Obscenities Pour Out - But She Can't Help It

PITTSBURGH - Darla J. Crowley never swears on purpose, yet her speech is punctuated with obscenities, racial slurs, sexual slurs, assorted yelps and outbursts of "FIRE!"

They are severe symptoms of a neurological disorder called Tourette syndrome.

"I like to say, I'm Darla, I'm 31 years old. Nigger. I have brown hair, blue eyes and yes, I have Tourette syndrome," she said, while hitting herself on the head and spitting. "Tourette is like an afterthought. I don't like - fat ass - for you to judge me because of my Tourette. F--- you, bitch. That is - FAGGOT! - unfair to me. You have not met Darla. You have met Tourette syndrome."

During a three-hour interview at her home, she choked out sentences between vulgarities, facial contortions and even an imitation of a squeaky escalator.

Despite this disability, which would entitle her to live off the government, she has held a regular job for years. Between the tics is an articulate woman who has found a will to enjoy life.

Her doctor said Crowley's case is more severe than most. Sue Levy of the national Tourette Syndrome Society said she was astounded that Crowley has worked for 10 years as a guard at the H.J. Heinz Co., where she greets hundreds of people every day.

"I like to make people feel their best," Crowley said. "If I can do that in the 35 seconds it takes to put an ID in the turnstile and pass me, I feel better. It only takes 30 seconds of listening to me before you realize that what I say isn't purposeful."

She credits Heinz, and especially her co-workers in the security department, for helping other employees accept her.

Tourette syndrome involves a malfunction of the neurotransmitters - the signals by which the brain tells the body what to do and say. Its symptoms are multiple involuntary movements and vocalizations, many of which are as mild as tapping a foot or clearing the throat. Hidden symptoms can include learning disabilities, phobias or insomnia.

Estimates of the number of people with Tourette's range from 150,000 to more than 1 million. Many cases are genetic; others seem to appear spontaneously.

"The majority have mild cases, never see a physician, do not take medicine and don't know what they have," said Levy, liaison at the association's headquarters in Bayside, N.Y.

Perhaps 25 or 30 percent of people with Tourette have coprolalia - the impulse to say offensive words. Coprolalia may involve malfunctioning signals from the part of the brain that harbors basic impulses such as sex and anger, Levy said.

Social stigma is the most painful aspect of Tourette syndrome, said Dr. Mark Webb, Crowley's psychiatrist.

"Despite the devastation that does occur to many patients with Tourette, there are effective treatments that involve use of medication and evaluation of . . . personal resources," he said.

Crowley often "tics" (she uses it as a verb) the opposite of what she believes.

"I know when I'm going to tic. I cannot stop it. It's like trying to stop breathing and stay stopped. You can stop breathing, but eventually you must take that breath," she said.

She was 11 when she began to display head jerks, grimaces and eye twitches. The symptoms worsened.

"I really thought it was something physical because she was very intelligent in school," said her mother, Anna Mae Crowley.

Crowley narrowly escaped expulsion from her Catholic elementary school. In public high school, other students mocked her, played tricks on her and even hit her. But her teachers were compassionate, she said.

After high school, she completed business school but could not hold a secretarial job.

At 21 she read an article in "True Story" magazine about someone whose symptoms sounded exactly like hers. After her doctor refused to accept her self-diagnosis, she contacted the Tourette Syndrome Association, which sent her names of local doctors familiar with the disorder.

She visited Dr. John F. Niel, a psychiatrist at the Western Psychiatric Institute and Clinic in Oakland, Pa. He has since died.

"When he first said, `You have Tourette syndrome,' I thought that was the greatest day of my life," she said. "I knew what I was doing had a name and it was a medical condition and I was not crazy and I was not the only person in the world doing these things."

Niel started her on the drugs that some people with Tourette use to reduce their symptoms. He also helped her begin sorting out the parts of her personality she could control from those she couldn't.

"He talked me through my feelings of anger," she said, referring to hatred she had harbored toward those who had laughed at her, punished her or insisted she could control her tics.

She wants to go to college but says the racial slurs she utters make it impossible.

She hates offending black people, and she hates sounding like a racist. Her greatest fear is that she will be assaulted because of the slurs.

For a time, she handed strangers a paper that explained her disorder. But for the most part, she avoids public places.

Even when she was taking heavier doses of medication that kept the tics more in check, she was asked to leave stores and restaurants because of the outbursts. Now she will venture into only two stores where she knows the owners. If a black customer enters, she runs out.

Since 1989, she has cut the dosage of her medication because her head felt foggy, she couldn't remember what she was told and she lost her spontaneity and wit. But in so doing, she has given up most social life outside of Heinz.

"I had never heard of Tourette before I met Darla," said John Palmieri, a co-worker at Heinz. "But I trusted that she couldn't help what she was doing and she respected that and we became friends."

Until her medication was reduced, Crowley sang in the choir of St. Michael Catholic Church in Pitcairn, Pa. "I was raised that you go to church every Sunday. I did until my Tourette got very bad. If it ever gets down again, I will go back," Crowley said.

"I'm not bitter about having Tourette. I attribute that to the way I was raised by my parents."

When she gets to heaven, she said, "the first question I am going to ask is, `Why did you allow me to have Tourette? What purpose did it serve?' Because I believe there is a purpose."