The challenge, as I remember it, is getting them to this place, not what happens once they’re here. And Erica is here. We’re in my bed doing the sweaty grapple. I like her, and although we’ve just met, I’m surprised and excited that it’s gone this far. She’s older than me, a sex columnist, more successful, and besides that, she has long blonde hair and tight leather jeans. Anyway, she looks good.
But there’s a problem. For all the kissing and rubbing, the bump and the jeans-on-jeans grind, I’m not getting hard. She tongues my ear, flexes her hips, stretches her fingers to explore my chest. But something is wrong – and if I notice, then so must she. Our foreplay becomes a game of hide-and-go-seek, with her reaching for me, and me twisting away.
I exhale heartily, feigning pleasure. Finally, when our jeans wind up balled on the side of my bed, there is no escaping what’s not there. “Is there something you’d like me to do?” Erica asks. But it isn’t her. There is nothing I want her to do. All I want is for her to be pleased. All I want is for this to be over.
“No, I’m sorry, you’re great, just keep doing what you’re doing,” I say. All I can do is buy time, and after about six more minutes, as we search for a Kimono, my concern blossoms into full-fledged panic. I’m 26 years old! Inside the condom, I’m a size-4 shoe in a size-16 boot. What the fuck is the matter with me?
I can penetrate, but only perfunctorily, so when she begins raising the volume of her exhaled breaths, of course I assume that she’s faking now, too. I’m thinking too much, enjoying too little, seeing what’s happening from above, as if I were at Madison Square Garden watching someone else performing onstage. Erica gets on top, writhing, gaining speed and momentum as she works herself up. I’m punch-drunk, thawing; paralyzed and deflated, with my eyes wide open, hands clenched at my thighs and as she jackhammers away, I’m mentally two steps past her, planning my apology for when she’s through. I’m worried about what she’s going to say to her friends. I’m worried about what she’s going to write in her column. I’m worried that – Oh, my God – this might happen again.
In fact, it does. And not just to me. Doctors say that more 21-to-31-year-olds in Manhattan are complaining about erectile dysfunction – ED – than they’ve ever seen before. I know this because after a couple of stagnant nights with Erica turned into a few weeks and then several months, I started making frantic calls – to doctors, all of my friends, an ex-girlfriend, and even Bob Dole. Andrew McCullough, a midtown urologist, says he’s seeing twice as many guys under 30 complaining about ED than even four years ago, when Viagra was introduced. “Maybe I’d see three young guys a week,” he says. “Now it’s more like six or seven.” Urologist Laurence A. Levine says he has seen an 800 percent increase in his patients under 40 in those same four years. And Ursula Ofman, a clinical psychologist and sex therapist, says a third of her patients are young men.
What’s going on here? “The reason is simple,” says McCullough. “It’s the anxiety and expectations of living in New York. Add to that the attention surrounding Monica and Bill and the advent of Viagra, and people are complaining about ED because there’s an increase in sexual awareness.”
Another way of looking at this is: It’s Samantha’s fault. The Sex and the City vixen’s craving for size, for novelty, for frequency, for orgasm on demand raised – or actually lowered – the bar for New York men like me. Faced with a city of women who now consider satisfaction to be their birthright, many of us have developed chronic performance anxiety. Or maybe men want to be loved for themselves, not their sexual characteristics.
“Every girlfriend I have has experienced this,” says Kathy, who is 25 and one of my best friends. “What’s surprising isn’t that it’s happening – it’s when a relationship can survive.”
My friend Bobby, 26, who lives in Gramercy Park and hasn’t had sex with his girlfriend in three months, thinks we’ll be fine. And Michael, 27, who admits that “half the time I have sex, something goes wrong,” believes we’ll work it out.
I appreciate their confidence, but I need to understand why I don’t work. I’ve worked in the past. And sometimes I work now. Why aren’t I working more often?
It isn’t easy making an appointment with a doctor when you work in a cubicle. Not because the doctor is busy, but because your co-workers aren’t. For my insurance to pay for a specialist, I’ll need a referral from my primary-care physician – and, of course, his business hours are the same as mine. “What’s the reason for your visit?” his secretary asks. “I’m having a problem sustaining an erection,” I answer through clenched teeth. Eyebrows arch to my left and my right.
My doctor is Irish, a redheaded Russell Crowe type who wears a wedding band and looks like he belongs on a rugby field, not the other side of a desk listening to me whine about my penis. He draws blood to measure my testosterone. But then a funny thing happens on my way to telling him about Erica. He tells me about Nicole.
