Another day, another low blow

The President being offensive on the news is such a common occurrence nowadays that we hardly register any surprise: He says something reckless, the Palace goes into linguistic gymnastics to reinterpret, water down or minimize what he said, and everyone moves on.

For women, it’s another day, another rape joke, or maybe a directive to shoot women’s private parts. For the poor, we get variations on the same theme of “Mahirap kayo? P****g i*a, umalis kayo. Magtiis kayo sa hirap at gutom, wala akong pakialam.” For his political enemies, the threats are varied and colorful, and too many to enumerate.

Even religion is not exempt from Mr. Duterte’s rhetoric, with his “Who is this stupid God?” speech. His words often resemble those spoken by a drunken tito at a family gathering: careless, full of hubris, sometimes lewd, and completely unconcerned with political correctness.

This week, in yet another episode of “Whom will PRRD offend next?” the President addressed Mayor Tomas Osmeña of Cebu City: “I will slap you, wait and see. And the shit you are bringing with you inside that plastic bag in your belly.”

It’s a new low in what the World Policy Journal calls Mr. Duterte’s “violent relationship with language.” Not that it would concern Mr. Duterte, but let this be a space for a health professional to talk about those living with ostomy bags, which are more than “bags of shit.”

An ostomy or a stoma is a surgically created opening that allows for drainage of stool or urine; often, a patient may need an ostomy bag attached to the skin to collect urine or feces. “Colostomies” or “ileostomies” involve a segment of the gastrointestinal tract; “urostomies” allow for the diversion of urine away from a diseased or absent bladder or urethra.

The ostomies can be temporary or permanent, and there are several reasons for getting an ostomy, such as trauma, inflammatory bowel disease or cancer. In the case of Mayor Osmeña, he is unashamed about explaining that he was diagnosed with and treated for bladder cancer, which is particularly challenging to treat: You’ve only got one bladder, and treatment for invasive bladder cancer is primarily surgical.

Those requiring surgical removal of the bladder may end up needing a urostomy permanently, as in the mayor’s case; thus, he lives permanently with a bag that collects his urine (and not his feces, for the President’s information).

The trauma of a cancer diagnosis is coupled with what some may consider disfiguring changes to the body. The physical care of the stoma may be demanding, and so is the valid fear of a leak, which may happen any time. Mayor Osmeña, on a Facebook post responding to Mr. Duterte’s comment, mentions the inevitable leak of urine when the ostomy appliance fails. Living with ostomies requires controlled movement, dietary adjustments, and the need for ready privacy and a change of clothes any time.

Having a stoma is life-changing, with a huge emotional and psychological impact on body image, sexual function, social interaction and mood. Patients often benefit from a referral to a mental health professional; in some hospitals, it’s protocol to refer a service patient to psychiatry as soon as the decision for an ostomy is made.

Many resources are available to help patients cope, from support groups to stores that help patients to accessorize and customize their bags. None of this minimizes the patient’s stigma, trauma or embarrassment, but they do help us — outsiders and patients both — to appreciate ostomies for the life-saving things they are.

They should not be easy targets for political diatribes, or a stick to beat people with.

But, anyway, who cares about yet another offensive, low-blow remark hurled upon a political opponent? One would think that, political differences notwithstanding, cancer and personal misfortune shouldn’t be a part of the arsenal of the President’s list of insults.

Alas, the President, unfamiliar with the concept of a low blow, fights dirty, unafraid of consequences, and meaning to hurt, so it’s actually no surprise.

As the past two years have made increasingly clear, it’s not Mayor Osmeña’s ostomy bag that’s full of shit.

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