Nancy Pelosi's problems are brought on by chronic fatigue and sleep deprivation caused by all the "work"(wink-wink)she has had done over the years. At the onset of what should be REM sleep, her knee caps twitch violently and interrupt her dreams of singing a duet with Babs Streisand or going a few rounds at the gym with Babs Boxer.
He is just appealing to his base.