Review Article Volume 5 Issue 5
İstinye University, Sociology Department, Turkey
Correspondence: Sinan Çaya, İstinye University, Sociology Departmen, Turkey
Received: January 27, 2020 | Published: October 30, 2020
Citation: Çaya S. A glance at the sociology of body & health, via “urology”. J His Arch & Anthropol Sci. 2020;5(5):193-200. DOI: 10.15406/jhaas.2020.05.00234
In addition to occupying itself with all aspects of traditional medicine; Health-and-Body Sociology also deals with the attitudes of laymen (non-experts) towards branches of modern medicine and the related professionals. In this very context; a lot of stereotypes which have developed among folks throughout ages are also involved. Indeed, such beliefs are deeply rooted in the popular culture. For instance, in former years, among typical townsfolk in Turkey, the phrase two clicks and a final gentle tap used to commonly describe the way an internist would examine his patient and pocket his earnings, fairly easily. Urology is a somewhat different branch of the medicine because the first associations coming to the mind relate it to the issue of sexual potency in the male and accordingly carry it onto a kind of alleged “luxury”-treatment plane. However; the entirety of the renal system of the human body is the topic of this scientific discipline; while female patients should normally fall into the same category, as well. This article involves certain personal experiences, inferences and claims, simply due to its very nature.
Keywords: urology, physician, patient, medical examination, doctor’s office (Privatpraxis)
In the recent past, my elder maternal cousin had passed away, soon after getting a malign tumor in his bladder. Among other paternal and maternal cousins of mine, it was he who had had a very high opinion of mine, throughout the young years of my development into manhood. Six years senior to me, he used to be a champion wrestler at the 78-kilogram-category, in his teacher-training vocational school. He became a school teacher and educated hundreds of children. In possession of a certain charisma he had always been emanating positive energy and boosting the morale of his associates. Another peculiarity of my favorite cousin: He had a face resembling both Alain Delon and Tony Curtis,1 popular movie stars of his time, depending on the interpretation of the beholder, a trait well-established through consensus in the nearby circles of ours and further enhancing his inborn charisma. Many thoughts pertaining to my late precious relative came to bombard my mind, taking me into deep contemplations. Then I came to realize that all those elements of thought should somehow get formulized and put in black on white, if I were ever to achieve a final relief or respite, psychologically.
This urge to record certain cognitive products of the mind (even if nobody would read them in due course) pertains at least to some scholars and is hard to ignore or forsake. (Turkish story-teller) Sait Faik mentions about it in an apparently autobiographic work of his. The protagonist had taken a vow not to indulge in any sort of writing onwards from a certain date. He is now leading an uneventful peaceful life style in his hometown, which is a Marmara island. One day the fishermen, upon returning from a collective plentiful catch, share the booty among themselves, in front of the tea-house, the very center of the coastal village. Nevertheless, they skip the honest-faced stranger who had also participated in the fishing campaign. The spectators show no reaction against this apparent discrimination, either. The victim himself has a resigning attitude, claiming none of his rights. The protagonist then rebels in his own manner! He enters into a grocery, buys paper and pencil, sharpens the pencil with his pocket knife, kisses his now-sharpened pencil and gets to work, that is to narrate the injustice he had just witnessed, in the form of a short story. The narration ends with the following sentence: “I would have gone crazy if I had not written all this!”. French author Alphonse Daudet also makes an allusion to the need to write, via the example of the historical scholar Michel de Montaigne, in his (again) autobiographical story, Poet Mistral. They had asked Montaigne why he would bother to write things which would only come to the attention of few people, if any. He had retorted:
—“Few readers would suffice me. A single reader would be enough. No reader at all would as well be quite enough!”
Daudet praises his (true in real life) friend Mistral in his eulogy-styled story because he insists in writing in the dialect of Provence (Great rhymed Epic/Épopée Calendal and other Works). At the time, the mentioned dialect was on the way of getting extinct, already. Only shepherds2 were using Provence in their own communicating activities. Ah, the brave poet. Montaigne must have had someone like Mistral in mind when he wrote, —Think of those, who, when asked what is the point of spending so much time and trouble on a work of art that can only be seen by a few people, replied, “A few is enough. One is enough. None is enough.” Whilst Mistral spoke his verses in this beautiful Provencal tongue, more than three quarters Latin, and once spoken by queens, and now only understood by shepherds, I was admiring this man, and considering the ruinous state in which he found his mother tongue and what he had done with it.
