Stuff You Should Know - How Tourette Syndrome Works

Episode Date: April 14, 2010

Gilles de la Tourette syndrome, commonly referred to as Tourette's, is a neurological disorder characterized by a combination of verbal and physical tics. Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

Hey everybody, do you ever scream at your printer or hurl empty ink cartridges across the room? We all do, which means that you likely suffer from cartridge conniptions caused by irritating ink cartridges constantly running out of ink. It's the worst everybody, we can all agree on that, but thankfully the Epson Eco Tank Printer is the perfect cure. It's cartridge-free, conniption-free, and prescription-free. With big ink tanks and a ridiculous amount of ink, you can finally kiss expensive ink cartridges goodbye. Yeah, so check out the Epson Eco Tank, just fill and chill. Available at participating retailers and at epson.com. Make a choice.

No, get the cabin. Only in theaters February 3rd. Read it R, under 17 at a minute without parent. Brought to you by the reinvented 2012 Camry. It's ready, are you? Welcome to Stuff You Should Know from HowStuffWorks.com. Hey and welcome to the podcast. I'm Josh Clark, there's Charles W. Chuck Bright doing a little dance. You always give me away. I do secret things for you and then you immediately say what I'm doing. Hey, Chuck just rubbed his butt. I didn't know that they were secret just for me. Yeah, it's my little gift.

I had no idea. Thanks for that, Chuck. Friday, dude, it's so good to be recording on a Friday. It's beautiful, it's like 80 degrees. Gorgeous. We have a window so we can see the beauty. Yeah. Or we can actually see that ugly building. The construction in the office is well underway. We've been inhaling volatile organic compounds all week. It's out of hand, actually.

Yeah. It's everywhere I turn their desk that shouldn't be there and cube walls stacked up. Yeah, it's weird. I can't believe we're not working at home through this whole thing. It's quite an idea, Brian. Is that a complaint? I don't want to come across as complaining. You're fine. I'm glad I have a job.

We don't have a sponsor, it doesn't matter. Okay. Chuck. Yes. Have you ever seen a Tourette's guy on YouTube? No. You haven't? Uh-huh. He's this guy. He's a hefty guy with glasses and a mustache and often a neck brace. Okay.

And he has a foul mouth, an anger problem. Uh-huh. He's fond of using Bob Saget as an expletive. He goes, Bob Saget! That's funny because Bob Saget is a very foul mouth comedian. He is surprisingly so. I love that about him. That in itself is almost a curse word. Yeah.

He's taken a lot of heat because he's very abusive toward his family members. I think I have seen this. I can't imagine that you haven't. He says just the craziest stuff. And also, the stuff he's saying is in response oftentimes to questions other people ask or whatever. So it really comes off as just a jerk. So I went on slopes to find out if the guy actually has Tourette's. He probably does not. He does.

He was diagnosed with Tourette's, but his family admits on the Feeling Guilty page that he does have anger and alcohol issues that exacerbate things. Okay. So he may just be a jerk as well? It's possible. Okay. He has raised awareness, one could say, of Tourette's syndrome. Tourette's syndrome. Tourette's going to be a problem throughout this whole podcast.

There is no S. It is Tourette's syndrome. Yeah. Unless you're just calling it Tourette's. Right. Without the syndrome, then it has an apostrophe S. Right. The reason why is because it belongs to a French physician, correct? Yes. His name was Gilles de la Tourette. It's how I'm going to pronounce it in my faux French.

And he was a physician in France in the 1800s. And he did not actually, he was not the first person to report about Tourette's. That was Jean-Marc Gaspard Ita. Yes. Very nice. And he described the symptoms of a lady, a noble woman named Marquis de Dempia. I'm impressed with you, Chuck. Yeah. She was elderly and she had, sounds like she had Tourette's and he described them as a tick illness. Yeah.

And then later on is when Tourette himself published the study of nervous affliction when he, he tracked nine people in a French hospital and then it officially became Tourette's. Right. It became the syndrome day Tourette. That's right. Yeah. We sound like we could collude at any moment. Yeah. So that's where the syndrome gets its name, right? Indeed.

And since then, well, I guess since the 19th century to, I'd say, the mid 20th century, it was basically like, holy cow, you had Tourette's syndrome. Yeah. And then in the later 20th century, we started to get a slightly better handle on what was going on with Tourette's sufferers. But we still don't entirely know what's going on there. Right. We suspect that it has a genetic basis. Yeah.

