Given that Lionel has Tourette’s syndrome, the narrative inevitably explores the difference between the brain and the mind. The brain here is an organ, a vast and complicated neural network that every moment processes billions of bits of information and, in turn, organizes that information and then communicates observations, perceptions, and information to others. By his own admission, Lionel’s brain does not work; it misfires: “My mouth won’t quit” (2). The torrent of words he cannot control and the physical tics he cannot anticipate are manifestations of a dysfunctional brain. Treatment fails him, and Lionel struggles to discipline his wildly misfiring brain. 

At critical moments, Lionel’s brain stumbles, fails him, and he becomes what others call a “freakshow,” a casualty of genetics, a liability, even an embarrassment. Early on, from his lonely days in the orphanage, Lionel struggles to make what he often terms his “Tourette’s self” disappear. An element of Lionel’s emergence as a character involves his making peace with a brain he cannot repair, how that damaged organ with its furious engine of odd and eccentric mannerisms is, ultimately, who he is. 

The mind, however, is something far different.