The Vasectomy Doctor

by Dr. Andrew Rynne

  Often in those days I would be asked by a woman with say, six children, if I thought it would be all right if she took the pill. She wouldn’t be asking me if I thought it would be all right from a medical viewpoint. No, she wanted to know if I thought it would be morally all right for her to use contraceptives. Or, in other words, doctors were sometimes looked upon as kind of surrogate priests, a role that I for one thought quite absurd. Frequently when people were leaving the surgery they would mistakenly say, ‘Thank you very much, Father’ before correcting themselves. But if there was all this hysteria about the birth control pill you can just imagine what a brouhaha there was going to be about sterilisation or vasectomy.

  The first session of four vasectomies in Ireland was conducted at the Irish Family Planning Association’s premises on Mountjoy Square in Dublin during the summer of 1974. The operator was a lady ophthalmic surgeon who had been flown into Ireland especially for the occasion. I was there too because as soon as I heard that the IFPA was setting up this service I had phoned them up to say that I had experience in about one hundred vasectomies from Canada and wanted to know if I could be of any service to them. In response to this they asked that I join with the ophthalmic surgeon and do the last operation on the list in order to demonstrate that I knew what I was talking about and that I could in fact do a vasectomy. All of that I thought was fair enough. After all I could have been anyone just chancing my arm as far as they were concerned and as always patient safety was number one. I carried out the last vasectomy on the list without any problems and the ophthalmic surgeon declared me a safe pair of hands and the rest is, as they say, history.

  Being taken on at that particular time by the IFPA to do the three or four vasectomies that they then had per week was extremely fortuitous from my point of view. The tiny private practice that I had built up by that stage was hardly sufficient to put bread on the table and this additional work was exactly what I needed right now. This was all pure luck and was a matter of just being in the right place at the right time. Had I returned from Canada three months later someone else would have got the job and I would have missed this opportunity altogether. It soon got around to my colleagues in general practice that I was doing vasectomies for the IFPA and they then started to refer the odd patient to me also. So between my weekly sessions at Synge Street family planning clinic and a trickle of private vasectomies referred to me by my colleagues there was less pressure on me now to build up a general practice in a hurry. This could be allowed to grow organically as it were, which is really the only way that these things happen anyway.

  Not indeed that all my hospital colleagues were that enamoured with the idea of a mere GP doing minor surgery outside of the hospital setting. They hated to see happening what they perceived as a loss of control. But the fact of the matter was that the consultant urologists of the day did not know how to do a vasectomy and even if they did were not at liberty to carry them out in their Catholic-controlled institutions.

  When I had carried out my first 631 vasectomies at Synge Street, where Nurse Marie Lee was my assistant, Dr Harry Counihan approached me one day to know if I might like to publish a paper on the subject of vasectomy in its Irish context. Harry was then the editor of the Irish Medical Journal. The paper was to describe how a vasectomy was done, the age profile of those having it done, the average number of children they had and describe any complications encountered with these first 631 cases. I thought that this was a splendid idea and agreed immediately to gather my statistics and start writing this paper. Little did I know what was coming next.

  In due course my paper was ready for publication. As is the way with these things, it was all very formally laid out with tables and figures and graphs and references. There are strict rules and protocols pertaining to the way one approaches the writing of what we call a ‘peer-review’ medical paper. The average age of men presenting for vasectomy at that time was 34.9 years, the average number of children that they had was 3.8 children. Were we to repeat this study today we would find that both of those figures had fallen quite considerably. Today the average family size for a man presenting for vasectomy would be in the region of 2.4 children while they also tend to be younger with an average age of about 32 years.

