and focuses instead on subjective and “productive alternative” treatment.19 Essentially, Sachs treats the duality implicit in TS by compelling his patients to distinguish between the I (patient) and the It (TS). For the most part, Sacks’ non-conventional treatment involves having the patient use art as means by which I conquers or copes with It. Thus, Sacks come across in much of his work as the self-described “naturalist and physician”.20 In The Man Who Mistook His Wife for a Hat, Dr. Sacks describes his consultation with a music teacher who by any stretch of the imagination is a normal human being but for a few minor but perplexing and quite often comic idiosyncrasies. These idiosyncrasies are a manifestation of a brain malfunction which misinterprets visual information. For instance, the patient has often mistaken fire hydrants for his students, his foot for his shoe and his wife’s head for his hat.21 Rose informs that Sack’s title was deliberately used for conveying two messages. First TS was used as a trope for the passage from the modern world into the post-modern world, particularly in the “betrayal of images”.22 In other words, the passage from modernity to post-modernity is fraught by frightening changes that render what we once knew to be true as patently false. This is more particularly demonstrated by the fact that the patient once knew his wife quite well, and now he cannot tell her from an inanimate object. Similarly, the patient’s own body parts such as his own feet seem alien to him. Changes have left confusion and misconceptions. In this regard, Sack’s patient’s condition (TS) is a trope for the post-modern condition. Secondly, Sack’s message is one of humor, not necessarily in terms of his patient’s clinical condition, but the post-modern condition, it is so hopelessly chaotic and confusing that it is an “unending joke”.23 The primary joke is that the chaos of post-modernity leaves one with the impression that they are in the wrong place at the wrong time. Thus Sack’s patient is living a life of utter confusion. His visual senses are not accurately informed in the duality trope underlying TS. Yet the patient is not particularly bothered by these mistakes because he is not conscious of these mistakes and is only made aware of them by those with whom he interacts.24 Thus Sack’s artfully puts the reader in touch with the TS patient by inviting the following questions: Which is more tragic? The helpless man who feels the loss of himself or the one who is numb to this loss, unaware of his existence to begin with? How can we possibly deem one of these predicaments more favorable than the other?25 Even so, Sacks manages to take the tragedy out of TS and takes his readers along to a place where they like the patient. From the perspective of an outsider or casual observer who is unaware of the misinformation, the music teacher is seen as touching objects and persons impulsively, much as the stims manifested by those with autism. For instance, patting fire hydrants would appear to the observer as an impulsive stimuli as the observer does not know of the music teacher’s mistake. A similar conclusion would be made in observing the music teacher attempt to put his wife’s head on his head in the mistaken belief that it was his hat. The condition therefore comes across as a dream, an It from which the I can return with some effort. As Tramontano puts it: Sacks offers rich insights into this clinical experience as a neurologist, telling and retelling the story of man’s capacity. Sacks wants us to reap the benefits of this strange and fantastic dream world and learn from the afflicted, whose voices he orchestrates into a symphony of human identity and potential.26 Sacks described how the music teacher coped with his lack of visual interpretation. He would have to examine an article closely and discern its functions through his other senses in order to get close enough to its identity to know what it might be. As for people, the teacher had no difficulty recognizing them by the voices. His wife described him as coping with songs. He sang when he performed basic functions like eating and dressing. If he was interrupted, the teacher would become confused.27This is the manner in which Sack’s compelled his patient to liberate I from It. He essentially put the music teacher in a place where he was able to find his own way out of the entrapment of TS. An Anthropologist on Mars: Seven Paradoxical Tales Sacks’ experience with the music teacher thus informs of the complexities of neurological disorders, and the coping mechanisms of both the afflicted and the loved ones. In his work An Anthropologist on Mars: Seven Paradoxical Tales, Sacks again shares the paradox of neurological disorders such as autism and TS and the individual’s innovative self. Just as Sack’s music teacher coped with teaching and functioning daily, Sacks portrays a doctor who manages to perform surgery notwithstanding the tics and nonsensical utterances associated with TS.28 Sacks describes the special place that the TS or autism patient occupies. When the neurological functions are shut down in one area, another part of the brain can be strengthened. Therefore the I finds a method of coping with and essentially escaping the It. Thus while a neurological malfunction can handicap an individual in one way or another, the individual’s consciousness can intensify to spur a degree of creativity that would not otherwise exist but for the neurological malfunction. Again, Sacks uses art to liberate the I from the It. Sacks himself describes this mystery of the brain: Defects, disorders, diseases can play a paradoxical role, by bringing out latent powers, developments, evolutions, forms of life, that might never be seen, or even be imaginable, in their absences.29 Thus the mysteries of the conscious mind are accentuated by TS and other similar neurological disorders. Contemporary literature engages in a situational analysis permitting the reader to see the disorder