Because they haven't tracked it to the gene, but they believe that there's a, or they've noticed that parents with Tourette's have a 50% chance of passing on to their kids. Right. Which is pretty strongly in favor of genetics. Yeah. We also know, and this, I found it very interesting, I didn't know this, that you always have the onset of Tourette's Tourette's. You're right. This is difficult.

Before the age of 18. Yeah. Usually it starts around seven peaks from eight to 12. Yeah. And then the ticks start to decrease steadily. Yeah. After that. Boys get them more than girls.

Yeah. I think they're four times likelier, three to four times likelier to have Tourette's girls there. And you can have Tourette's and not notice it too. Yeah. And then you can have a visible tick. It's just in the gene is in your body. Right. If it is indeed a gene.

Yeah. Let's stop beating around the bush, shall we? Let's. Let us talk about caprolalia. Very nice. Thank you. Caprolalia. Right.

That is what most people think of Tourette's is the old joke. Hey, that guy's got Tourette's if somebody yells in obscenity. Right. A vocal tick. It's a complex vocal tick. Very complex. It might be like a grunt or clearing your throat or something like that. Right.

A complex vocal tick is a symptom of Tourette's syndrome where you are stringing words together. Right. Or even just saying a word would be a complex vocal tick. But specifically with coprolalia, caprolalia, I don't know. These words aren't uttered often within a social or emotional context. Right. It's quiet in the auditorium when the kid blurts it out. Right.

And it's an obscenity. They blur obscenities or reference to genitalia or bodily functions. Whatever. Or sexual acts. Right. Yeah. Bob Saget. Right.

The thing is, though, is a lot of people who age and have coprolalia learn to, they learn tricks. Like they might mutter it a little more. Right. They might mask their mouth with their hands. Uh-huh. They might say just the first letter or two of the word, like, and that is enough for a lot of people who suffer from this affliction or have this symptom.

Right. But in other cases, it's so extreme that you can't say anything but that word that comes out. And what I've read is it's akin to wanting to sneeze, but say sneezing is socially unacceptable. Right. So you have to cough. Uh-huh. But that doesn't satisfy the urge to sneeze, and eventually you're going to have to sneeze.

Do you know what I would do? What? I would just turn around and look at the guy behind me every time. You're like, whoa, dude. Right, yeah. What's your deal? Well, apparently also there's a kind of sub-suffering of coprolalia where people blurt out like racial and ethnic slurs in the company of people who would take offense to that.

The researchers point out, although I'm not entirely certain that they have a true handle on this, they point out that this doesn't necessarily indicate, you know, the thoughts of a person who has coprolalia. Right. It's just, this is what's in their mind right then, or what they're saying, or what's coming out. Yeah. Well, that is, it can be a symptom of Tourette's, but it's only in less than 15% of sufferers.

So the common thing that most people think of is actually very uncommon. Right. And like you said, a lot of people have such mild symptoms, you wouldn't even notice it. Like I could have Tourette's syndrome, Chuck, a very mild case and you wouldn't know. I'd know. Okay. So they, stat-wise, one in a hundred people suffer from a mild form, which is a lot more than I would have thought.

Yeah. And about 200,000 Americans, it's just Americans, have the most severe forms. Right. So that's definitely a little more common than you would think. And it is pan-cultural, but it's not found in equal amounts in every culture, which kind of undermines the genetic basis idea. Yeah, a little bit. Because there's a lot more Tourette sufferers in the U.S. than in Japan.

Interesting. Yeah. I wonder if that's something to do with our culture. We're a foul mouth culture. Maybe. Right. And we're very nervous. I think the Cold War did it to us.

Well, they do say that anxiety sometimes can increase the amount of ticks and relaxation. That's one of the things they'll try and get you to do is relax yourself with like breathing techniques. Right. So that could have some credibility. We'll get to that. Dr. Clark. Thank you.

Dr. Bryant, whether or not it has a genetic basis, and by the way, if it does, we'll know for certain within five to 10 years because we're going to understand every single gene in the human genome within that time, I think. It's scary. It is very scary. All the ramifications, that's a podcast in itself. Yes, it is. Look for that one.

