Read Gulp: Adventures on the Alimentary Canal Page 16


  United States v. Montoya de Hernandez set the precedent for the 1990 case of Delaney Abi Odofin, who spent twenty-four days in detention before passing the first of his narcotics-filled balloons. “An otherwise permissible border detention,” the Justia.com summary concluded, “does not run afoul of the Fourth Amendment simply because a detainee’s intestinal fortitude leads to an unexpectedly long period of detention.”

  How is such fortitude even possible? Why didn’t Odofin’s mass contractions seize the day? Why didn’t his colon burst? Whitehead explained that the body has yet another rupture-preventing protective mechanism. A rectum that remains distended long enough will eventually trigger a slowing or even a shutdown of the production line, all the way upstream to the stomach if need be. Contractions of the colon and small intestine wane, and gastric emptying slows. This mechanism was documented in a 1990 study in which twelve students at the University of Munich were paid to hold back as long as they could. To see, one, whether and how long it’s possible to suppress the urge, and, two, what happens when you do. The authors were impressed. “Volunteers succeeded in suppressing the urge to defecate to an amazing extent.” Having just read Odofin’s case, I wasn’t all that amazed. Only three of the twelve made it to the fourth day.

  The other thing the Munich researchers reported, and a mild duh here: the longer the material was held back, the harder and more pellet-like—the more scybalous—it became. Because as long as it sits in the tube, moisture will keep on being absorbed from it. The harder and drier the waste gets, the tougher it is to eject. Holding it in causes constipation. The authors concluded their work with a word of advice for constipates (to use the exotic and rarely employed noun form): “Follow each call to the stool.” Or, in the words of a British physician quoted in Inner Hygiene, James Whorton’s excellent and scholarly* history of constipation, “Allow nothing short of fire or endangered life to induce you to resist . . . nature’s alvine† call.”

  Constipation is the least of an alimentary canal smuggler’s worries. About 6 percent of drug mules suffer bowel blockages‡ when packets logjam or the ends of the condoms become entangled. And there are overdoses. In the early days of alimentary canal smuggling, mules would wrap drugs in single condoms or fingers of rubber gloves, a thickness sometimes dissolved clear through after a few hours in gastric acid. Depending on the quality of the latex, the drugs would also leach through intact packaging. In more than half the reported cases of cocaine-swallowers spanning 1975 to 1981, the suspect died of overdose. (An antidote exists for heroin, but not cocaine.) Insult to injury: should you die on the job, you run the risk of your accomplices gutting your carcass to recover the drugs,* as happened to two of the ten dead Miami-Dade County, Florida, drug mules whose cases were covered in the American Journal of Forensic Medicine and Pathology paper “Fatal Heroin Body Packing.”

  At Avenal, drugs are typically hooped rather than swallowed. Parks’s unit regularly intercepts illegal narcotics, as well as an evolving assortment of prescription drugs. (Wellbutrin, Xanax, Adderall, and Vicodin are snorted for various off-label recreational effects. The Rogaine that appeared in a recent over-the-fence drop appears to have been sought for its intended purpose.) Rodriguez has had cell mates who’ve opted to swallow. Two died of overdose. “One, he had like six months left. I go, ‘Don’t do it, man, you’re too close to the house.’”

  I ask Rodriguez how close he is to the house. Dumb question. Rodriguez is in for life. I had assumed the killing was gang-related, but it was over a girl. “It wasn’t even my girl.” Rodriguez rubs his thigh and looks away briefly, acknowledging something long past but still sharp. “I’m not the kid I was when I came in.” That was twenty-seven years ago. “I’m starting to get white hairs, man. I’m starting to go bald.” He lowers his head, to show me the bald spot or to register shame, I’m not sure which.

  I don’t know what to say. I like Rodriguez, but I don’t like murder. “Dude,” I finally manage. “Was that Rogaine yours?”

  • • •

  HERE IS ANOTHER reason so many drug mules prefer to swallow contraband, despite the risk of an overdose. “The rectum is taboo across many of the regions where mules originate. In the Caribbean and Latin America, any use of the cavity is automatically associated with homosexuality, which can still lead to a fatal beating in many communities.” This is from an e-mail from Mark Johnson, of the UK firm rather hazily known as TRMG, or The Risk Management Group.

