NOW THAT THE TABOOS HAVE RECEDED

Struggling with aging and diabetes, I put all my meds in a box and made an appointment with an experienced doc.  I was shocked and amused to discover that many of my problems came down to constipation, a lifelong struggle.  It has always been kind of a painful and taboo subject.  

When I was in primary school and complained about the pain and slowness of big hard stools, my mother snapped, "Wait till you grow up and have to have babies!  That will hurt a lot more!"  But I'm not her and I didn't have to have babies, so I didn't.  

Not that she didn't try to help.  The "pediatrician" who was just the local doc who worked out of his house a few blocks away, recommended a nasty stuff call "petroauger"-- I think it was goop from seaweed, the gel they grow stuff in with Petri dishes.  He told her to scrape the flesh of an apple with a spoon and give us that, so we stood in a row like little birds with open mouths while she dutifully extracted pectin from apples and shoveled it in.

But this time the doc treated it more seriously -- he sent me for an Xray that cost more than a hundred dollars.

But it was worth it, because clearly there was the knot of half-digested food sitting in the tubing blocking everything -- but no tumor.  (I think everything is cancer.)  Of course, part of the culprit is the Ghost of Menses Past (I'm 79) which always tenses everything up at the onset and relaxes my whole body and outlook a few days later when the hormones shift.  This was new to the Doc, this ghost thing, but he didn't make fun of it.

I was already drinking my 8 glasses of water a day, though the "againsters" said I didn't have to.  (They say coffee, chocolate, butter and daily aspirin are okay, too, which calls their motives into question.)  And once I even took fiber pills for a while, but now the Doc was definite.  DO IT.  It works.  But the fancy stuff with a name is more expensive than generic.  And bran cereal helps as well.  Also the nagging "fruits and vegetables" which is not so easy if you're not by a supermarket.

Then a friend, rather liberated from the whole taboo about excrement, told about having to figure out how to provide her doc with a sample of feces to check for blood and so on.  She was resourceful and managed it, but I went to my favourite helper, "YouTube", and discovered that other people are given kits that are very helpful.

Here are a couple of Youtube vids of advice.

https://www.youtube.com/watch?v=oFQo0E3N1F8

This one is short and practical.  You could figure out how to do it with no kit.

https://www.youtube.com/watch?v=KhyMFw9eSzc

This one is funny and far more extensive, but rest assured that no feces were produced during this show -- just replicas with substitute substances.  It makes the point that proper digestion is largely a matter of water and fiber -- enough of both.

https://tonic.vice.com/en_us/article/bj3dqd/what-your-poop-looks-like-can-reveal-a-lot-about-your-health  Since one's guts are a veritable chemical factory, excrement can tell a lot about liver and bile and even the swarm of microbiotics that live in the intestines and can be either good or bad.  There are even protocols for poop transplants for those who took too many antibiotics and killed off their local populations.

l'm putting the Bristol Stool Chart on here whole, but you could probably find it online as well as the others.  The condition at the top of the list is called in more poetic places "lion balls."  Since we once at Animal Control had to impound a half-grown lion and I was the only one willing to risk my life by cleaning out her cage, she did indeed make "lion balls" out of her food.  Her name was Jamalya, and she belonged to the son of the King of the Gypsies, who lived only a few blocks from me.  I suppose you think I'm making this up.  I'm not, but I don't think the Doc believed me about either the lion or the Ghost of Menses in old age.  Docs don't get out much.

Now that the taboos have receded enough to speak plainly about bodies and how they work, it is a great relief to know what's happening and what ought to be done about it.

When I did my hospital chaplaincy in preparation for becoming clergy, I thought I would have a lot of conversations about God, but no -- the patients wanted to talk about peristalsis -- this is, when will I begin to poop normally again?  Abdominal surgery will interrupt the rhythm, partly because of the action of the anesthetic.  I wish I'd known then (1980) what I know now, but I did my best.

The first time I was sent to a patient's room I'd just sat through a speech about getting people to face their mortality and the possibility that they might die, because cutting people open is a drastic thing to do.  I was prompted to bring the deity into the conversation but not to insist since they might be atheists or something.  

So I went to the room where the family of an older lady were standing around while she lay in bed, partly prepped with twilight drugs.  "Would you like a prayer?"  Everyone thought so.  I talked about infinite blue sky and unknown destinies and mentioned the seriousness of surgery.  Everyone's eyes got wider.  Finally I asked what procedure would be happening.  Haemorrhoids due to constipation.  The daughter said, "My, we didn't realize how serious this is!"

But in contrast a later patient about the same age was in for varicose veins.  They raised her legs for convenience and dislodged a clot.  She died then and there.  Life is serious.  Poop is serious.  Bodies are serious.

But that doesn't mean you can't make jokes about it in an era where emoticons include little piles of poop that don't fit into the Bristol Stool Chart.

SCARY ON BOTH ENDS

One of my more popular “travel” sermons that I used for pulpit supply (when a person is asked to speak on a Sunday because the usual minister is away) was called “Everybody Poops.”  I don’t know when we all started using the word “poop” instead of the more vulgar “shit” or the more Latinate “defecate,” but even the scientists now talk about “poop.”  I suppose it has something to do with onomatopoiea.  Little kids loved it. 

Anyway, the point of the sermon was to discard the processed and unnecessary on grounds that a) it can get toxic to hoard, b) you will have no space for new stuff, and c) it’s withholding from participation in the processing world, a sign of lack of trust.  Part of the reason I was thinking about it at all was that during my hospital chaplaincy, when I expected to be having serious discussions about God and the afterlife, all the patients (esp. the older ones) could think about was moving their bowels.  Could they?  Would they?
  