2011. Whether or not it has a genetic basis, they have kind of, and by they, I mean people who are involved in Tourette research have the government have, although they do fund some through the National Institutes of Health, they've kind of narrowed down some regions of the brain that are likely candidates for the underlying mechanism of Tourette syndrome. Right. Yeah. I thought this was a little weak.

I did too. And I didn't like the word pinpointed. Yeah. Because I mean, they picked the thalamus, the basal ganglia and the frontal cortex. And it's kind of like those are the three things that control like your motor functions or like, well, it must have something to do with that then. Or your frontal cortex, which is in charge of controlling the motor activity of speech, including speech.

So it seems like, I don't know, those are the obvious parts of the brain. Right. Like nobody did any real research. That's not true, of course, but you know, they're just like, it's probably this part of the brain. But like we know enough about the brain of someone were to have sat us down beforehand and said, pick out the three parts that may be responsible, I probably would have picked out those three.

I would have said frontal cortex. Sure. Sure. The problem is, Chuck, is not only do we not know that much about the brain, humanity in general, and science specifically, doesn't have that great of a grasp on the brain. We said it before. But, and we'll say it again too, but it looks like the likeliest candidate is not necessarily a brain region, but these brain regions working are malfunctioning in conjunction because

of an excess of the neurotransmitter dopamine. Yeah. Misfiring transmitters. That's always the case. And again, the reason why they think that this is possible is not because they have any hard scientific evidence that this is the case. They've just noticed that in Parkinson's patients, which are the opposite of Tourette's patients in a lot of ways, they move much more slowly, unsteadily, and their motor function seems

to be impaired. It's decreased. And they've found that there is a lack of dopamine in Parkinson's patients. So they're like, well, then it probably just means that there's an excess of dopamine in Tourette patients because that's the universe is that cut and dry. Little flimsy. Right. That's what I think.

Yeah, me too. And it's just such a crapshoot when you're dealing with a brain. You just don't know they're doing their best though. Yeah. Should we talk about symptoms? Yeah. Let's. Well, we already covered the obscenity bursting cupra lalia.

Very nice. Thank you. You took the cue. And that is the rare symptom. More commonly, what you're going to see is like eye blinking, throat clearing, shoulder shrugging. I know a guy. Facial grimaces.

Yeah. Facial grimaces. Well, he had Tourette's and I didn't even know it until, you know, recently when I was researching, I was like, oh, that guy Andy had Tourette's. Wow. Because he would go like, uh, like, and like blink and turn his head and like make a little guttural sound like that. Well, yes, then he would have Tourette's because you said that he had a motor tick and a vocal

tick, right? Yes. So if he just had, you know, the shoulder shrugging or eye blinking or twitching, just that he would have had a chronic motor tick disorder, right? Or if he just made the guttural sounds, he probably would have had chronic vocal motor tick disorder. That's a tough one to get out, isn't it? Yeah.

Well, since we're here, we might as well go ahead and say, and I didn't realize this either that there are all these very specific classifications. So if you, if you're being diagnosed with Tourette's, they rule out a lot of other things first and then once they've ruled out all the other stuff, they go, okay, have you, what kind of ticks do you have? Right. How often do you have them? When did you start getting them?

Because it's got to be before 18. Right. You have to have multiple motor ticks and at least one vocal tick and both of those have to happen within one year. And within that year, you cannot go three months without a tick and still be diagnosed with Tourette's. Right. I didn't know it was that specific.

I didn't either. But it's in all of its based on observation, obviously. But if you have something else, Tourette falls under the umbrella of movement disorders, right? Right. So there's all these different kind of sister sibling disorders that could be, that could be diagnosed rather than Tourette. It's kind of like Tourette is a melange of movement disorders or motor disorders. I'm a long, it's very nice.

Thank you very much. We're back to the French, right? Exactly. 2023 is already well underway, everybody, so don't wait any longer to level up your small business. And the way you can do that is by joining up with stamps.com. That's right. Because with stamps.com, you're going to be able to print your own postage and shipping

labels right there from your home or office or home office. And you know, it's ready to go in minutes. You can get back to running your business sooner than later. Yep. Stamps.com is like the post office elevated. They have rates you literally can't find anywhere else, which comes in handy because postage rates just increased again, like up to 84% off of USPS and UPS. Plus stamps.com automatically tells you your cheapest and fastest shipping options.