  The rectal taboo is equally strong among Islamic terrorists. Johnson’s colleague Justin Crump, CEO of the London firm Sibylline, told me about the suicide bomber who tried to kill Saudi Deputy Interior Minister Muhammad bin Nayef in his home in Jidda in August 2009. Since little remained of the bomber’s lower torso, the location of the explosives became an item of fizzy speculation among terrorists and counterterror experts. “All the jihadist websites were saying it was a swallowed device, that he had it in his stomach.” Crump believes it was simply taped in place behind the bomber’s scrotum.

  “What was interesting,” said Crump of the web postings, “was that there was a massive reluctance to say it could have been stuffed up his bottom.” He recalls examining photographs of the bombing aftermath with a source of his, a former Al Qaeda militant. “He was saying, ‘Oh, yeah, look at the way his arms came off. Definitely swallowed, definitely swallowed.’ He was really keen to head off any notion that . . .” Here Crump himself seemed to trip over the taboo. “. . . To head off the other option.”

  No recorded instance exists of a suicide bomb being concealed inside a terrorist’s digestive tract. Swallowing or hooping explosives, as opposed to wearing them in a vest, would reduce the destructive potential by a factor of five or ten, Crump says, because the bomber’s body absorbs most of the blast. Bin Nayef was no more than a few feet away from an explosive the size of a grenade, but because the bomber was squatting on it, the target walked away without serious injury.

  The only reason to smuggle a bomb inside one’s body would be to get it through a strict security system, as exists in most airports. Crump says it’s not worth the trouble; it’s almost impossible to bring down a plane with a cache of explosives small enough to be alimentarily smuggled. A packet the size of a cocktail wiener is about the limit of what can be swallowed without undue travail. An accomplice could push the explosive material into the bomber’s stomach in the form of a long thin tube, but the bomber would still need to swallow the timing device and somehow keep the digestive juices from rendering it inoperable.

  Crump says a rectal bomb wouldn’t bring down a plane either. “At most, you’d blow the seat apart.” I showed him a Fox News piece that quoted unnamed explosives experts saying that a body bomb containing as little as five ounces of PETN could “blow a considerable hole” in an airline’s skin, causing it to crash. “Total codswallop,” said Crump. As fans of the TV program MythBusters know, even blowing out a window in flight won’t create explosive decompression. The cabin will depressurize, but as long as the oxygen masks drop, people are likely to survive. “Remember that Southwest 737?” asks Crump. “The roof panel ripped partway off and they were fine. As long as you’ve got the pilots at the controls, and the plane’s got wings and a tail, it will still fly.”

  Most suicide bombers don’t achieve their goals via the explosives themselves. It’s shrapnel that kills people. The typical marketplace suicide bomb is packed with nails and ball bearings—things you can’t get past the airport metal detectors. To make a bomb that could bring down a plane, you’d need something that is, ounce for ounce, more explosive than TNT or C-4. Generally speaking, the more explosive the material, the more unstable it is. Trip and fall, or cough in the security line with a stomach full of TATP, and you may explode prematurely.

  Materials found at Osama bin Laden’s compound in Pakistan are said to have included a plan for surgically implanting a bomb in a terrorist’s body—“in the love handles,” according to an unnamed U.S. government source quoted on the Daily Be
ast. (Breast implants have also been tossed around as a possibility.) Crump has heard credible rumors of Al Qaeda physicians having tried out body implantation on animals. “But here again,” Crump said, “there are a lot of issues. How to detonate it. How to keep the body from absorbing most of the blast.” How to protect the explosives and the detonator from moisture.

  This was comforting, but only for a moment. “Really, why bother with all that?” Crump said. “With a bit of prior observation, I can generally figure out a way to avoid going through a body scanner at most international airports.”

  THE PREFERENCE IN California prisons for rectal smuggling is a little surprising given the preponderance of Latinos and African Americans—two populations that are, taken as a whole, somewhat less comfortable with homosexuality. Prison, I’m guessing, is a place where extenuating circumstances erode the stigma that otherwise attaches to extracurricular uses of the rectum.