  I mentioned the formal way that this paper had to be laid out only because this factor gave me some comfort, false comfort as it turned out, that my work would remain buried in academia, never to see the light of day through the popular press. That was the way I needed it to be. Both my parents were alive at the time and I did not want to upset them by their learning of my wanton anti-Catholic ways. To use the modern parlance, I was not yet ready to ‘come out’ on the subject of vasectomy. But, if I thought that the popular media were not going to pick up on my article in the Irish Medical Journal, then the Sunday World had a surprise for me. The very next Sunday after my piece was published in the Irish Medical Journal, the Sunday World seized upon it in the worst way possible. Right on the front page and in true tabloid fashion the headline roared out to my parents coming out from mass:

  Irish Doctor Sterilises 631 Men in Dublin Clinic.

  So that was it. The cat was out of the bag. My father took it very badly indeed. That day he phoned Fr Hughes, the parish priest of Clane, who was now a neighbour of ours. We had just moved across the street from him into a Victorian house called St Ann’s. My father asked that the priest go over to my house and have a word with me. Someone raised the possibility of excommunication as a way of dealing with me. The priest duly called over, having phoned me in advance. To be fair about it he was all sweetness and light. He did not want to be there in the first place and only came over because he had promised my irate father that he would. We opened a bottle of Jameson and got stuck into that. But it was a no win situation and both of us knew it. I had no intention of discontinuing vasectomies since I have always felt that this was a private matter and it was up to an individual’s conscience. I was in no mood for religious dictates and that was that. We parted that evening good friends, agreeing to differ and, in the fullness of time, everybody settled down, including my father.

  Although all of this was something that I would have much preferred had never happened it is, as we all know, an ill wind that does not blow some good. The Sunday World at that time had a huge circulation and this was banner headlines front-page coverage. Were we to pay for this kind of advertising you would be looking at tens of thousands of euro at today’s rates. If there were any men in Ireland who did not know that vasectomy was now available here before the Sunday World quoted my article then there were very few of them left afterwards. Business started to rise steadily. Synge Street family planning clinic was still the only centre in Ireland offering vasectomy so they came from far and wide, from Kerry to Donegal, Wexford to Louth. In time more centres would open up but for the first three or four years we had the entire country to ourselves.

  This was not my only brush with the clergy. Another parish priest from a neighbouring parish phoned me up wanting to know if he could come and see me in my own house. When I got this phone call I thought to myself, this is great, I’ll have a parish priest on my list of patients and that will do no end of good in lifting my practice profile as it were. But the priest had different plans for me.

  When he arrived Fr Mulvihill greeted me cordially and walked straight into the drawing-room. And no thank you he didn’t want tea or coffee and as for the other stuff he never touched it. Things were off to an ominous start. Once in the large room the priest starts going around to the pictures hanging on the wall and, with his hands held behind his back, peers at each one trying to make out the artist’s signature and then he makes some inane comment or other as to his opinion on the artistic merits of the picture in question. He throws out the odd question like ‘Are any of these rumours that I have been hearing about you true?’ Since I’m not quite sure to which rumours he was referring, I kick for touch and say ‘of course not’.

  ‘Oh that’s good,’ says the
priest.

  Three pictures later and another artist identified and commented upon the priest holds out his left little finger to me and inquires if he were to ask me to chop it off would I oblige. This I understood to be an oblique reference to mutilation, a pejorative sometimes heaped on vasectomy by those opposed to the operation for whatever reason. But at this stage I had had just about enough of this meddling cleric offering me his version of gratuitous moral guidance. As politely as I could, though at this stage I was getting quite annoyed, I informed the man of the cloth that if ever I felt the need for his counselling on medical ethics that he would be the very first to know and that in the meantime I would be most obliged if he would leave my house. He did, saying that he was most relieved to hear that none of those rumours he had been hearing about me had a shred of truth to them and that he felt that that was the case all along. The incident was not without its funny side.

