Change

"To be a successful soldier you must know history. ... What you must know is how man reacts. Weapons change but man who uses them changes not at all. To win battles you do not beat weapons -- you beat the soul of (the enemy)."

-- General George Patton (1944)

Jeff's mother, Esther, broke down into tears that followed the lines of age etched into an otherwise stoic countenance. Her son, a convict on parole now living at home, had been in an accident early in the year, after which he suffered from intense tics that shook his head several times a minute. He was the source of her grief because she had failed as a mother. She could see no hope for her son, which deepened the parental guilt that laid heavily upon her golden years -- guilt not born from a mistake in parenting but from an intrinsic motherly duty towards her offspring.

"My son," she said, "is ..." as she sobbed into my shoulder which made me uncomfortable, as we stood there for a moment until she composed herself. Hugging my patients is not commonplace.

"Bring your son in and let me see him," I said.

"He has no insurance," she said.

"That's all right, just bring him in."

A few days later Jeff's mother brought him to the clinic. My nurse took a brief history.

I was not prepared for the severity of this man's depression. He was crying reluctantly, the lines of his face matching those of his mother, while he was seizing mildly and suffering violent tics. His eyes, glassed by medication, darted up at mine and down at the floor as he explained his problem.

"I wake up in my own urine," he said. "I can't go out in public or talk to anyone, and I don't think I can take much more."

The medications he was taking, I believed, were causing the incontinence. He described several occasions of grand mal seizures along with the obvious tics that violently turned his head in defiance of the heavy drugs.

"I think I can help you," I said cautiously. I, at that time, had some success in a case of Huntington's chorea in which the patient supplemented a raw diet of massive amounts of phosphatydal choline along with infrequent spinal adjustments. With that in mind, I proceeded to examine Jeff and found a severe subluxation in the cervical spine which was verified on x-ray. I adjusted it and started him on about 18 grams of choline.

Two days later Jeff returned beaming when I entered the treatment room.

"No drugs," he said, "and my bed is dry." His tics were marginal.

"That powder tastes awful," he said, "and I spent a lot of time hugging the throne after I take it."

"You can avoid the diarrhea with that by spreading the dose over the day," I said.

"It's okay," he said, "that's how I know it's working."

"Spread it out into four doses," I said. "I don't want to exchange chronic diarrhea for urinary incontinence unless there is no alternative."

So Jeff continued to improve over the next few months.

"Doc, I think I have to go back on the medication," Jeff said.

"Why?" I asked, thinking that he may already be on it, since he was doing so well.

"The terms of my parole include taking Anabuse daily and whatever other medication the doctor requires. The doctor thinks that I am taking the meds, and if he finds out that I am not, my parole could be revoked."

With that he left.

The next week he missed his appointment. His mother explained that he had taken the medication prescribed by the doctor. Most of the time he was laying around, and she thought he was very depressed. She was worried again.

He made his next appointment lookin' chipper as usual, and I suspected immediately he was off the medication.

"I decided to go off the medication, even if they put me in prison," Jeff said.

"I will stand behind you with the parole board if you need it," I said.

A few weeks later Jeff returned for a visit.

"I told the doctor I would take no more of the medication as long as this other was working," he said.

"Do you want me to send him a treatment plan?" I asked.

"No," he looked down, "I told him I was taking a vitamin and showed him the bottle, but I didn't want to get him mad by telling him I was going to a chiropractor. The doctor said that as long as I was doing okay I could stay with the vitamin."

Tourette's syndrome, along with many other spastic neuromuscular conditions including severe fibrositis are affected by the availability of neurotransmitters. Spinal adjustments and nutritional supplementation are certainly indicated for a trial period of several weeks. But remember that one must also influence the soul.

Willard Bertrand, M.D.
Union, Oregon