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10 October 2018updated 05 Oct 2023 8:32am

What the gut knows

Horrifying, mysterious and sentient, our guts are the link between life and death – and if we understood their power we might be happier

By Naomi Alderman

The proximity of the anus to the genitals, Freud tells us, is the source of much if not all human neurosis. It’s fashionable to distance oneself from Freud these days, to say “I wouldn’t go that far” and “of course Freud was sex-obsessed”. But I would go that far, and most humans are sex-obsessed.

The gut, frankly, is a problem. What it does is not only mysterious and puzzling – as are all our internal organs – but also difficult for us to bear. And when we start to think about the symbolism of the gut, we might understand what Freud meant.

At one end of the gut is the mouth – a delightful place of many different kinds of joy. At the other end, there’s the anus. It produces farts, which stink of decay and poison. It makes poo, also sometimes foul-smelling, bearing disease, a sticky contaminant. And it comes out of us! And not just out of our own bodies, but out of a hole right next to the parts of the body that can give us great pleasure, whose development indicates adulthood, which can produce new life. It’s like a terrible joke played by human biology, to drag us down from the heights to the depths, to remind us that whatever ecstasy we find, we’re also, essentially and at all times, full of shit. This is why poo is so funny. This is why we have to laugh at it. If we didn’t laugh, we’d cry.

For Ernest Becker, author of the Pulitzer Prize-winning book The Denial of Death, the anus and the shit it produces are more than just a joke – they’re a terror. They represent the corruption of the flesh, the fate that awaits us all. “What am I?” a child might ask herself. “I am a thing which takes in beautiful, glowing, healthy, delicious, colourful, exciting food. And then what happens? I turn it into shit.” This is the inevitability of decay writ small, writ daily. It is the inevitability of death. “The anus and its incomprehensible, repulsive product,” says Becker, “represents not only physical determinism and boundness, but the fate as well of all that is physical: decay and death.”

The three-year-old daughter of a friend asked her mother what happens to the food she eats. “Your body takes energy from it and then you turn it into poo,” replied the mother. Her daughter’s crying was inconsolable. “No mummy, no no,” she kept saying, “no no no.” It is the same cry as in Julian Barnes’s Nothing to Be Frightened Of, when he recounts his thanatophobia – fear of death – as he wakes in the night, “alone, utterly alone, beating pillow with fist and shouting ‘Oh no, Oh No, OH NO’ in an endless wail”. The mouth, the anus, the intestines between them, transforming beauty to rot and deliciousness to disgust. It is in here that the rubber meets the road in our relationships with our bodies – where we come daily face to face with the corruption and decay that is our eventual inheritance. Bodies are mysterious, we are puzzles to ourselves. But it’s here in the intestines that the obvious mystery is most apparent. If I can do this to food, what on Earth am I?

When I was in my early twenties, my mother, then in her mid-fifties, was rushed to hospital with a burst intestine. The reasons for the rupture have never been particularly clear. Perhaps it was an infection in a fissure in the gut. Perhaps it was a weakness caused by the Caesarean through which I was born, years earlier. Perhaps something else entirely. She had to have a colostomy bag for 18 months, while her bowel healed; there’s an experience to bring a family face to face with the realities of the workings of the gut. My mother’s mother had also experienced some kind of ruptured bowel in her mid-fifties. I stare at my stomach and wonder what it has in store for me.

But that’s not all. If the story of my family were written by a novelist, one might say that the symbolism around the stomach and the bowel and the process of digestion was just a little overdone, just a bit too obvious. A close relative was born with pyloric stenosis – one of the sphincters in his stomach wouldn’t open – and his earliest days were long bouts of dramatic projectile vomiting while his mother tried to persuade the doctor that something was really wrong. He had to be operated on when he was only a few days old, just a tiny baby with a great long scar across his abdomen.

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And these refusals of the stomach are only one side of the story. There are also the stomachs that are too welcoming, too efficient, too delighted to accept nutrition. I’m fat. My father is fat. My grandmother was fat. My aunt was fat, until she became a Weight Watchers leader. Our family stories are wound in a tight nexus around eating and not eating, digesting and not digesting, wondering how to get food to go through the body well, or how to stop it.

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I don’t just think it’s my family. Culturally, we are obsessed with food and diets. We create ever more luxurious constructions of fat and sugar – anyone fancy a cronut, an arrangement of buttery croissant pastry fried like a doughnut? But at the same time we come up with ever more punishing dietary regimes, everything from fasting two days a week to cutting up healthy stomachs because we find fatness, now, so culturally unacceptable. We watch celebrity chefs on television drizzling chocolate sauce or honey or butter, and associate food with sex from Jamie Oliver’s cheeky Naked Chef to Nigella’s flirtatious looks and Gordon Ramsay stripping off at the start of The F Word. At the same time eating disorders are on the rise, and our beauty ideal becomes thinner and thinner, fuelled by Photoshop, when real human bodies don’t look thin enough. Last year there was an 8 per cent rise in young people being admitted to hospital with eating disorders in the UK.

We are worried about food, about digestion, about our stomachs. The intestine is the seat of our anxiety. And our anxieties are meaningful. To be anxious about something is to be obsessed with it. If you have constant anxious thoughts about a topic it’s because, on some level, you are enjoying thinking about it. What is it about food and eating that gives such satisfaction in contemplation? I suspect that it has something to do with Thanatos. It’s been remarked before that the Victorians were obsessed with death, but couldn’t bear to talk about sex, and we are the other way around. We talk about food and about youth and about sex. The starts of things. We live in those beginnings, as if it could be the first day of spring forever.