So use stamps.com to print postage wherever you do business. All you need is that computer and printer. Set your business up for success. When you get started with stamps.com today, just use our promo code stuff for a special offer that's going to include a four week trial plus free postage and that free digital scale, no longterm commitments or contracts. Just go to stamps.com, click on the microphone at the top of the page and enter our code stuff.

Have you ever just thought to yourself, why me? Why is life so unfair? What do other people see when they watch me walk by when I catch my reflection? People run. They're like, I have a contagious infection, but it's not my mental health. I know that can be crushing. I'm talking about plaque psoriasis, but you didn't see that coming. I'm sick of the judgment, the discomfort and itching.

Vitamic cream is the one daily steroid free treatment. I know I've been missing. Vitamita Pinneroff Cream 1% is a prescription topical treatment for adults with plaque psoriasis. Do not use if you're allergic to Vitamic cream. The most common side effects of Vitamic cream include red raised bumps around the hair pores, pain or swelling in the nose and throat, skin rash or irritation, including itching and redness, peeling, burning or stinging, headache, itching and flu. Tell your doctor about all the medicines you take and if you're pregnant or plan to be,

ask your doctor if Vitamic cream is right for you. You deserve more from your topical. To learn more, visit TopicalUpRising.com. So Chuck, I jumped ahead a little bit, didn't I? Yeah, that's all right. There are some other really interesting tidbits about Tourette's that I was unaware of. Normally, they start out higher up in the body and then as the patient ages, the ticks move further down.

Yeah, I thought that was interesting. So you might start out with eye blinking or shoulder shrugging or neck tensing or something like that. I should say, by the way, since this isn't a video podcast, you can't see it, but every time Chuck or I describe some sort of tick, we try it out ourselves. It kind of feels almost involuntary. It is. And then from there, it can work its way down to the arms and hands like clenching your

fists, that kind of thing. And then eventually, down to your feet, so you might stomp your feet really loud or you might have a hitch in your giddy up, as they say. Who says that? The Tourette researchers, they? Walter Brennan, the old Westerns. And then ultimately, Chuck, he can move into the respiratory and alimentary systems. So a tick can manifest as a hiccup or whistling or belching or throat clearing or something

like that. So it makes a cycle over time. It doesn't necessarily, but it can. Right. And once it starts moving, brother, it's tough to bring back to its original position. Yeah. What happens is there's an urge. They all suffer, describe this buildup they feel.

It's like building up in their body, like this urge to do it. And then that is satisfied by the tick, whatever that tick is. And sometimes you can learn to control that a little bit, but they say that you're just kind of putting up the wall, which will be broken at some point. So your tick will be even worse later on in the day. It's like if you're in a business meeting and you're just holding it back and holding it back, you might get out of the business meeting and have like a really bad tick or something, which is, I guess it's good if you can control it, but you got to know when

to let it loose too. Well, yeah. And I imagine that that kind of comes with living with Tourette. Like you realize, okay, I'm going to have a really big tick after this business meeting, but if I can hold it during the meeting, then I'm probably better off. Or, you know, if you're alone, I'm sure you just let the ticks fly, right? And also I was reading about a, the New York Times has a lot of question and answer blogs about Tourette syndrome.

Really interesting stuff. One guy said that he uses his Tourette's as a jerk meter or a jerk sensor. So like he's found that people who, people react very differently, but they can kind of be lumped into two categories. One, people who can look past it and be friends with you. And the other category are people who just can't. And apparently people who are not down with Tourette's are kind of f**ks. Sure.

I mean, in what way, other than the fact that they're kind of jerks for not being understanding. I think that's enough. Don't you? Oh yeah, sure. I mean, this is something, I don't, I don't even know that you could say Tourette's syndrome is misunderstood. No. And I think the greatest misunderstanding is thinking that all Tourette's sufferers

have coprolalia. But other than that, I mean, it's not like this is some hidden mystery that everyone walking the planet hasn't heard about just because it's so fascinating. And it doesn't have any attendant like physical problems associated with it. It's completely based on brain function, you know? And although there's not like, you know, you're not wheelchair bound when you have Tourette's syndrome. There are other, I guess, behavioral problems or disorders that usually accompany it or

can very frequently, right? Yeah. OCD, obsessive compulsive disorder and ADHD, which is adult attention deficit hyperactivity disorder. Yes. Thank you for filling in the blanks there. And they're not always linked, but a lot of times they are like a child if you've been diagnosed with Tourette's and you're a kid.

