Helen fit the bill.
So, what had I been thinking? Where was my head? Up my ass, worrying about potency, penetration, penis, pelvis. What about Helen, what about fertility, and our having a third child? Yes, we had two wonderful daughters. We had not been infertile from the get-go. No reason to feel sorry for Helen or for the two of us. Yet it was hard to see a talent stopped in its tracks just as it was reaching its prime—not unlike an athlete stopped in his tracks by a leg injury or a concussion, not unlike a pianist or violinist who can no longer use his hands, not unlike a chef who loses his sense of smell and taste.
I got on the horn with the prostate surgeon at Columbia-Presbyterian Medical Center. “Okay, so we never collected any sperm before the surgery. But what can I do now? How do I regain some semblance of fertility?”
“We can extract sperm from your testes. The sperm should be viable. There’s a guy I know well at an academic medical center in Houston who can extract the sperm. He’s a nationally recognized fertility expert. He can do a needle biopsy. I’ll call him today and see what we can arrange.”
Doctor talk for, “We’ll put a large needle in one of your balls and see what we find.”
Oh, fuck. Ow, ouch. A new way of fucking, a new way of making babies. A new kind of intimacy.
Within days I was in an operating room in Houston undergoing this needle biopsy. I must have been in a hell of a trance. My vows, my mantras were taking me to strange places—this trip to Houston, this enthusiasm for putting my testicles under the knife. Was this my plan, or some master plan designed by Aristophanes? Potency will wait; fertility comes first.
A few days later, back in Washington, DC, I heard from the fertility guy. “Your sperm cells have been affected by the radiation. They are extremely immature and currently unviable. That could change in the next few months or years. Let’s keep in touch. We can do the same procedure down the road.”
What had Helen and I been thinking? Of course the radiation had a profound effect on rapidly reproducing cells like sperm cells. The fertility guy had seen only what was visible under the microscope. What about the invisible effects of radiation? Radiation scientists speak of “bad invisible information”—information stored in proliferative cells, in the DNA. This faulty coding can lead to congenital and degenerative diseases in the bone marrow and elsewhere—untold consequences on any offspring. Visions of a child with two heads and one arm and three legs come to mind.
Here is what Eric Hall, the author of the definitive textbook on radiobiology, has to say about radiation damage, “If the damage is a mutation in a germ cell leading to hereditary changes, it may not be expressed for many generations.” What a legacy—great-great-grandchildren with two heads. Thank the gods for immature and unviable sperm—at least no legacy of horrors three or four generations from now.
An unusual mourning dawned on Helen and me, a mourning over an ambiguous loss. No, this was not the sense of loss one feels after a miscarriage or after a stillbirth or after the death of a young child. This was a grief over all the unborn children, over all of what might have transpired, over all of the abstract potential for life, all of it intangible and unpalpable. No remains, no coffins, no ashes, no stones to mark the grave, no tombs to mark the loss. No religious institution or rituals to grab onto. No ceremonies, no funeral services, no wakes—no priest or rabbi to mark this loss of fertility, this end of a couple’s unique gift, a gift for themselves and from themselves to the world.
No wonder then, in all species except man—and man only in the last century—life expectancy coincides with the age of male or female menopause. A question from the gods: Is there any point to life after our reproductive years have ended? Finality and the end of fertility—one and the same, say the gods of ontogeny and phylogeny.
Helen and I fortunately still had two young daughters, then five and seven years old, to raise—a genuine life’s work and pleasure, a reason to live beyond one’s end of fertility.
Plus we had a new torment to confront.
Oh, fuck. I had unremitting and unrelenting pain in my left testicle ever since the surgeon stuck a needle into it. The area healed uneventfully, but the pain never stopped. My pelvis seemed to be a tinderbox, neurally ready to explode, with sensory fibers confused and overloaded and unable to figure out what they were connected to.
The surgeon in Houston had never seen such a response to a “simple” needle biopsy. Simple, my ass. Simple, my balls.
It appeared to be some kind of causalgia or neuralgia, according to the terminology of 1985. People can get these causalgias in the brachial plexus above the shoulder—causing horrific pain in the arms. Others can suffer from a similar phenomenon in the sciatic nerve in the lower back. Still others, having gone through an amputation of a limb, can have an unremitting phantom-limb pain. But how many people end up with an unrelenting pain in the balls? Or in one ball to be exact—one ball too many.
Neurology textbooks at the time described causalgia as a “distressing symptom,” a hell of an understatement. Lord Brain, the aptly named writer of the definitive neurology textbook used in 1985, described it as an “intense and persistent burning pain, which is subject to paroxysmal exacerbations, which may be excited . . . by actual contact with the (affected) limb.” Yeah, my limb, my tail, my testicle was simply getting the wrong kind of excitement.
The treatments for this condition, circa 1985, were ghastly and mostly ineffective. Surgeons had to resort to a sympathectomy, the cutting of the damaged peripheral nerve that was the source of the pain and the cutting of the sympathetic nervous system stimulation in the area. But in an area dense with neural tissue, how can anyone know which of the many peripheral nerves is implicated?
No one was going near my balls, if I had a say. No scalpels, no needles, no medical palpations. I was already relentless in second-guessing the original needle biopsy. Relentless pain and relentless second-guessing.
Then I had physicians stating or implying the pain must be all in my head, that it cannot possibly be real. The pain was unimaginable—no one could conceive of it. Proof positive of Philip Roth’s notion, “Nothing that befalls anyone is too senseless to have happened.” Proof positive of Susan Sontag’s notion: The default assumption surrounding any mysterious ailment, a problem without a known clear-cut cause, is that it is “all psychological.”
I envisioned myself rotting in a revolving door of chronic-pain-clinic hell, a torture that might be worse than the actual pain.