If we keep on worrying about food – am I eating enough, or too much, is it the right sort? – we can just flush our shit away in a clean tide of water and never think about it, or what it represents, again. If we focus on youth, we can send our elderly to nursing homes and not have to look at them or think about them. If we’re always talking about sex, the beginning of everything, there won’t be room for death: the end of it all. Is it possible, therefore, to be delighted by shit? And might we do better as a society and as individuals if we worked out how? I suspect it is, and I suspect that a full appreciation of the workings of our own horrifying poo machine, the intestine, could lead us in good directions in this enterprise.

Of course, shit can be delightful, as anyone who’s ever suffered from constipation will affirm. My brother and his wife recently had a baby girl, making me an aunt for the first time. They’ve been so thrilled, we’ve all been thrilled, when she’s done a long and healthy poo. Pooing means everything’s working right. Inflow, outflow. Pooing means: this is how it’s supposed to go. Death, at least when it comes at the end of a long and useful life, means the same thing. It might be that nature knows what it’s doing; it might be that the process of decay, utterly out of our hands, has some beauty to it.

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Contemplating the wonderful things that “nature” knows, and that we have no idea about, might be a good point to introduce the neurons in your stomach and the nature of the mass of bacteria living in your gut. Did you know that you have brain cells in your stomach? They cover the walls of your gut. You have as many neurons in your digestive tract as a cat has in its head. Think of all the things a cat knows: what’s nice and what’s nasty, who to trust and who to steer clear of, where good food comes from and how to hunt it down. That’s the kind of thing your stomach might know. No wonder we talk about a “gut instinct”.

The neurons in the gut are connected directly to the brain via the vagus nerve, which enters your brain right next to the parts that deal with emotions. The stomach can seem to know things that we don’t know ourselves. Experiments have been done in which people are fed food through a tube – they cannot taste or smell or chew it, but the entry of their favourite foods into their stomachs makes them predictably happier than some equally nutritious slurry. Your stomach knows things. You get butterflies in your stomach because those neurons down there have some idea about what’s going on.

There are parts of ourselves which we cannot access. In her memoir The Shaking Woman, Siri Hustvedt writes of a sense of duality she experiences when in the grip of a shaking fit. She has “a powerful sense of an ‘I’ and an uncontrollable other”. Our bodies, full of intelligence, our stomachs, full of neurons, are in some sense other “selves” within us, communicating with the brain but not fully part of it.

There’s an even more real “uncontrollable other” within the gut, though. We think of ourselves as single, unitary, contained within this envelope of flesh; everything inside the outline of our skin is “us”. And yet. Your gut contains a “microbiome” – an ecological community of micro-organisms. They’re the “good bacteria” so beloved of adverts for probiotic yogurt. The cells of our gut flora are much smaller than the cells of our own tissue – so much so that we actually contain more gut flora cells than human body cells. If I were to hold a referendum inside my skin with each cell getting a vote, I wouldn’t come close to taking office.

And that analogy isn’t as ridiculous as it sounds. Gut flora can influence mood and health – everything from depression to rheumatoid arthritis can be improved by increasing the variety of flora in the gut (our guts, apparently, would like to be a proportional-representation government, the more variety the better).

Our gut flora can release hormones which encourage us to eat more of the food they like. Moreover, we’ve only been able to culture about 5 per cent of the flora in the gut. We have no idea what the other 95 per cent are. All you can get in your probiotic drinks are that measly 5 per cent – for the rest, you’ll have to wait until we’ve gene-sequenced the missing gut flora, a process which is ongoing. Or, if in dire straits, you might consider a faecal transplant, which is exactly what you think it is. Miracle cures have been achieved by inserting the poo of one person with a “golden stool” into the gut of another, via a drip or a faecal enema. The new colonies of bacteria grow, and the recipients of the transplant start to feel better – it’s worked on a range of conditions including rheumatoid arthritis and killer bacteria C. difficile. But don’t try this at home.

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The point is that what’s going on inside our intestines is far more complex and far more intelligent than we imagine when we look at our stool and think “how did that come out of me?” The labyrinthine and beautiful arrangement of intestine sitting in the centres of our bodies has a brain, and our internal neighbours have desires.

And this is comforting regarding our major issue, Thanatos, too. I do not know how to digest food, but my intestine has it covered – as well as some thoughts on how anxious certain situations and people make it feel. I may not know how to die, but my body’s got it covered. The French thinker Michel de Montaigne, the inventor of the essay, took a bad tumble from a horse and almost died of the resulting injuries. While his friends were horrified to see him clawing at his clothes and apparently in agony, he experienced a blissful, easy sensation. When he recovered, he wrote of his brush with death: “If you don’t know how to die, don’t worry; Nature will tell you what to do on the spot, fully and adequately. She will do this job perfectly for you; don’t bother your head about it.”

From our cultural food neuroses we can learn that we’re obsessed with beginnings, not endings. That we are troubled by the apparent limitlessness of our own desires – stoked by consumer capitalism. And that, although we know we’ll eventually turn everything to shit, we don’t want to think about it. But perhaps what we need is that thing so little discussed in modern Western society – a little faith. We may not know how to make our poo, but our stomachs do. We might not understand how to die, but our bodies will get us through. We know more than we think. And we don’t have to know it, to know it.

Naomi Alderman’s novels include “The Power”

“Beneath the Skin: Great Writers on the Body” is published by Profile Books and Wellcome Collection (£12.99)

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This article appears in the 10 Oct 2018 issue of the New Statesman, How austerity broke Britain