“Sit down and don’t rush me,” said Martin as soon as I opened the door. He is a 65 year young man who came in yesterday for his annual physical. Sitting on the exam table with nothing but baggy boxer shorts, he was holding a sheet of notebook paper and peering at me through his bifocals.
“You see this?” he asked waving the paper at me. “I have a lot of things I need to ask you, and I don’t want you rushing me out of here.”
“Alright, alright,” I said taking a seat to listen.
I knew this was going to be good. Martin is a self-diagnosed agoraphobic who only leaves his house once a year to visit me. “I’m all ears.” His annual physical usually runs an hour at the very least.
He began: “I’ve got a lump on my back, there is a mole on my face that bleeds, every joint in my right leg hurts, I can’t gain weight, I have toe nail fungus on both feet, and last week I got semen in my eye and now I see lightening bolts.”
“Is that it?”
“No, I’m just getting warmed up,” he smirked sarcastically. “Take care of those, and then we’ll move on.”
“Semen in the eye?” I laughed. “You’re still having sex at your age?”
“Every day smart ass and sometimes twice.”
“Are you still dating the same person?” I asked knowing very well he is. I love instigating him.
“You mean “muscles”?” he winked. “Yes, but he’s married with five kids. Technically, I’m single and I like it that way.”
“You must be a magic man to keep him coming back for more?”
“He’s twenty years younger than me, and we have sex everyday,” he said flatly. “There is a lot you don’t know about us old folks.”
“A lot I don’t want to know.”
Thinking the elderly engage in sexual activity for most is like asking them to imagine their parents having sex. Yet, the fact remains that most of my elderly patients continue to engage in sexual activity well into their 70′s. Sexual enhancing medications like Viagra, Levitra and Cialis have definitely lent a helping hand in bedroom.
When I first started residency these medications did not exist. I can recall my urology rotation where middle age men were lined up outside the clinic waiting to be seen, all with similar complaints of erectile dysfunction. I learned quickly that there was little we could offer these men other than emotional support for feeling emasculated. Dr. Jorgenssen, the Chief Urologist, ordered a battery of tests and even prescribed an injectable product called Caverject, which helped to engorge the penis but you had to stick a needle in it first. Ouch. The other alternative was Muse, a pellet that had to be pushed inside the urethra. Double ouch. Often the only other viable solution was to surgically implant a prosthetic that either inflated the penis through a pump that was implanted under the skin or surgically insert a silicone rod into the shaft so that it could be manipulated up, for sex or down, for non-sexual activity.
Half way through my rotation, Dr. Jorgenssen came into the clinic and said to me, “Do you have any money?”
“Why?” I asked. Was he going to ask me for a loan?
“Buy stock in Pfizer,” he said mysteriously.
I didn’t. Of course that was the year Pfizer launched Viagra and the rest is history.
The funny thing is that some older gents, like Martin, don’t need anything but a warm body named “muscles” to arouse them. I hate to think what he would be like on Viagra – a shut in with a chronic erection. That would be a recipe for disaster. I can just imagine his frantic 911 call, the EMS busting through his door and finding him naked with a blue penis and a 40-year-old Italian passed out on the floor.
Now you see why I don’t want to imagine the elderly having sex?