DR. JOHN'S CASE NOTES................................................................ In the wider population, tourette's syndrome is believed to affect as many as one in a 100, but for many the symptoms will be mild and relatively unnoticeable. However, for a few who have the full blown neurological disorder, they are compelled to live their lives as if possessed by demons. TS as we all know is characterised by repetitive, stereotyped, involuntary movements and vocalisations. The syndrome was named after Dr. Georges Gillies de la Tourette, the pioneering French neurologist, who in 1885 described the condition in an 86 year old French noblewoman. In the rare cases where the vocalisations of sufferers are more complex, certain words or phrases are repeated over and over again.......often involving outbursts of swear words and/or other offensive material. These may well occur when the sufferers get excited or anxious. However, in the bizarre world of bridge every club is over-run with members affected by a very specific but unusual type of TS......being one....... which unfortunately displays chronic symptoms. I have labelled this DIRECTOURETTE'S SYNDROME. This dire form of TS causes bridge players to suddenly shout out in loud bellowing voices the same offensive word....." di...rect....orrrr ". This can go on from different parts of the room every 2 or 3 minutes. This uncontrollable form of vocal behaviour can be triggered by any real, perceived or imaginary infringement of table etiquette, or rules of play, by the opposition. Sufferers tend to be players who fall into three distinct personality types: those who are over-competitive ( and are looking for any avenue to obtain an improved score, those who are overly unpleasant and just plain awkward, and those who are overly obsessive about complete obedience, and the strict adherence to every aspect of the way the game must be played.