My friend Steve is the bravest man I know. This is his story. I simply helped him put his words to paper. He has been married for 25 years to a wonderful woman, Jane. God bless them both.
Some million plus American men are being made sterile this year. I am one of them. We are doing it on purpose, by means of a vasectomy. Voluntary male sterilization is touted by advocates as inexpensive, readily available, and virtually painless. It is not, that’s plain silly. It is also said to be the safest and surest method of contraception known, simple to perform and often reversible. Apparently it is, absolutely. It is said to improve one's sex life. It might at least a bit.
There are at least a dozen persuasive reasons for having a vasectomy.
Consider the possibilities:
Our planet—in case you've been away—is dying. The sun is 16 percent dimmer than it was at the time of the Great War. Garbage and smog choke our cities. Several rivers and a large lake or two are already dead, and we're working on the oceans. Four million people will starve to death this year, and twice that many will come close. The single biggest cause of these troubles, we are told, is people. There are over 7 billion now, but twice that many are expected by the middle of the century.
The true pessimists have let their life insurance lapse.
There’s economics: Who can afford more children? Ask the man who has three. Summer camp, orthodontia, guitar lessons, shoes, and all those other tedious necessities are nothing when arrayed before the humbling $65,000 a year required to put Junior through Princeton.
Most contraceptive devices are distastefully mechanical. Many interrupt the spontaneity of the sex act. Women are panicky about the pill, and they have justification. The coil, or IUD, has been known to create infection for some women. For still other women, further pregnancies might be dangerous or fatal.
In a society, where the traditional family unit is losing its respect, some people have no particular feeling for children. Others want to defer the responsibility indefinitely, preferring adoption if the desire arises. The confirmed bachelor who succumbs to matrimony at forty-two has a perfect excuse to remain at least partially unencumbered. For the growing number of single men seeking sterilization, paternity suits are notably unsuccessful, and no marriage fixated females could claim to have forgotten their pills.
The list can be doubled, but the advantages are clear. So are the drawbacks.
From the time I began seriously considering a vasectomy, I agonized over every aspect of it. There is the religious issue, most disapprove of the procedure. There is the notion of virility based on the ability to impregnate women. But then comes the psychological crunch, the most deeply-rooted fear of all. Whisper it, “castration.” Vasectomy is not castration. But symbolic or actual, virtually all men, whatever their sexual inclinations, carry that piece of emotional baggage around in their psyche. Not everyone can work it out.
Most of my liberal friends, when advised of my consideration of voluntary sterilization, expressed interest and even praise. It's a great cocktail party topic. But one of my neighbors was thunderstruck. An upwardly-mobile, hairy-chested type, he was pronging barely budding nymphets in Brooklyn before my suburban classmates and I had our first wet dreams. He could not fathom why I might permit myself to be "mutilated." His horror shook my resolve.
An erstwhile art student and unpublished novelist, I am possessed of a hyperactive imagination. One of my most persistent images had me strapped to the operating table, the surgeon's knife poised... and a playful nurse goosing the doctor at a highly critical point in the proceedings. When that particular fantasy first materialized, I knew I would insist upon total anesthesia during the operation. I wasn't about to be awake in the event my most cherished possession was accidentally snipped off like a wilted geranium.
Despite such reservations, I went ahead and talked to my doctor. He didn't do vasectomies. He recommended an associate. I was referred to the Association for Voluntary Sterilization in New York. It is an educational and referral agency, listing cooperating doctors throughout the country. The printed matter they sent noted vasectomy clinics. However, I understood that these offered the quickie, in-and-out form of operation, and though it was claimed that the discomfort is no worse than that of a pulled tooth, I rejected this in favor of hospital comforts.
It’s important to patients that doctors look the part. In an age of specialization, this must be difficult for them. Nevertheless, I always felt that GPs should be kindly but gruff, and slightly stooped. And show me a gynecologist who leers a lot during examinations and I'll show you a poor man. My Dr. Simon fulfilled his role admirably. Tall, thirty-ish, handsome, graying slightly at the temples, he exuded calm confidence. There's just a touch of raffishness in the cast of the mouth, indicating some knowledge of life. In short, the kind of man you like to imagine in the cockpit of your 747 or giving you a vasectomy.
At our initial consultation he answered my questions with brevity and clarity. And honesty. He would perform the operation in the local hospital (he was Chief of Urology) because there is some post-operative discomfort. "How much?" I asked.
"Like a swift knee in the groin," he responded casually. That's why he recommended a Friday—to allow the weekend for recovery.
Another myth shattered. The more ardent proponents of vasectomies suggest that the process requires a mere 15-minute interval with the doctor, followed by a fast pastrami on rye and a quick jog back to the office. In reality, there is much tugging and pulling during the operation and the local anesthetic used is injected directly into the scrotum. A patient suffering any fear or uncertainty about the operation might snap his cork right there on the table if he can see everything that's going on.
Dr. Simon satisfied himself that I had no serious emotional problems. If he suspected I had, he would have referred me to a psychiatrist. Some men are pushed into the operation by their wives and are none too happy about it. A few unbalanced persons seek a vasectomy in the desire to be mutilated.