from the perspective of the afflicted and those with whom he/she interacts. Observers are both perplexed and pleasantly surprised because the afflicted does not always subscribe to normal expectations. Just as the patient is not expected to make involuntary and repetitious movements of the body or to impulsively touch items, such a person is not expected to perform or function at a high level. Yet in both instances, the individual’s lack of control over his body does not take total control of his consciousness. The Relationship Between Cognitive Disability and Space Motherless Brooklyn In Leham’s Motherless Brooklyn TS symbolizes modern America and more specifically urban America by focusing on Brooklyn.30 Thus TS as a trope for Brooklyn likewise acts as a trope for post-modern urban life. Leham accomplishes this in an unusual way, by choosing a person with a disability as the narrator and protagonist and thus allows the normal to be presented through the eyes of the abnormal and allows for a realistic perception of the disabled and at the same time the abnormalities of Brooklyn, a perfectly imperfect post-modern urban lifestyle. Brooklyn, originally settled by the Dutch works well as an example of modern urban America. Over the years, this New York borough has become so cosmopolitan that it is familiar to virtually anyone, everywhere around the globe.31 Thus, as a symbol of TS, Brooklyn provides a good and easily identifiable metaphor for shedding light on the exigencies of TS. Therefore the novel works well as a “description of” TS.32 By using Brooklyn as the setting and as a trope for TS, the reader is forced to question presumptions relative to the idea of normality and abnormality. Much like Sacks’ An Anthropologist on Mars: Seven Paradoxical Tales and The Man Who Mistook His Wife for a Hat draw attention to the paradox between neurological disorders and creativity, so does Lethem’s Motherless Brooklyn. Lethem’s protagonist, Lionel Essrog has TS and is a detective. One would expect that as a result of his TS, Essrog would not make a good detective. However, it is precisely because he has TS that he is a good detective. TS has manifested itself in Essrog in a compulsive tendency to pay great attention to detail.33 For instance, Essrog Explained: Everywhere they’re smoothing down imperfections, putting hairs in place, putting ducks in a row, replacing divots...Only – here’s the rub – when they find too much perfection, when the surface is already buffed smooth, the ducks already orderly, the old ladies complacent, then my little army rebels, breaks into the stores. Reality needs a prick here and there, the carpet needs a flaw. My words being plucking at threads nervously, seeking purchase, a weak point, a vulnerable ear.34 Essrog’s narrative makes a subtle connection between post-modern urban life and TS. TS, like Brooklyn, the post-modern model hub of urban life, there is a call for a constant construction and reconstruction of that which is real. The end result is a perpetual disruption of the flow of things. Just as TS invites involuntary and compulsive disruptions, so does urban life in post-modern Brooklyn. Essrog resists or rebels against nature in that he is suffering from TS, a disability which would conceivably handicap him as a detective. But as previously mentioned, instead of failing as would be naturally expected of him given his TS, the reverse occurs. Lionel, despites the odds, is as good and detailed detective. Brooklyn with its continuous influx of people and machinery converging in time and space also represents rebellion against nature. Thus, Brooklyn is described as encapsulating a “melancholic spirit of newness” and a “homogenizing impulse spurred on by a capital’s desire to maximize a white, aspirant, bourgeois consumer market”.35 Thus Letham writes in Motherless Brooklyn that the “dressed-up crowd” is not aware of the “neighbourhood’s past or present reality”.36 Peacock also points out another anomaly that solidifies the connection between Brooklyn and TS. The protagonist’s mother died when the protagonist was just 14 years old and thus leaves behind a fragmented self, although the fragmented self is buttressed by the presence of TS. The motherless protagonist with TS is akin to the motherless Brooklyn who has not so much lost a mother, but has lost its identity and its rich history in its fragmented post-modern condition.37 Just as Essrog defies the generally accepted characterisation of TS and finds positive expression as a detective, Brooklyn it its post-modern condition defies its past. It has been observed that for the most part Lethem has a tendency to “subvert traditional genres in some way”.38 The central theme is evolution where characters have a tendency to defy that which is normal for them to accept.39 Likewise, Lethem’s Essrog defies his TS and takes on work as a detective and thus Lethem subverts the typical detective story which typically portrays the detective as possessed of extraordinary skills of detection.40 The mere fact that Essrog has TS distances him from the typical crime fiction detective with extraordinary skills of detection. Brooklyn which is a cosmopolitan city and with a large population and often described as the happening city, can also paradoxically be a lonely place. In this regard, Motherless Brooklyn not only uses the individual to describe the paradoxes and complexities of TS, but also the place and time to do so. Thus the reader is inescapably struck by the many paradoxes of both Brooklyn and TS. Urban realism depicted in Brooklyn demonstrates the reality of crime, economic struggles, commercialism and dissociation among the throngs. Through Essrog the reader learns that TS can remove or reduce the ability to perform basic functions as a result of tics, but may not remove more acute and complicated functions. These paradoxes only contribute to convey the confusing nature of both Brooklyn and TS. Schliefer’s description of TS exemplifies realism in Motherless