Vintage Sacks by Oliver Sacks Page B

intrinsic beauty and excellence sometimes superior to speech.
    I was so moved by Groce’s book that the moment I finished it I jumped in the car, with only a toothbrush, a tape recorder, and a camera—I had to see this enchanted island for myself. I saw how some of the oldest inhabitants still preserved Sign, delighted in it, among themselves. My first sight of this, indeed, was quite unforgettable. I drove up to the old general store in West Tisbury on a Sunday morning and saw half a dozen old people gossiping together on the porch. They could have been any old folks, old neighbors, talking together—until suddenly, very startlingly, they all dropped into Sign. They signed for a minute, laughed, then dropped back into speech. At this moment I knew I had come to the right place. And, speaking to one of the very oldest there, I found one other thing, of very great interest. This old lady, in her nineties, but sharp as a pin, would sometimes fall into a peaceful reverie. As she did so, she might have seemed to be knitting, her hands in constant complex motion. But her daughter, also a signer, told me she was not knitting but thinking to herself, thinking in Sign. And even in sleep, I was further informed, the old lady might sketch fragmentary signs on the counterpane—she was dreaming in Sign. Such phenomena cannot be accounted as merely social. It is evident that if a person has learned Sign as a primary language, his brain/mind will retain this, and use it, for the rest of that person’s life, even though hearing and speech are freely available and unimpaired. Sign, I was now convinced, was a fundamental language of the brain.

A SURGEON’S LIFE
    Tourette’s syndrome is seen in every race, every culture, every stratum of society; it can be recognized at a glance once one is attuned to it; and cases of barking and twitching, of grimacing, of strange gesturing, of involuntary cursing and blaspheming, were recorded by Aretaeus of Cappadocia almost two thousand years ago. Yet it was not clinically delineated until 1885, when George Gilles de la Tourette, a young French neurologist—a pupil of Charcot’s and a friend of Freud’s—put together these historical accounts with observations of some of his own patients. The syndrome as he described it was characterized, above all, by convulsive tics, by involuntary mimicry or repetition of others’ words or actions (echolalia and echopraxia), and by the involuntary or compulsive utterances of curses and obscenities (coprolalia). Some individuals (despite their affliction) showed an odd insouciance or nonchalance; some a tendency to make strange, often witty, occasionally dream-like associations; some extreme impulsiveness and provocativeness, a constant testing of physical and social boundaries; some a constant, restless reacting to the environment, a lunging at and sniffing of everything or a sudden flinging of objects; and yet others an extreme stereotypy and obsessiveness—no two patients were ever quite the same.
    Any disease introduces a doubleness into life—an “it,” with its own needs, demands, limitations. With Tourette’s, the “it” takes the form of explicit compulsion, a multitude of explicit impulsions and compulsions: one is driven to do this, to do that, against one’s own will, or in deference to the alien will of the “it.” There may be a conflict, a compromise, a collusion between these wills. Thus being “possessed” can be more than a figure of speech for someone with an impulse disorder like Tourette’s, and no doubt in the Middle Ages it was sometimes literally seen as “possession.” (Tourette himself was fascinated by the phenomenon of possession and wrote a play about the epidemic of demonic possession in medieval Loudun.)
    But the relation of disease and self, “it” and “I,” can be particularly complex in Tourette’s, especially