Ganser Syndrome
or Being Approximate: illness or ingenuity?

In 1898, Ganser first described his eponymous syndrome as a "hysterical twilight state" characterized by clouded consciousness, somatic conversion symptoms, hallucinations, and the offering of approximate answers to simple and familiar questions. Ganser hypothesized that the syndrome was an associative reaction occuring as a result of an unconscious effort by the subject to escape from an intolerable situation. The subjects that Ganser was working with were prisoners on remand and the intolerable situation was prolonged incarceration {new window}.

Ganser Syndrome It was the offering of approximate answers (vorbeireden), or what Ganser referred to as "talking past the point," that particularly intrigues me. Doctors would ask simple questions such as: How much is two plus two? How many legs does a horse have? How many fingers do you have? And, to prisoners, Do you have problems with the police? Approximate answers (e.g. two plus two is five) were interspersed with ridiculous answers (bearing no relation to the question), correct answers, and "I don't know" answers. Circumstances of awaiting criminal sentencing are laden with enough fear and distrust to understandably inspire strategies of benign falsification. The extremely simple and obvious questions that were asked must have seemed extraordinarily suspicious, some sort of trick [Whitlock 1982: 202].

The overtly indirect answers offered by the patients struck me as both clever and funny, savvy more so than factious. With further cogitating and musing, the discourse of doctor and Ganser patient seemed more and more like the banter of stand-up comedy teams or the cunning wit of a trickster. My imagination took me swiftly from medical science to vaudeville.

Doctor: How many noses do you have?
Patient: I do not know if I have a nose.
Doctor: How many fingers am I holding up?
Patient: I can't be certain that those fingers are yours.
Comic l: What is the height of dumbness?
Comic 2: About six feet, aren't you?
Comic 1: Do you know how rude you are?
Comic 2: No, but if you hum a few bars, I'll tap my feet.

Being approximate. Talking past the point. Moving beyond the unmarked place that is "the place to be." In being approximate we choose metaphor over literalness, difference (however slight) over sameness, fuzziness over accuracy. In that gap, we draw near to but do not meet, we resemble but do not duplicate. We are more or less correct.

To be approximate is to be a boundary-bender, existing in the gaps created by almost, barely, beside, nearly, quite, but not exactly. Being approximate conjures a kind of ambulant approach to knowledge and fact, putting the very notions of precision and accuracy, correctness and literalness into doubt. What do we compromise in our obsession with correctness? Do not the characters of clown, fool, trickster—in their role as cultural commentators from the vantage point of either the inchoate (not-yet-formed) or the queer (unwilling to form as prescribed)—demand that we question the moral righteousness of the straight-man, the one who always seems to know?

It is important to note, regarding the Ganser syndrome per se, that while the patient—a prisoner on remand or not—may challenge the doctors need to categorize, to find evidence in keeping with the terms of predefined categories, the doctor does not experience the system of classification to be undermined. The doctor, the audience, does not "get the joke" because the doctor is disinterested, from the perspective of authority, in experiencing the kind of fracture of positive order and rational reasoning that the joke initiates. He is intent upon the act of diagnosing, recognizing something he already knows. In any event, the doctor is also operating from a vantage point of empathy and according to joke theorist Mandel [1970] empathy kills humor. Rather than being lured by the approximate, medical science constructs pathology of the approximate: the aberrant sign becomes a symptom of a disorder—not of a social body bent upon a certain kind of knowing, but of the patient exhibiting the sign. Medical science's threshold for uncertainty—for seeing not just the point but beside the point as well—ultimately determines the kind of boundary (from porous to impenetrable) that is fabricated between health and sickness.


External References [links open in new window]

What is Ganser Syndrome?
Cleveland Clinic

Ganser Syndrome
eMedicine article by Robert C Daly and Can M Savasman

Sigbert Josef Maria Ganser
Who Named It