“Once, I traveled to England to meet this girl, Nicole,” he says. “Man, she was hot.” He kicks his feet onto his desk – mud-colored Cole Haan shoes and mauve socks – and contemplatively locks his hands behind his head. “I get there, right? And things are going nicely – dinner, dancing, the works. But when we got home that night … I couldn’t perform. God, I felt like an asshole.” I’m on the edge of my seat. So what did you do? “What could I do?” he says sadly, frowning. “I waited out the trip and never saw her again.”
An erection is caused by the oxygenated blood flow to the penis. When a man is sexually aroused, the blood flows faster, which stretches the muscle fibers and causes the penis to enlarge. All sorts of things can screw that up: prostate cancer, bike riding, a bad day on Wall Street. I’m not sure what my problem is. I don’t even like riding bikes. I don’t feel acutely stressed out, but I do drink, and I smoke, so I don’t know, maybe I am . . .
At this point, I’m willing to believe everything, try anything, because Erica and I are just barely surviving. We’ve been together for about six weeks, and I still haven’t been able to get a regular, sustained erection. I don’t even like to be around her because I know where the night will end. This leads to premature evacuation. She begins to think I don’t like her. I haven’t told my mom or dad, but Erica and I have discussed it to death: Bad sex, as a topic for a sex columnist, never seems to get old. Sex has become a battle pitting me against myself, and I’m getting my ass kicked all over Mulberry Street.
When my testosterone test comes back, the results are “normal low.” I have no idea what the numbers mean (my prolactin is 3.4 out of a 3.0 to 19.0 range; my TSH is 2.35 uIU/mL out of a .40 to 5.50 range), but my doctor dismisses me over the phone with a final “You’re fine.” I’m disappointed. I don’t feel fine; I feel soft. I’ve had years of good-if-not-great sex. Okay, sometimes I’m quick on the trigger, but even if I wasn’t always fantastic, at least I was functional. “Normal low?” Normal, I understand. “Normal low” sounds un-normal, abnormal. It sounds no good at all. After a few more badgering phone calls, he refers me to Jed Kaminetsky, a Lexington Avenue erectionologist I’d told him I wanted to see.
Even Kaminetsky’s waiting room is humiliating. One of his five secretaries hands me the standard doctor-issue paper cup to pee in, and there’s a line to the small bathroom. When I get in, the age-spotted men talking testes in the john block my passageway to the sink. It’s all I can do not to run out of his office.
After setting the cup on a tray full of them, I am handed a questionnaire, and the pain begins. “What’s the reason for your visit?” Erectile dysfunction. “How long has it been since your penis functioned the way you think it should?” Fluctuates. “Are there any positional variations in your ability to obtain or maintain an erection?” Jesus Christ, I don’t know. “Please circle the number which best describes the quality of your erection with self-masturbation,” the questionnaire goes on. “Do you have any curvature on the penis with erection?” And on: “Do you have trouble with ejaculation?” And on: “Please circle the number which best describes the quality of your erections when your partner stimulates you orally.” (This on a small graph with numbers from 1 – none – to 10 – rigid.)
Kaminetsky is a little man with big hair and a blue Viagra paperweight on his desk. His assistant, Betsy, has a framed picture of her Dalmatian mounted on a block of Viagra notepads. Though primary-care physicians write most Viagra prescriptions, it isn’t difficult to deduce that Kaminetsky has done his bit for Pfizer, the maker of the drug. He draws more blood, takes more tests, including one extremely unpleasant probe involving a rubber glove and a Vaseline swab. I’m not sure what Kaminetsky is looking for that my regular doctor couldn’t find, but the end result is his prescribing a nocturnal-penile-tumescence machine called a RigiScan.
The RigiScan does what its name implies – it scans the penis for rigidity, recording my erections during the course of the night. The average sleeping man has three to six erections, each lasting as long as 60 minutes. If you’re having no problem sustaining an unconscious hard-on, the thinking goes, the problem must be mental, not physical.
There are three parts to the RigiScan. The clunkiest piece is the white plastic computer – it looks something like a Wet Tunes shower radio – that takes the readings; it weighs about three pounds, requires six nine-volt batteries, and gets Velcro’d from my knee to the top of my thigh. Two wires plug into the computer, ending in two loops that lasso my penis – one at the tip, one at the base. The loops expand and contract every fifteen seconds. This circuit measures and records erections, then the doctor downloads the results. There is to be no alcohol or ejaculating prior to strapping myself into the RigiScan, which I’m to use for four consecutive nights, the last one preceded by a dose of Viagra.
