THE APPOINTMENT
For many men, phoning an 'impotence clinic' to make an appointment is like phoning up Long Bay Gaol and asking for a room—it's that ridiculous an idea. Do you want to share your deepest unmanly concerns with someone on the other end of a telephone? Not only are you going to be asked very personal questions about 'your problem', but you will actually have to make an appointment to go to the clinic and see someone about it. For many men this situation is like saying to a prison guard, 'Here are my wrists, handcuff me.'
One of my patients arrived for his appointment and showed me an advertisement for the clinic that he had kept in his pocket. The advertisement was dated two years previous to the appointment date. He told me that he had kept it for two years. It had taken him all that time to summoned up the courage to call the clinic and make an appointment.
The anxiety men experience when they arrive at the clinic is unmatched in any other medical situation that I have experienced, including the casualty department in South Africa. At first, I routinely took blood pressure readings for all my patients as this is a necessary part of any physical examination. I soon discovered that ninety-nine per cent of the patients I tested had an elevated blood pressure. From this result, one might conclude that all patients with erectile dysfunction are hypertensive. I stopped measuring blood pressure once I realised that the heightened anxiety my patients were experiencing was causing this elevated reading. After discontinuing the test, I was relieved to see that being more relaxed, their blood pressure had normalised by the time of their second visit.
Nervousness can bring out the worst in some men. They can become quite hostile. I recall a very proud Spanish man who saw me about a 'slight' problem with the strength of his erection. He became quite agitated the more he talked about his problem. Suddenly, he stood up, swore at me and abused the existence of such a clinic, and walked out. I haven't heard of or seen him since.
This highlights the dilemma faced by many men suffering from the symptoms of impotence. I have learned that the most difficult issue for most men is having to admit that they have a problem at all. For a great many of men, performance in the bedroom is the hallmark of being a man. Similarly, many women believe that part of the reason for their existence is to bear children so that humankind can continue. Some women no longer feel like a woman if they cannot continue to bear children for whatever reason, whether this is due to menopause or surgical procedures that have left them unable to menstruate. So too, do men with erection problems feel incomplete.
Men may refuse to acknowledge that they can no longer perform the manly duties. They think that these 'manly duties' include being able to perform adequately in the bedroom. For the average man, an admission that he can no longer do this is a very bitter pill to swallow. What makes things worse for a man is that erectile dysfunction is unexpected. Men are not yet aware that impotence is a common problem. Few of them are aware that effective treatments exist. When symptoms occur at whatever age, a man tends to feel that he is the only sufferer with this problem. On principle, he won't even admit that he has a problem, not even to his trusted general practitioner.
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