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Public Health

A woman has to go to the bathroom really badly.

Isn’t it a little strange that while driving home from work, you start feeling like you have to pee as you get about a mile from home? The closer you get to home, the greater the feeling intensifies until you do the pee-pee dance while trying to figure out which key opens the front door. The problem is, it doesn’t stop there. The feeling intensifies until you reach the toilet.

Why do you have to pee the closer you get to home?

If you know this feeling all too well, you should be happy to see that it isn’t a coincidence that the closer you get, the more you have to go; it’s science. “The closer you are to that access, the more you’re going to feel that sense of urgency and your body is going to say, ‘Oh, hey, we’re almost there, we have it,’” Jessica Stern, a clinical assistant professor of psychiatry at NYU Langone Health, told The Huffington Post.

You’ve probably heard of the mind-body connection, but did you know it also extends to the brain-bladder connection? According to Stren, there is an ongoing dialogue where the brain tells the bladder whether it’s okay to go to the bathroom. So, when you’re commuting home from work, your brain says, “Not now, bladder,” until you get closer to home, and then the brain gets less demanding, and the bladder takes over.

bladder, brain, pee, poop, use bathroom, restroom, urgency, dance, A man has to go to the bathroom really badly.via Canva/Photos

“As one gets closer to the bathroom, the inhibitory signals from the brain become less and less as the thought of urinating becomes stronger and stronger,” Dr. Victor W. Nitti, a professor of urology and obstetrics and gynecology at the David Geffen School of Medicine at University of California, Los Angeles, told The Huffington Post.

The more you wait to use the restroom until you get home, the more your mind will associate coming home with having to go to the bathroom until it becomes habitual. “The more you go to this place where you’re arriving at home and having to go to the bathroom immediately, the more that pattern is going to start to develop,” Stern said.

bladder, brain, pee, poop, use bathroom, restroom, urgency, dance, A woman on the toilet.via Canva/Photos

So, now that we know there’s a brain-bladder relationship happening, what about your bowels? Is there a brain-bowel relationship, too? Because it seems like the closer we get to home, the greater the utrge to poop as well.

Why is it the closer you get to home, the more you have to poop?

Jack Gilbert, a professor of surgery at the University of Chicago and the university's Microbiome Center director, says there is a similar effect on the bowels. Our body chemistry changes when we get home which makes us more comfortable going poop. Gibert says that coming home “triggers the relaxation response that allows you to release the inhibitions that led you to hold it in' while in unfamiliar surroundings.” That’s a big reason why people often suffer from constipation when they go on vacation, because the body isn’t sure where it’s safe to go. Remember, many of our systems are running on ancient evolutionary data that, thousands of years ago, meant that going to the bathroom in the wrong place could get you eaten by a wild animal.

Interestingly, our mind works overtime, communicating with our bladder and bowels without us knowing it, so we have a safe and comfortable place to go to the bathroom. Still, it would be cooler if the brain tols us we have to go pee or poop after we opened the front door instead of a mile from home.

A woman holding a rose at a funeral.

A family in Rochester, New York, is seething after going on an intense, four-year emotional rollercoaster, much of which could have been prevented. In July 2021, the family of Shanice Crews reported her missing after she abruptly disappeared, leaving two children behind. In April of 2024, police informed the family that she had passed away and her body was found in a Rochester lot.

To add further grief to their incredible loss, the family was told that she died from acute cocaine intoxication, even though they believed that Crews was never involved with the drug. “Reading the autopsy was traumatic. That was, it's one thing to hear it, you know what I’m saying, but then it’s another thing to actually read it, and then her name is attached to it,” Crews’ sister, Shanita Hopkins, told Rochester First. “So we thinking, this is how she died. And then we’re trying to think, did somebody like lace her, or is she doing this on her? It’s so much that goes into it. Your mind just goes crazy.”

- YouTubewww.youtube.com

Because the body was in a state of advanced decomposition, authorities didn’t allow the family to see it. Still, they insisted that the dental records on the corpse matched. The family quickly had the body cremated and then, last summer, held a memorial service for Crews.

Then, last November, Hopkins received a shocking text from a person she did not know in Detroit. The text was accompanied by a photo of Crews looking happy and healthy. “Her first message is ‘Ma’am’ — with the picture of my sister – ‘Ma’am, I’m concerned, your sister is not dead. She just volunteered at my event today. This is just a random message,” Hopkins added.


The Monroe County Medical Examiner’s Office, which swore that the dental records were a match, conducted a DNA test on the unknown woman’s ashes. “We went the next day. They wanted my youngest sister because she and Shanice have the same mom and dad, and then they wanted her son. So both of them went and they did a DNA test, and when the results came back, they said it wasn’t it wasn’t a match,” Shanita says. “We dealt with the ashes and stuff–we put them in necklaces and we mixed my mom with this stranger…yes,” Shanita says.

