With a straw under my left nostril, I sniffed a chalky line of pink powder from a dinner plate. After invading my sinuses, the powder shocked my brain—a floating pile of mush from eight pills of ecstasy—like a defibrillator. I passed the plate to my friend, Jason, who sniffed a line with his own straw then flexed his arms like he just deadlifted 500 pounds.
“How many pills are left?” I asked, grinding my teeth.
Jason removed a small Ziploc bag from his pants pocket. Inside the clear plastic was one pink ecstasy pill imprinted with an image of Buddha.
“We still have lots of beer,” Jason said.
Jason left the living room for the kitchen. We were at the house of Jason’s cousin, Christina, who had since left with her boyfriend. My girlfriend Olivia had also left half an hour prior. When he returned a few moments later, Jason tossed me a Kokanee, which I nearly finished in one gulp. When I used stimulants, beer quenched my thirst and increased my high.
On a mounted television, NFL Total Access played for the fifth or sixth or seventh time—I’m not sure how many times exactly, but it was 4:30 a.m. and I felt like Rich Eisen and the other NFL Network personalities had been discussing the upcoming 2010 NFL Draft for at least the last five pills.
“Sam Bradford,” Jason said, switching his attention to the television. “With the first pick, the Rams should draft Sam Bradford. He’s a beast.”
I took a second swig from the bottle, finishing it.
“He did win the Heisman Trophy last year,” I said.
We watched NFL Total Access several times over, drinking Kokanee after Kokanee, each time refining our NFL Draft selections. We pretended to be NFL executives instead of 18-year-old high school dropouts on a large amount of ecstasy drinking beer we weren’t old enough to buy. With the second pick of the draft, the Detroit Lions should select Eric Berry, the six-foot, 212-pound safety from the University of Tennessee, we decided.
“Imagine if we actually ran an NFL team,” Jason said. “We’d win a Super Bowl in five years or less, bro.”
“No doubt,” I said.
My bladder, now filled with liquid, vibrated like a cell phone.
“I’ll be right back,” I said to Jason who had begun crushing the last pill with the bottom of a drinking glass.
In the washroom, I stood in front of the toilet, unzipped my jeans, and aimed. But nothing came out. My mind was scrambled with thoughts. Did Olivia get home okay? Tonight was only her fifth time doing pills, and she had to drive all the way from downtown Regina to the south end. And what should I say to Dad? I spent the 80 bucks he gave me for new wiper blades on pink Buddhas with Jason. Jason. For a minute it looked like he was having a heart attack but, I don’t know, it also looked like he was trying to beatbox or something.
Nobody could piss under such pressure, I told myself. I just needed to focus. So I closed my eyes and tuned out the bathroom walls which appeared to be breathing. I thought about the colour grey, a neutral thought. I adjusted my stance and visualised a stream of urine hitting the toilet water like a basketball player visualising a shot swishing through net. Nothing.
“It’s ready!” Jason shouted from the living room.
I zipped my jeans and joined Jason in the living room. We sniffed the last pill and went back to drinking. My bladder, on the verge of bursting, spasmed every few minutes. I tried to follow Jason’s disjointed commentary, a difficult feat under any circumstance as he could switch from communism to Wu-Tang Clan like nothing, but all I could think about was my extreme discomfort.
Several hours and dozens of unsuccessful bathroom trips later, I partially emptied my bladder while sitting on the toilet. The temporary relief was more euphoric than ecstasy. I didn’t know it at the time, but my bladder would never fully empty again.
#
“You tested positive for chlamydia,” Jim said.
Jim was my counsellor at Edgewood, an addiction treatment centre in Nanaimo. After I told Jim about the bladder issues I’d experienced every day for the previous three years, sober and not sober, he arranged an appointment with an Edgewood doctor. I told the doctor my symptoms, and he ordered a urine test.
“Chlamydia? Never would have guessed,” I said.
My first STI at twenty-one years old was a joyous occasion. I had feared my drug use, from ecstasy to unregulated substances I ordered from China, might have been to blame. After the urine test, it appeared the problem, chlamydia, was much less complicated. My bladder issues included spasms, sudden urges to urinate, and most frustrating of all, the inability to void my bladder. Instead of exiting in a stream, my urine dribbled. Sometimes, I had to go over thirty times in a day and never felt the satisfaction of an empty, relaxed bladder. I’d also wake up several times during the night, which made me perpetually tired during the day. The doctor at Edgewood prescribed an easy fix: seven days of antibiotics.
