Bonk (18 page)

r
ather than shore up a broken penis, might it be possible to simply install a new one? If a hand or face can be transplanted, why not a penis? Surgeons have, in fact, considered it. Danish surgeon Bjoern Volkmer said in an email that the topic came up some months ago with regard to a young patient whose penis had been partially amputated to remove a malignancy. One problem, Volkmer said, is that erectile tissue can react to trauma by growing the same sort of tough, nonelastic, fibrous tissue that contributes to impotence. This includes the trauma of attack by one’s own immune system, an inevitable side effect of transplanting someone else’s tissue into or onto your body. Immunosuppressive drugs would mitigate, but apparently not prevent, the problem. (The other, larger hurdle, with cancer amputations, is that the immunosuppressive drugs needed to protect the new penis would leave the patient defenseless against the cancer.)

But if you happen to be impotent because someone has
cut off
your penis, then the microsurgeons can help you. The world’s most experienced penis reattachment surgeons can be found in Thailand, where, during the 1970s, an estimated one hundred vengeful Thai wives, spurred by media coverage of a prominent 1973 case, sliced off the penises of their adulterous husbands as they slept. When a suitably equipped microsurgeon was on hand to reattach the errant appendage, the men were able to resume philandering within a matter of months. Though probably with reduced success: The penises, though operative, were shorter, numb, and often only partway erectable.

The most serious complication, in the Thai attacks, was infection. Two of the wives flushed the penises down the toilet, forcing their husbands to grope for their lost manhood inside the septic tank. (Incredibly, both were found, cleaned, cleaned some more, and reattached.) More commonly, the women would hurl the penis out the window. In the cases described in “Surgical Management of an Epidemic of Penile Amputations in Siam,” all the recovered penises were “grossly contaminated.”

Better that than eaten by livestock. Many rural Thai homes are elevated on pilings, with the family’s pigs, chickens, and ducks tending to mill about seeking shade in the space underneath. It is not, oddly, the pigs, but rather the ducks, that the castrated Thai must worry about. The paper does not provide the exact number of penises eaten by ducks, but the author says there have been enough over the years to prompt the coining of a popular saying: “I better get home or the ducks will have something to eat.”

And then there are the castrations wherein the blade and the stalk belong to the same man. One of the Thai case reports was that of a husband whose wife had complained about his failings in bed, whereupon he walked into the bathroom and severed his penis with a straight-edge razor. (While the Thai women in the article almost without exception used kitchen knives, the autocastrating male tends to reach for his razor. Or, in the case of one Thai farmer, a
shovel
.) The remorseful wife rushed both husband and penis to the emergency room—the latter wrapped, like an exotic lunch, inside a banana leaf.

A small but unsettling subset of autocastrations are the product of religious delusion. The New Testament contains a troublesome passage about celibacy (Matthew 19:12). In the passage, Jesus is ticking off all the kinds of eunuchs in the world. “There are eunuchs born that way from their mother’s womb, there are eunuchs made so by men, and there are eunuchs who have made themselves that way for the sake of the Kingdom of Heaven.” In 1985, a thirty-one-year-old Australian man added himself to the last category. It was an especially tragic case, as this man was already more celibate than many priests. He had never had sex, never had a girlfriend (or boyfriend). He lived with his parents, where, quoting the case report, “every spare moment was spent sitting in his room reading the Bible from cover to cover.”

Except for the occasional five or ten moments that he devoted, with tremendous guilt, to masturbating. Worried that the keys to the Kingdom would be withdrawn, or the locks changed or however that works, he decided to atone. Employing the skills he had picked up while castrating bulls on his father’s farm as a boy, he opened his scrotum with a razor, cut out his testicles, and flushed them down the toilet. The author of the case report interprets the disposal as a sign of resolve; ambivalent autocastrators often “bring their organs with them to the hospital.” Indeed, this man made no effort to retrieve his testes and voiced no regret for the act. He also refused testosterone replacement therapy, and has no doubt made great strides in the church choir.