The medical examiner’s office has offered to pay the family back for the cremation and funeral expenses, but the family wants more than that. They’ve recently hired a lawyer to examine the family’s options.

death certificate, pronounced death, certificates, legal documents, death, united statesA death certificate.via Canva/Photos

It will be interesting to see what difficulties Crews may experience after she has been declared deceased. In 2023, Phil Anderson was declared dead by the IRS and didn’t realize it until he tried to file his taxes, and his account was locked. His social security number was mixed up with his daughter’s, who had passed away from cystic fibrosis. Anderson had to reach out to his Congresswoman, Brittany Peterson, who represents Colorado’s 7th district, to have his IRS account unlocked. "Last time I checked, and in the immortal words of Monty Python, 'I'm not dead yet,'" he said, according to USA Today. Although it’s relatively rare for the US government to declare someone deceased incorrectly, it does happen. According to USA Today, 3.1 million deaths are reported to the Social Security Administration every year, and less than one-third of one percent ever need to be corrected.

Canva Photos

Lighting a candle? That's basic compared to these advanced tips.

Poop anxiety isn't the most heavily studied medical field, but some estimates say up to a third of people suffer from some kind of anxiety around going to the bathroom in a public place or another person's home. On the low end, they can feel ashamed or embarrassed. At the higher end, they may avoid social functions, public events, or leaving their own home entirely. This phenomenon also tends to affect women more than men. For some people the worry gets so bad that they constipate themselves or refuse to eat, all because they're worried of what people will think of them.

But you don't have to have extreme "shy bowel" to know the uncertainty associated with feeling a rumbly tummy while you're a guest in someone's house. There are a lot of unknowns to manage. How good is their soundproofing? Does their toilet actually flush properly? Will someone be waiting to go in right after me? Some people anticipate these worries and come up with elaborate rules and routines to leave as little evidence of their go as possible.

A guy took a simple question to social media: Should you always courtesy flush when you're a guest in someone's house? The answer sparked a huge debate about the secret etiquette of public pooping.


poop, bathroom, dancing, funny, humor, toiletThis dancing poop says pooping can be fun!Giphy

In a thread on the subreddit r/NoStupidQuestions, the OP asked: "My mother tells me that at other people's houses, when going to the bathroom, it's expected to do a 'courtesy flush'. Is this a real thing?"

For the uninitiated, a courtesy flush is when you flush halfway through your "go." The thinking is that it helps get rid of odors before they build up. Not only that did the poster's mother advocate for courtesy flushing, she insisted on a very specific ritual when visiting other people's homes:

  1. Always carry Poopurri and spray before you go
  2. Flush halfway through your session
  3. Flush at the end (obviously)
  4. Clean toilet bowl with wand... every time!
If it sounds a little extreme to you, you're not alone.

However, some commenters were extremely pro-courtesy flush.

toilet, bathroom, home, hygiene, cleaning, etiquetteWhite ceramic toilet bowl with cover. Photo by Giorgio Trovato on Unsplash

"I’ve done the 'courtesy flush' thing for years… mainly to help minimize lingering odors more than any other reason."

"That’s good advice. First flush on delivery, second flush with clean up. Reduces odor and skid marks."

A few people noted that the courtesy flush is common in jails and prisons, of all places. Due to the tight (extremely tight) quarters, inmates are encouraged to repeatedly flush while they go. I don't want to know what the consequence might be for violating this code.

Others claimed the courtesy flush was a waste of water:

"Flushing twice seems very wasteful in my opinion. I would not like a guest to do that."

"No, please don't waste my water. But do make sure everything goes down."

"If someone did that at my house I'd be low key annoyed at them for wasting water."

Experts agree that the effectiveness of the courtesy flush is very much up for debate. Does it mildly lessen odor? Maybe. It's also a gigantic waste of water. Older toilets can use up to six gallons per flush—yikes! An extra flush is also questionable at best when it comes to sanitation—flushing poop with the lid open is known to spray bacteria all over the bathroom. Yuck.

"Everyone poops, I don't want my guests worrying about it," wrote one commenter. "Crack a window if it's like, lethally stinky, I guess. If you clog the toilet, the plunger is in a plastic tub right there. If you need help, cool, now we have a funny story."

The courtesy flush, however, was only the beginning of the OPSEC tips for pooping in public.

- YouTubewww.youtube.com

Some commenters were on board with OP's mother's idea of using the toilet brush if it's available:

"If there's some brown stuck to the porcelain after I flush, and if there's a toilet brush on hand, I give it a quick cleaning and a second flush. But not if things look clean otherwise," someone wrote.

Another commenter had an even more advanced idea: "You can also float a strip of toilet paper on top of the water before you poo. Gets wrapped in paper as you drop off your delivery and less likely to leave skid marks in the bowl."

Of course, commenters in threads all over the Internet sing the praises of Poo-Pourri, or even carrying a lighter with you at all times to burn up some of the stinky oxygen. And how's this for a pro-level tip?

"Tip for the courtesy flush.. if one who finds it hard to poop in a public bathroom because you don’t want people to hear you. Flush just right before you push and the sound of the water will cover the sound of gas etc and it will go right down with the water so very minimal smell."