The RigiScan feels like an electronic boa constrictor that pulses every fifteen seconds and squeezes with a grip I imagine Derek Jeter might use on his Louisville Slugger. Between blasts, which aren’t hard enough to hurt and are too mechanical to feel good, I lie awake, bracing for the next clamp.
Kaminetsky’s gut tells him my problems are mental, not physical. But my biggest erection problem tonight is that I’m strapped into this fucking machine. I can’t sleep a wink. To take a piss involves disassembling the network, turning on the lights, and then, once I’m wide awake, putting my penis back into the vise. You try falling asleep after that. It will be ten days before I use it again.
Kaminetsky has given me three Viagra pills. I give one to my dad, and I need only one for the RigiScan, so the indomitably curious Erica and I decide to test making love after I pop the third one and we share a bottle of red wine. We look forward to it like payday.
But I don’t like Viagra. You know how when you have a headache and you take a Tylenol, you can’t feel it do anything? Viagra is the opposite of that. You take the pill, then shoot up in the air like someone’s stomped on the tail of your skateboard. I walk around my small apartment with an aching erection the size of a Poland Springs water bottle. The last thing you want to do is make love with an erection like that. My penis feels as if there were a weight attached to it, like it wants to drop, but the medicine won’t let it. It feels disconnected from the rest of my body, like a prosthetic arm or a remote-controlled robot with somebody else in command. But this is our make-or-break moment, and Erica and I make love on my floor. It’s a science project – a missionary, joyless affair.
“I’m never doing that again,” I say when it’s over.
“Bullshit,” she says.
It took me more than a month to use the RigiScan four times, and by then, of course, Erica and I had broken up. To celebrate my 27th birthday, my 53-year-old father, his two brothers from the Lower East Side, and my 16-year-old cousin took me out for a sangria-fueled dinner in Chelsea. My father had come in from Potomac, Maryland, to surprise me. He couldn’t have imagined the surprise I had waiting for him. This is why I called former Senator Bob Dole: I needed some help in breaking the news. “Your dad is younger than I am,” he said. “Be honest. When I did the Pfizer spot, I knew I’d catch flak. But it’s more important to get the word out. To help people. So I said, ‘Okay, let her rip.’ Your dad will understand.” He paused a beat, and added, “It’s your mom I might not tell.” And so I told Mom about breaking up with Erica; I told Dad about my ED.
“Your grandfather would roll over in his grave!” he said at my birthday dinner. Grandpa Matthew was a fur trader, a Polish immigrant whose pinochle-playing friends flooded his Knickerbocker Village apartment with tequila and cigar smoke. His three sons – Kenny, a court clerk; Chet, a music teacher; and Lester, my father, who works with the Housing Opportunities Commission in Washington, D.C. – were liberal family men, but still gruff: The air-conditioning drip didn’t fall far from the fire escape. My father broke the long silence: “You mean you have a problem with your prick?”
“I don’t know what the problem is,” I said. They were drop-jawed, silent, staring at me as if I’d sprouted eight heads or just told them I was gay. My cousin couldn’t understand. But then a strange thing happened. My dad said, “The truth is, I remember your grandfather telling me about when it happened to him.” He smiled, and then he added, “I also remember when it happened to me.” And so the conversation went, everyone clamoring for an opportunity to tell about the time he couldn’t get it up.
“I think the number of young men complaining about erectile dysfunction caught doctors by surprise,” says Ed Laumann, a physician and supervisor of The National Health and Social Life Survey, the bible of erectile dysfunction. “We did a population survey in 1999, and 7 percent of 30-year-old men said they suffered from ED for at least two months in a row. Now, young people aren’t rushing up saying, ‘I’m impotent!,’ and I think this could be underreported by about 30 percent.” And that is young men suffering ED for at least two months. That excludes the whiskey-dicked, the Mister Softees who can’t get hard on a shame-inducing Saturday night. Two years ago, Laumann conducted a test in China, adding the word intermittent to the questionnaire and again asking 30-year-old men if they’d experienced ED: Over 35 percent answered yes. That could mean up to 65 percent of 30-year-old men experienced episodic ED in the past year. But no one is studying this, and we aren’t speaking out. Nobody wants to admit it.
