Early Thursday morning, driving to Indianapolis in the dark, in the rain. Every other vehicle on the road is a mile-long semitruck, a mobile septic tank. Some huge hauling platform, extra wide and slow, spraying water from 32 oversized wheels, angry waves crashing into my windshield. I am speeding on slickened lanes trying to get around these leviathans. No visibility, pushing forward into smeary darkness, the rhythm of windshield wipers like an anxious thudding heart.
Both hands on the wheel, whole body tight. Trying not to die. Then I think: why not. Maybe this is the way. It will look like an accident. Will hurt my loved ones less.
But it would not be that simple. I would only be maimed, scarred, burned. Bones broken and skin peeled and never-healing wounds requiring redressing and state of the art ointments. Billion dollar hospital bills and declarations of bankruptcy and pledge drives and fund raisers and go fund me’s and go fuck yourself give me money for a brand new body.
Even in the pouring rain my car would burst into flames and my face would melt off and then I would go on some somber ABC news program; they would wheel me out in front of the camera, my head this smooth, hairless clay ball with holes, a hideous mutant affront to humanity, some horror movie hand carved puppet, cracked voice bubbling up from charred vocal chords, a tone of blazing agony, croaking out that life is precious, I cherish every morning cup of coffee. Viewing public shuddering and changing the channel to a Big Bang spinoff, to how I met your four gay fathers.
Okay, so keep driving, keep living. Why am I thinking about it? Why does driving into a ditch or a tree seem like a good idea? For the last six weeks I have been driving to Indianapolis to see friends and what I might have possibly called a new girlfriend. Things were looking up. Then last weekend I learned I needed surgery. I am driving to an appointment with a surgeon. My old health problem has returned.
I knew I would have to deal with this again someday, but I thought it would be much later. The timing is terrible. I have no insurance and little money. Society is continuously shitting its pants over covid and trump and any day the hospitals could be buried in bodies and everything will be shut down and locked down and we will all be forced at gunpoint to shelter in place. We will be confined without food, gnawing on the armrests of our sofas, looking at our loved ones in fear, their familiar faces morphing before our frenzied eyes into giant germs.
The condition I have will not physically kill me but it is psychologically devastating. One of the problems with this disorder is that it is embarrassing. Not just embarrassing like a fart that slips audibly betwixt your cheeks in the checkout aisle; it strikes at the core of masculine identity and self-worth and totally undermines a stable and healthy self-image. If only it were something like having no bowels.
If that were all, I would level with people. I would tell my coworkers, my boss, anyone on the street. “Hey, I am missing my intestines, I need to shit in a bag. It sucks but hey what are you going to do.” And people would cringe a little and they would say sorry and they would move on, like everyone moves on from everything.
But here it is: I am impotent. I cannot get or sustain full erections. I am 34 years old and I have always been this way. The popular image of impotence is some old guy with heart disease and diabetes, his fat sclerotic ass asking the doctor to prescribe him extra strength viagra. And it is just this hack comedian punchline insult innuendo condition: HAHAHA CANT GET IT UP ANYMORE.
I was born like this, born into this, as Charles Bukowski would put it. They now call it congenital venous leak, which means: thanks to a satanic/mengelian anatomical configuration, my penis cannot trap sufficient blood for sustainable erections. Arterial inflow is fine, but then the blood leaks right back out. Take a tire with a hole in it and try to pump it full of air and see what happens. If you pump hard enough, you can blow up the tire for a second, but you are fighting a lost cause. For the most part I lived with it in silence and shame. When I did bring it up with family doctors, they told me it was all in my head.
Because a young man cannot possibly have a physical problem with his penis. This is what I was told and what I forced myself to believe. Oh good, there is nothing wrong with my penis, I am just crazy.
If you follow the medical literature, you will see that the specialists now recognize that an overwhelming majority of cases of impotence are physical and not psychological. Still, in popular imagination, if you are a young man who says he cannot get it up, you will be told you just need to relax, you need to see a psychologist, just crack open a beer and let things work as nature intended.
Except this is my nature, this is how I have been built. I will skip over the years of feeling like a total biological waste product, the shame and self-loathing and frustration and the women I pushed away who tried to love me. And the women who did not even try to understand, who rejected me and told me sex with me was “too difficult”. The background depression and distant dark skies that loomed even during the happier moments. Skip over all that to me finally fixing my problem five years ago by undergoing surgery for a penile prosthesis, or what is also called an implant.
