Regular readers will recall that your gentle narrator suffers (the word is chosen with care) from bowel disease (see Busting a gut, Bite me, Home Economics, GAH! Michael Gove! and The loud symbols). I have been lax
ative about contributing to the blog over the last seven months, after being buried under an avalanche of work from which one arm now feebly waves, soon (I hope) to be followed by the rest of me. These two things may not seem related to each other, but my colitis is caused by work-related stress, which is also called work addiction (see I was flying from the threat of an office life and Exemplum Docet). Thus, I live in a little feedback loop, working at whatever pace I feel I can stand and then accepting whatever reward or punishment my insides see fit to respond with. I am eternally grateful to have the skills to work from home most of the time; a husband who finds my swollen stomach and disreputable underwear (of which more later) quirky and charming; and a toilet right next to my study (John Keay comments on the internal disorder of George Everest, whose ‘[r]ebelliious bowels leant an urgency to the working day’. Yes. Yes, I expect they did). Giant Bear has even furnished the upstairs toilet with a comfortable wooden seat, a tasteful selection of bra catalogues and a thing called a Primal Stool that cost £20 but is worth its weight in gold (this is a similar thing: do scroll down to see the unicorn-poo advert). Bowel disease is misunderstood, difficult to talk about, jolly painful and surprisingly common; and work addiction is just everywhere and awful. While I wait for mountain rescue, therefore, here are some jolly facts about bowel disease and work-related stress.
- Bowel disease is the great leveller.
People with small children seem to talk about poo all the time: how often their babies poo; how copious, stinky and frequently produced their babies’ poo is; and how their babies sometimes manage to defecate so heartily that they get poo right the way up their backs in a single movement. I don’t have babies, but having colitis allows me to join in nonetheless.
‘Yup,’ I say, finishing my tea. ‘I’ve done that.’
‘When you were a baby?’ My childbearing friend is momentarily distracted by the menu, or possibly the child. ‘Or do you mean last time you went to China?’
- Working too much makes you a shitty worker.
My understanding of the strike that junior doctors undertook recently (the first such strike in my lifetime) is that they were protesting against two things in particular, captured (as is so often the case these days) in a hashtag: #notfairnotsafe. One, they argue that working longer hours as proposed (for a higher wage, but a lower overall hourly rate) implies that the ridiculous hours and shifts that they already work are not sufficient. Two, they argue that working longer hours will exhaust them and make them bad doctors. I don’t understand why there is any discussion to be had about this. We all agree that tired motorists are dangerous. Are exhausted doctors dangerous? YES. OF COURSE THEY ARE: TO THEMSELVES AND OTHERS. I have lost count of the number of mistakes I have made, documents I have deleted and spreadsheets I have cocked up because I was simply too tired to be competent. With the obvious exception of smug health-bastard Jeremy Hunt (Jim Naughtie has established precedent, so this is fine), nobody is stupid enough to think a tired doctor is a competent doctor, but nobody, in any line of work, should be working so many hours that they are too tired to do their job properly. I used to work four days per week; then, to cover for a colleague, I did two months of five days per week. I would have done better to stay at four days per week, because I was so tired that a. I caught a bug and had to miss two days’ work; and b. forgot to save my database and lost another two days’ work. Net gain: nothing.
3. Number of times I have soiled myself since being diagnosed: four.
Once *just* after a Departmental meeting; once while sitting quietly in a chair, reading a book and minding my own business; once in China after some questionable fish; and this afternoon. When I went to Dublin for a week a few years ago, I packed twenty-one pairs of knickers by the simple method of counting seven pairs of knickers into the suitcase (‘Monday Tuesday Wednesday Thursday Friday Saturday Sunday’) three times without realising I had done so. Do normal people even *own* twenty-one pairs of knickers? They do not.
- Being addicted to work means not being allowed to go cold turkey.
Some addictive substances (drugs, alcohol) are things that we have no physical need of, by which I mean that removing these things from our lives, while extremely difficult, is not damaging, but rather may have considerable health benefits. We may feel the need (physical, physiological, psychological, emotional) for another cigarette, drink, high, win or whatever, but we can live perfectly well without these things, just as we can live without smoking, drinking, drugs, gambling, sex or pornography. The most difficult addictions to deal with, I suggest, are those where cutting the destructive substance or behaviour out of one’s life altogether is not possible. If one is addicted to food or work, for example, one has to find some way of changing that relationship to make it healthy and sustainable: one cannot simply stop eating or working. I don’t think there are many therapists who, confronted with (say) a smoker would suggest that he or she learn to manage his or her relationship with tobacco: the emphasis and end goal would always and unquestioningly be to give up, totally and forever.
- Number of times I have thought, ‘that’s it. I’m going to die on the toilet. Like Elvis, except he had a cheeseburger to keep him company’: three.
Halfway through reading this post, my husband showed me a picture of the thing below (it’s a cheeseburger-shaped anti-stress ball) and said, ‘shall we get one, and keep it in the upstairs toilet?’