  Rodriguez speaks freely about the situation in Avenal. Rather than antagonize gay inmates, he says, gang leaders tend to employ them. “We call them ‘vaults.’ If they’re reliable, the homies will approach them—‘Hey, check it out, you want to make some money?’”

  Everyone else has to practice to get up to speed. Rodriguez recalls his “cherry” assignment—the blades—as extremely painful. He says gang underlings are made to practice. I picture muscular, tattooed men puttering around the cell with soap bars or salt shakers on board. Lieutenant Parks showed me an 8 × 10 photograph of what he said was a practice item, one that landed the apprentice in Medical Services. Deodorant sticks had been pushed into either end of a cardboard toilet paper tube and wrapped in tape. “As you can see,” he said in his characteristic deadpan, “it’s a rather large piece.” (Rodriguez says it was hooped on a bet.)

  “To avoid anal laceration, dilation may have to be performed progressively over a period of several weeks or months.” This quote comes from a journal, but it is not a corrections industry journal or even an emergency medicine or proctology journal. It’s from the Journal of Homosexuality. A corrections or even a proctology journal would not have gone on, in the very next sentence, to say, “Rowan and Gillette (1978) have described the case of a man who derived sexual pleasure from inflating his rectum with a bicycle tire pump.” (As I did not pursue the reference, I remain ignorant of this man’s fate and whether he exceeded the recommended PSI of the human rectum.)

  Air and water (in the form of enemas) are the safest route to recreational distention because of the dependable ease of their removal. (An exception must be made for liquids that harden into solids. See “Rectal Impaction following Enema with Concrete Mix.”) Solid objects tend to “get away from you,” says gastroenterologist Mike Jones. “There’s lubricant on the object, on the hands, you’re in the throes of excitement and you’re trying to grab it, and it’s like, gone.” The ensuing panic makes it worse. Recall that anxiety causes clenching.

  In the words of Anna Dhody, the ghoulishly ebullient Mütter Museum curator, “Every hospital has an ass box.” The emergency medical literature is rife with case reports full of nouns you don’t expect to see in a journal: oil can, parsnip, cattle horn, umbrella handle. The verb of choice, by the way, is deliver. As in: “This suction must be broken to deliver such glass containers.” “A concrete cast of the rectum was delivered without incident.”

  One paper on the subject looked at thirty-five emergency room cases, all of them men. An explanation for the preponderance of males can be found in the aforementioned Journal of Homosexuality paper: “For males, dilation of the rectum . . . causes increasing pressure on the prostate gland and seminal vesicles, thus producing sensations that may be interpreted as sexual by some individuals.” (The author, or perhaps there are two by the same name, appears to be a man of divergent interests. I found a list of his books on Goodreads.com. Colorado above Treeline, the list begins. Life of a Soldier on the Western Frontier. And then, nestled between Medicine in the Old West and Exploring the Colorado High Country, was The Enema: A Textbook and Reference Manual.)

  Any discussion of the sexuality of the digestive tract must inevitably touch on the anus. Anal tissue is among the most densely enervated on the human body. It has to be. It requires a lot of information to do its job. The anus has to be able to tell what’s knocking at its door: Is it solid, liquid, or gas? And then selectively release either all of it or one part of it. The consequences of a misread are dire. As Mike Jones put it, “You don’t want to choose poorly.” People who understand anatomy are often cowed by the feats of the lowly anus. “Think of it,” said Robert Rosenbluth, a physician whose acquaintance I made at the start of this book. “No engineer could design something as multifunctional and fine-tuned as an anus. To call someone an asshole is really bragging him up.”

  The point I had been making is that nerve-rich tissue, regardless of its day-to-day function, tends to be an erogenous zone. Is it possible that these people who wind up in the emergency room are just folks whose anal play toys escaped into the interior?

  Some, perhaps, but not all. Anal sensitivity cannot explain the man with the lemon and the cold cream jar. It cannot explain 402 stones. It cannot explain brachioproctic eroticism.* Research done by sexologist Thomas Lowry in the 1980s confirms the existence of a separate and devoted group of people whose specific joy derives from the sensation of stretching or filling. Lowry sent me a copy of his paper and the questionnaire he’d used to gather his data. Item 12 was a drawing of an arm, with the instructions, “Indicate with a line the deepest you have been penetrated.” Suffice it to say that the anus, exquisitely sensitive though it may be, does not lie at the heart of these people’s passions. Suffice it to say that some people enjoy Exploring the Colorado High Country.