“Everyone keeps erectile dysfunction private because it relates to their self-esteem,” Laumann says. “Young men aren’t coming forward because of their egos – but I think that’s beginning to change.” Evidently, Pfizer does not. It repeatedly ignored interview requests for this story. Perhaps this is because it has been widely reportedly that men (and sometimes women) are taking Viagra, its $1.2 billion–a–year drug, for recreational purposes. Whatever the case, Pfizer recently commissioned Laumann to conduct a national erectile-dysfunction poll, and the age demographics begin at 40. If the leader of the erectile-dysfunctionary revolution doesn’t want to help my demographic, where is a young man to look?
“Sex for life!!” reads the advertisement in the Daily News for the Boston Medical Group, on 37th Street near Second Avenue. ERECTION PROBLEMS? PREMATURE EJACULATION? IMMEDIATE RESULTS, the ad also purrs. I call Boston Medical on Tuesday, and on Friday I am waiting in a small, cream-colored office surrounded by full-color diagrams of penises; there’s a latex glove on the floor. It feels like an abandoned inner-city sex-ed classroom. I fill out a short form that asks about diabetes, heart disease, cancer. I check no to every question except smoking and booze, sign a release, and wait, flipping through a worn, five-year-old issue of Sports Illustrated. And then I see Farhad Mohebban.
Mohebban is a chatty Iranian Jew whose eely bedside manner makes a routine exam seem perverse. “You should marry in the faith,” the doctor says as he palms my testicles and inspects my penis. His are the fifth and sixth male hands I’ve had on me since this problem began. I think I may never have an erection again.
And then, because the next set of tests has to be conducted with an erection, he injects the side of my penis with protein. “You can play, of course you can,” Mohebban continues, “but when it comes time to marry, it should be with one of your own.”
The intracavernous pharmacotherapy (ICP) doesn’t hurt, but what nearly kills me is watching a needle be inserted into my defenseless prick. After the shot, which sends a rush of oxygen and hormones called a vasodilator directly into the tissue, I pull up my pants and waddle into a different cream-colored room. I brace myself as a thunderous erection involuntarily rises while I read about a young golf rookie named Tiger Woods. My penis feels like it’s carrying dumbbells. It feels like a dumbbell, leaden and strained – uncomfortable, like an erectile migraine. The injection makes Viagra feel like a kiss. After 25 minutes of raw, scared regret, I’m back in Mohebban’s office.
“Do you have an erection?” he asks.
“Ripping through my fucking jeans,” I reply.
“Drop them, please,” he orders. “You’re a good-looking Jewish boy.” The room feels as though it will swallow me whole.
“I think your problem is premature ejaculation,” he says. What?! How the hell did he come up with that? I want to be treated for erectile dysfunction, but whatever your ailment, Boston Medical can promise sex for life!! because it offers one remedy: the ICP shots. It then sells you the ICP in two discount-via-frequency packages – six months for $1,150, two months for $520.
Mohebban tells me this is what I need: self-administered shots into my penis that will force an erection, and then I’ll be so erect that I’ll have time to practice ejaculating. After six months, he says, I’ll have learned how to control my ejaculation, and I can stop taking the shots. Maybe I’d find a nice Jewish girl who’d administer them, he jokes. Then, erect, on my way back to a small waiting room, I see a kid with headphones over a Yankees baseball cap. He’s wearing a baggy Roca Wear T-shirt over draping Sean John jean shorts and filling out a medical checklist. He looks like he’s 18. We look at each other for a moment from across the hall, but I flinch, turning the corner and ducking into my cream-colored room. The Boston Medical Group’s office is not a place to make friends.
Victor Marrero, 30, Mohebban’s assistant, has a slight mustache and wears a high-school ring under his latex glove. His are hands Nos. 7 and 8; 7 holds my penis from the bottom, 8 presses a thumb at different points down from the top. Victor tells me it’s been about 30 minutes since I was injected with ICP, and I’m about 60 percent erect. I ask him if he went to medical school. “No,” he says, “medical-assistant school.” Marrero starts to sell me the ICP. I pay $175 for my visit and feel like I’ve just been erectly screwed.
The RigiScan results come back mixed. i don’t know why doctors administer all of these medical tests, because when the results come back, if there’s anything that doesn’t make sense, the doctor just discounts it with a nonchalant dismissal. If these tests don’t matter, why did you have me put an electronic boa constrictor around my cock? The results show that I have normal nighttime erections, but that the base of my penis is more rigid than the tip. Kaminetsky calls that a medical impossibility. Then reiterates that I am fine. That my problem is mental. Kaminetsky recommends a visit with Ursula Ofman, Psy.D.
