A Taboo Subject

Transferring skills from the most oblique direction

Should I write this subject, let alone pick a topic which is SO taboo? There are two things worth pointing out. Sometimes we find a piece of information, in this case, information from Radio 4, Woman’s Hour, that can be transposed for a succinct message that the power of a message, rather than the subject, is valuable.

The title has nothing to do with the message in this case, but the message can be distilled down to how do we deliver information. As a communications medium, I want to bring out communications from two experts in their field: important but very different. The narrative, therefore, comes down to whether the message will likely impact effectively. Do we lecture, or do we empower? So let me transport you in Star Trek terms from feet to… er, the end of the bottom – the anus.

 Radio 4 – 18th August 2022 10-11.00

Emma Barnett, a relative newcomer journalist told her audience that there is a growing popularity of anal sex amongst straight couples but the tale is about injury in women. It turns out that men have stronger muscle rings compared to women. Her expert guests were Lesley Hunt, a colorectal surgeon at Sheffield teaching hospital and Claudia Estcourt from the British Association for sexual health and HIVMs Hunt gave a methodical discourse on anatomy and medical complications. As you would expect, the subject was factual, informative, and designed to point out that this was not a good method to engage in.

Barnett is good at cutting to the chase as a journalist and is more direct than her predecessor Jenny Murray.

“If women wanted to have anal sex, what is the safest way to do so?” Barnett asks Ms Hunt.

“That’s the question I was hoping you wouldn’t ask me, really. I think anything that’s inserted into the anus risks doing damage there,” says Ms Hunt.

“Do you have anything to add?” Barnett asks Professor Estcourt.

“Absolutely!” responds Professor Estcourt.

The message

At this point, I was listening but vaguely. The background noise of the car’s radio suddenly caught my attention. Without hesitation, Estcourt has a message and one that was different to Hunt. The professional respect was retained throughout, but there was a hidden moment that (and it is my interpretation) suggests to Ms Hunt, we cannot afford to miss a golden opportunity here and if you don’t, I will engage.

Before I continue, I want to remind the reader, especially the professional reader, that communication is about, what we need to convey, not what we want to convey. Smoking has never been banned, but it carries a strong health warning and financial penalty in tax generation.

Footwear preferences

Nearer home, and I mean feet, Dr Helen Branthwaite was interviewed about her speciality in podiatry – I quote from one of the articles from ConsultingFootPain (Published 9/6/22). Her research focuses on appropriate advice and footwear application without pigeonholing people.

“Promoting footwear that looks like something your 90-year-old granny would wear is not going to attract younger people to change. If the advice doesn’t represent how people want to present themselves as a person, there will be minimal change as body image is important.  I think when we attach ourselves as a healthcare professional to an idealistic shoe as a flat lace-up, that’s all very sensible-looking with no expression in it; then we’re on a hiding to nothing to engage the majority of people. Merging components of healthy footwear should ideally offer improved function, with fashionable footwear this allows expression and individualism.”

Her artistic eye and flare creep in again as she considers the key parts of the shoe. She knocks the idea of the “sensible shoe” being the driver behind the formal mantra expounded through podiatric teaching.  

Returning to Professor Estcourt

Consent was agreed on mechanisms of cessation between consensual partners, use of a water-based lubricant, condoms to avoid infection and if any problems arise, contact your local sexual health clinic who, have an excellent relationship with the local colorectal surgeon and other services if referrals are required  – quoting content rather the exact words.

Barnett then asks, “are the NHS guidelines clear enough?” Professor Estcourt makes clear the NHS does not provide the latest facts.

“They need a bit if revamping don’t they… need to acknowledge this is increasing as part of someone’s sex life…never has there been a time when withholding information needs to help people be informed.”

Thinking outside the box

There is always something we can learn from other disciplines. Where we find such inspiration can be unusual but applying the merits from others  – a reward in itself. Footwear cannot be held up alongside sexual preferences, perhaps, but then footwear itself is not without some sexual intonations. 

Back from the subject matter, we see Hunt and Estcourt come from the same medical backgrounds but have followed different pathways. Both see the world in different ways as well as see pathology. This is balanced against people’s needs, desires and intent, with or without advice. Like the cigarette analogy, we see the idea of forbidding something seldom helps and yet Hunt recognises the damage done by the practice based on the weaker structures of the anal muscles in females. Estcourt does not condone anal sex but realises you cannot fight against the current. In much the same way, all specialists must travel the middle road of being reasonable. We see this when it comes to foot deformity and unsuitable footwear. Dr Branthwaite makes much of this in her own experience and for us, the learning comes from realising how we communicate and view matters that are passionate to us and are vital in any area of health care education.


Thanks for reading ‘Bottoms Up and Communication’ by David R Tollafield for ConsultingFootPain

David is a former consultant and lecturer and believes quality communication is important in all areas of healthcare. You can read more information about foot health and healthcare on ConsultingFootPain.co.uk or sign up for his Reflective Podiatric Practice Newsfeed

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Published by Busypencilcase Communications. Est. 2015 for ConsultingFootPain

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