THE VIRILITY SOLUTION: MY JOURNEY INTO SEXUAL MEDICINE
The desperate need for a quick, effective solution for ED was brought home to me by the action of one of my patients. It’s a case that I cannot FORGET. Miles, a quiet man with a gentle manner, was in his late thirties when he first came to see me more than fifteen years ago. I met him when I treated his wife, Kathleen, for pneumonia. The father of three and very successful in his work, he was in fine health. His only complaint – if it could actually be called that—was of general fatigue. His zest for life , he told me, had waned.
Concerned that these were warning signs of a general depression,
I asked if his feelings were linked to any singular event or change in circumstance. His answer was an unemotional no; he said that he probably had been working too hard, and that it was getting to him. But over the course of his twice-a-year visits, his malaise never lifted. Eventually, I suggested that he consult a psychiatrist. But he didn’t feel it was necessary.
However, he did tell me something new. From time to time he had trouble getting an erection. I recited to him what I had been taught: his problem was in the realm of psychiatry, not internal medicine. I actually quoted the set-in-stone statistics that all doctors at the time knew by heart: “Almost 90 percent of sexual problems are psychological in nature.” With that, I offered the names of several highly regarded experts, and Miles said he would consider seeking out one of them. That was the first—and last—time that he ever mentioned his problem.
A few months after his visit, I received a frantic call from Kathleen, who asked me to meet her at the emergency room of a local hospital. Miles had taken an overdose of pills. When 1 arrived, the news was terrible. He had already died.
Eventually, Kathleen told me the series of events that led to this tragedy. The sad truth was that Miles took his own life, in part, because of a growing despondency over his inability to function sexually. Kathleen felt that losing his erections had led to diminished self-esteem and, ultimately, to a total loss of self. His sense of failure was so acute that he felt he could no longer be a father to his children, or a husband to his wife. His personal worth had been so devalued that for him, there was no other recourse.
Miles’s case haunted me for a long time. I wondered what pieces of the puzzle I had missed and how I could have intervened. He had told me that there was a lot of work-related stress in his life. Was that the cause of his ED, I wondered?
I realized that Miles was probably only one of millions of men who suffered alone. There had to be a way to bring help to those who needed it. But before that could happen, I had to find out everything I could about penile physiology, the workings of male sexual organs, and what the available treatments entailed. I consulted colleagues whose specialties were in urology, psychiatry, psychology, and sex therapy. I met with physicians who were treating patients suffering from prostate cancer and diabetes.
The first—and the most startling—thing I learned was that in addition to psychiatric treatment, there were only three, basic medical procedures to alleviate ED: vacuum erection therapy, penile injection therapy, and penile implant surgery.
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