I will also skip over all the complicated mechanics of how it works and say that it does work; it gave me the ability to sustain erections and have sex without going soft. Another thing to skim over is how it changed my life and allowed me to focus on my other interests. In the last five years I have rediscovered my love of writing and literature. I have been able to write a collection of short stories and a novel with the peace of mind and confidence and self-worth provided by the implant.
What I have in me is a mechanical device, and like all such devices, they break. But according to the statistics, most will last at least ten years. Mine lasted five. 95 percent of these devices are still functioning after five years. I fell into the five percent of unlucky bastards within a category of already unlucky bastards who depend on a prosthesis for what should be a god given ability. Now I have to deal with getting this thing replaced and having another surgery.
Let me state this definitively, in case you cannot reach this conclusion yourself: penis surgery is no party. It is the next to last thing I want to do. It just so happens that the last thing I want to do is live with a limp penis for the rest of my life. So I must have penis surgery. Anyone reading this with somewhat normal sexual function who thinks, “I would never subject myself to that,” I will say, if you had true organic impotence, I bet you fucking would.
What is penile implant surgery.
They put you on your back and cover you in protective materials to guard against infection. While you are under general anesthesia, the surgeon cuts you open using what they call minimally invasive technique, using a small incision either in the penoscrotal junction or just above the penis in what is called the infrapubic region. Surgeons have improved this procedure over the years and the devices have become more sophisticated. They used to chop away and just stick a couple of semi hard rods in you that you could bend up or down. If you had one of the older devices, you were never really that hard, but also never really soft. Now they very carefully create just enough space in your erectile chambers, the corpus cavernosa, or the shaft, in layman’s terms, to slide two inflatable tubes connected to a reservoir of saline that they place in your abdomen.
Finally they put a pump in your nutsack connected to the reservoir, a pump that you press to send the fluid from the reservoir into the tubes in your shaft. When the tubes fill with saline, they expand, giving you a normal looking and feeling erection. Everything is internal, and for the most part undetectable. You press on the pump to get an erection and then you press a deflate button to send the saline back into the reservoir. Your penis stays hard for as long as you want, until you choose to deflate it. Unless a woman sees you pressing on your nuts, and unless she grabs the pump herself, she would never even know.
It sounds crazy but it is very close to a natural erection, except it can actually get even harder than what a normal man could achieve, and in the soft state it is pretty close to a normal flaccid penis. But they have to cut you open and create space in your penis and abdomen and ballsack and for the first two weeks after surgery it feels as if someone has taken a cheese grater to your groin. When you start inflating at about 3 or 4 weeks it just feels as if someone removed your dick and jammed a broomstick in its place; it feels rigid and uncomfortable and unnatural.
But then, with just a little more time, your body adapts to it, and it really does feel normal, a part of you. And then you can have sex for as long as you want. If you get some coke or meth you can go for 48 hours. Or you can go a minute and a half if you are busy. Maybe you need to get groceries or your favorite show is about to start. Or you can be chaste. But the point is, you can do it if you want. And the mental freedom of knowing you are now capable, after having been incapable, is worth the pain and dread of surgery.
At this point in my life, I do not want this ability so I can go bang hookers in the orient. I want this ability so I can connect with someone I love. There are other physical ways to do that, and I have no intention of neglecting a wider range of sexual expression and intimacy, but I also believe that something would always be missing, even in the most supportive and loving relationship, if I do not get this fixed.
I am looking at a 17,000 dollar out of pocket cost, which I can partially cover. I would need help from family for the rest, or I will have to take out a loan. Also thinking about enrolling in a plan through the marketplace and waiting until after january. But that sounds like another nightmare on top of the one I am already living. Making calls and talking to uncomprehending customer service representatives, getting faulty information, signing up for a plan that seems to cover it but then at the last second I learn that the surgery is excluded.
