San Francisco nurse Susan Wong is on a mission to break down the poo taboo and save the world from constipation, one viral video at a time.
For nearly 40 years, Wong, who lives near Ingleside Terrace, worked as a nurse at UCSF, where she helped transform the institution’s colorectal clinic beginning in 1999. She earned a reputation for her charm and ability to ease patients’ nerves coming in with problems ranging from off-color bowel movements to colon cancer. The “rear admiral” and the “butt whisperer” are just a few of the nicknames Wong wears like a badge of honor, and she’s also racked up several service awards for her work.
Patients and online viewers come to Wong with a wide range of gastrointestinal questions and problems: How many times should I poop in a day? Why does it hurt when I poop? What types of foods create the most gas?
Along with the help of her son Julien, Wong has recently taken her health education skills to a wider audience. First by starting a YouTube channel called Butt Talks TV where she provides advice and breaks down the basics of a healthy digestive system. The show has nearly 9,000 subscribers.
The Examiner recently sat down to plumb Wong for advice and get to know the hometown medical hero. This conversation has been lightly edited and trimmed for length.
Why are we all so disgusted by poop? And how do you approach breaking down the stigma around poop-related health issues?
I think we’re disgusted by poop because of first our reactions to it when we’re little. I talk in the book about toilet training, and how you feel about that. Did you have a positive experience or negative experience? How were you treated in preschool when you had to poop or pee? A lot of my work intersects with psychology.
Everybody has poop issues, and some linger longer than others. More than half of the human population is constipated. We don’t want people to brush away their problems. So I will point out some of the problems and present solutions. And I think wearing the lab coat kind of helps separate me as a health professional. You have to think of good visual stimulation.
What has internet fame been like?
There’s been a lot of positive feedback and there hasn’t been a whole lot of negative feedback. I think it’s just opening a line of communication because most people don’t know how to talk about this. When you use a Mr. Bean-style, then people can laugh about it. And they’re really laughing at themselves sometimes. Or they might have a revelation that this really pertains to them and maybe they should pay attention to this, or they might see someone else in their circle that could benefit from this information.
The other part of the power of social media is how much you can reach internationally. I couldn’t believe it. I answer a lot of the questions on Instagram, TikTok and YouTube from around the world. People in Romania, Thailand, Australia, Canada, Mexico … you name it.
But in terms of whether I get noticed on the street? Nah. Only one time. I like to be incognito; I’m not one who seeks attention.
Nurse Susan Wongs YouTube channel Butt Talks TV, where she posts new videos regularly. (Examiner screenshot)
Tell us about your book!
The book has a main fictitious character going through it — her name is Ella. She’s a hardworking young woman who isn’t taking good care of herself and has constipation. She goes through an array of symptoms. And then finally, she comes to a halt. She has to get examined because she can’t go on anymore. The book goes into some of the gastro physiology and how she’s eating. And I go into the history of food and how food has changed over the years. I talk about artificial sugar processing and how we’re eating processed food more, it’s not grown or picked immediately, and those foods have affected our gut. A fiber bar doesn’t substitute for fresh fiber, a protein bar doesn’t substitute for protein. I also give a lot of recipes and discuss things that we use for constipation, like fiber supplements and laxatives.
Stress also affects your gut, it just turns it off. And if you don’t get enough sleep, your body doesn’t turn down and rest to let the gut move. The character in the book had a lot of stress. I wrote it for laymen because it can’t be too lofty to deal with this.
How did you first get started in the field of health care?
There were a few avenues that brought me into nursing. My parents were from Hong Kong, so I often acted as the translator for my mother and had to go to the doctor’s office with her to help translate for my younger brother who had asthma. Our pediatrician was Chinese American, and her skills as a clinician, her poise and bedside manners were all so polished. She was just a very multifaceted, talented woman who spoke Cantonese and English. So that helped give me an insight into what a professional medical provider looks like. I didn’t know it at the time, but the skill of being able to speak a foreign language would play a major role in my adult life.
Growing up, my family ran a grocery store in Alameda and it was all hands on deck. I learned very early on how to break change, so my math skills sharpened. And since I had to work at the store, I had very little free time to play. I was reading a lot. My escape was going to a library. I knew I didn’t want to go into a family business, that was a nightmare for me. But my mother did endorse going to school and getting an education.
I actually came into my own personal journey when I was looking for birth control as a college student. I knew that that was something that I had to learn about quickly because the hormones are just stirring, going crazy. I went to Planned Parenthood, and there again, a wonderful health educator who happened to be a nurse talked to me about condoms. Condoms were at the time coming in vogue with all these colors, styles and textures. It was quite a different outlook from what I was used to. I was expecting something very boring and matter-of-fact. But when the nurse presented it to me, it was very light and there was no stigma attached. I felt empowered by that visit, and I actually bought condoms for myself.
What was it like entering UCSF at that time?
I was one of five Chinese American women who also had Cantonese as a second language. I used my language skills to serve Chinatown, North Beach and South of Market, and it was really helpful. At the time, my grandfather lived in Chinatown. So I knew how there is the tourist side of Chinatown and then there is the ‘behind-the-scenes’ Chinatown, the real down-to-earth side where the Chinese lived. For my project for the public health program I was in, I took photos of that. The ladies making dim sum and people just doing their work. Living and sharing a bathroom down the hall with multiple apartments on the same floor.
UCSF prepared me quite well for my career outside after I graduated. We had a six-month training called area of concentration, and I focused on pediatrics. So there I learned a lot about play therapy, music and art, and talking to children about their illnesses. I worked with children of many ages and with many types of diseases and illnesses.
So you’ll notice in Butt Talks TV, it’s playful and it’s educational. Throughout my career, whether it was in the operating room, dialysis or inpatient, I saw how education plays a major factor in medicine.
What advice can you give our readers about how to have better poops?
Definitely try to eat a balanced diet, including fruits and vegetables. And hydration is also very, very important. Here (in the U.S.) we have a diet that is high in starch and protein and some water. And we’re not always using vegetables and fruits. And we’re not even eating grains. So those things are important to kind of keep the flora in the gut going. And to also make the food leave our system quicker so we don’t have that bacteria buildup.
Of course, there are people who can’t afford all that. I would often speak to patients on food stamps. But there are options. Oatmeal can store in the pantry; dry fruits like raisins and frozen fruits and vegetables all still count. You could buy foods that store a little longer like carrots, celery, cabbage, to kind of keep it around longer if you can’t go to the store all the time. Cans of beans and dry grains. Just put that into people’s minds and say, hey, you know, here are a few things that you can do.