A grope into the social history (of Turkey)
Formerly the Arabic Word Bevliye was employed in Turkish instead of the Occidental word üroloji. In a similar manner nisaiye was used instead of jinekoloji. Intaniye was used instead of enfeksiyon.3 The Word bevliye also had its verb form: bevletmek (to urinate or rather, the euphemistic connotation being much more pronounced here, to relieve oneself). Years ago, while visiting a student apartment in my undergraduate days, I at a point needed to use their house toilet. The three pious students, the hosts, had put up a signboard warning the visitors, just across the door to the restroom: PLEASE DO NOT RELIEVE YOURSELVES STANDING! (There the word bevletmek was written instead of the vernacular urinating or pissing synonym in Turkish: İşemek or sidiğini yapmak) (Figures 1&2). While I was a boarding Lycée student in Istanbul, the father of one of the roommates in the dormitory was a urologist in a Mediterranean city. Despite numerous teenagers from wealthy families, this very boy was the one who attracted most severe animosity from the rest of the school community. (Those were the years when social ideas were upheld in high esteem in the country. The years overlapping with the times which Francophone Turkish journalist Hadi Uluengin refers to as his “years of lunacy” in his corresponding Francophile foreign scool, at the time. Some students were even so cruel as to harass the boy by constantly referring to him as the son of the “c*ck specialist”. The mere label reveals how the branch of urology was actually regarded in popular culture, at the time.
The “tableaux” emerging about urology was that it is a sort of “luxurious” (i.e. not really vital) Med-branch dealing exclusively with problems related to male potency and other related malfunctioning of the organs. Author Haldun Taner talks about the tendency of Turks to sexualize many concepts, especially on the occasion of sportive competitions: If one comes to think about it, who or what is a goal-keeper on a football field, anyway? A passive character rather than an active one! The protector or watchman of the precious nest! He who gets conquered, he who sometimes cries in remorse leaning against the nets! More than any other person; the goal-keeper who cannot prevent a certain score recorded by the opposing football team, does indeed resemble an unsuccessful virgin who had been unable to protect her chastity”. It appears that the issue of potency is an omnipresent preoccupation in the entire eastern-Muslim World. An American anthropologist’s field study dating back to late 1960s in the Afghan city Bamian and the surroundings verifies a strong belief among the population culminating in a fear of loss of potency due to magic by the enemies: Many grooms take precautions against this black magic [a charm to cause impotence], especially if there is a disappointed suitor who could purchase a charm [ta’wīz]. Before a wedding the groom and a few friends visit a shrine and walk around it saying a prayer for protection from a black charm. Often the groom obtains a charm that will counteract a black charm. And in the marriage ritual sometimes a prayer [du’a], is recited in order to preserve the marriage from black magic.
The prevailing opinion about urology was thereby a very unfair, void and defected understanding or conception. Urology, in reality, revolves around the entirety of the function and disorders of the urinary system of the human organism. The affinity to the branch concerns females as well as males. A mere infection of the urinary tract compels any female to be a subject of urology. She hastens to go seek professional medical aid from urology.
The few urologists of modern Turkey
It should be noted at this point that in Turkey only very few female urologists are available. A news-video notifies that their numbers add up to eight, altogether. {The same holds true for specialists in orthopedics. When I took my wife to an orthopedics-clinic to get her arm-cast removed, I casually inquired into the matter, while conversing with the chief-assistant. He replied that the scientific discipline requires physical strength and henceforth a pretty big body built like that of his own is a prerequisite, let alone acquiring any female candidates. On the other hand; it is known that in the early days of the republic (after the abolishment of the Ottoman Sultanate) a substantial number of females in this very field of medicine did practice their professions in the bosom of the young republican country, nullifying the claim that women would not make orthopedics experts. However; it shall be a pounding estimation to state that the mentioned fact about the early republican era’s female orthopedicians happens to be a sort of counteraction in essence, i.e. an attempt to prove the worth of the republican regime and her educated cadre of women (or else to disprove the incapacity of the regime and her female citizens). One might compare it to a reaction-formation defense mechanism (Reaktionsbildung) on a massive scale just as a child afraid of a swinging chair at an amusement park may go ahead and choose to become a pilot when he grows up!