#
I entered the bathroom attached to my Edgewood room and stood in front of the toilet. Five days earlier, the antibiotics had run out. After telling the doctor my symptoms remained, he ordered another urine test. According to test results, I was chlamydia-free. I stood in front of the toilet because I had to pee but also because I prayed some kind of delayed response to the antibiotic regimen might occur. Maybe, I thought, this time will be different—maybe, right now, I’ll release a thick, heavy stream, empty my bladder, and fall into my bed for a full night of sleep.
I aimed and stared into the toilet bowl, but nothing came out. I massaged the head of my penis, a trick I had learned after desperate trial and error on stimulants. Urine trickled. I waited for a miraculous stream to emerge, a waterfall in the midst of record drought, but all I got was drops. How I missed the sound of urine hitting toilet water with force.
I zipped my pants and headed for the door. Then, another symptom: involuntary leakage. Sometimes it was only a few drops, but, this time, it was substantial. I changed my boxers before lying in bed. Twenty minutes later, I was back in front of the toilet, massaging and praying. I wondered if my faulty bladder was a kind of cosmic punishment for the damage I caused during my addiction. The stealing, the lying, the danger I put myself and others like Olivia in. This is the cost, I thought, and I am paying it.
#
At the Nanaimo General Hospital, I was on my back on a metal surgical table. I wore a blue hospital gown, and my knees were bent and spread open. Dr. Cabell, a urologist, helped position my feet into stirrups at the end of the table. He planned to insert a flexible tube equipped with a lens into my urethra and advance it into my bladder. The procedure is called a cystoscopy.
After my four-month stay at Edgewood, I had decided to stay in Nanaimo. I had made recovery connections in the small coastal city, from finding a 12-step group to making sober friends, and it didn’t make sense to start that process again in Regina. One of the first things I did as a new, sober Nanaimo resident was find a general practitioner, Dr. Dodo, to treat my bladder. Dr. Dodo had prescribed several incontinence drugs, including Vesicare and Myrbetriq, but none worked. After six months of prescribing medications, Dr. Dodo referred me to a urologist.
Dr. Cabell stood between my legs and faced me. With gloved hands, he applied a numbing jelly to my external urethral opening, the one-centimetre slit on the tip of my penis the tube would somehow enter. If I could have chosen one orifice in which to never have a foreign, medical object penetrate, I would have chosen my external urethral opening.
“I’m going to insert the tube now,” Dr. Cabell said. “It’s going to sting a little.”
He inserted the lubricated, flexible tube inside my urethra, but it may as well have been sharpened No.2 pencil. The tube moved up my urethra as if it was tearing new ground instead of travelling a developed, well-worn path. Yes, I wanted to say to Dr. Cabell who was following the action inside my urethra on a screen beside the table, it stings a little.
When Dr. Cabell reached the bladder, he sent a sterile solution through the tube to fill the bladder up and provide a clearer look at the organ. When the solution entered my bladder, I had an urge to urinate so intense it felt as if every urge I’d ever had to urinate had been combined into one. Internally, I questioned Dr. Cabell’s “sterile solution” which felt more like a particularly potent blend of wasabi.
“Good job,” Dr. Cabell said.
He removed the tube from my urethra. I assumed he did so slowly and carefully, but I was too focused on my need to urinate to notice such details. After cleaning up the numbing jelly and directing me to sit up on the table, Dr. Cabell told me the results of the examination.
“It looks good up there,” Dr. Cabell said. “I can’t see anything wrong.”
It had taken nine months to first see Dr. Cabell after Dr. Dodo’s referral, my symptoms were worse than ever, and I had just received a tube up my urethra. I didn’t accept Dr. Cabell’s prognosis.
“Is there anything you can do?” I asked.
“I could prescribe Flomax,” Dr. Cabell said. “But it probably won’t help.”
I doubted it would help either since all of the other medications hadn’t, but I was desperate for relief.
“It’s worth a try,” I said.
He scribbled a prescription on a pad and passed me a slip of paper.
At my first appointment with Dr. Cabell, I had told him about my history of drug use and how I suspected it might have something to do with my bladder issues. He didn’t say much in response to my concerns, and instead asked if I had ever injured my genitals. Bladder issues at my age were uncommon, he had said, but traumatic impact to the genitals, like a bicycle accident, could cause problems. I had told him I couldn’t remember a bicycle accident or any other accident in which my genitals were injured.
“Next time you have a sudden urge to urinate, try to focus on something else instead,” Dr. Cabell said before directing me to leave the procedure room. “Remember, mind over matter.”
