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There’s no doubt that individuals with TS can be successful—even superlative—soldiers. For example, the French author André Malreaux served as both a field soldier and a pilot in the Spanish Republican cause, in a French tank unit in World War II, and managed to escape a German prison camp after his capture by the Nazis. You don’t get much more heroic than that, and he was a highly decorated veteran as a result.
Recently some newspapers have highlighted cases of “unfit” troops serving in Iraq, usually soldiers from Reserve and National Guard units ordered into active duty status. A few of the individuals profiled have had a diagnosis of Tourette syndrome, seemingly indicating that people with TS are uniformly believed to be unfit for service.
Young men and women interested in military careers may find such stories distressing. Those who dread the return of a military draft or who hope to avoid forced active service may use the stories to support their point of view. What are the facts about TS and service in the US military?
Basically, those who have TS and wish to avoid military service can almost certainly do so. Those who do want to serve in the military may encounter barriers, but, under some circumstances, they may be given a chance.
It is a known fact that many individuals with tic disorders or TS have served with distinction—indeed, one of the best-known medical studies on TS was based on examining young Israeli soldiers1. In the case of the US military, however, successful careers for people with TS happen only when the rules are bent. If military recruiters do their job as directed, no one who has ever taken a psychiatric medication (including most of the drugs used to suppress tics) or who has ever been diagnosed with a neuropsychiatric condition will be admitted.
However, even in the military, rules are sometimes set aside.
Currently, military recruitment and retention are in crisis. In April 2005, the Army had missed its target by 42 percent, and the Army Reserves by 37 percent. Other branches of the service are experiencing similar shortfalls, and fewer current personnel are re-enlisting voluntarily. One result is that recruiters under pressure to hit targets may be tempted to ignore information about past medication use or medical history.
Although medical fitness rules are often presented as rigid, the reality is that recruitment officers can and do take a case-by-case approach. In the current environment, an individual whose TS symptoms have all but disappeared by adulthood and who no longer takes medication may well slip through the net with ease. “Slipping through,” however, is fraught with danger.
However, as TS symptoms tend to be exacerbated by stress, even the most patriotic and motivated would-be soldier should consider whether any aspect of TS could prove to be a danger to himself or others under dangerous conditions. As all military personnel must be prepared to undertake combat, even those who are hoping for a career that keeps them in the fileroom, computer center, or mess tent, must think long and hard before trying to sign up.
In 2004 a well-trained and experienced Guardsman sent to Iraq to provide security for Special Forces troops had to be sent back home when stress severely exacerbated his tics. If you know in your heart that this could happen to you, you may want to consider an alternative form of national service. The same thing applies if you can only keep your ticcing manageable with meds, as those meds may not be available on the front lines.
No matter how confident you are about your fitness for service, do not be tempted to hedge the truth. Potential recruits are legally required to reveal their medical history; remember, the military has the right to access all of your childhood medical records. Lying to a recruiter is a felony. If you are found to have done so, you will be given either an administrative discharge that will prevent re-enrollment in the future—the dreaded “4F”—or even a dishonorable discharge. You can also be fined up to $10,000 and spend as long as three years in jail. If a recruiter pressures you to lie so he can meet his quota, don’t. It won’t be only his career on the line if you do.
Instead, be completely honest: a waiver may be possible if you pass a military medical examination and your past health records check out. The usual criteria for a waiver are demonstrating success in school and/or work without the use of medication.
Although basic military service is not necessarily barred to those with TS, some related choices may be. The service academies will not admit anyone who has a neurological condition, such as ADHD or TS, that persists in any way past adolescence. Some forms of security clearance will be harder (or impossible) to obtain. Admission to elite units may not be possible.
In any case, would-be recruits with TS need not feel stigmatized: these barriers exist for individuals with hundreds of common medical conditions, including asthma and allergies.
1 Zohar, Pauls, et al.(1986), Journal of American Academy of Child & Adolescent Psychiatry
©2007,2008 Tourette Syndrome Association, Inc. 42-40 Bell Boulevard / Bayside NY 11361 / 718-224-2999