***This post contains graphic content.***
Taking heroin makes
you so constipated, it’s a nightmare…The heroin makes you constipated so you
won’t go to the loo for a couple of weeks, two, three weeks. So then I’ll take,
not a huge amount [of Epsom salts], but I always end up taking too much, but it
does, it clears you out…Being constipated is quite nasty, and I mean horribly,
horribly. It’s like bloody coal mining, the agony and the pain. Putting your
bloody fingers up your bum to pull out bits of, like, fucking diamonds. It’s
not nice, [it] really is not nice.
Neil sits at the table in his parents’ kitchen across from
the interviewer. A freshly-washed suitcase dries out in the sun. Tomorrow,
he’ll be leaving for three months of residential detox and rehabilitation for
his heroin habit.
Source |
In the
April 2013 issue of Medical Anthropology:
Cross-Cultural Studies in Health and Illness, Lucy Pickering, Joanne Neale,
and Sarah Nettleton published “Recovering
a Fecal Habitus: Analyzing Heroin Users’ Toilet Talk.” As part of their
larger work on drug users, they found themselves talking to many of the heroin
users about shitting—how agonizingly painful it is. Neil had been asked broadly
about the physical effects of heroin, and instead of focusing on oblivion,
sores, illness, drowsiness, contentment as many of the other users had done, he
had focused on this: the painful betrayal of the body to do a basic function
which Neil did not have to even think about before.
We don’t
talk about shitting very much. There is a silence around the topic. Even in
Phillipe Bourgois and Jeffrey Schonberg’s book, Righteous
Dopefiend, a profoundly beautiful and detailed ethnography about
homeless heroin users in San Francisco ,
constipation caused by heroin use was never mentioned. The literature on shit
is pretty sparse in comparison to just about every other topic. We don’t talk
about our bodily functions with other people; it’s part of being in society.
When we’re little, we learn how to
use the porcelain potty, and then once we have mastered that, we also master
the silencing of discussing our bodily functions. This trajectory is a mirror
image of the one that has happened in human history. Historically, shitting was
a communal act (see Roman public toilets or English peasants). We could talk
about it. But as history as progressed, the silence and the taboos around bodily
acts—farting, blowing one’s nose, shitting—have increased. Furthermore, it
became a function of class. The upper classes did not want to smell like the
lower class; by suppressing their bodies, by asserting control over them, they
asserted their supremacy. This goes all the way back to the Cartesian mind/body
dualism issue—the idea that mind and body are separate. In that frame, mind is
usually privileged over the body. Controlling one’s body shows one’s strength
of mind.
In the
authors’ narrative about the heroin users, the users were more open about their
defecating when their excretory systems began to malfunction from the drugs.
(Opioids increase
the amount of time stool takes to move through the gastric system by
increasing nonpropulsive contractions in the middle of the intestine and
decreasing propulsive peristalsis—in other words, they make the muscles that
move things through your intestines mess up.) As the drug users became
increasingly marginalized in society, they also stopped partaking in the
silencing of their body functions.
More
plainly, marginalized people suddenly get to talk about marginalized things. To
reverse the equation, people who talk about marginalized things become
marginalized. (What would happen if you started talking about shitting all the
time? …Exactly.)
So what if
people really need to talk about
defecating? If we put so many layers of silence on top of defecation, how can
people really get the help they need? This is true not only for heroin users,
but what about patients who are using opioid-based medications? The elderly who
have problems managing their defecation? It’s embarrassing to talk about. If
people feel like they can’t ask for help, when they do, we marginalize already
marginalized populations.
Pickering,
Neale, and Nettleton delve into this silence in an academic space with a
marginalized, ‘othered’ population. It’s a place to start, but only start.
There’s a lot more that needs to be done to eliminate this cultural silence so
we can help people better manage their bodies and lives.
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