I mean, all you can do really is clap at the social-anxiety-fueled ingenuity on display. The experts seem to agree here. Even Healthlinerecommends carrying air purifier spray, lining the inside of the bowl with toilet paper to absorb sound, and flushing several times to reduce anxiety worries.

The general consensus is that, when pooping at someone's house, basic etiquette applies. Clean up after yourself to a normal degree, but remember, as the saying goes: Everybody poops.

Some people are really protective over the bathrooms in their homes, which is their right. But if that's the case, they really shouldn't be having guests over and expecting them not to partake in normal human biological behaviors.

Some of the advanced tips shared by anxious-pooers might help, but try not to send yourself into a tailspin trying to cover your tracks. In extreme cases of bathroom anxiety, experts say cognitive behavior therapy or even antidepressants may be needed. But the rest of us might just need to read that world famous children's book again.

Health

The forgotten link between Candy Land and polio and why it still matters

The history of the classic board game holds an important lesson about disease.

Photo credits: Amazon (left), Bror Brandt (right)

Candy Land was created for kids in the hospital with polio.

Candy Land has been adored by preschoolers, tolerated by older siblings, and dreaded by adults for generations. The simplicity of its play makes it perfect for young children, and the colorful candy-themed game has endured as an activity the whole family can do together.

Even for the grown-ups who find it mind-numbing to play, there's some sweet nostalgia in traversing the Peppermint Forest and avoiding the Molasses Swamp that tugs at us from our own childhoods. There are few things as innocent and innocuous as a game of Candy Land, but many of us may not know the dark reality behind how and why the game was invented in the first place.

candy landCandy Land has been a family favorite for decades, but it was originally created for kids with polio.m.media-amazon.com

Candy Land was invented by retired schoolteacher Eleanor Abbott while she recovered from polio in 1948. She was convalescing in a San Diego hospital surrounded by children being treated for the disease and saw how isolating and lonely it was for them. The game, which could be played alone and provided a fantasy world for sick children to escape to, become so popular among the hospital's young patients that Abbott's friends encouraged her to pitch it to game manufacturer Milton Bradley. The post-World-War-II timing turned out to be fortuitous.

“There was a huge market—it was parents who had kids and money to spend on them,” Christopher Bensch, Chief Curator at the National Toy Hall of Fame, told PBS. “A number of social and economic factors were coming together for [games] that were released in the [post-war era] that has kept them as evergreen classics." Candy Land soon became Milton Bradley's best-selling game.

Since the game doesn't require any reading or writing to play, children as young as 3 years old could enjoy it when they were feeling sad or homesick in the polio ward. As the polio epidemic ramped up in the early 1950s, the game gained even more popularity as parents often kept their kids indoors during polio outbreaks in their communities.

The polio vaccine changed the game—both for the disease and for Candy Land. Jonas Salk’s inactivated polio vaccine (IPV) was licensed in the spring of 1955 and a widespread vaccine campaign was launched. By 1961, polio cases had dropped from 58,000 to only 161. The disease was considered eradicated from the Americas in 1994, and, as of 2022, the only countries in the world to have any recorded cases were Pakistan and Afghanistan.

graph of polio cases from 1988 to 2021Vaccine GIF by World Health OrganizationGiphy

In the 70 years since the polio vaccine came out, Candy Land's connection to the disease has been lost, and it's now just a classic in the family board game cabinet. The fact that polio has so successfully been controlled and nearly eliminated makes it easy to forget that it used to be a devastating public health threat that spurred the need for the game in the first place. Children are routinely vaccinated for polio, keeping the disease at bay, but anti-vaccine messaging and fear threatens to impact the vaccination rates that have led to that success. Vaccination rates took a hit during the COVID-19 pandemic, and with the appointment of one of the most popular vaccine skeptics as the U.S. Secretary of Health and Human Services, public health specialists are concerned.

There is no cure for polio, so the vaccine is by far our best weapon against it. According to infectious disease experts, it's not impossible for polio to make a comeback. “It’s pockets of the unimmunized that can bring diseases back," Patsy Stinchfield, former president of the National Foundation for Infectious Diseases, told Scientific American. "If you have a community of people geographically close to each other and they all choose not to vaccinate, that community immunity is going to drop quickly. And if a person who has polio or is shedding polio enters that community, the spread will be much more rapid.”

Without herd immunity, vulnerable people such as babies who are too young to be vaccinated and people with compromised immune systems are at risk in addition to the unvaccinated. And since up to 70% of polio cases are asymptomatic, there can be a lot more disease circulating than it appears when symptomatic disease is detected. No one wants the serious outcomes that can come with polio, such as paralysis, the inability to breathe without assistance, or death, especially when outbreaks are entirely preventable through vaccine-induced community immunity.

The fact that kids have been able to enjoy Candy Land for decades without thinking about polio at all is a testament to vaccine effectiveness, but it's also a reminder of how easy it is to take that carefreeness for granted.