Talking About It

Tom Nickel
6 min readSep 10, 2017

There’s things we need to talk about that we don’t. Usually the taboo topics are the ones that talking about could help the most. That’s what I mean by ‘need.’ If we talked about what happens when we’re dying, we’d be better at handling it when the time comes. I can’t prove that, but it seems obvious.

Lots of things don’t get talked about because they’re not nice. The cartoonist Roz Chast titled her award-winning graphic memoir of her parents last years, “Can’t We Talk About Something More Pleasant,” capturing her Mom’s aversion to verbalizing even when death was clearly approaching. To me, avoiding any mental preparation or simulated experience of something unpleasant pretty much guarantees that it will be.

So after I was diagnosed ten years ago with a form of blood cancer, I started talking more about end of life. I led workshops. Spoke openly about having cancer, as if it wasn’t something to keep quiet about. I became a hospice volunteer caregiver. I try not to overdo it; I hope I haven’t. I’m just trying to help bring dying out of the dark and let it feel normal.

And now I feel that way about peeing. Penis talk might be even more difficult than death and dying talk. The two main dramatically different functions is some of it. The screwing part is such a personal and cultural powerhouse it kind of overshadows the peeing part, which most of us take for granted. Until it starts changing, usually along with the other part.

This point of the body’s life is where things start to get interesting with a lot of organs and muscles and connective tissue. People do talk about the specifics of aging, even men. They remark on the perceivable changes, frequently as a minor complaint … ‘I had to get up four times last night to pee.’ The tone suggests that we could do without it, but we’re handling it.

That’s about as far as it tends to go. Since I can’t generalize about all Men, I will say for myself that as long as I can manage a changing situation without too much life disruption, even one that is clearly going downhill, I will not do anything beyond minor complaining. I do not believe that I am alone in this regard.

Prostates get bigger and they do not stop gradually growing in mass all by themselves. In some terrible design oversight, this known-to-get-larger organ got placed right above a male output tube that absolutely must stay open. Many many things about life and death are full of uncertainty. Prostate growth and its potential for disrupting the flow of pee is not one of them. It is as close to a certainty as you get in aging human bodies. Should be a no-brainer to prepare for and to mitigate any pain and suffering that results when the nearly inevitable comes to pass. Or not pass. Or has to pass too urgently, or too often.

I had no idea what to do or that I needed to do anything when those obvious signs were presented to me by my body, because I could handle it. I even wrote a piece in which I bragged about managing this life change through the strategy of Proactive Peeing. What I was doing was wrong, in the sense that it did not end up reducing pain and suffering. It increased it. Even made this totally obvious problem into a life-threatening medical emergency. Because I didn’t really know what to do. I just thought I did. I just thought I was managing it so well. And all because I’ve never really talked about it with anyone.

Yes I hear about men’s pee meds on sports talk radio, and I’m aware of my friends’ minor complaining. Neither of these sources have been particularly enlightening. That’s why, when I stepped up to the toilet to pee one night recently and nothing happened, even after all my start-it-going tricks, everything I did next was completely wrong. Plus I was on a little island that supposedly had a doctor somewhere, which was not the perfect place to be so wrong.

It all got fixed, temporarily, by means of a tube in my dick, but it didn’t have to come to that. Maybe if I’d made dietary changes, maybe if I’d taken Flo-Max years ago, maybe then I wouldn’t have stretched my bladder to twice its recommended capacity waiting for a catheter from some Doc somewhere.

Only then, when the pee just plain stopped coming, did I start to learn. I think the most surprising thing I learned was how many friends I had that knew all this, had been down that same path themselves — AND WE NEVER TALKED ABOUT IT. They were coming out of the woodwork early on in my infirmity. ‘Roto-Rooter surgery, yeah, I had that six years ago,’ really? Shit, I never knew. I could have learned. I even heard about someone’s father who got plugged up like I was and who thought drinking a lot was just the ticket. He almost exploded. My approach was a variation on his. Doesn’t sound crazy at the time if you’re as ignorant as my friend’s father and I were.

Would I have learned? You can argue both sides on this one. I think I would have. I have made major life behavior changes before and I could have in this case. But that’s all just words. Point is, I never had the opportunity. I get some of the blame of course for my part in the denial, and I’m not blaming my friends at all. In fact, I’m not blaming anybody or anything. I’m just trying to talk about peeing, like I’ve been talking about end of life for years now.

I think death and dying are more talk-about-able than they were ten years ago. Products to help family conversations about dying are available on Amazon. Death Cafes are a thing. The Governor of California, who once studied to be a Catholic Priest, signed choice-in-dying legislation into law. Atul Gawande writes popular books about being mortal. B.J. Miller gives popular TED Talks about hospice.

I’m not suggesting that Men’s Urinary Health become a main course at the cultural buffet. Global warming, endless war, and expanding inequality are probably more urgent matters. I’m not really even trying to write about Men’s Urinary Health at all, a topic I knew next to nothing about only a month ago. I’m trying to write about talking, an exchange that amounts to something more than minor complaining and assuring everyone that we’re handling it. Having taboo conversations where we can help each other figure out what our bodies are saying.

Often when things are unpleasant it’s because they’re unfamiliar. When you enter into areas not usually discussed with someone, and go back and forth saying what’s real — that’s not unpleasant. In fact, it feels so good it’s almost embarrassing when you’re not used to it.

In my experience, when people are close to the end, they don’t talk all that much. But when they do, it’s usually about stuff that is not usually spoken of. They know they have permission and what I have learned from them has expanded me, and somehow at the same time comforted me like nothing else I can think of. Well, Bob Dylan sang that if we’re not busy being born we’re all busy dying. So what are we waiting for, let’s talk about it.



Tom Nickel

Learning Technologist focusing on VR, Video, and Mortality … producer of Less Than One Minute and 360 degree videos