At an interview conducted in the eastern part of Turkey with one of those eight female urologists in 2014, the following comments were noted:—“Urology does not deal with the well-being of male sexuality alone. As a matter of fact; we carry out operations pertaining to kidney and prostate problems. Women are also liable to develop such disorders. I chose this branch because I knew about all this and I was also aware of the tendency of women to keep aloof from male doctors. Leakage of urine and similar problems of women can only be treated properly through aid of a urologist. It is an utterly wrong convention for them to apply to gynecology, for similar problems, in this country. They should instead choose to go see urologists to ensure better and earlier possibilities of healing”.
A champion sportsman as a patient of urology
One night in the aforementioned lycée-dorm-room, while on the threshold of sleep, the hand-radio concealed under the pillow of a boy informed the public that the champion oil-wrestler Mustafa from the Black Sea City of Ordu4 got stabbed in a fight in a night club in the very Mediterranean province mentioned above; and got hospitalized for an urgent kidney surgery. The particular roommate of ours let out an instinctive comment: — “It is my papa who will operate on the body of the sportsman. My daddy is the unique urologist in the city” (Figure 3). While fulfilling my compulsory military service (as a sub-lieutenant) I befriended with a commissioned practitioner doctor, a first lieutenant of the Air Force, in the officer club. He was from the coastal city of Ordu (on the Blacksea line). His name was Mustafa but he eagerly demanded to be called Ordulu Mustafa (Orduian- Mustafa, i.e. Mustafa from the city of Ordu) by everybody around, as an allusion to and an identification with the aforementioned champion oil-wrestler. He was intent in getting this particular nickname well-settled and widely-accepted. He was a good fellow and nice to talk to. After the completion of my service time I came to hear that Mustafa won and started a urological residency at a military hospital and got movedto an eastern city after finishing his training there.
Impressions from nearer dates
I was on the verge of getting married. Idly strolling through the streets of the quarter of Khalkedon on the eastern bank of Istanbul, I just happened to come across a white rectangular signboard indicating the private office (le cabinet privé / die Privatpraxis) of a urologist. I found myself heading for the staircase, enslaved by an internal impulse. I started climbing the steps one by one. I just felt like going through a medical exam! There I was, captured by the affinity of an iatrogenic check-up. After all, insufficient biological knowledge could lead one to certain waves of anxiety. For instance; an individual with missing information may think the asymmetric formation of the two testicles as an abnormality. Indeed, much later I was to thumb through a medical book in French and read that the left testicle is bigger, heavier and slightly lower than the right one (plus gros et plus lourd et un peu plus bas).5 The same book (by MD Khan) would mention that coming from a cold bath, the scrotum shall have shrunk a lot. The passage would go on specify that the sight is more esthetic than the ordinary state of things, which had compelled the ancient Hellenistic sculptors to represent the male body as such.
When I was primary school boy, we used to go swim in a nearby creek in a group of neighborhood buddies. I was familiar with those state of things ever since those times. Once we even got indulged in a heaty argument about this physiological shrinking phenomenon due to coldness exposure. A somewhat older boy eavesdropped the statements pronounced and invariably took on the role of imposer of good manners and good conduct. He angrily mumbled patronizingly:
—“So, those sons of bi*ches had been deliberately performing such experiments?”
One of us intervened to alleviate his rage:
―“Well, err, big-brother, no deliberate experiments actually. You know, we go swim occasionally. This is why we all know about it.
In reference to a minimum level of essential useful knowledge about such topics; a fortunate coincidence was to happen sometime later than this visit to the doctor. I bought some pistachio-nuts from a provincial grocery, weighed and put in a mini (cone-shaped) paper-bag made out of a newspaper sheet (a common usage at the time). Gnawing at the delicatessen in a tea-shop, my glance fell on the printed stuff on the lateral outer face of the paper cone: A question—answer session of a columnist, a practitioner-doctor of the involved newspaper directorate. A good piece of luck that I read this portion!