Many times you'll be diagnosed with OCD or ADHD afterward. And not only that, but sometimes you can have disorders as a result of Tourette's like a sleeping disorder or a learning disorder because of the Tourette's. Right. And they, I know that 25% of Tourette's sufferers have ADHD, which is a pretty strong link. But I also wonder if some of it has to do with misdiagnosis. The one that I kind of bought into was the OCD Tourette link. Yeah.

You're 20 times more likely to have OCD or symptoms of OCD if you have Tourette's. Yeah. And parents who have OCD have a higher likelihood of having kids with Tourette's syndrome. Right. So there's a little something there. And something linking them? Well, something, something. So Josh, let's say one of us has Tourette's and we want to try and rein it in some.

What can we do? Do you mean treatments? What, what are my options? Well, I think probably the gentlest option is behavior modification. Yeah. Behavioral therapy. Yeah, Josh. Habit reversal therapy is one of the behavioral therapies we'll use a lot of times.

It's got five components, but the main key there is the competing response. Right. You feel a tick coming on and oftentimes you'll do the, the competing response is sort of linked to what your tick is. So if you have like a shoulder thing and you feel a tick coming on, you will like really relax your shoulders or roll your shoulders and like roll your neck around or something to try and like fight back the tick. Right.

You want to use the same muscles to create the opposite movement though. Right. It's kind of like when your ear bug cords are kind of bent, right? Yeah. You have to bend them back the other way for a while to get back to the middle. It's just like that. Yeah. I can't believe I didn't think of that.

Thanks for that, Chuckie. What I don't understand though is that, I mean, it makes sense in one way, but if you're always going to be doing that competing response, what's the difference? No, the point is, is you're not always doing the competing response, just like your ear bug cord is not going to always be twisted the other way. You're just working it out from being twisted one way for so long. So eventually you would be able to eradicate the ticks? That's the point.

By doing this? Okay. Yeah. I thought it was just to keep from doing the tick. Well, what's the difference between shrugging your shoulder up and down? No. I see that point. No.

I think that it's to eventually get to the point where you're not having those ticks any longer. Gotcha. There's also regular straight up, good old cognitive behavioral therapy, which mainly focuses on relaxation techniques, identifying and dealing with stressors, because like you said, Tourette syndrome is often set off by emotions, stress, right? There's drugs. There's drugs.

There's always drugs. You want to, these are tough, man. This is dicing. I think that these are generally reserved for people with Tourette syndrome that really interferes with their daily life. Yeah. If you can't get it through behavior modification and it's more than a nuisance, then you might want to look into something like an anti-psychotic, Josh.

Yeah. Like Pemazide or Hella Peridol or something. Yeah. These are rough. Well, that's the deal. That's why doctors don't throw you on these meds if you have Tourette's like immediately because they can bring along some side effects like men growing breasts, men growing breasts, drooling, restlessness, and sexual dysfunction, and seizures.

Yeah, so in a lot of ways, the cure can be worse than the disease when you're using anti-psychotics or Tourette syndrome. Since it occurs in conjunction with ADHD or OCD, a lot of times the doctor will just piggy back the Tourette treatment onto treatment of ADHD or OCD, right? Yeah. If you have OCD and Tourette syndrome, you're probably going to be prescribed a SSRI like Zoloft or Prozac or something, and then Ritalin or something to treat ADHD may help alleviate the Tourette syndrome too.

Yeah. But Josh, if all these don't work, then you've got a really, really debilitating case of Tourette's and none of this stuff works. There is an experimental surgery taking place called Deep Brain Stimulation where they connect electrodes to wires from a small battery pack in your chest, sort of like a pacemaker for the brain is a good way to describe it. Yeah. And it supposedly prevents against the misfiring of neurons.

Yeah. It blocks the firing of the neurons. Isn't that crazy? It is. And they're not using this widely now because it's really experimental at this point, but they do use it for Parkinson's. That's going to be one of those treatments that in 50 or 100 years looks just ridiculously primitive and barbaric.

