At any given time, about five percent of men and nine percent of women, just like you and me, suffer from incontinence. This means that they cannot hold their urine or feces until they reach a bathroom. In other words, that affects one in twenty men and one in ten women. Incontinence in adults can be caused by old age, injury, neuromuscular disorders, and cancer, to name some of the more common causes.

As a forty-year veteran of the medical field, I thought I had a good grasp of the causes and impact of incontinence. But when I was diagnosed with cancer, I was forced to confront my own internalized stigma around this health condition. It was a humbling experience, to put it mildly. I found myself grappling with feelings of embarrassment, shame, and even a sense of betrayal by my own body.

During the last eight years of my father’s life, I must admit that I judged his bathroom habits. Not because he was incontinent, but because he refused to accept this fact about himself. His preoccupation with finding a bathroom was a constant in our lives. Every car ride was a strategic mission, planned around our relative distance from rest stops. His refusal to use absorbent briefs was a testament to his pride and his aversion to being seen as weak.

“Why do you not just wear absorbent briefs?” I asked him impatiently many times, using the euphemism for adult diapers. “I think you would feel so much freer if you did not have to worry about being near a bathroom all the time.”

My father resolutely refused. He was a proud man and not a fan of weakness. In fact, that was another reason I judged him. Throughout my life, I had seen him to be unmerciful to those he deemed weak or dependent. The memory of him looking down on others in their challenges made me see his own moments of weakness, like karma or hypocrisy. But would I have behaved differently in his place? This question, more than any other, taught me the importance of empathy.

Yet would I have behaved differently in his place? When he finally agreed to wear absorbent briefs, I was embarrassed to be seen buying them at the pharmacy. “These are for my father,” I would say at the cash register, loud enough for everyone nearby to hear. “Old age really does a number on you, you know?” I quipped.

If you knew my father, it would not have been hard to understand the roots of my attitude. He was a man for whom no one was ever enough, not me or himself. Looking around today, I see him as a mirror of a culture in which unrealistic standards of perfection are expected and glorified, a culture in which admitting difficulty or need is often seen as an admission of failure.

Even now, we are seeing a global rise in blaming people for their illnesses and disabilities. This is what my psychology professors would call “defensivism bias”: a story concocted by the mind that if you do all the right things, you will not experience difficulty or need. For this to be true, those who experience misfortune must have failed in some essential way. They must have fallen into a trap you, by virtue of hard work, can avoid.

My own fear of weakness manifested itself as I approached middle age. I became a fitness fanatic, taking pride in winning amateur fitness competitions and offering advice on marathon training on social media. As a doctor, I took excruciating care not to judge my patients or others. But like most people, I judged myself far more harshly than others. My athletic achievements only served to whisper that I was not enough.

So, I experienced a level of horror to find myself in exactly my father’s situation recently. I had been diagnosed with prostate cancer and, after surgery to remove the cancerous tissue, urinary continence was not an option for the near future. Let alone fitness competitions or marathons! I was unceremoniously sidelined and forced to grapple with my personal demons.

My cancer diagnosis was humbling in many ways. Accustomed to being the physician, I now received care from medical staff who sometimes clearly did not know who I was. For the first time in my adult life, my ability to work was taken away when I developed complications after the surgery. I experienced excruciating pain that made me reconsider whether life was still worth living until the cause of the pain was eliminated.

And there were the Depends®.

As a doctor, I understood that this situation was unavoidable. However, pieces of me were missing. The outlook made it very unlikely that the plumbing would work correctly, at least not in the short term.

I found myself struggling to accept that I also needed absorbent briefs. And I wondered if this was what every patient experienced. How many of us say, “That is fine for someone else, but not for me?”

The thought that some of the patients I saw routinely may face this situation troubled me profoundly. What could I do about this?

It was a moment of reckoning for me when I realized I had been a hypocrite. I had encouraged my father to wear absorbent briefs, yet I had disclaimed ownership of them in the pharmacy line. Our culture needs a fundamental shift in this regard. We need to start addressing the stigma around incontinence directly, and I was ready to be a part of that change.

I found inspiration in Deion Sanders, a Hall of Fame athlete renowned for his remarkable careers in both the NFL and MLB. He had stepped into the spotlight outside of sports as an advocate for incontinence awareness, lending his image of ultimate strength and skill to the brand. I realized that Sanders’s vocal advocacy for the benefits of absorbent briefs was precisely what I needed. And exactly what I now wanted to commit myself to.

The stigma around incontinence would never fall away until “Depends” could be spoken in the same breath as strength, skill, and perhaps even sexiness. It is time for a change. People like me and my patients would never internalize the idea that wearing adult diapers did not undermine us as people until we saw more people we admired discussing their own use of this type of product. Let us be the change we want to see.

I am no Deion Sanders. I am no Hall of Fame athlete and indeed no household name. However, I had spent over a decade cultivating my image as a fitness enthusiast and marathon runner, in addition to being a doctor who advises on physical and mental health.

I therefore sat at my keyboard to send a different message to my social and professional networks. It was time to do what needed to be done, and in the process, heal something that had been broken for a long time. “I want to share a personal journey,” I typed tremblingly. “It has changed my perception of many things, including dignity and health …” As I finished my first explanation of my journey with Depends, my fingers hovered over the “Post” button. I pressed it and prayed that whoever needed this post would see it.

Francisco M. Torres is an interventional physiatrist specializing in diagnosing and treating patients with spine-related pain syndromes. He is certified by the American Board of Physical Medicine and Rehabilitation and the American Board of Pain Medicine and can be reached at Florida Spine Institute and Wellness. 

Dr. Torres was born in Spain and grew up in Puerto Rico. He graduated from the University of Puerto Rico School of Medicine. Dr. Torres performed his physical medicine and rehabilitation residency at the Veterans Administration Hospital in San Juan before completing a musculoskeletal fellowship at Louisiana State University Medical Center in New Orleans. He served three years as a clinical instructor of medicine and assistant professor at LSU before joining Florida Spine Institute in Clearwater, Florida, where he is the medical director of the Wellness Program.

Dr. Torres is an interventional physiatrist specializing in diagnosing and treating patients with spine-related pain syndromes. He is certified by the American Board of Physical Medicine and Rehabilitation and the American Board of Pain Medicine. He is a prolific writer and primarily interested in preventative medicine. He works with all of his patients to promote overall wellness.