This is one of several essays from my private cancer journal. It is not intended as anything than a record of my states of mind as I struggled with the disease and the effects of the treatment.
February 5, 2000
Impotency was never a concern for me.
It's not that I was some wild stud who could perform at any time. I merely knew that a man (at least this man) might sometimes be unable to get an erection or might even lose it and I had learned how to cover the situation with other techniques. Or if that was impossible, I just shrugged it off because I never considered an erection as a measure of my masculinity, or so I thought.
I even went so far as to wonder why it was an issue with men. Maybe they weren't as secure in their manhood as I felt I was because it didn't apply to me.
Even in the months when the undiagnosed cancer was causing increasing problems, I managed to deal with it. I attributed it to what I thought was the pain of pelvic osteoarthritis, rather than anything connected to my sexual parts. Besides, I still had sexual feelings and desire so if hip pain caused erectile problems, that didn't stop me from enjoying a woman or giving her pleasure and my ability would come back around later.
But then I started my hormone treatment to stop the production and influence of my testosterone because that is what feeds the prostate gland. It might help the pain, I was told, but it would also effect my sex drive. I was willing. The pain in my hips, legs and back was nearly unbearable. I could hardly walk, sit or sleep.
To my surprise and relief, the pain disappeared. But so did my interest in sex.
Yes, I had been warned it would happen, but no one told me how deep the cut would be. At least when I was in pain, I still had some sexual interest that could surface with relief. But now it didn't. I could feel it slipping slowly away like a full moon waning into black. Soon the touch or caress of my girlfriend Caren was not only not arousing, but it grieved me. It was like being mocked for the man I wasn't and couldn't be and I couldn't fight it. I was as impotent in spirit as I was in body. As a man, I was disgraced.
One night in bed, I finally broke down and cried.
Caren had curled up against my back and had reached her hand around to gently caress my cheek. I couldn't take it. I took her hand and held it against my chest and tried to hold the tears but it made me choke.
"What is it?" she asked softly.
Her question released the grief that had been building for weeks. I shook my head while I cried, unable to answer, unable to say the words. She kissed me on the back and pulled me against her.
"That's okay," she said gently. "That's okay."
But it wasn't okay. That's why I was crying. Her touch had painfully reminded me of what I had lost and it hurt too deep and all I could do was bury my face into the pillow and cry in shame for not only was there no response but now I was crying and her face was against my back to comfort me and I wished I was dead but all I could do was pour my shame and agony into the pillow that I had to bite to muffle my scream of rage at what I had become. Somewhere later the night took pity and let me slide exhausted into a sleep with no dreams.
I began to have additional bouts of depression. Despondency from the cancer was interlaced with depression about my identity as a man. I would break down crying at the slightest provocation. A scene from a movie, a piece of email or even a remark could rip me into pieces or send me into a black hole. That was the worst. The Black Hole. I could feel myself sliding down into it. The pressure would build and light would fade and it engulfed me. Sometimes it was comforting, like being wrapped in blankets. There was no feeling. But not for long. Then the pain and the grief would hit. That was when I was glad I didn't own a gun. I imagined holding one, fingering the barrel, opening and closing the cylinder, loading and unloading slick, shiny bullets and feeling the action of the hammer.
Me, the one who wondered why men were so bothered by impotency was now despondent, being ripped to shreds because it was worse than merely being "unable to perform." I had lost interest in the subject. An analogy would be food. Imagine slowly losing your appetite. There are days when you have one but days when you don't but then the latter grows until you don't have any appetite. And then the aroma and sight of food is no longer interesting. You look at food and think, "That used to make me hungry" but there is nothing but that vague memory. You no longer want to go to a market because you see food and it is not that you miss it. You miss the enjoyment and this turns into depression.
That is what happened with me and sex.
Like so many men, I enjoyed seeing an attractive woman. But the ADT [acronym for the hormone therapy] cut so deep that even that was gone. I would look at an attractive woman but all I would get is a memory that I used to enjoy looking at attractive women. There was nothing else. It began to have an effect on my relationship with Caren. Without even knowing it (until she pointed it out to me), my simplest physical expressions of affection had fallen out. I wasn't even sitting with her on the couch to watch a TV show.
I tried to read about it. Apparently this wasn't true for all men. I read about men with their wives or companions and how they were in love and affectionate, even if the man was impotent. What was the matter with me? Was this something that would pass (I was still less than two months since my diagnosis) or was it permanent? Did it effect all men this way even temporarily or was I some exception? How much of it was the ADT and how much of it was me?
The material I found gave me no answers and I didn't know whom to ask.
Meanwhile, thing started to improve.
I don't know if it was simply the effects of the ADT leveling out, my getting used to it or just me getting used to impotency but I started to feel more comfortable with the issue. I didn't like it but it was no longer ripping my guts out. Maybe that was the bottom and now I could improve.
The worst was yet to come.