Right. You know? I can't believe they suck up wires and block firing of neurons. Yeah. Pacenakers in the brain. You talk about famous people. Yeah. Because I know we mentioned in, I think in our OCD podcast about Mahmoud Abdul Rauf,

who was the basketball player. Yeah. Yeah. Was that him? Yeah. I thought it was like Chris. Chris Jackson. He changed his name.

Oh, okay. That was me paying attention. I thought his name was Cassius Clay. And I think we got emails saying, no, he didn't have OCD at Tourette's or the other way around, but I think he was diagnosed with both in conjunction. I might be wrong. You're probably right, Chuck. Dan Ackerwood.

I had no idea. Yeah. One of the Blues Brothers. Yeah. Pete Bennett, who apparently was on Big Brother, which apparently is a TV show. I have not heard of this. I haven't either. James Boswell.

He's a writer. Jim Eisenreich. He's a Major League Baseball player, I think for the Cardinals maybe. We'll find out. And who else, a little guy named, like, the tinker on the piano named Mozart? Possibly. Possibly. That might be false.

They don't know for sure. And then a few other people I haven't heard of, goalkeeper for Manu, Tim Howard. Yeah. I'm more of an Arsenal guy. Really? Yeah. Figures. 2023 is already well underway, everybody, so don't wait any longer to level up your

small business, and the way you can do that is by joining up with Stamps.com. That's right, because with Stamps.com, you're going to be able to print your own postage and shipping labels right there from your home or office or home office. And you know, it's ready to go in minutes. You can get back to running your business sooner than later. Yep. Stamps.com is like the post office elevated. They have rates you literally can't find anywhere else, which comes in handy because

postage rates just increased again, like up to 84% off of USPS and UPS. Plus, Stamps.com automatically tells you your cheapest and fastest shipping options. See you Stamps.com to print postage wherever you do business. All you need is that computer and printer. Set your business up for success. When you get started with Stamps.com today, just use our promo code STUFF for a special offer that's going to include a four week trial plus free postage and that free digital scale.

No long term commitments or contracts. Just go to Stamps.com, click on the microphone at the top of the page and enter our code STUFF. Have you ever just thought to yourself, why me? Why is life so unfair? What do other people see? When they watch me walk by, when I catch my reflection, people run like I have a contagious infection.

But it's not my mental health. I know that can be crushing. I'm talking about plaque psoriasis, bet you didn't see that coming. I'm sick of the judgment, the discomfort in itching. Vitamic cream is the once daily steroid free treatment I know I've been missing. Vitamatopiner off cream 1% is a prescription topical treatment for adults with plaque psoriasis. Do not use if you're allergic to vitamin cream. The most common side effects of vitamin cream include red raised bumps around the hair pores,

pain or swelling in the nose and throat, skin rash or irritation, including itching and redness, peeling, burning or stinging, headache, itching and flu. Tell your doctor about all the medicines you take and if you are pregnant or plan to be, ask your doctor. Vitamic cream is right for you. You deserve more from your topical. To learn more, visit TopicalUpRising.com. What does that mean?

I don't even know. Okay. It's just arsenal. That's like coming to America and be like New York Yankees. Right. But no, I think if you're a man you fan, you would go to Europe and be like, I'm a man you fan. I don't see.

I thought arsenal was like the big guy. No, they're both pretty big, but it doesn't matter either way if you don't really play soccer and you're an American and you call it soccer. Right. And you're an arsenal fan. Sure. Making air quads. Yeah.

You're a jackass. If you walk in here with an arsenal sweater or something one day. I would not. Maybe a scarf. Those things are saucy. Check. There's one last thing. We talked about coprolalia.

Coprolalia. Yes. Coprolalia. Mm-hmm. There's also copropraxia. Uh-huh. The involuntary use of obscene gestures. Sure.

Like this. I had that in traffic at times. Yeah. Yeah, you do. But yours is voluntary. That's a big difference. There's also echolalia. Mm-hmm.

Mm-hmm. Right. Right. Oh, boy. Exactly. That's when you repeat things that someone says, I guess. Yeah. Uh-huh.

And then lastly, there's echopraxia, which is me doing, I'm stroking my goatee as Chuck does too. Except you don't have a good, phantom goatee. Right. Okay. So you mimic someone's motion, bodily motions. Mm-hmm. Interesting.

