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      CAN EVERYONE PLEASE STOP SHITTING THEMSELVES?

      August 11, 2009

      By Alex

      14

      Many of you will spend your mature years in an oversized nappy, sat in warm fecal matter for hours until a brutal nurse finally flips you over with no ceremony or cooing and clinically wipes you clean. It’s an infantilist’s wet dream.

      I’ve had bad experiences with incontinence (though really, who has good ones?). A while ago I went to see a woman who had dementia. She was blabbering like a baby. Before I examined her I held her hand – physical contact with a confused patient helps to gain trust and stops them panicking if they don’t remember you. Then I noticed her fingernails looked like she had been gardening in a toilet. I pulled my hand away and saw her entire little wrinkled paws were dirty. It was only then the smell hit me. In horror I watched as she dived her delicate old-lady hands deep into her nappy and extracted a handful of shit, which she gleefully sucked off her fingers, smacking her lips.

      That was how I learnt she practiced coprophagia, the consumption of feces. Kind of hard to ignore that one. It’s often due to severe frontal lobe damage, which means the area that learns socially acceptable behavior, such as using a toilet, no longer functions. Eating your own shit is pretty high up on the socially unacceptable scale.

      About half my patients are incontinent, whether from old age, medication, disease, or injury. The rancid smell of defecation wafts through the hallways and lingers heavily around a patient’s bed. I have become a connoisseur of shit. I can differentiate by smell alone if they have diarrhea, sickly sweet melana (blood-stained), or shit infected with C. difficile bacteria, which is the worst. I am a nasal Nazi who is militantly protective over the sanctity of my cilia. I try not to breathe in but all resistance to the onslaught is futile. And it is an onslaught. I have had shit smeared on me, thrown at me, and been forced to dip my hand in its brown depths. The warmth through my glove is always disconcerting.

      One patient extracted all the stool from his nappy, put it on his bedside table, and tried to mold an Eiffel Tower with his hands. It stood like a monument to his bowels next to a get-well card. Another elderly man tried to give me his turd as a present to say thanks for my help. He was deeply offended at my polite decline, and positively furious that the nurse took it away from him. They are both likely candidates for an unfortunate contingent of the incontinent called shit-smearers. Shit-smearers generally touch their poo while defecating, then wipe their hands clean on any available surface. It is believed to be an expression of frustration at their incontinence and condition.

      It is an understandable frustration. Nappies are a model of humiliation. We’re not talking Pampers Easy Ups, but great cumbersome torture devices that go up to the belly button and sag down the legs. It feels perverse pulling down a patient’s nappy to discover a wealth of black fuzzy pubic hair. Staff shortages mean sometimes they are left rotting in their nappies for hours, until eventually it seeps out the top, making brown smears up their back and on their sheets. I don’t have to change nappies, which is a good thing, but if a patient shits on you, you can’t react with disgust and retch on the floor. You have to politely reassure them: "It’s absolutely fine, everybody does it." The nurses have this incredible anti-poo spray, which makes all crust disappear so they can wipe it away easily. It’s like the Mr. Clean of the scatological world.

      Shitting yourself in public is the ultimate indignity, topped only by having someone else wipe your bum. As much as I don’t appreciate poo-eating, poo-smearing, and poo-flinging in particular, I am glad when people are not aware of the horror they are being subjected to. Though after this blog, I think karma will probably greet me with some flying turds.

      DR. MONA MOORE

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