Humiliation and intimacy

Peculiar insight into the human condition. Perhaps.

Warning that this post contains some heavy material, emotionally and descriptively.

If I had to pick the single worst thing about living in hospital, there would be some stiff competition. There is the constant disruption, having no control over things like when I wake up, with people barging into the room at whatever time suits them to do things like jab me with needles or slam bin lids. There is the total dependency on others to complete the most mundane of tasks, be it feeding myself or attempting to get my teeth brushed. There is the infuriating frequency with which staff will talk about me when I’m in the room, or ask each other questions that I know the answers to but which they do not bother to consult me about because the default assumption is that a patient is either clueless or unreliable. And don’t get me started on those doctors who treat you like a moron simply because you don’t have medical degree, and who will happily lie to your face safe in the knowledge that they sit far above you in the organisational hierarchy of authority.

However, the number one worst thing about being an early stage spinal injury patient in hospital is, for me at least, the daily humiliation.

This goes well beyond the complete dependency aspect of my current situation. Or rather, I never before realised what complete dependency really involved. You see an aspect of spinal injury I wasn’t aware of until it happened to me is that it’s not just that you lose the ability to use your legs and possibly your hands (jury still out for me on that one). You also lose functional control of your bowels and bladder. But whilst you are alive, the body’s processes go on. So that means a catheter for urine and the delights of assisted removal of faeces.

Hence this week I underwent a minor surgery to drill a tube directly into my bladder, making my penis effectively redundant barring some miracle medical recovery. Truth be told I have anyway by now long ago lost count of the number of strangers who have either seen my genitals or had to wash them. Far worse though is the daily ritual of what is officially known as “manual evacuation“.

This involves being rolled onto one’s side as one person holds you in position and another inserts a suppository up your rectum. (Again, the silver lining of being paralysed is that at least I can’t feel this, although I am reliably kept informed of what is happening in real time.) If all goes to plan and the nurse on duty that day doesn’t get distracted by something else and forget, then around 20 minutes later the team returns and full evacuation begins. This involves various kinds of stimulation to ensure that I empty my bowels. As my face is turned away and pressed into the mattress, I thankfully cannot see what is going on - but I can smell it. Until this point in my life, I don’t think I ever really understood the phrase “shame washed over me“. Now I live it every day.

Being English and well brought up, I find it virtually impossible not to apologise to the nurses every time this ritual takes place - so that is pretty much every morning. I think every nurse I have apologised to has told me not to, and assured me that it is just a regular part of the job, and by no means the worst. I do not doubt that they are telling me the truth. And yet it does not make me feel any less humiliated. To go from being an entirely independent fully grown man who could climb 7b sport, 7a Boulder, E3 trad, and the week before his accident did the Snowdon horseshoe solo in under five hours, to being too weak to sit in a chair without medical assistance, and having to wear a nappy to physiotherapy sessions in case the ordeal of manual evacuation did not finish the job - well it’s quite a lot to take.

But it has given me a new perspective, or maybe insight. If someone had asked me three months ago what the opposite of humiliation is, I think I would’ve been dumbfounded. If I had been pushed to offer an answer, I might have gone for something obvious like praise or acclaim. But now I have a very different view. I think a better answer is that the opposite of humiliation is intimacy.

If humiliation is having to be at your most vulnerable in front of strangers and feel swamped with shame, then intimacy is the capacity to be totally open and vulnerable with another person that you know and trust and instead feel safe, loved and affirmed by. Indeed intimacy is the real hallmark of being loved and in love.

If that’s right, it at least partly explains in turn why the present experience of humiliation feels so hard to take. (And to be clear, I do not think I am somehow unique in this regard- I’ve just never had to think about it before.) Because one thing my life is entirely devoid of at present is intimacy. To be sure, my parents have been incredibly supportive. But there are good sociological and biological reasons why a grown man cannot experience intimacy with his parents. I have also been lucky enough to receive many visits, and even more cards and messages, from friends. But again these are not sources of intimacy, even though they are enormous sources of support more generally. No doubt part of the problem here is being a white middle-class British male. For despite all the much remarked advantages this brings, a major disadvantage is how emotionally cut off from others this condition is liable to leave one being. I broke up with my long-term partner last February, and whilst she has been unbelievably supportive of myself and my parents since the accident, intimacy is no longer something she can offer me, not least as she recently told me that she has started a relationship with somebody else. In turn, I am faced with the daunting prospect of never having intimacy again, given the situation I now find myself in.

In the meantime, there are the daily manual evacuations. I have been promised that in time I will acquire skills to do this for myself, but the truth is it feels as impossible to me now as does the prospect of ever again experiencing full and genuine intimacy.

I am aware that I am a terrible judge of the long-term truth and prospects I really face. That’s part of the nastiness of my situation: the mind plays tricks on itself. And I am assured that many people who have been through what I am facing go on to access the fulfilment, and end the humiliations, that frequently preoccupy me at present. But one thing I wonder in the meantime is the extent to which this kind of very specific mental torture is recognised by people who have not been through it.

I think prior to my accident I could just about imagine what life in a wheelchair would be like. I don’t think I could ever have understood the contrast between humiliation and intimacy before living through it as I have had to do for the last several weeks. If nothing else, at least I’ve learned a bit more about the nuances of the human condition. I share what I think I’ve learned with you in order to offer you an insight that I hope you will never yourself have to experience first hand.