I will leave you with the story of a fifty-six-year-old government officer in India who told emergency room doctors that he had cut off his penis in order to cure a long-standing case of incontinence. One of the physicians, who wrote up the case for the
Indian Journal of Psychiatry
, suspected deeper mental turmoil was at play, as the patient had earlier jumped into a well, in what was ruled an attempted suicide. Though given this man’s flair for therapeutic overkill, it’s possible he was merely thirsty.

A penis amputation is not a cure for incontinence but it was, for one perplexed seventy-year-old man, a cure for his impotence. The newly invigorated member was a phantom. Phantom limbs are a common consequence of arm and leg amputations; owing to peculiarities of the nervous system, the sensations that existed in the limb beforehand often persist after the surgery. Occasionally, this happens with mastectomies—the phantom breast even seeming to “swell” at certain times of the month—and with penectomies (seven of twelve cases, according to one survey). Phantom expert V. S. Ramachandran, of the Brain and Perceptual Process Laboratory at the University of California, San Diego, once had a patient with a phantom appendix. So painful was it that he had trouble believing his surgeon had removed the real one.

In the case of the seventy-year-old, the phantom erection was so vivid that the man would bend over and “check for its presence.” It must have been a bittersweet victory: to feel erections after two years of impotence, yet have no penis with which to take advantage of them. It’s a urological rendering of the O. Henry story about the woman who cuts off her long hair and sells it to buy her husband a watch fob for Christmas—not knowing that he has pawned his watch to buy a set of combs for her hair.

The phantom erections eventually stopped when the penis amputee, at seventy-four, was shot in the back and paralyzed from the waist down.

The Lady’s Boner

Is the Clitoris a Tiny Penis?

a
woman in an MRI tube has few secrets. The man at the control console knows the size of her heart and the contents of her womb. He knows if she’s had her breasts enlarged or her stomach stapled. He can see into her bladder and knows whether she’s wishing she’d stopped by the restroom before climbing onto the exam table.

Ken Maravilla, a University of Washington radiology professor, knows all these things about Meg Cole
*
(bladder contents: half a cup). Very soon, he will also know how stimulating she finds the X-rated video that he has arranged for her to watch while she gets an MRI. Before you too arrange to have your next MRI done at UW, you should know that not everyone gets the Maravilla treatment. Only study subjects.

Maravilla has a side interest in sex research. His work has shown that MRI can provide an unambiguous measure of how much blood is in the tissues of a woman’s clitoris. As it does with men, sexual excitement ushers more blood to a woman’s genitals. Clitoral blood volume, then, should yield a simple, dramatic portrait of what Masters and Johnson oh-so-appealingly called “mounting readiness.” Maravilla has found that, on average, women’s clitorises hold twice as much blood while they are watching porn than when they are watching, say, footage of a Space Shuttle launch.

“Mary, we don’t use the term ‘porn,’” Maravilla says quietly. “We say ‘erotic videos.’” (Or, when we’re feeling especially defensive, “VES,” for visual erotic stimulation.) Maravilla, sixty, is a slim, gracious man. His hair is cleanly cut and contoured. He speaks easily about sex, but is sensitive about the porn thing. This is understandable: His proposal was originally turned down by the university’s human subjects review board. Maravilla had to sit down with them, convince them that “it was above-board, that there was nothing voyeuristic going on.”

Of the many ways to quantify a woman’s sexual fires, MRI is the least intrusive, in that nothing need be inserted, suction-cupped, or otherwise affixed. This is sexological measurement at its most demure. Cole lies on her back with a radio frequency coil laid lightly, like a heating pad, over her hips. She is given a pillow and a blanket, and the lights are turned down. It’s like first class on a British Airways flight to Europe: downright comfortable under the circumstances.

Cole has what the
Diagnostic and Statistical Manual of Mental Disorders
calls female sexual arousal disorder (FSAD): She is regularly in the mood for sex, but her body doesn’t respond to the preliminaries. To be more precise, it doesn’t respond the way she’d like it to. If it wasn’t a problem in Cole’s eyes, it wouldn’t be a problem in the eyes of the
DSM
. Part of the diagnosis is that the condition causes “marked distress or interpersonal difficulty.”

