5 March 2025

My weak bladder gives me an insight into the White House

Perhaps I have more in common with Donald Trump and Elon Musk than I thought.

In a pensive mood after listening to a Radio 4 programme about the dangers of ketamine abuse. In case you didn’t know, ketamine is a tranquillizer mainly given to horses, and, oddly, infants. (It was its veterinary usage that was the first jaw-dropping thing we learned about it. “A horse tranquillizer?” we would say, alarmed.) At higher dosages, though, as in when it’s used recreationally, it can lead to terrible bladder problems, and there are many teenagers around now who have to wear nappies, and will probably have to do so for the rest of their lives.

I first heard of it in the Nineties, when I was following the anarcho-rave collective Spiral Tribe for an article that never got published. The Tribe were an engaging bunch, but they’d taken so many drugs that ecstasy wasn’t having any effect on them. They also told me about DMT, a powerful hallucinogen which only lasted 15 minutes, but during that time you stepped into another reality. “You breathe it in, and then you’re breathing out butterflies,” said one, memorably.

Will Self once came round to my home and did an impression of someone on ketamine. He stalked around the kitchen like a praying mantis in slow motion. “Iiiit maaaakes you feeeeel liiiike thiiiis,” he said in a low, booming voice which scared the cat. “And,” he added in his normal voice, which also scared the cat, “it leads to severe dissociation, so that basically, you don’t even know you’re there.”

He didn’t mention the bladder problems, because people hadn’t been taking it for kicks that long. And the kicks from the drug didn’t sound remotely attractive in the first place. I decided to leave it well alone.

If it had been around in my early twenties, though, it would probably have been a different story. Hugely influenced by Hunter S Thompson, I was a big fan of the pharmacopoeia then – apart from heroin, wisely – and I considered it a waste of a weekend if I wasn’t off my nut on at least four different substances at once. I became a quite competent self-medicator; with the right training and inclination, I could have become an anaesthetist. No lasting damage: I think the fact that I was able to spell “pharmacopoeia” and “anaesthetist” just then without looking them up proves that I am still compos mentis. Heck, I can even spell “veterinary” today, and that one usually gives me a bit of trouble.

But if ketamine had been around then, would I have taken it? Let’s assume a yes, although it is by no means a given. I think I would, by now, be in nappies, and have been so for some time. For me, it would have been the recurrence of a childhood nightmare: for I had a weak bladder as a child, and I can’t say the experience didn’t leave a mark. I still remember the horror of a Cub Scouts meeting in a freezing church hall in Belsize Park in the Seventies, the pressure of the afternoon’s orange squash beginning to build up. Sitting cross-legged on the floor while a leathery old fraud taught us about knots, I realised I was too scared to put my hand up and ask to go to the loo. And so the inevitable happened: the first, uncontrollable burst, the spreading patch, the sensory insult of the damp, woollen shorts, and the blush of shame enveloping my cheeks. This happened more than once. I remember first encountering James Joyce when I read the opening of A Portrait of the Artist… It begins with an episode of enuresis, and I thought: Jimmy’s my man.

I wouldn’t have thought so much about it were it not for the fact that the current US president, Elon Musk, has, by his own admission, taken ketamine that’s been prescribed to him to help with his occasional “negative chemical mind state”. In an interview with the US journalist Don Lemon, Musk said he was only taking “like a small amount once every other week or something like that” – not enough to cause him any troubles Down There. But should the pressures of firing federal employees require him to increase his dose dramatically, there is surely at least some chance such issues might develop. Factor in the wild online rumours about Trump’s need for diapers – his former lawyer Michael Cohen joined in last year by calling him “Von ShitInPantz” – and could it be that, by the end of this presidential term, the world’s two most powerful people will be: 1) Someone who has poor control over his bladder, and 2) Someone who has poor control over his bowels?

We’ve been here before with Trump, of course, with the conjectured existence of the “pee tapes” from a Moscow hotel; it is funny how his administration is haunted by the cloaca. I wonder what Freud would have made of it. He had much to say about faeces; not so much, if I recall, about urine. For my part, it is possible that my experiences in that church hall have led to a certain diffidence when it comes to claiming authority; one loses confidence in even getting a badge on your arm saying you can put up a tent when you’ve soiled yourself in front of Akela and 50 of your peers. It makes one feel disqualified from high office. But not in Trump and Musk’s case. They are incapable of shame at every level. This is what we’re up against.