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I’m a Pediatric Urologist. Political Talk of “Bedwetting” Harms My Patients.

By Steve Hodges, M.D.

In my capacity as a pediatric urologist, I don’t have much to say about politics, except this: I wish political operatives and pundits would retire "bedwetting" from their professional discourse.

Headlines like "Democrats need to quit bedwetting" and "K-Street’ Is Bed-Wetting Over House Speaker Mike Johnson" aren't just resorting to cliche. They're perpetuating myths about actual bedwetting, nocturnal enuresis, a misunderstood medical condition for which children — my patients — are routinely blamed and shamed.

Political use of the term, popularized in 2008 by Barack Obama political advisor David Plouffe, apparently dates back at least to 1980, when the Modern Legal Glossary defined “bed wetters” as young Congressional Democrats “who panic easily when things don’t go their way.” “Bedwetting” even rates an entry in Taegan Goddard’s Political Dictionary, referring to “excessive worry about a political outcome.”

Why is this a problem? Because contrary to popular opinion, panic and worry do not cause bedwetting.

X-ray any child with enuresis, and you'll find a rectum enlarged by stool accumulation — in other words, chronic constipation. The stretched rectum aggravates the nearby bladder nerves, causing the bladder to contract forcefully and empty without warning, day or night. Anxiety and stress play no role.

But because society reflexively — and without evidence — associates bedwetting with stress, children with enuresis are routinely referred for mental health or behavioral counseling and other inappropriate "treatments," when all they need is a course of laxatives and suppositories. Many of these children end up depressed over a condition that is highly treatable but misconstrued by society and used as a laugh line by political pundits.

Every election cycle, "bedwetting" infiltrates the political media. I know this because I’ve set a Google Alert to track public perception of a condition I've treated for 20 years.

A few more examples:

•In a profile of a rare Democratic optimist, Simon Rosenberg, New York Times journalist Adam Nagourney described Rosenberg as "the voice of — well, whatever the opposite of bed-wetter is these days."

•Democratic strategist James Carville told CNN: "Democrats need to quit bedwetting. My Wife has already changed me to rubber sheets."

•The San Francisco Chronicle headlined, "Democrats are ‘bed-wetting’ even amid electoral wins. Is the anxiety justified?"

•On Pod Save America, co-host Jon Favreau said, "Here’s my thing on the bedwetting." A few weeks later, co-host Tommy Veitor said it was unfair to expect Democrats to "stop bedwetting" because "Everyone’s allowed to feel a little anxiety."

•New York Times columnist Michelle Cottle wrote that climate change “remains a favorite culture war cudgel for Republicans, slamming Democrats as a bunch of bed wetters wrecking the economy.”

•The Washington Monthly published "A short history of Democratic pre-election bed-wetting."

Pundits may think they're being funny when describing "Democratic bedwetting." In truth, they're reinforcing the assumption, internalized by many parents, that children could control their wetting accidents if they really wanted to, or if they just stopped being so anxious.

Some parents take these assumptions to unthinkable extremes. In addition to reading about the torture deaths of children with enuresis, I often hear directly from teens who are punished for their bedwetting. A 15-year-old honor student and athlete with enuresis told me his father had taken away his electronics and even his breakfast in order to teach him a lesson. "My dad screams about how I’m not a little kid anymore," the boy emailed. "He wants me to sleep in a wet mattress to learn what ‘discomfort is.’"

Political jokes about bedwetting don't help kids like that.

It's hardly just the political media that gets bedwetting wrong. The notion that enuresis has psychological roots has persisted for centuries and is pervasive in popular culture. In TV, film, and books, bedwetting portends psychological distress. Inevitably, the kid who wets the bed is the one neglected by Mom! (See: Borgen, Fleishman is in Trouble.)

Certainly many children with enuresis experience stress, anxiety, even serious depression and suicidal ideation. But that’s because these kids miss out on sleepovers and sports camps and live in terror that their friends will discover their pull-ups. Bedwetting causes anxiety, not the other way around.

The good news: Unlike the angst of political operatives, enuresis is entirely treatable. When the rectum is fully evacuated every day, it shrinks back to size. The bladder nerves recover. Wetting stops. Unfortunately, countless children miss out on effective treatment because adults presume they're just stressed out.

Every time political operatives scold their party for “bedwetting,” I think of my patients who have been scolded, blamed, teased, or punished for a condition that is totally beyond their control.

I try hard to persuade my patients that accidents are not their fault. When I hear pundits joke about "bedwetting," I resolve to try harder.


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