One reason I want to go into the medical field is that I want better healthcare, better insurance. I want an inside perspective so I can make better decisions and get better coverage for what will always be an issue for me. Another reason is that I would like to help people with similar problems the same way I have been helped. I know everyone hates American medicine right now and everything is too expensive and doctors do not care and big pharma shoves pills down your throat and up your ass, everything is corrupted and bloated and inefficient and everyone is burnt out and we are all 400 pounds and diabetic and insurance companies are evil and ceo’s give themselves a bucket of caviar as a bonus every time a poor man’s organs fail in the gutter outside a hospital.
And I know western medicine takes a reductive and mechanistic approach when we should be more holistic. We should all be walking around barefoot on the soft loamy soil and sunning our buttholes and performing breathing exercises and eating nothing but raw cow kidney. Drinking herbal tea and stretching and playing the flute in the forest. No one would ever get sick and die if we just stopped having jobs and government and authority and power structures and the patriarchy, if we just drank period blood from wooden bowls and hitched rides on the wings of eagles and owls.
From within this rationalistic, reductive, exploitative healthcare system that sucks up all the vital fluids of the earth and hooks people up to machines and replaces their organs with grinding gears, I still think some good can be done, I think people help others from time to time. Believe me, I tried all the herbal supplements and the testosterone boosters and the exercises and eastern methods and ancient practices. The heavy squat routines and all meat diets and every noninvasive treatment on the planet. For ten fucking years I read obscure forums and old posts promising to restore my functioning and rebalance my energy. Creams pills stretching breathing nothing worked. An implant works, though it is not a perfect solution.
A 100 percent authentic product of the western scientific revolution that has destroyed everyone’s else’s lives and made all the indigenous people cry cured my erectile dysfunction and gave me the precious gift of being able to have sex for more than 30 seconds, have sex without apologizing and saying it is me and not you no I really do think you are very sexy. Walking around all day with an invisible handicap, a secret identity a superdeficiency no one would ever guess, a reverse Clark Kent mild mannered by day but limper than a wet rag by night bad comic book existence. Not just the fact of not being able to have sex in that moment, the denied momentary pleasure like your friends ate all the cake and left you with celery sticks, but the haunting presence, the nagging reminder of biological and masculine unworthiness, the truth of my alien condition hidden and smoldering within like an ulcer, permanent acid reflux singing my insides as I smile at every stupid boner joke.
The whole modern televised digital and pornogrophied world is this fractal gauntlet of hard spitting dicks and no one seems especially happy with it or well-adjusted to it but everyone is at the same time supposed to participate in it or at least accept it. Monogamy is a construct, love is oppressive bullshit, pair bonding is for actual species of birds but listlessly pulling and rubbing your genitals to streaming images and masturbating into strangers whom you do not even like is superior, advanced, empowering. So I do not want any of this to come across as a desperate desire to rejoin the digitalized orgy. I want to feel whole, like a fully capable man who can physically express intimacy and love.
The thing is, I can masturbate with a semi limp penis. I still have some natural tissue engorgement and arousal. I could just remain in my room and eat spicy takeout noodles and jack off and have “relationships” with onlyfans accounts. But I want to fix my penis; not because I am missing out on all that extremely fulfilling tinder sex but because I want to make love to an actual woman that has some presence of mind, that has some spiritual orientation and can form an emotional and sexual bond with another human being. Does this even exist anymore?
I am going to put myself through the ordeal of surgery not so I can distract myself with ten years of fornicating, but so I can have a complete relationship with a complete woman who is somehow miraculously healthy enough to love and support another person, who is not already thinking about what else is out there before the cum even dries.
Surgery for a new implant on December the 23rd. Until then trying to live in the present, trying to maintain my interests, my character, my personality. Trying not to crawl into this pit of depression, inadequacy and distraction, this hole of fake research and analysis where I piss the day away watching surgery videos and reading about all the different scenarios and outcomes. Dreading the small risk of infection, asking myself what if something goes wrong. Some quiet voice inside telling me I cannot live until I get this fixed. Life on hold, but day by day I get closer. Better now than two weeks ago. As it gets closer the combined feeling of excitement and horror builds. The swirl of hope and fear intensifies.
Never thought I would be single again. Never thought I would need surgery this soon. Part of me wonders why I hope for a lasting relationship after the last two women who left me. I guess there is just something stupid and indomitable and romantic in me despite nature and society sending me strong signals to give it up.