At any point in time, approximately five percent of men and nine percent of women, just like you and I, experience incontinence. This indicates an inability to hold their urine or feces until they can reach a restroom. Essentially, this impacts one in twenty men and one in ten women. Adult incontinence can stem from various factors such as aging, injury, neuromuscular disorders, and cancer, among other common reasons.
Having spent forty years in the medical profession, I believed I had a solid understanding of the factors and effects of incontinence. However, when I received a cancer diagnosis, I had to face my own ingrained stigma surrounding this medical issue. It was a humbling experience, to say the least. I found myself struggling with feelings of embarrassment, shame, and a sense of betrayal by my own body.
During the final eight years of my father’s life, I confess that I critiqued his bathroom habits. Not because he was incontinent, but due to his refusal to acknowledge this aspect of himself. His constant focus on locating a restroom became a regular part of our lives. Every car journey was a tactical operation, strategically planned based on our proximity to rest areas. His unwillingness to use absorbent briefs showcased his pride and his reluctance to appear weak.
“Why don’t you just wear absorbent briefs?” I asked him impatiently on numerous occasions, using the euphemism for adult diapers. “I think you’d feel much more liberated if you didn’t have to constantly worry about being close to a bathroom.”
My father firmly declined. He was a proud individual and not one to embrace weakness. In fact, this was another reason I judged him. Throughout my life, I had witnessed him being ruthless towards those he viewed as weak or dependent. The memory of him looking down on others facing difficulties made me aware of his own vulnerabilities, as if it were karma or hypocrisy. But would I have acted differently in his situation? This question, more than any other, highlighted the value of empathy.
Yet would I have acted differently in his situation? When he eventually consented to wearing absorbent briefs, I felt a wave of embarrassment when buying them at the pharmacy. “These are for my father,” I would state at the checkout, loud enough for everyone in earshot to hear. “Old age really takes its toll, you know?” I joked.
If you were familiar with my father, it wouldn’t have been challenging to comprehend the foundations of my perspective. He was a man for whom no one was ever sufficient, either for him or for himself. Observing today, I regard him as a reflection of a culture that sets unrealistic standards of perfection, a culture where acknowledging difficulty or need is frequently interpreted as an indication of failure.
Even now, there is an increasing global tendency to blame individuals for their illnesses and disabilities. This phenomenon is what my psychology instructors would term “defensivism bias”: a narrative fabricated by the mind suggesting that if you do everything right, you will not encounter difficulty or necessity. For this to hold true, those who face misfortune must have faltered in some fundamental way. They must have fallen into a trap that you, through hard work, can circumvent.
My own anxiety about weakness became evident as I neared middle age. I transformed into a fitness enthusiast, priding myself on winning amateur fitness competitions and dispensing marathon training advice on social media. As a physician, I was painstakingly careful not to judge my patients or others. However, like most individuals, I was far more critical of myself than I was of others. My athletic successes only whispered that I was insufficient.
Thus, I felt a deep sense of horror when I found myself in precisely my father’s predicament recently. I had been diagnosed with prostate cancer, and after undergoing surgery to remove the cancerous tissue, urinary continence was not an option for the foreseeable future. Certainly no fitness competitions or marathons! I was abruptly sidelined and forced to confront my personal demons.
My cancer diagnosis was humbling in many respects. Accustomed to being the doctor, I now received treatment from medical personnel who often clearly didn’t recognize who I was. For the first time in my adult life, my ability to work was stripped away when I encountered complications following the surgery. I suffered severe pain that led me to reconsider whether life was still worth living until the source of the pain was resolved.
And then there were the Depends®.
As a physician, I recognized that this situation was inescapable. However, aspects of my identity felt absent. The prognosis suggested it was very unlikely that the plumbing would function properly, at least in the short term.
I found myself battling to accept that I also required absorbent briefs. And I pondered if this was a common experience for every patient. How many of us declare, “That’s acceptable for someone else, but not for me?”