It was a question about a sticky, viscous liquid oozing from the phallus during the act of defecation. The corresponding reply affirmed on the spot that the relatively bigger prostate-gland of some males gets subjected to the message effect (indirect rubbing) of the stool which is leaving the large intestine, thereby causing the situation asked about. The statement said that this occurrence has neither a specific treatment nor it is a major hazard6 worth of any worry, basically. Well now, they say that knowledge is power! It is indeed! Let us move on from where we left the narration: I had climbed the stairs to the doctor’s office in slow motion,7 using a metaphor from the movie-world. (Germans would say in a time-magnifier, Zeitloop) and eventually I located myself within the place. There was neither another patient nor a second professional person of some sort (a secretary8 or a nurse or a lab-technician or a paramedic whomsoever). A good piece of luck, insuring full privacy! There was only doctor himself (working as a single pistol, using a Turkish metaphor): Fiftyish-looking, high hairline, smocksleeves rolled up, smelling of tobacco, a mild and fatherly facial expression. A providential luck it was to end up in this very man’s office!
Right in the middle of the medical examination the phone at the table rang. The doctor left me as I was and walked toward it. He was obliged to come up with certain explanations to satisfy the uneasiness of his interlocutor on the phone. According to my inference, the voice on the other end of the line was none else but a naturally anxious type of a patient who was somehow enjoying a special kind of favor and lenient treatment from his medical advisor-and-protector. Hanging up the receiver the doctor could not help mumbling, all by himself:―“There you are again! You spoiled, fussy, grumpy chap!” Having heard of this I must have smiled a contagious smile since a broad, good-humored smirk got to spread on the face of the doctor, as well. “Confirmed Good Health” & Related Benefits, Repercussions. So, I got it over and everything was in order. Relief, respite! (The irony of fate: My wife herself would never have a primigravida, in the future). An encouraging say from a lay-person’s mouth is one thing; getting it from the voice of a formally recognized authority is another. If the words of the physician are disappointing to you, common defense mechanisms usually get triggered, spontaneously―Karen Horney (1885-1952) and some other behaviorists call them coping mechanisms, while Erich Fromm (1900-1980) prefers the phrase orientations, instead. But they essentially point to the same thing, anyhow (Çaya 2018)― and that particular mechanism assumes the function of a support, a walking stick (cane) of some sort. It is a good thing that it works in this manner!
The pinnacle of the difficulties, the most crucial or perilous moment is thereby assuaged, softened up and rendered easier to surpass! All this riddance of the bottleneck is accomplished thanks to the working of the involved psychological “savior” mechanism; the most common type of which, pertaining to the topic of health, probably occurs in the form of denial (rejection, mécanisme de refus, Verweigerungsmechanismus). In order to dissipate the bad diagnosis, the individual gets to consider the given doctor as incompetent. Inside his head one goes on calling him a horse-doctor (or a blacksmith as a pejorative term of Turks for despised doctors). The affected individual says auto-suggestive hushed questioning remarks like “how come his professors at the faculty of medicine permitted his graduation?” etc. Nevertheless; as a final analysis, a deep-down-inside accounting process of cognitive nature is already at work and a poison of anxiety is emerging and growing incrementally but steadily! A hard moment to experience (erleben) if you come to think of! Truth is hard to submerge in pretexts. Alas! Then a swap of some cordial words were exchanged with the doctor. The man had been a military physician. So, a retiree from the rank of o lieutenant-colonel. During the landing of the Turkish troops on the island of Cyprus he was stationed at Adana military hospital, the nearest center on the mainland-Turkey to the scene of armed conflict. The only man of the residency of urology, it was he who had carried out the surgeries of the warriors touché by bullets in their renal systems. If the gentleman is still alive, I wish him all goodness on this earth. If he had left the world of the living, then I wish he rests in outermost peace!
Sociology of Body-and-Health occupies an important position among special sociologies. Whatever constitutes the collection of attitudes, perceptions, beliefs of a given folk about preservation or regaining of good health, lies in this field of the social sciences. The discipline investigates the grounds behind the preference of disadvantaged sectors of a society for healers of all kinds rather than formally-educated physicians. Accordingly, the discipline provides beneficial guiding lines and extra insights about health issues for medical authorities. Meanwhile; the discipline of Body-and-Health Sociology affects inquiries into popular approaches and evaluations of the branches of modern medicine within certain communities. For example, in Turkey, some years ago a prospective government project was debated about abolishing the few specialized mental hospitals and enlarging the capacities of psychiatry clinics in general hospitals, as a compensation. The idea was to eradicate the concept of asylums and lunatics. If a cured person returns home from just any hospital, it is more probable for him / her to escape the label of a “crazy person” after all. (Nowadays mentally deranged people are also being considered merely as sick people just like physically ill ones, by large masses of people in Turkey. This conception might have rendered the project an unnecessary burden to carry out). The afore-given affirmations and narrations filtered from personal recollections may be valorized from such an angle within the scope of Body-and-Health Sociology. Zealous experts of urology practicing their precious talents in former days as alluded to before, might also serve as good role-models for those involved in the branch, presently. As a final attesting it may be said that urology is not a non-vital field of medicine pertaining to sexual malfunctions of male organs as it used to be largely imagined by teenagers. It is the duty of the urologist to take action in cases of serious renal and urinary disorders9 of males as well as female patients (Figure 4).