  Gustav Simon was the doctor for them. In 1873, Simon pioneered† the “high introduction” of a whole hand, “richly oiled,” into the rectum. This was done with the other hand pressed to the abdomen, to palpate the pelvic organs and check for abnormalities. (Gynecologists employ the method today, though typically hold themselves to two fingers.) Any resulting “pain in the parts,” Simon assured the reader, was fleeting.

  Mike Jones explains the arousal-by-stretching phenomenon by way of shared wiring. Defecation, orgasm, and arousal all fall under the purview of the sacral nerves. The massive vaginal stretch of childbirth sometimes produces orgasm, as can, at least in one diverting case study, defecation. Jeremy Agnew, in his 1985 paper “Some Anatomical and Physiological Aspects of Anal Sexual Practices,” wrote, “Contraction of the anus upon manipulation of the clitoris during physical examination is often observed by gynecologists.” Which kind of makes you wonder who Jeremy Agnew’s gynecologist was.

  I have a question, and forgive me in advance. If filling the rectum with stones or concrete or arms can be a direct flight to ecstasy, why is constipation so universally a misery? Or is it? Are there people who derive sexual gratification from self-manufactured filler? Is the urge to go ever complicated by the urge to come?

  I accosted William Whitehead with these questions. “A lot of visceral sensation seems to follow what’s been called a kind of Janus-faced function,” he managed—meaning pleasure and pain on different sides of the same head. He had sidestepped the constipation question. Not wishing to be a pain in the parts, I lobbed the question over to Mike Jones’s court.

  “I think that the difference is that constipation is very rarely a self-determined event.” What Jones was getting at, I believe, is that sexual arousal depends on the players and the circumstances. The difference between Ping-Pong balls and scybala is the difference between sexual intercourse and getting a Pap smear.

  Most fans of back-door activities probably enjoy a combo plate of rectal and anal sensations. Why else would someone have invented the anal violin? Agnew describes this unusual item as an ivory ball with catgut attached. “The ball is inserted into the rectum while a partner strokes the attached string with a type of violin bow, thus transmitting vibrations to the anal s
ensory end organs,” and puzzlement to the neighbors.

  I never asked Rodriguez my question about “masked anal manipulation.” (The term refers to gratification of anal carnality via seemingly nonsexual behaviors. It does not necessarily, though surely can, involve a Lone Ranger getup.) It seems to me no masking is needed: that men in prison can be fairly open about their anal intents. If a prisoner puts an iPhone up his rectum, it’s because he wants to use it or sell it. If, on the other hand, he puts a toilet brush up there, he is seeking something more ineffable. Rodriguez told me about this one. “They took him out on a gurney, man. The handle was sticking out.”

  I told Rodriguez about the 402 stones.

  “The rectum will stretch. Believe that.”

  THOUGH THERE HAS yet to be a case of a terrorist detonating a bomb in his alimentary canal, explosions inside the digestive tract are well documented. Flatus is mostly hydrogen, mixed with (in a third of us) methane. Both gases are flammable, a fact that occasionally becomes obvious in the endoscopy suite. As in volume 36 of the journal Endoscopy: “A loud explosion occurred in the colon immediately after the first spark induced by argon plasma coagulation.” And again in volume 39: “Immediately on starting to treat the first of these angiodysplasias with APC, a loud gas explosion took place.” And finally in Gastrointestinal Endoscopy, volume 67: “The authors reported that a loud gas explosion was heard during the treatment of the first of the angiodysplasias.” Intestinal gas is not always funny.

  * * *

  * Available in four languages, with minor modifications.The Portuguese edition, for instance, makes a distinction between the sausage of Types 2 and 3 (referred to as linguiça, a fatter German-style product) and that of Type 4, which is compared to salsicha (the more traditional wiener). The Bristol scale is, after all, a communication aid for physicians and patients. The more specific phrasing was undertaken “for better comprehension across Brazil.”