American In His 50s Develops New ‘Uncontrollable’ Irish Accent From Cancer

This may have been a wee bit of a surprise. A case report recently published in the journal BMJ Case Reports described how an American man in his 50s developed for the first time an “Irish brogue” accent. This wasn’t one of those temporary accents that people use to say “they’re magically delicious” when eating a bowl of Lucky Charms. No, the Duke University (Amanda Broderick, Matthew K Labriola, and Andrew J Armstrong) and Carolina Urologic Research Center (Neal Shore) authors of this case study deemed the man’s accent “uncontrollable.” In other words, he still spoke in the accent even when tried not to do so. Plus, he really didn’t have much of an Irish background. Sure, he had spent some time during his 20s in England, which is across the Irish Sea from Ireland. Sure he had some Irish friends and family members. But that wasn’t enough to make him sound more like Bono.

So what got this man’s Irish up, so to speak? The man apparently had what’s called foreign accent syndrome (FAS). This can happen when you suffer an injury to the parts of your brain that regulates the rhythm, melody, and intonation of your speech. Broca’s area is the region near the front of the dominant side of your brain that typically manages such speech production. Broca’s area is labeled with a number eight in the the following diagram of the human brain:

Broca’s area helps direct the way the body parts involved in speech move such as your lips, tongue, larynx, and pharynx.

Adopting an Irish accent requires a “tongue” of work so to speak. As Suzi Woltmann described for Backstage, an Irish accent differs from an American accent in several ways. First, the vowels are softer with an “a” being more like “ah” than “ay,” an “o” being more like “uh, i” than “owe,” an “i” being more like “oi” than “eye.” Secondly, you should emphasize “r” sounds by “placing your tongue farther toward the front roof of your mouth.” Thirdly, you can replace “th” and “t” sounds with “d,” as in “over dere” instead of “over there.” Or “whoop dere is.” Or “dere are den reasons why I hate you.” A fourth step is to drop the “g” at the end of words. So it’s “Dancin Queen” not “Dancing Queen.” Finally, you can add a somewhat Valley Girl-esque upspeak with an upward lilt to what you say so you sound a bit like you are asking questions all the time. Additionally, try throwing in some Irish slang such as “Acting the maggot”, “Eejit”, and “Manky.” Of course, don’t overdo it. After all, you won’t find too many Americans saying sentences like, “Awesome cool like boujee vibe checks are bussin’, dripping, bro.”

Here actress Saoirse Ronan tries to teach Stephen Colbert how to speak with an Irish accent:

Damage to Broca’s area can occur when you suffer a severe head injury such as when someone drops an anvil on your head, a bleed in your brain, a stroke, multiple sclerosis, or the growth of a tumor.

In this case, the man had prostate cancer. This cancer had started off as one type of cancer and then transformed into another type, one called small cell neuroendocrine prostate cancer (NEPC), based on finding on a biopsy. However, when the man had first developed the Irish accent, doctors had found no other abnormalities on his neurological exam or brain MRI.

Doctors eventually determined that this was a “para” situation. Not a “pair of” situation but one where the prefix “para” one, means “next to,” and refers to the cancer. The word “neoplasm” is a medical term for “new growth,” another way of describing cancer. The term “paraneoplastic syndrome” refers to a situation that can occur when someone has cancer. When that person’s immune system detects the presence of cancer cells, it can start mobilizing cells and various chemicals in the body to attack this cancer. Unfortunately, this immune attack can be a bit like a nervous guy on a date for the first time. It just starts firing off prematurely in random directions. Nothing is safe around the guy or the immune system including the body itself. This can result in a paraneoplastic syndrome where the immune system’s actions cause damage to different parts of the body.

When the damage is to the nervous system such as parts of the brain, spinal cord, and nerves, it’s called specifically a paraneoplastic syndrome of the nervous system. Doctors concluded that the man’s Irish accent was the result of such a paraneoplastic syndrome injuring the speech control parts of his brain. Unfortunately, the man ended up not surviving the prostate cancer, which eventually spread to his brain despite chemotherapy. The ultimate cause of his death may have been another paraneoplastic effect of his nervous system that led to paralysis.

This was certainly not the first reported case of foreign accent syndrome. FAS is not common. It’s not every day that your friends launch uncontrollably into a different accent. Nonetheless, there have been reports of FAS with a variety of circumstances such as strokes, blood vessel malformations, herpes simplex encephalitis, and even Covid-19. Foreign accent syndrome is a reminder that people are not as different from each other as made out to be by some. A foreign accent may seem very different and make it seems like someone is so apart you. But in actuality a foreign accent can be simply a few inches or centimeters in your brain apart.