I passed muster. First, I was to obtain a complete physical examination by an internist before arranging an appointment for the big day. Both my wife and I had to sign a release confirming that we understood that the operation was irreversible and that there was no guarantee that it would work. Neither of these caveats was likely to be true, but physicians must keep one eye on their patients and the other on the law. There was another question from my wife. Yes, the quantity of ejaculate is approximately the same after the operation, only it is sperm-free.
Dr. Simon emphasized that a postoperative sperm-count was mandatory. In the normal male, the count registers zero after 10 or 12 ejaculations. However, there are rare cases where it takes longer to clear out the canals.
The man who doesn't have a sperm count makes a serious mistake. It's not a bad idea to have one made a year after the operation. The biological urge to reproduce is strong: There are recorded cases of the canals growing back together, called "spontaneous reanastomosis." This is unlikely under present surgical techniques, but the possibility exists.
One man, his marriage shaky, had a vasectomy performed when his wife went home to mother for several weeks. Three months after she returned, she became pregnant. He hadn't told her of the operation. He divorced her with considerable self-righteousness. He remarried, didn't tell his second wife, and she was soon with child. So he left her too. Since he had never had a semen analysis, he could never be certain whether he was merely a consistent cuckold or whether something had gone amiss in his operation.
Following my interview and physical exam, a date was set. The night before, Tony called. He had had his vasectomy. He was a booster, and his tone was distressingly hearty.
"Understand you're having your gears stripped tomorrow," he boomed.
"Good idea to have it on a Friday," he said. I asked why. "Because it aches a little."
"Aches a little?" I responded weakly.
"Hurts like hell, as a matter of fact '' He chortled. I gasped.
''Watch out for the attendant," he warned. I hesitated to ask why. "He shaved me from mid-thigh to navel. Itched like crazy for two months."
Marvelous to contemplate. Walking around for a week as if carrying a basketball between my legs and looking like a plucked chicken for seven more.
Despite this little help from my former friend, I showed up at the hospital. After the usual endless wait, and with a twinge of guilt that I was taking up space intended for sick people, I was finally told to slip into one of those dreadful backless and bottomless gowns. Another wait, and I was wheeled into the operating room. I had not been shaved. For some reason that had become a major part of my concern.
Before I drifted off under the anesthetic, grateful that I wouldn't hear any ensuing giggles, I urged care upon the doctor.
An untutored man horrifyingly envisions a 4" opening cut along the shaft of the penis, and a snapping of tubes resembling the innards of a telephone cable. Not true. The surgeon makes a quarter-inch incision on one side of the scrotum and draws out the appropriate tube, called the vas deferens. This is not as easy as it sounds. There are a number of tubes twisting around in there, many quite similar in feel and appearance to the vas. An experienced doctor can pick out the right one.
He cuts out a section of the vas, perhaps as much as an inch long. These segments are retained for analysis later, and sometimes kept permanently to prove the operation was performed properly. Depending on the surgeon, he will fold the ends back on themselves and sew them shut, or electrically cauterize the ends, sealing them. The point is to create a gap, a defect in the ducts. The wound is closed and the process repeated on the other side of the scrotum. It all takes 10 to 15 minutes.
I slogged back to consciousness in the recovery room. As I make it a point to be charming with airline stewardesses and nurses, I mumbled something about "What a lovely face to wake up to," to my own angel of mercy. One can never tell where such efforts might lead. (I said I have a rich fantasy life.) As soon as she turned her back, though, I lifted the sheet and peered down apprehensively. It was still there. Under an ice bag. Second observation. Almost no hair had been shaved. Third, it was beginning to hurt. I adjusted the ice bag.
My wife picked me up a few hours later. Her expression was one of awe and concern. Fourth observation: you pick up points with your mate. After sitting around helplessly through a couple of pregnancies, it was gratifying to know I had taken a share of the responsibility after all that fun. She fluttered about for two days, mostly changing the ice. I was very brave. Monday I went back to work. The catgut stitches melted away in a week, and so did the lingering ache. I avoided riding horses and motorcycles.
Six weeks later, Dr. Simon instructed me to "collect a specimen by any means." I found that fascinating medical sanction for whacking off was to do the collecting in a clean wide mouthed jar at 8:30 in the morning and get it to the laboratory. I am not a morning person. Still, I marched to the bathroom after my coffee and toast, prescribed jar in hand. It took awhile, not unlike attempting to function sexually on stage. And it was damned hard to aim. After 15 minutes, my wife's small voice at the door: "Can I help ?"
The average male may produce semen supporting around 60,000,000 spermatozoa per cubic centimeter. Anything above 20,000,000 of the little troublemakers is regarded as indicating fertility. The canals have to be cleared of lingering spermatozoa through ejaculation, so contraception by other means is required until the lab gives the all-clear.
There is a little gold pin that announces the safety of the bearer to prospective bed mates, for the ideologically committed or the exhibitionistic.
Dr. Simon called a few days later. "The count is zero," he announced. "Have fun."
I intended to.