- Bowel disease makes you feel really, really old
Were I so inclined, I could produce a Venn diagram showing the commonality between my life and that of a woman forty years older than me (let’s call her Daphne). Yesterday’s diagram would show that Jess walked (rapidly, happily) to the train station to catch the same train as Daphne, while Daphne’s great age forced her to make the journey on the bus; Jess has brought a copy of Silent Spring and some knitting to keep her occupied during the journey, while Daphne prefers the Telegraph and crochet; Jess has decided not to bring any food, while Daphne has a packet of mints, and so on. The only area of overlap is that both Jess and Daphne will spend a significant part of their day worrying that they are going to disgrace themselves because *there is no toilet at the station*. That’s very annoying, think both Jess and Daphne upon arrival, with enough time to buy their tickets, but not such a long wait that they get cold and cross. The train will be here in a minute, and once we get going I can use the facilities on the train. Imagine the disgust of both our protagonists (Jess says a curse word; Daphne does not, but her lips get very thin) when it turns out that *there is no toilet on the train either*.
My usual train trip is around 50 minutes, and fortunately there *are* some facilities at the other end. But, really: good grief. There is a person at the station (sometimes two!) to sell tickets to the Great Unwashed *and* a model railway shop. There must, therefore, be at least one toilet. Giant Bear tells me that there *is* a toilet, but that in order to use it, Daphne and I would have to queue up and then yell through the ticket window that we’d like to borrow the key, please. There is also nowhere for the staff on the train to relieve themselves; at least the ticket inspector can walk from carriage to carriage to distract himself (and maybe do a little poo in the corridor where nobody will notice), but no such luck for the driver. John Pudney said the following about toilets at stations seventy years ago, much of which still holds today:
For the ordinary run of early railroad passengers, there were no arrangements whatever; and patience was the only necessity. At early morning stops, men were wont to salute the sunrise, as decorously as they might, at the ends of platforms, while women stood in earnest conversation here and there, their long skirts providing cover even though the platform itself offered little by way of camouflage.
- Being addicted to work is socially acceptable.
While I think it could be argued that we have a society with a dysfunctional attitude to many addictive substances and behaviours (food, alcohol and sex spring to mind), the attitude to work goes beyond that into stark raving mad. We all talk about our ‘busy’ lives: it is entirely normal for women in particular to babble on about ‘juggling’ all the things we have to do, on top of earning a living, which somehow takes up far more time and energy than it should. I am no longer surprised to receive (and send) emails at 6am or 11pm; nobody apologises or even expresses surprise when it becomes clear that I work weekends; and while I was at the university, I once went into the office on Boxing Day and I wasn’t the only person in the Department.
- Bowel disease has ruined the following words forever: movement, regular, irrigation, stool. On the plus side, Andrew Motion is now a funny name.
- Bowel disease makes you feel that nobody will ever want to have sex with you again.
There is swelling (sometimes soft; sometimes tight and hard like a tyre). There is diarrhoea (yellow, mostly liquid and excitingly explosive). There is dehydration (headaches, itchy eyes), horrible stomach cramps, massive hair loss, brittle nails, tiredness that mere sleep cannot touch, and endless medical humiliations (pooing into little trays; enemas; strangers inserting Things into one’s special area in the name of Science). There are ruined clothes, from which the physical stains can be removed, but which I can never bring myself to wear again. Finally, there is the terror that every tremor and gurgle in the abdominal region may be about to burst forth into the Bog of Eternal Stench, punctuating yet another day with what can only be described as arse-sneezes: hot, gritty crap that pebble-dashes the inside of the toilet in a splatter pattern strikingly reminiscent of the vomit one sees on the pavements outside student residences, except that this is yellow, streaked with blood and mucus, smells like the devil’s farmyard and CAME OUT OF MY ARSE.
These are the times when the unconditional love (and relaxed attitude to nudity) of an understanding and patient partner is better than all the peppermint oil and herbal tea in the world. Here is a little story I call ‘Disappointment’: the other day, Giant Bear came home from work, and without explanation, silently removed his shoes, tie, waistcoat, braces, shirt, trousers, socks and, with a certain sense of inevitability, his pants. Why, good evening, darling, I thought, ceasing to stir the dinner for a moment, and trying to remember if my own underwear was a. the kind that can be flung aside in a sexy fashion; b. not that kind, but at least stain-free and vaguely respectable; or c. in such a state that I’d have to bundle it up in my jeans and then attempt to kick both carefully into a dark corner. Just as I was about to spoil the moment by talking, my husband had a jolly good look at his pants, turned them round and put them back on again. ‘Had them on back to front all day’, he observed, and went upstairs to get dressed.
 John Keay, The Great Arc (London: HarperCollins, 2000), p. 146.
 John Pudney, The Smallest Room (London: Michael Joseph, 1954), p. 75.
 Just as I am no longer able to eat English mustard because gaaaaaah.