Yeah. Well, there you have it. That's Tourette. Anything else? Oh, Medical Marijuana is a study, a field of research right now for treatment of it. And all the potheds are like, yeah, man, it works really well, the treatment of Tourette and all the scientists are like, we don't know. Do you see me yelling out words, bro?

Exactly. The jury's definitely still out on Medical Marijuana in any of its uses, but we're looking into it. Right. Yeah. So that's definitely it. That's it for now. If you want to learn more about Tourette syndrome, you can type that in.

That's T-O-U-R-E-T-T-E syndrome. And there's a really cool picture of a Tourette sufferer. It's a multiple exposure picture of a Tourette sufferer undergoing a series of ticks. It's pretty neat. You can type that into the handysearchbar at howstufffirst.com, which of course means it's time for Listener Mail. The return of Listener Mail. Yeah, it's been a while, hasn't it?

Yeah, it's been a little while. We've been so long-winded lately that there hadn't been any room. Mm-hmm. The jury's been like, enough. She's listening. So I'm going to call this one Patriot Offsets. This is from Rob in Cincinnati, Rob Kay. And I'll just summarize the beginning.

He was a little put off by the whole carbon offset thing, because he's like, how can you be an environmentalist and support this? It basically means you're free to do whatever you want as long as you buy these offsets. He was put off in the same way by the Catholic Church who sold indulgences to offset the sins of the wealthy. Uh-huh. We got a lot of email about this. Apparently, I said something about a karma offsetter, and they said indulgences are kind

of like that. Yeah. So he was put off by that, and they were very popular. So he says, in the spirit of the carbon offset, Josh and Chuck, I am now creating the Patriot Offset. Okay. I noticed once or twice in the blogs that you two get a few people who are a bit close-minded and question your patriotism.

Yeah, that happens from time to time. Yeah. They think we're not patriots. Some guy asked me if I served in the military very mockingly. Oh, really? Yeah. You should have said, yeah, Howard Stern always says he was in Vietnam when he was there. He tells these big long stories about it.

I have 15 years in the Army with three deployments so far for the simple price of a shout out on the podcast, I'm willing to give each of you a year of my Army time and let's say three months of peacekeeping deployment in Kosovo. Awesome. You guys had a blast. Trust me, he says, in Kosovo. So next time anyone calls you a hippie or anything like that, just tell them that you bought your service to your country and you are true Americans, and that is from Rob.

So we now have served a year in the Army. So do we get a year each or a year combined? Were we in the same platoon, same unit, or did we do any search and destroy missions? We need to come up with this stuff. Yeah, I think we were definitely probably bunk mates because I remember that one night went out, well not in the same bunk. Oh, okay. Bunks are on top of each other.

I just remember being on that top bunk that night when you beat me with the bar of soap in the towel along with all the other guys. You were asking for it, Squealer? You shouldn't screw things up for the rest of the platoon, I had to wipe down the latrines because of you. Yeah. Sorry. Pile?

Well, I got it in the end with the soap. You certainly did. Wow, Chuck, that one was fraught with the innuendo. Innuendo. Nice. All of it was super clean, though. And also, did you know that in the Civil War, wealthy people could pay people to stand in for their conscription?

Oh, really? Yeah. That didn't surprise me. Which we just kind of did. Yeah. With no money changing hands, it's basically illegal. So shout out to Rob. Yeah, big shout out to Rob.

Thank you for the military service for us. If you want to give Chuck or I anything, we love free stuff. You can send an email to us describing it and possibly offering something to StuffPodcast at HowStuffWorks.com. For more on this and thousands of other topics, visit HowStuffWorks.com. Want more HowStuffWorks? Check out our blogs on the HowStuffWorks.com homepage. Brought to you by the reinvented 2012 Camry.

It's ready. Are you? You're ready to travel in 2023 and since 1981, Gate One Travel has been providing more of the world for less. Let Gate One handle the planning for you with affordable escorted tours and European River Cruises. And right now, through January 30th, use promo code HEART20 to receive 20% off your tour. That's promo code HEART20 through January 30th.

Visit gateonetravel.com for more information or to book your tour. That's gatethenumberonetravel.com. Once again, use promo code HEART20 through January 30th to receive 20% off your 2023 trip. When Las Vegas welcomes you to Awakening, a new theatrical experience created by award winning artists enriched by spectacular sound, meet colorful characters and journey with them through wondrous realms. Experience Awakening.

Tickets at Awakening.com.