Also, in that setting I learned what happens if a person does NOT ever move their bowels.  All that stuff gets stuck in the intestines.  Maybe past help from an enema.  Hospitals have sets of “spoons” in various sizes designed to pull out stuck feces.  The most extreme case might require surgery to remove what amounts to internal coprolites, the fossilized feces that prove that even dinosaurs pooped.  Or sometimes, when intestines are blocked, a flexible tube is snaked down the nose to the stomach in a reverse of forced feeding, so as to suck out the backed up substances.  Of course, that only works if they’re still liquid.  In fact, one of the secrets to keeping peristalsis moving along is to drink plenty of water.  The nutrition in food is liquified and oozes through the wall of the guts into the circulation system, both lymph and blood.  If THAT process gets stuck or reversed, the result is diarrhea.

The alimentary system, from mouth to anus, is essentially a long permeable tube that lets us take the world into us and, if things are going well, return what we don’t need for the use of other creatures, animal or vegetable -- usually the latter.  If the world cannot be ingested, we will die.  If the world cannot be excreted (feces is only one way -- breath, sweating, metabolism are others), we will die.  We are a pass-through, not a destination.  

But here comes the swerve.  Some time ago a dermatologist looked at my pink cheeks and told me I had rosecea.  When I googled at that time, the posts said no one knew the cause, but a year ago in August an article by Ed Yong blew the whistle.

New Scientist published a story stating that rosacea – a common skin disease characterized by red blotches on one’s face – may be “caused” (more on this later) by “tiny bugs closely related to spiders living in the pores of your face.” Tiny bugs that “crawl about your face in the dark”, lay eggs in your pores, and release a burst of faeces when they die.

Mites are relatives of ticks, spiders, scorpions and other arachnids. Over 48,000 species have been described. Around 65 of them belong to the genus Demodex, and two of those live on your face. There’s D.folliculorum, the round-bottomed, bigger one and there’s D.brevis, the pointy-bottomed, smaller one. These two species are evolution’s special gift to you. They live on humans and humans alone. 

They don’t poo! The mite has no anus, and stores its waste in large cells within its gut. Nutting saw these as adaptations for a life spent head-down in a tightly closed space. When the mite dies, its body disintegrates and the waste is released. 

People with rosacea should look away now

For the most part, it seems that they eat, crawl and mate on your face without harmful effects. They could help us by eating bacteria or other microbes in the follicles, although there’s little evidence for this. Their eggs, clawed legs, spiny mouthparts, and salivary enzymes could all provoke an immune response, but this generally doesn’t seem to happen.

But like many of our body’s microscopic residents, Demodex appears to be an opportunist, whose populations bloom to detrimental numbers when our defenses are down. Several studies, for example, have found that they’re more common in people with HIV, children with leukemia, or patients on immunosuppressive drugs. Perhaps changes to the environment of the skin also allow the mites to proliferate beyond their usual levels.

In dogs, an overabundance of D.canis can trigger a potentially lethal condition called demodectic mange. In humans, these blooms have been linked to skin diseases like acne, rosacea and blepharitis (eyelid inflammation). The New Scientist piece will undoubtedly bring this to many people’s attention, but scientists have been talking about such connections for decades. The rosacea link was first put forward in 1925!

Dermatologists have since repeatedly found that Demodex is more common in the cheeks of people with rosacea.  According to an analysis of 48 separate studies, , people with rosacea are eight times more likely to have a Demodex infestation. Obviously, correlation not causation, blah blah blah, you know the drill.

Kevin Kavanagh suggests that rosacea may be caused not by the mites themselves, but by the bacteria in their faeces. After all, antibiotics that kill the bacteria, but are harmless to the mites, can sometimes successfully treat rosacea. 

The subject of feces is repulsive to many.  The subject of little mites that live on your face and never poop until they die in an explosion of icky excrement is a proper one for Halloween.  I guess the mask would feature a red face with crawly things on it.  I don’t expect anyone dressed as a turd to knock on my door, but you never know.  This is a small conservative town with its roots in a Belgian farming community only a hundred years ago and they are preoccupied with cleanliness, neatness, and control.  They have not forgotten the lesson of the plague that killed a third of the population of Europe.   Strips of stubble are their neatly regimented version of what is discarded to be decomposed.  We wrestle with the problem of our sewage lagoon.  (The muskrats solved one problem by chewing through the electrical wire of the pump and electrocuting themselves.)  All day Corky and I have been reworking my kitchen sink drain and my waste stack valve.  You can't just ignore this stuff.

Halloween is a retention ceremony: the retention of memory of the dead, the retention of skeletons, the retention of the last of the growing season.  Only the root vegetables survive underground now.  The original jack o’lantern was a turnip rather than a pumpkin.  But a pumpkin can survive for a while after frost unless it is carved, which opens the way to rot.

If I use poop as a metaphor for memories that ought to be discarded, it won’t be very useful because we mostly value memory -- at least our own.  The memories of others might not be very welcome, particularly the mass graves of people we have excluded, excreted, considered diseased and unwelcome.  (A few nights ago I watched “A Secret,” a French film about a family denying its Jewishness.   The film includes brutal and obscene footage of the naked skeletal bodies found dead at the newly liberated concentration camps, pushed into mass graves by bulldozers in a danse macabre of arms and legs flung tumbling.)  Too horrible to bear.  But we must.  The plot hinges on a silly little pup toy in a sweater.

What frightens us becomes trivialized, little clawed bits hidden in our flinching flaking skin.  Masks.  Playfully screaming children.  Fires contained in vegetables.  Saying poop instead of shit.  The temperate-zone world of the northern hemisphere is now entering a time of starvation and death for many people.  But first a night of mockery and abandon.  Laugh now.  Weep later.  If you are lucky enough to have an anus, take care of it.