Brooklyn and thus draws a poignant parallel between TS and Brooklyn. According to Schliefer: Tourette Syndrome is clearly an organic condition that involves, among other symptoms, the seeming emotion-charge use of language, the spouting forth of obscene language that, as researchers note, ‘may represent’ among other symptoms ‘a common clinical expression of underlying central nervous system dysfunction.41 In much the same way, Brooklyn can be seen as a hub of confusion, chaos and paradoxical loneliness, all symptoms of it’s the dysfunction that naturally follows from the post-modern condition. Thus Lethem’s realism in Motherless Brooklyn is more aligned with current post-modern conditions. According to Baker realism in the post-modern environment is no more than an artificial façade that covers up history with transient fixtures and fittings.42 Lethem injects realism into Brooklyn and at the same time into TS. Realism is injected into TS by placing the TS condition at the center of the novel and inviting the reader to view the world through the eyes of the individual suffering from TS. By taking this approach, the reader gets a view of the normal from the perspective of the abnormal and is thus forced to concede that the distinction between normality and abnormality is perhaps an illusion. What should be perceived as abnormal suddenly appears more natural and what should be perceived as normal suddenly appears to be unnatural. Implicitly, there is a correlation between Brooklyn as a symbol of TS and Essrog’s TS and Charles Darwin’s adaptability theory expresses in his Origins of the Species. By virtue of Darwin’s adaptability theory, when changes occur in the environment, people adapt for survival.43 Thus people will typically adopt survival techniques and thus only those who are able to adopt will be able to survive. This theory is more popularly known as Darwin’s “survival of the fittest”.44 In this regard, Essrog is compelled to find a technique for existing with TS just as one must find a way to exist in Brooklyn. The neurological malfunctions implicit in TS makes it virtually impossible to make sense of the world in which Essrog lives. Similarly, the perpetual motion in Brooklyn creates confusion. The ever moving crowds, trains and the general hustle and bustle of urban life appears to be going nowhere and appears to be devoid of origin. Just as Essrog must make sense of the TS symptoms, the urban dweller must make sense of Brooklyn in order to survive. Essentially, TS and Brooklyn have the potential to leave the individual in a place and space without meaning. Conclusion The depiction of TS in contemporary fiction, quasi-fiction and non-fiction draws attention to the emergence of a profound awareness of syndromes in modern times. As depicted in Motherless Brooklyn, TS appears to act as a trope for modern realism. Contemporary literature thus ensures that TS and other neurological disorders are no longer in the exclusive domain for the medical field. Writers such as Sacks, Lethem and Friedman have removed the stigmatized labels of TS and have instead brought them into profound focus. Sacks not only shared the comic aspect of TS and autism but also the fact that individuals with neurological disorders can also be gifted. Lethem shares the struggles manifested in TS and at the same time demonstrates that TS can also benefit the individual in ways that normal persons do not experience. Friedman demonstrates that both autism and TS can separate the afflicted from those who are not afflicted in ways that resemble earthlings and aliens. Essentially, contemporary literature offers a rare understanding of the uniqueness of neurological disorders and at the same time exposes the complexities and mysteries of the human mind and emotions. Neurodiversity in comtemporary literature therefore brings TS and other neurological disorders into common parlance. It helps to dislodge labelling and by doing so courts empathy and in some case awe. Contemporary literature informs that TS and other forms of neurological disorders are abnormal in paradoxical ways. While tics are abnormal, persons with tics are not expected to lead normal lives. Yet, contemporary literature informs that individuals with ticks, are not only able to lead normal lives, but they are often gifted in ways that persons who are characterized as normal are not. References Baker, Stephen. The Fiction of Postmodernity, New York, NY: Rowman and Littlefield, 2000. Bursztyn, Alberto. Childhood Psychological Disorders: Current Controversies. 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Peacock, James. “Jonathan Lethem’s Genre Evolutions.” Journal of American Studies, (2009) Vol. 43: 425-440. Rajapakse, T. and Pringsheim, T. “Pharmacotherapeutics of Tourette Syndrome and Stereotypies in Autism.” Semin. Pediatr. Neurology, (Dec. 2010), Vol. 17(4)L 254-260. Reid, Robin, Anne. Women in Science Fiction and Fantasy: Overviews. Westport, CT: Greenwood Press, 2009. Rose, Jacqueline.“ ‘The Man Who Mistook His Wife for a Hat’ or ‘A Wife is Like an Umbrella’ – Fantasies of the Modern and Postmodern”. Social Text, 1989, No. 21: 237-250. Sacks, O. W. The Man Who Mistook His Wife for a Hat and Other Clinical Tales. New York, NY: Touchstone, 1985. Sacks, Oliver. An Anthropologist On Mars: Seven Paradoxical Tales. New York, NY: Vintage Books, 1995. Scahill, E. G. et al “Contemporary Assessment and Pharmacotherapy of Tourette Syndrome.” NeuroRX, (April, 2006), Vol. 2(2): 192-206. Schliefer, Ronald.“The Poetics of Tourette Syndrome: Language, Neurobiology, and Poetry.” New Literary History, (Summer 2001) Vol. 32(3): 563-584. Snyder-Grenier, Ellen Marie. Brooklyn: An Illustrated History. Philadelphia, PA: Temple University Press, 1996. Tramontano, Arielle. “Singing in the Key of I”. Mercer Street, (2009): 53-59. Zuriff, G. E. “Science and Human Behavior, Dualism, and the Conceptual Modification.” Journal of the Experimental Analysis of Behavior, 2003, Vol. 80(3): 345-352. Read More