This section of the book is from the "How and When to Be Your Own Doctor" book, by Dr. Isabelle A. Moser with Steve Solomon, published in 1997.
The history of my own constipation, though it especially relates to a very rustic childhood, is typical of many people. I was also raised on a very constipating diet which consisted largely of processed cheese and crackers. Mine was accelerated by shyness, amplified by lack of comfortable facilities.
I spent my early years on the Canadian prairies, where everybody had an outhouse. The fancy modern versions are frequently seen on construction sites. These are chemical toilets, quiet different than the ones I was raised with because somebody or something mysteriously comes along, empties them and installs toilet paper. The ones I'm familiar with quickly developed a bad-smelling steaming mound in the center--or it was winter when the outhouse was so cold that everything froze almost before it hit the ground in the hole below. (And my rear end seemed to almost freeze to the seat!) The toilet paper was usually an out of season issue of Eatons mail order catalogue with crisp glossy paper. Perhaps it is a peculiarity of the north country, but at night there are always monsters lurking along the path to the outhouse, and darkness comes early and stays late.
When nature called and it was daylight, and there was no blizzard outside, the outhouse received a visit from me. If on the other hand, when it was dark (we had no electricity), and there was a cold wind creating huge banks of snow, I would 'just skip it,' because the alternative--an indoor chamber pot, white enamel with a lid--was worse. This potty had to be used more or less publicly because the bedrooms were shared and there was no indoor bathroom. I was always very modest about my private parts and private functions, and potty's were only used in emergencies, and usually with considerable embarrassment. No one ever explained to me that it was not good for me to retain fecal matter, and I never thought about it unless my movements became so hard that it was painful to eliminate.
Later in life, I continued this pattern of putting off bowel movements, even though outhouses and potties were a thing of the past. As a young adult I could always think of something more interesting to do than sitting on a pot, besides it was messy and sometimes accompanied by embarrassing sound effects which were definitely not romantic if I was in the company of a young man. During two pregnancies the tendency to constipation was aggravated by the weight of the fetus resting on an already sluggish bowel, and the discomfort of straining to pass my first hard bowel movement after childbirth with a torn perineum I won't forget.