I was pissed. Dr. Cabell, it seemed, believed my bladder issues were imaginary or could be fixed with the help of a meditation app. I left without saying anything more. Soon after, whenever my bladder acted up, my girlfriend Sarah and I began to jokingly say, “Remember, mind over matter.”
#
I didn’t have a high school diploma or GED, but, after passing a Grade 12 English equivalency exam, Vancouver Island University accepted my application to their Bachelor of Arts program. I planned to major in creative writing and minor in journalism. When I was using drugs, I couldn’t imagine going back to school, never mind having the opportunity to follow my dream of becoming a writer. I had thought, surely, I would continuously remain in a state of poor mental and physical health until I died young.
If my bladder was some kind of punishment for my addiction, then VIU felt like a reward for my newfound recovery. But my bladder situation managed to restrain my excitement. Would I be able to participate in class if I left every twenty minutes to urinate? Would I be allowed to leave class without asking? If I left often, would the instructors think I was using drugs in the washroom?
At around the same time I received my VIU acceptance, I quit my job at a window cleaning company. I only lasted six days. The problem: such a job provided no reliable washrooms. From driving in a truck with Gary, the company owner, to cleaning windows at job sites, I’d hold my bladder for hours at a time. If I was lucky, we’d clean the windows of a Dairy Queen with a public washroom or we’d work in a rural area where I could pee in a bush.
On my second day, I told Gary about my continual need to urinate, but I didn’t feel comfortable divulging further details to my new boss, mostly because I didn’t want him to think I wasn’t capable of doing my job. I also didn’t want him to know my drug history. I didn’t tell Gary about my bladder spasms, inability to empty my bladder, or my sudden urges to go. I thought if I mentioned the surface of my issues, that I needed to pee often, he’d stop at a washroom once in a while. But that didn’t happen. Ray had contracts with ten to twenty clients a day, and there likely wasn’t time to make frequent washroom stops. At the same time, I didn’t communicate my needs.
My only professional working experience had occurred in the world of construction and labour. One of the reasons I planned to attend VIU was to obtain a career I was good at and passionate about, preferably one involving writing. If I wanted to make my VIU experience different than my experience working for Ray, I needed to confront my fears and make my needs clear.
#
A nurse handed me a plastic cup in the emergency room at Nanaimo General Hospital, a plastic cup I was supposed to pee in. The reason I was in the emergency room, however, was my inability to pee.
“Good luck,” Sarah said with a laugh.
Cup in hand, I couldn’t help but laugh too
My new Victoria-based urologist, Dr. Wilson, had injected Botox into my bladder the day before, a relatively new procedure for overactive bladders. Since the injection, I’d only passed a tiny amount of urine, which Dr. Wilson didn’t mention as a potential side effect. At Sarah’s apartment, my about-to-burst bladder had caused me to crouch in pain. Worried, Sarah convinced me to visit the hospital.
In the ER washroom, I stood in front of yet another toilet. I twisted the lid off the cup, rested it on an adjacent shelf, and let the rituals begin. A quick prayer to the Pee God. A quick massage. The colour grey.
With the cup under my penis, I held my breath and squeezed. A couple of drops fell into the cup like water from a leaky faucet. I repeated the process, even though holding my breath and squeezing my bladder worsened the tension headache originally caused from holding my breath and squeezing my bladder at Sarah’s place. I had a feeling my symptoms had been exacerbated by the Botox injection, at least temporarily, and that the urine test likely wouldn’t show anything, but it was a necessary step before I could see an ER doctor. I was tempted to scoop the cup into the toilet bowl to artificially add some millilitres. Instead, I squeezed and squeezed until my urine met the quota line.
After Sarah and I sat in the waiting room for an hour, a nurse called my name and led us to a medical room. Shortly after, the ER doctor arrived and informed us the urine test came back clear.
“How long ago did you get the Botox injection?” the doctor asked.
“Yesterday,” I said.
“That’s why you’re having issues,” he said. “Your bladder is seized up right now, which means the Botox is working. After a couple of days, your bladder should relax.”
“What can I do in the meantime?” I asked.
“Some people find having a hot bath loosens their bladder and allows them to urinate,” he said. “I know it’s a little strange peeing in the bath, but you can have a quick shower after you’re done.”
I didn’t tell the ER doctor I lost all shame associated with peeing in the bath long ago. Most days, a hot bath was my only relief.
#
One week before my first semester at university, I sent an email to each of my instructors. “I am just wondering is it okay for me to leave the class unannounced when I have to go?” I asked. “I don’t want it to look like I am disrupting the class or taking breaks whenever I feel like it.”
All of them replied and said: yes, of course, please feel free to leave whenever you want. It only took 15 minutes of class time to realise university wasn’t like elementary or high school. Students left at will, and nobody had to put up their hands to ask.
