This poem employs language in ways that are characteristic of the involuntary outbursts seen in patients with Gilles de la Tourette's syndrome. The devices include frequent obscenities, word repetition, and a jerky, spasmodic forward motion. The male Tourette patient is thwacking "the roof of the car, knuckles / calloused and winking . . . " He is driving with his wife beside him, patting her thigh, "her thighs are warm as kettles, your palms moist / as hiss . . . " Whatever it is that happens in the last stanza, he becomes excited, "god damn, god fucking / damn, and god bless." [30 lines]