Expert: MARK A. HOWELL - 12/22/2011

Question
QUESTION: Hello again sir, I've come to ask you on your professional opinion. A few days ago, I went in to talk to my local recruiter. My first one was SSgt. Gonzalez. This time it was Sgt. Caro. Both wonderful Marines.

I came to talk to them about a few questions and I guess they wanted to get more information on me. When asked about my medical health, the only issue I had was Tourettes; which I was then told I was disqualified. However, my question comes into play because 6 months prior, they knew I had Tourettes, (very mild form, eye blinking only) and I was still given the option to enlist. The reason why I was turned down as I was told, was due to the decrease in the number of Marines. My whole life's goal was to be a Marine and I was devastated. My brother, who came along with, now proudly wear the USMC shirt he was given after he was able to pass. I feel hurt, destroyed and like my life has been ripped apart, but my proudness for my brother being able to make it into a recruit keeps my spirits up.

I'm a bit confused sir, why am I not allowed to now, but 6 months prior it was ok? I know these good men would never lie and told me they were proud of my character I showed when I was honest about my condition.

However, they said I didn't seem like I had Tourettes and none of them even noticed it. I went home crying and hurt, but I didn't give up. They said I should get a second opinion from another neurologist to see if I was misdiagnosed, something my family has been thinking for years. I personally don't see or feel my Tourettes, only blinking a bit more. My SSgt. was talking about how one Marine Sgt. is still in the Marines and he has Tourettes with his head jerking and twitching. Is there a reason why someone with more severe Tourettes got in while I didn't?

My father is talking to a LT. Colonel and he said I have a strong chance of getting in if I can get my doctor to prove I was either misdiagnosed or that it no longer affects me in a way that's noticeable. I can carry out every day of my life no problem and most people assume its just nerves.

Sir, what do you honestly think my chances would be if I was found to be misdiagnosed? I was ready to become a recruit, and they told me I still met the requirements.

Being a Marine is something I've wanted to become since I was 8. The same day our country came under attack. I've had many dreams torn away from me and I don't want to give up my most prized dream yet. I want to be a Marine and I want to show others I can overcome what life throws at me. I just need to know if I have a chance to even get into it.

Thank you sir.

~Tayl0r.

ANSWER: Taylor,
Sorry to hear you're having such problems.  Your big problem seems to be the name of the disease.  You say Tourettes and everyone immediately thinks the worst.  Nobody thinks of the
more common tics of eye blinking, coughing, throat clearing, sniffing, and facial movements.

Tourette's does not adversely affect intelligence or life expectancy. The severity of the tics decreases for most children as they pass through adolescence.  Notable individuals with Tourette's are found in all walks of life.

You're correct when you believe you may very likely have been misdiagnosed.


Tourette’s may be diagnosed when a person exhibits both multiple motor and one or more vocal tics (although these do not need to be concurrent# over the period of a year, with no more than three consecutive tic-free months.  If you have vocal tics only it may be from Tourettism
Wilson's disease, or Hypothyroidism or any number of related problems. Secondary causes of tics #not related to inherited Tourette syndrome# are commonly referred to as tourettism.  Most doctors simply don't take the time to order an MRI, EEG, or other expensive Brain imaging study necessary to rule out that condition and in order to save the patient's family money.  Do you recall if such tests were done on you?  It's simply easier to say Tourettes and start treating it, since many treatments are similar. Other medical conditions that include tics or tic-like movements—such as autism or other causes of tourettism—must be ruled out before conferring a Tourette's diagnosis.  Sounds like you didn't get that thorough of a diagnosis.  Since you have motor tics only and not vocal tics also, then you likely do not have Tourettes Disease.  Your doctor did not do you a favor by being in a hurry.
 
Tourettes Disease is frequently misdiagnosed or underdiagnosed, partly because of the wide severity, ranging from mild #the majority of cases# or moderate, to severe #the rare, but more widely-recognized and publicized cases).

If I were you I would go to a different USMC recruiter in another town and start all over again, denying you ever had Tourettes.  Recrtuiter shopping is perfectly legal because your recruiter is only in your town for your convenience.  Another recruiter would be glad to accept a cash bonus for recruiting you.

Colonel H



---------- FOLLOW-UP ----------

QUESTION: Thank you sir, as always for your wonderful replies. The thing that got me upset was that when I was first diagnosed; Tourettes was never even considered. However, I was put on Ritalin and all these other chemical cocktails and then I started to exhibit these symptoms.

Thank you sir, I'm happy to know you know its not all about swearing. I heard a few of the recruiters were making jokes about Tourettes and asking me if I ever swore on purpose... I laughed, but it made me feel a bit embarrassed. I know they meant well, but its frustrating when people automatically think Tourettes = Coprolalia. Like you said, Coprolalia is the most well known one thanks to the media and Youtube videos such as http://www.youtube.com/watch?v=nb3VgCqbr6g and http://www.youtube.com/watch?v=dguO6R6pdOw feed into the stereotype that Tourettes is all about vulgar language.

We're moving up to Addison, so I'll take your advice sir and start fresh!

Another question sir, my friends are interested in signing up as well. If I get them to sign up and they refer me, do I rise to the rank of Private First class or what? And would it only count if they went through with it?

Thank you for being so kind and informative. What you told me truly give me hope and my spirits up. Merry Christmas sir!

Answer
T.J.,
Yes, they definitely have to go through with it.  There's constantly different rewards being offered for getting recruits for them, but usually it's money.  Sometimes it's U.S. Citizenship.  If they're serious, check with your recruiter at the time you sign up.
Colonel H