In Praise of Tourette's

Nationally syndicated cartoonist and musician Jeffrey Koterba describes how the disease has been his artistic muse—even if it does lead to the occasional embarrassing outburst.

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I owe it all to dopamine.

If not for my brain’s excess of this illicit-sounding neurotransmitter ( dope), would I be able to come up with six editorial cartoons a week? Without Tourette’s syndrome, would I hear odd phrases and rhythms in my head that lead to songs and guitar solos?

What if without Tourette’s, I might be more creative? How many days of my life have been squandered following my muse on a meandering voyage to nowhere?

Besides dopamine, serotonin might play a role, too, researchers say, as well as other brain chemicals and receptors. Famed neurologist Oliver Sacks—my hero—has theorized that there is a connection between Tourette’s and creativity. Some experts have even floated the idea that Mozart suffered from Tourette’s. But the science probably is better left to the experts who don’t have ink-stained fingers and piles of sketches at their feet. Whatever the case, I’m convinced that while everyone may have a muse, mine gets high—and therefore, even more inspired—on the weird chemical makeup of my brain.

Of course, I didn’t always believe this. In fact, I wasn’t diagnosed until well into adulthood. As a kid, my father said I had “nervous habits.” He had them, too. He was a jazz drummer whose strange eye movements and frequent throat clearing seemed to diminish when he let loose on the tom-toms.

In the late 1960s and 1970s, when I was growing up, there wasn’t the kind of awareness that exists today for anomalies of the brain, at least not in my little world, on the southern fringes of Omaha, Nebraska, near the meatpacking district. So I went for many years believing that my tics and twitches were simply what my father called them, not knowing that, all along, I had inherited from him a peculiar neurological disorder. And it is peculiar.

At any given moment, my brain might tell me that I absolutely must grunt. It doesn’t matter if I’m alone or in public, although more often than not, the desire seems to be stronger when I’m in potentially embarrassing situations—like on a crowded elevator or at a funeral. Likewise, my brain might tell me to blink my eyes, or to stretch my mouth, or to screech like a hungry animal in the jungle at dusk, or to contort my body like a deranged acrobat.

I might also have to step on a speck on the floor, in a very specific way, over and over, or stick my pinky into the “F” hole of my Gretsch archtop guitar, or stare out of the corner of my eye, at a point of reference in the room, which, I suppose, gets into obsessive compulsive behavior, which is often a component of Tourette’s.

I can go long stretches, days or weeks, without a major outburst. Then, without notice, I’ll grunt and thrash about, confounding those in my path. I wish I could think of these episodes as wild lovemaking with my stoned muse, but in the end, my body is left utterly depleted and spent on the floor, my throat raw, sheets of paper left blank and without a single idea.

Whether my body is twitching or calm, my mind is working full-steam, toying with words, repeating phrases. My muse is also capable of connecting two or three completely unrelated concepts, and combining the elements in unexpected ways. Usually, these efforts are time wasters. But it’s that diamond in the rough I count on, the cartoon or song that emerges from the nonsense.

What Tourette’s feels like is difficult to describe. I mean, how am I supposed to know what it doesn’t feel like? If you want to attempt to get inside my head, try this: Imagine that you’re at the front of a crowded church on your wedding day. All eyes are on you—doesn’t matter if you’re the bride or groom, but the way my mind works, you might be a male-female Siamese twin, marrying yourself. Imagine also that you have an itch on the inside of your thigh, a nagging itch that’s driving you crazy. The more you try to ignore it, the more it calls out to you, “Scratch me now!”

Now substitute the sensation of needing to scratch that itch with the desire to throw your head clean off your body, as if you’re a track and field athlete, in the shot put category, and your head is a metal sphere. You’re in the church and your dopamine is absolutely insisting that you heave that head of yours through one of the stained glass windows. Which window, you ask yourself? Which window can you shatter that will be the least sacrilegious?

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The more you know you can’t jerk your head, the more you want to, need to, have to. The urge is as strong as the lust you’ve been feeling in anticipation of your wedding night, although sex is the last thing on your mind right now. It’s your head and those stained-glass windows you’re obsessing over. Yet, somehow, time slows down and you think of the beauty of it all, your head floating through one of those windows, the translucent shards of glass, all those blues and greens and crimsons floating, disintegrating into the outside world, the sunlight now coming in pure and golden.

Certainly, most creative people are able to do what they do without having to suffer the embarrassment and fatigue of tics. So I’m back to my earlier question: Would I be able to create without Tourette’s? It scares the hell out of me to consider the possibility. If ridding myself of my need to twitch meant losing even 10 percent of my ability to create, then, no thank you, I’ll cherish my tics forever.

Maybe that’s why I’m hesitant when it comes to taking medication to suppress the symptoms. Over the years, I’ve experimented with small doses, and currently I’m on an infinitesimal amount of antianxiety medication, which may or may not be helping. I’ve also learned techniques to suppress the urges, to at least keep them under wraps until I can go off someplace alone, where I can twitch to my heart’s content. Also, exercise helps, as does cutting back on caffeine, sugar, and stress.

What if, however, my belief system is just my way of explaining away a strange and annoying syndrome to myself? Clearly, it isn’t the most efficient way of working. Maybe Tourette’s is as simple as this: that because of my need to twitch I have to force myself to focus on something else; when I’m so focused on coming up with a cartoon idea, or writing a song, or writing this piece, I trick my brain, overpowering that thigh-itch at the altar of my wedding.

An even scarier thought: What if without Tourette’s, I might be more creative? How many days of my life have been squandered following my muse on a meandering voyage to nowhere? How many precious life-breathing hours have I approached my office chair from the right side, always having to leave it on the left, and if I screw up the sequence, having to start again? And all those gorgeous pencil lines that I erase just because I must, and those beautifully inked cross hatches that I slather with Wite-Out like a blizzard, negating all my hard work? Only to redraw everything the same, a few moments later.

But after all that, let’s be honest. What you’re really wondering is, do I spew out obscenities with wild abandon?

Not exactly. At times, the words or images that litter my cerebral landscape are bizarre and filthy—concepts that I would never include in a cartoon for a family newspaper and certainly can’t share with you even now. Often while performing with my band in front of an audience, I’ll be singing a romantic and innocent song I’ve written, while David Lynchian images play out in my mind, as though I’m dreaming in the daylight.

Having said that, I don’t have coprolalia—a rare manifestation of Tourette’s that results in outbursts of profanity. Coprolalia may be the public face of Tourette’s, the symptom that makes its way into popular culture and movies, but it doesn’t define most of us with Tourette’s.

As I’m writing this, I’m focused on that tongue-twisting word, coprolalia. In the same way dopamine reminds me of marijuana, coprolalia makes me think of “Australia.” I want to stretch my mouth on the last syllable, imagining my gaping mouth is formed into the shape of the country that’s also a continent. But I have to resist—I’m at a coffee shop in Omaha (drinking decaf).

I glance around the room and wonder how many of the other patrons are in contact with their muse at this moment. Is her muse dancing sweetly in her head? Is his muse sleeping off a hangover? These questions distract my mind from what I’m really craving: to stretch my mouth. I can’t ignore the urge too long. After all, it just might be my muse’s way of flirting.

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Jeffrey Koterba is an acclaimed syndicated political cartoonist. Since joining the Omaha World-Herald in 1989, he has been a finalist for Editorial Cartoonist of the Year from the National Cartoonists Society and has placed second in the National Headliner Awards. His work is distributed through King Features Syndicate to 400 newspapers nationwide, and has appeared in such publications as The New York Times, the Chicago Tribune, and The Washington Post, among others.