Ofman’s office is on a perch high above Impotency Row. She is wide-bodied, blunt, German, indiscriminately dressed. Her waiting room is stocked with recent New Yorkers.
“What is the problem?” she asks.
“Erection thing,” I say.
“When did it begin?”
“I guess when I started seeing this girl.”
“Tell me about it. Tell me where it all began.”
We’re walking through what happened with Erica, and little details are bringing back larger pictures. Erica talked a lot about sex. There was the time I cooked salmon. Had we acknowledged then what was not right? Our first morning together was February 14. I wished her a happy Valentine’s Day as she came out of the shower. The night before, I’d gotten hard, I just hadn’t come.
“I didn’t come!” I yell to Ofman. “I didn’t come because I didn’t want to come too soon!”
“What happened next?” she asks. “Think details, tell me exactly what happened.”
What happened? I thought. Exactly what happened next? I lie on Ursula Ofman’s couch squeezing two beige pillows, surrounded by books like Sex for Dummies and The New Male Sexuality. The next night, I remember, was Erica’s birthday party. There were drinks on the Bowery, I remember being nervous about meeting her friends, so a friend of mine joined the party. He bought Erica and me beers, had a Sprite and cranberry juice, then went home. I stayed on, I remember, and Erica and I wound up at her friend’s apartment on the Lower East Side. She was house-sitting. There were CDs scattered all over the floor. We lay beside them. Again she was on top. It was our second time making love. The second time I didn’t come.
“Again I didn’t come!” I tell Ofman. “Again I didn’t come!”
“Good,” she says. “What happened next?”
And I remember the salmon. This was at my place on Mulberry Street: couscous, broccoli, a bottle of white wine. I’d bought a pint of Ben & Jerry’s, but we didn’t make it that far. That was the night we searched for the Kimono. My air-conditioning wasn’t working. That is where it all began. I remember panicking, I tell Ofman. I remember being nervous, feeling judged. I remember watching myself. I remember wishing that we were through. “That’s where it started,” I say. “That’s where my erectile dysfunction began.”
“So you see,” she says, “by trying so hard to please her, you forgot about yourself. Eventually, I think, you were trying so hard that you became physically disabled. You were no longer able to become erect. You took the pleasure out of making love. I don’t think you have a problem. I just think you need to relax.”
I could kiss her. I feel as if I could go out and sleep with the world. Later, I discover that ED in the majority of all men is psychosomatic. This problem doesn’t just occur in young men. In Laumann’s China study, where the average age was 41, 65 percent of the men’s erection problems were nonmedical. Every year after 40, a man’s erection problem is more likely to be physical by .6 percent. There are no studies with 30-year-olds, but Laumann believes that if you conducted this test in Manhattan, with my age demographic, all of these numbers would be higher.
“New York is more hedonistic than China,” Laumann says. “People have more partners, it’s more competitive, and that increased anxiety, especially among young men, would influence ED even more.” This is why psychological factors figure so heavily into drug research – the body is tightly connected to the mind. You’d be amazed at the sexual consequences of even the most common drugs: Prozac can delay ejaculation. Propecia, a hair-loss retardant, can hinder sexual desire. And Pepcid AC, an antacid, can cause “dry” orgasms, where the semen is forced back into your bladder.
I want to call my doctor, explain Nicole to him. I want to call Kaminetsky, tell him to keep his RigiScan results. I want to call Mohebban, call Victor, tell them to fuck off with their ICP. I want to call my cousin, Uncle Kenny, and Chet. I want to call Bob Dole. I need to speak with my dad right away.
First, though, I call Erica, and she just laughs. “You’re not the only guy I’ve ever experienced this with,” she says. “You’re just the only guy who had it for so long.”
Four months later, my erection spring training is put to the World Series test.
Julie is a college senior at McGill University in Montreal. I got her number through the girlfriend of one of my best friends in New York. Visiting the city, I call Julie, and she meets me at a Best Western hotel. I’m smitten, all the clichés. We spend the whole weekend together, and on the day I leave, we find ourselves sweaty-grappling in her bed. She’s younger than me, and I really like her, and besides that, she has curly brown hair, and wears a green bushy sweater with sleeves that go down past her hands. She looks good. And today there is no problem. Between the kissing and the rubbing, the bump and the jeans-on-jeans grind, I am totally erect, and I feel there’s nothing we can’t do.
The details, Julie says, I should keep to myself, but it’s been six months since we met, and it may be time to look for another apartment: After Julie finishes college, she’s moving in with me here in New York.