O shepherd! What is your worry?
Loneliness? This was your fate, also?
Are your herds far
Far away from you, at the moment then?
Founder of modern Turkey (Mustafa Kemal Atatürk) has a famous saying: “It is the intelligent, agile and morally-right ones among the sportsmen whom I really appreciate”. His particular namesake probably does not overlap with this maxim of the statesman a hundred percent, so to speak. Still, the vice of licentiousness may be considered only a minor spiritual defect in face of more conspicuous ones infesting some other men of sports like traits amounting to sheer criminal tendencies (connections to gangs etc.).
In my childhood days I never missed wrestling matches. It was a tradition for the referee to introduce the participants to the spectators by reciting their names and nicknames in beautifully rhyming couplets or stanzas. The introductory sonnet for Mustafa was something in the line of:
In the kitchen we keep some delicious lasagna
Here comes from Ordu, Head-wrestler Mustafa!(Figure 6)
Muslims have a partial-washing ritual before each of the five-times-daily-prayers (small-job-ablution) which is durable until one breaks wind or pees or defecates or takes a sleep. (Belching is not a horrific act in this context although it is a shame in American culture). A sexual act or pollution without an act is a different, bigger issue. It renders the person unclean until he/she takes a big-time-ablution, which amounts to ritually washing the entire body with clean running water. Below is an extract from professor Doksat’s presentation in French, regarding this issue. (As it is to be encountered in the below-given piece of poetry, another similar Islamic precept is regular clean-shaving of the genital regions both for men and women. In the army, recruits even get inspected from time to time, a measure against pubic lice in close-crowded living conditions) (Figure 8).26‒32
A passage in a Wambaugh-novel got embedded in my memory merely by reference to this specific issue. 28-Year-old female Navy detective Bobbie Ann Doggett (nicknamed “Bad Dog”), at the end of the adventurous plot gets engaged in a mutual gun-shooting. She conceives her bullets springing from the canon as if gliding in the air towards the opponent while she gets aware of a wetness in her pants, as well. Urine release! (Wambaugh does not write crime novels like Agatha Christie; he talks about policemen themselves. He had worked for the police force himself).
SHEER UNGROUNDED FEAR
In the jaundice epidemic
As a precaution, it seems,
To each of us in the dorm
two yellow capsules
were provided recently.
In the evening of that day
in the “john” à la Franca
While I was pissing off;
I happened to see that my pee
Was all orange in color!
(In an à la Turca “john”
one can’t observe it, at all).
O man, what is that?
Trouble never comes singly!
Here it is additionally:
Inside my panty-cloth
dyes of crimson pattern, too!
Of course, I was overwhelmed.
Then I recollected what?
Mohammad Ali Clay's
Good old manager had said:
—"Tomato-juice-like, his urine,
in paste-like consistency;
After all, the champion
had received many punches
Directly at both kidneys"
Those were the days when doctors
Diagnosed our hero
With that awful thing, I mean
The disease of Parkinson!
(A newspaper clipping,
Headline of a sports-page)
Then I entered the canteen
My face long in depression!
Good Providence that I did!
At the very first table
didn’t I now eavesdrop
some sentences containing
Phrases like orange piss?
The medicine we’d taken?
Yes, nothing but a side-effect!
Not a serious issue.
Gracious Goodness! I had shared
the alleged “misfortune”
with some fellow-students
who were smart to awake!
Now in very high spirits
My head starts functioning
in much more of a sound mode:
In a matter of seconds
did clarify in my mind
Aforementioned red spots:
This very morning early
I took a nice warm shower
Meanwhile I did something else:
While taking ablution,
I did not mean to neglect
An archaic precept,
Exigency of my creed:
A pubic-hair clean-shave
I affected so nicely
with an extra-sharp-razor!
This was the whole commotion,
The whole futile anguish.
None.
None.
Author declares that there is no conflict of interest.
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