  But it was also extremely galling. That a priest should have the audacity and bare-face impudence to come into someone’s house and to in effect deliver to the occupants a lecture on his own home-grown version of morality was quite simply outrageous. Suppose the boot was on the other foot for a moment. Suppose that I phoned up this parish priest and told him that I needed to have a word with him and would it be all right if I went into his house and spoke to him. Then suppose on arrival I started to peer at his pictures and tell him that in my view he was grossly overweight, clearly was eating all the wrong foods and not taking nearly enough exercise and if he didn’t mend his ways that soon he was in for an early and painfully slow death. How long do you think it would take the priest to show me the door and rightly so?

  But it wasn’t all doom and gloom by any means. Up in Synge Street family planning clinic where I was doing all those vasectomies and was for three years the only doctor in Ireland so engaged, we also had the occasional laugh as well. We had this background music playing from one of those old eight-track tape players. They are defunct now but at this time in the early 1980s they were considered state of the art technology. This classical music was supposed to relax the clients who might be understandably apprehensive about what they were soon to undergo. As such though I never gave any thought as to the content of this piped music and in time, like traffic noise or the sound of a rookery, never heard it at all.

  One day we had this man on the table and we were well into the second half of his vasectomy and everything was going grand. Then suddenly out of the blue the man says: ‘Jesus I don’t believe it!’

  ‘You don’t believe what?’ Marie my nurse wanted to know.

  ‘I don’t believe the music you’re playing in the background there.’ We all stop and listen. I’m not sure because classical music at the time was not my forte. But the patient on the table was in no doubt whatsoever: ‘That’s the “Nut Cracker Suite”,’ he informed us with justifiable outrage. From that moment onwards Tchaikovsky was taken off the menu of our in-house entertainment package.

  Another time we had a clinical photographer in taking a series of photographs of a vasectomy being performed. I had been asked to give a lecture on the subject of vasectomy and needed to augment this talk with a series of slides each showing the various stages of the procedure – the local anaesthetic, the incision, the grasping of the vas with this special forceps and so on like that. Each photograph was a close-up on the scrotum only with the rest of the patient being off camera.

  The man having the vasectomy and at the same time having a series of photographs being taken of the operation was very much amused by the whole thing and was wearing a broad grin on his face throughout the entire proceedings. Marie was gifted with a fine Dublin sense of humour. When she saw him grinning away at the camera she said to him: ‘You do not have to smile for these photographs you know.’

  * * *

  My parents’ health continued to be of concern. My father’s rheumatoid arthritis had perhaps passed its worst but he had another problem equally incurable then as it is today. Macular degeneration is an insidious blinding disease that affects the back of the eye or retina. If you think of the eye as a small camera then the retina is the film or that part of the eye that captures the image and relays it via the optic nerve to the brain. The retina is a delicate structure fed by tiny little blood vessels. If these vessels are in any way compromised then damage is inevitable. Macular degeneration runs in my family. My father, and now two cousins, had been affected. In order to reduce my chances of getting it I take a daily dose of Zinc along with a good multivitamin capsule. Studies have shown that this nutritional approach should reduce my chances of developing macular degeneration by at least thirty per cent

  My mother’s health if anything was even worse. For a woman who never drank or smoked and who did all the ‘right things’ all her life she was very unlucky to have had a small stroke when in her sixties and then to develop Parkinson’s-like symptoms later on.

  Up in the big house my brother and sister-in-law are getting restless and unsettled. The house is too big for them and whatever interest Davoc ever had in farming he is rapidly losing it. Clare beckons them. Clare is the ancestral birthplace of the Rynnes. Our people all come from Cluana and Clunnaha outside of Ennistymon. Clare moreover is probably the best county in Ireland for traditional Irish music, something Anne and Davoc are very interested in. There are perhaps more romantic than practical overtones to this notion of taking up roots and settling in Spanish Point but that is what they are intent on doing. Soon the big house will be empty but not for long.

