DR. JOHN'S CASE NOTES : THE U-HOLD U-OUGHT SYNDROME .... Only in the bizarre world of bridge, does this particular variant of tourette's syndrome exist. Strangely, it affects only the male players, who all suffer from it to varying degrees. The syndrome involves sufferers making the same utterances every time they open their mouths to speak to other members. All initial greetings begin with "you hold.. ", but later on during the conversation, most of the comments and remarks start off with " you ought.." . These two word utterances will always be made with attention seeking shrieks, especially by those who are prone to getting on their high horses. The victims cannot control these outbursts........which automatically pop out at each and every time they seize the opportunity to speak. Even though they hadn't considered for a moment what the final statement was going to be, they feel compelled to complete the statement....... with the first thing that comes into their head, irrespective of whether it is correct, meaningful or relevant. They are compelled to improvise, and should nervousness set in gibberish inevitably follows. They make several half-baked attempts to define the actual hand the person was meant to hold. Similarly, they might make several attempts at alternative plays or bids the person ought to have made at that point in time, hoping that one of these suggestions could be correct. Even when discussions move away from hands, the " you oughts " still persist, in that victims quickly move into the realms of general advice: " You ought to.... take lessons ".... "find a new partner "...." calm down ".....or even...." give the game up for good ". Indeed, as this syndrome fully develops the ordinary lives of these sufferers become blighted. Family, friends and work associations start to avoid from them at all costs, fearful of receiving barrage after barrage of such lordly but pointless suggestions. On a final note, many psycho-analysts believe this is syndrome is closely linked to a type of autistic, obsessive compulsive disorder. This might explain why men seem to be far more predisposed to becoming victims of this awful affliction.