Now, with a Bachelor of Arts degree hanging on my wall, it’s both funny and a bit embarrassing to look back at these emails. I was so nervous about my bladder interfering with my first chance at university and my second chance at life, but the kind responses from my instructors reassured me leaving class to use the washroom wasn’t a big deal.
I remember getting my first A+ in Dr. Sprout’s class for an annotated bibliography assignment. Before it was due, she had touted the assignment as the toughest to date. When I saw the letter grade after Dr. Sprout handed my assignment back, it helped put my health into perspective. My bladder issues are irritating, I had thought, but at least I’m sober today. And somehow, without a high school diploma, I’m a university student, and I am actually doing pretty good.
#
“Have you ever used ketamine?” Dr. Wilson asked.
“Maybe five or six times,” I said.
I was at Dr. Wilson’s Victoria office for a checkup post-Botox injection. My symptoms had improved, but only marginally so. I had less involuntary leakage, but my other symptoms remained the same.
“When I went to inject the Botox, I noticed your bladder was extremely inflamed,” Dr. Wilson said.
Dr. Wilson explained my inflammation and symptoms were consistent with ketamine bladder syndrome, a condition chronic users of ketamine sometimes developed. Dr. Wilson said he didn’t know my bladder was inflamed before the procedure because he relied on the cystoscopy report from Dr. Cabell, my previous Nanaimo urologist, which stated my bladder was in good condition. I was angry, but not totally surprised, at Dr. Cabell’s latest show of incompetence.
Still though, I had only used ketamine a handful of times. A few weeks after leaving Dr. Wilson’s office, however, I realised I may have used ketamine hundreds of times without knowing. Ecstasy, slang for 3,4-Methylenedioxymethamphetamine (MDMA for short), is often adulterated with other drugs, including ketamine. I don’t know exactly how many ecstasy pills I consumed, but, over a three-year period, I consumed them consistently. Sometimes once a week. Sometimes five times a week. When I first started, I’d do two or three pills a night. Near the end of my ecstasy phase, I’d do upwards of twenty pills over several nights. Some pills produced MDMA-like effects: euphoria, increased sociability, planning a chain of restaurants with a person named Jeff you met ten minutes ago. Other pills produced methamphetamine-like effects: teeth grinding and watching NFL Total Access on repeat. And other times, I consumed pills that contained a hint of ketamine’s dissociative effects.
During my first appointment with Dr. Wilson, he had asked what drugs I used in the past. I didn’t mention ketamine. Instead, I mentioned ecstasy, meth, cocaine, LSD, hydromorphone, and bath salts. To this day, I’m not sure if ketamine-tainted ecstasy damaged my bladder because it’s impossible to know if any of the ecstasy pills I regularly took were tainted with ketamine. It seems the likely cause, but I will never be certain.
Near the end of my post-Botox checkup, I asked Dr. Wilson if there was anything we could do about my bladder now that we had a potential reason for my symptoms. Not much, he said. If I wanted, I could try another Botox injection in eight months.
#
I’ve been sober for over seven years, and my bladder is pretty much the same as when my issues started in 2010. I’ve adjusted, the best I can, to my symptoms. I’m used to the spasms. I’m used to getting up and down, up and down, to use the washroom.
More often than not, I’m grateful for my new life. At VIU, I was a journalist for five years at the student newspaper, The Navigator. Two years ago, I married the girlfriend who accompanied me to the ER appointment, Sarah. And for nearly three years, I worked at a non-profit that provides housing to people experiencing homelessness, and I was able to get up anytime to use the washroom. After the window cleaning job, working in an office with a washroom felt like the ultimate blessing.
At other times, I’m bitter. I’ve experienced many cases of the “Why me?” syndrome. And also the “If only” syndrome. If only I could enjoy all the great things my life now includes—relationships, meaning, purpose—while also enjoying a functional bladder. This mindset often arises when I’m exhausted and groggy from waking up so frequently during the night. Some level of bitterness, I imagine, will exist as long as I am a human being who needs to urinate.
Today, I don’t entertain the idea that my bladder issues are a result of cosmic punishment. My bladder is the way it is, most likely, because of the substances I consumed. And if I were to consider the cosmic balance of the universe one last time, if such a thing exists, I think the tides of gravity have shifted quite substantially, all things considered, in my favour.
My favourite place to pee is the temperate rainforests of Vancouver Island, which I often hike. Behind huge cedar trees. No toilets or plastic cups—just fresh forest air.
*Names were changed to protect identities.