  Over in Robertstown the canal festivals are in full swing and that hurricane of a man Fr P. J. Murphy drives that sleepy little village into action making the once near derelict Grand Canal Hotel a major tourist attraction. Fr Murphy was a classic example of just what can be achieved given enough enthusiasm, drive and energy. When he was killed in a car crash a few years later the whole Robertstown project fell on its face never to recover. But we had some great years there. Along with Ned Farrell acting as host, playing the bodhrán and telling funny stories and Gerry O’Mahony on box and Frank Burke on fiddle, I was asked to join as singer and occasional whistle player. We dressed up in sort of Georgian costumes with knee breeches and white stockings and wigs that didn’t really fit us. At half time we would go into Mulannies next door to slake our thirst. It really was more of the same and shades of the Abbey Tavern fifteen years earlier – drinking, playing and earning a few bob for doing what we all loved.

  By now Downings House was empty and idle and sad. If it was left that way for long it would start to moulder and reach a point of no return. It needed major work done to it while it was still relatively dry inside. I negotiated with my sister to purchase the house and an adjoining eleven acres of woodlands and pasture. All the windows needed replacing, it needed to be re-plastered all around, rewired and plumbed, a central heating system installed and a new roof fitted. All of this work was commenced in June 1979 and finished at the end of November that same year. Just at that time it was easy to find good craftsmen because there was a lull in the building industry. That’s why I was able to get all the work done so quickly. By Christmas we had sold St Ann’s on Clane’s main street and had moved back into the house that I was born in. All of this, like most things in life, happened not by design but by happenstance.

  I believe Ann viewed this move to the large house as something of a mixed blessing. For me it was different of course. It was where I was born and where I grew up. But for Ann there were no such emotional attachments to alleviate the impracticality of the whole thing. She once referred to the house as a ‘glorified wind tunnel’, which was probably quite accurate and certainly quite witty. But the house and the unsatisfactory land division that I negotiated with my sister was undoubtedly another nail in the coffin of an already shaky marriage.

  A year after moving into Downings we applied to the Eastern Health Board to adopt a child. The screening process for potential adoptive parents was, as it remains today, long, gruelling and per
sonally invasive. It was also incompetent because it failed to unearth the cracks that must have been already appearing in our marriage. In due course a three-year-old boy called Adam was identified as a probable candidate. Adam was of mixed parentage – his father Nigerian, his mother Irish. We took him in and loved him as one of our own. But when he reached maturity he flew the coop and today sadly we have almost no contact with him at all. But sometimes adoption can be like that. Sometimes, no matter how hard you try, adopted children are never quite yours and perhaps this is understandable at a certain level. Adopting is not always the same as natural parenting; at least it wasn’t to be for Ann and I. That is not to say that the whole experience was not worthwhile and hugely rewarding in itself. A sad ending but perhaps adoptive parents should not always assume a long-term relationship.

  * * *

  Robert Brook built the village of Prosperous in 1780. Brook made his money by collecting rents in India – nice work if you can get it. He invested almost a million pounds of his own money in setting up a cotton industry and building the village of Prosperous for its workers. The houses were all to be of brick and slate and each to have enough land to graze a cow. Many of these houses survive today such that, in the old part of the village, you can still easily appreciate the broad Georgian streetscape with its two small squares.

  The glory days for Prosperous were short lived. In spite of receiving two grants from Grattan’s parliament amounting to almost two million pounds, this massive project never really got off the ground. Brook blamed drunkenness among the workers but the truth in fact may have lain closer to home. For a start the location was wrong and the concept too grandiose. Very little product was ever produced from the cotton mills and the whole venture folded within a few years. The successful battle of Prosperous in 1798 nearly finished the place off for good. Lewis, commenting in 1837, describes Prosperous as ‘little more than a pile of ruins situated in a low marshy spot, surrounded by bogs and without water of importance nor reasonable hope for its revival’. I am glad to say Lewis got it all wrong. Today Prosperous is a vibrant little community with new people moving in all the time. In 1980 I was chairman of the bicentenary committee when, thanks to the creativity of Nan Clark, we had a week of activities ending with the unveiling of a monument beside Healy’s post-office. Here we placed a plaque on the wall commemorating Robert Brook.