FSAD is the ladies’ edition of ED (erectile dysfunction). It is distinct from FOD (female orgasmic disorder) and HSDD (hypoactive sexual desire disorder, or low libido).
*
Confusingly, there is also female sexual dysfunction, or FSD, but this is simply the catch-all term for anyone who has one—or a combination—of these conditions. Lack of desire (HSDD) is the most common of women’s sexual complaints, and we will get to this later. (Monkeys will be involved. Do not change the channel.)

Female sexual arousal disorder is the least common. Women with FSAD and nothing but FSAD are difficult to find. The coordinator of tonight’s study, Joanna Haug, had to interview 140 women to find the volunteers who comprise the study’s subject group. Unexpectedly, Haug finds many of her subjects by running ads in the sports section of the
Seattle Times
. “I used to run them in the food section,” she says, “but I kept hearing women tell me they heard about the study from their husband.” Men are often more troubled by their wife’s sexual responses, or lack thereof, than are the women themselves.

Cole is not a stereotypical “nonresponder.” She is not conservative or inhibited. She is the opposite of these things. When I came in, she was chatting with Haug about the best Seattle sex shops. A friend of hers teaches a bondage safety class sponsored by a local police department. “People kept getting hurt,” she is saying. “I guess it was monopolizing too much of the officers’ time.” If a woman like Cole is having trouble getting aroused, it seems reasonable to look for a physiological explanation.

Haug sits beside Maravilla in the MRI control room, which is actually labeled “Control Room,” just like in a James Bond movie. She is a likable, no-nonsense English-woman in pinstripe pants and a ponytail. At Maravilla’s signal, she presses a button to activate a conveyor that will move Cole into the MRI machine. The conveyor carries her toward the magnet feet-first and cinematically slowly.
*
James Bond inching toward the spinning saw blade.

Haug selected the sexually explicit clips for the study. I ask her where she got them, thinking, I don’t know, that there’s a supply catalog of explicit video clips produced specially for sex researchers. Haug blinks at me. “Sex shop.” Joanna Haug has more interesting business receipts than the rest of us.

Maravilla centers an image of Cole’s clitoris on the screen. The image bears no resemblance to the vague nub one generally pictures. This is because we’re looking at the whole organ, not just the one-tenth of it that is visible to the eye. Maravilla takes me on an underground tour. “Here are the crura,” he says, pointing to a pair of matched arms that branch away from the tip like halves of a wishbone. “And this is the glans,” he says, as though Cole has a penis.

In a sense, she has. Time out for a short primer.

i
can recall, many years ago, being told that a clitoris
*
is a vestigial penis. The feminist in me, who is small and sleeps a lot but can be scrappy when provoked, took umbrage at this description. I resented the implication that men have the real deal, while women make do with a sort of miniaturized, wannabe rendition.

But it is true. Male and female fetuses both begin life with something closer to a clitoris. The male’s expands into a penis, while the female’s remains more or less as is.

Even in their adult forms, the two organs have much in common. The clitoris, like the penis, ends in a sensitive, nerve-dense, pleasure-yielding bulb of tissue called a glans. Like the penis, the clitoris has a shaft, and that shaft contains a pair of expandable chambers called corpora cavernosa. It also has a prepuce, or foreskin, just like the penis does, and if you draw it back you may, just as with the penis, discover a wee cache of smegma. Robert Latou Dickinson, a pioneer in the field of female smegma, described it in his
Atlas of Human Sex Anatomy
as “tiny, hard pellets, white and glistening.” The text includes a thumbnail illustration of three such pellets, placed alongside a clitoris, for scale. The drawing is dated 1928 and labeled, in Dickinson’s neat, boyish calligraphy, “Smegma.”

And yes, a clitoris expands when its owner is aroused—though not as quickly or extravagantly as does a penis. Masters and Johnson filmed dozens upon dozens of clitoral erections: Responses to vibrators, to fingertips, to “stimulative literature,” to intercourse. (Filming the clitoris during a missionary position coupling was of course problematic, as the male missionary is in the way. In this case, the artificial coition machine was called in to pinch-hit.)