Into this void stepped a surprising figure—my internist. A conventional guy, thorough and systematic in his approach to patients, standing behind a veneer of scientific detachment, he oddly suggested I try acupuncture and sent me over to Jing Wu.
Wu turned out to be a more than fascinating fellow. He was living proof of the absurdity of F. Scott Fitzgerald’s line that “there are no second acts in American lives.” Here Wu was in his second act, after having been run out of Wall Street by the Securities and Exchange Commission (SEC) in his initial career as an investment banker. With a financial scandal behind him, with the loss of millions of dollars—when that sum meant something—Wu had no choice but to reinvent himself.
He turned back to his Chinese roots, to his roots growing up above his parents’ laundry in Greenwich, Connecticut, and used his Harvard education and considerable intellectual curiosity and energy to understand the vagaries of Chinese medicine. Without any formal education in anything remotely connected to clinical medicine, Western or Eastern, he arranged apprenticeships over the years with Chinese medicine experts in Hong Kong and on the Chinese mainland. He was a throwback to the way careers developed in previous centuries, when people developed skills as farmers and artisans and even potato chip makers through apprenticeships, not through college and graduate school educations.
He could talk about fire and water, the kidney pulse, the spleen pulse, now with the best of them in China and the United States—all mumbo jumbo to anyone with a Western-trained ear.
&
nbsp; Wu threw himself into his second act. He took on the task of coming up with a new translation of the I Ching, otherwise known as the Chinese Book of Changes, which explored the dynamic balance between opposites. A newly-minted Daoist, he put together a new translation of Lao Tsu’s Tao Te Ching, a series of poems and statements that looks at the paradoxes of life while preaching humility and a willingness to go with the flow.
A remarkable second act, though a bit more subdued than his first. In his first act he was purported to have had an affair with Jacqueline Kennedy Onassis when she lived in a home he owned in Middleburg, Virginia.
In his second act, he reinvented himself in the image of a traditional Chinese peasant doctor.
Wu’s intervention worked, and worked almost immediately. In my first encounter with him, he delicately put needles into my back, mostly in the lumbosacral region.
“We want to find a way for the brain, the leader of the nervous system, to believe that the radiated and scarred tissue in the prostate bed is still viable and alive. It is as if your brain has written off that area of the body, has assumed it is all dead and desolate—and your brain is now receiving weird and distorted signals from that part of the body.”
My pelvis had become some fallow acreage, not worthy of any irrigation or seeding or cultivation. Wu and I wanted to find some way to reverse the brain’s perception.
There is nothing like quick success to make us into converts. Religion is notorious for producing a similar quick conversion. Nostalgia for our childhood innocence, when the world seemed simpler and safer, can lead us back to religion in our grimmest and grimiest hours. It works almost immediately; it provides instant comfort—and we are hooked, born-again Christians, Muslims, Jews before we know what hit us.
Acupuncture is a harder sell, especially in the West in 1985 and 1986. Even the Chinese themselves had forgotten and neglected this cultural and medical treasure over the preceding hundred years. In the late nineteenth and for the first half of the twentieth century, Western medicine in China was in unprecedented ascendancy, and traditional Chinese medicine was in unprecedented descendency. The medical teaching programs initiated in China by Western institutions such as Harvard, Yale, and the Rockefeller Foundation were exceeded only by the highly Westernized medical school developed by St. John’s University in Shanghai in the late nineteenth century. By the time the Nationalist government of Chiang Kai-Shek came along, leaders were more than willing to sell traditional Chinese medicine down the proverbial Yangtze River. In fact, the government passed legislation to outlaw traditional medical approaches like acupuncture and herbs on the grounds that it was backward and primitive and laden with superstition.
Under Mao Zedong the communists took a more pragmatic, albeit cynical, approach. “We have an enormous country, with only thirty-eight thousand Western-trained doctors serving five hundred million people,” they seemed to be saying. “Let’s throw the population a bone by hurling three hundred thousand traditional medicine specialists at them to give some semblance of providing for their medical needs.”
Mao did initiate some notable public health and preventative medicine campaigns. But the situation took a major turn for the worse with the Cultural Revolution in 1965. During the first six years of this revolting revolution, all medical schools, including schools of traditional medicine, were closed. When they reopened, their curricula were decimated along with any pretense of a meritocracy. Students were not selected for admission based on their capabilities, but instead on vague political considerations like a “willingness to serve the people.” No cynic could have devised a more dramatic means for destroying a rich medical tradition—a distinct and complementary view of how the human body operates, compared to the West—than Mao and the Gang of Four and their predecessors had done.
Only in 1976, with the death of Mao and the overthrow of the Gang of Four, did traditional Chinese medicine begin to make a comeback. But that comeback would take a number of years to spill over into the West.
So, acupuncture in 1985, in Washington, DC, had little or no cachet. But for me the second treatment worked even better than the first. The ungodly pain in my testicle was receding, and it was being replaced by a more appropriate and understandable pain in my lower pelvis, at the site of the scarring from the surgery and radiation.
This evolving pain, I could handle. Exercise, exercise, exercise: Basketball and tennis became my daily staple. But the pain became exacerbated with any effort to move the muscles of the pelvis, with any pelvic thrust or pelvic tilt. When squeezing in and tightening these pelvic muscles—something we naturally do when holding in a bowel movement, or when getting sexually aroused—I could feel a burning and knife-like sensation in the lower pelvis.
“The normal muscle tissue is trying to push and pull and contract alongside the really scarred and unmovable tissue,” Wu explained. “When you squeeze in, the burned and radiated tissue remains stuck, glued to its bony insertions. The normal muscles are out-of-sync with this fixed and rigid scarred stuff.
“At some point after we convince your brain to pay attention to this scarred stuff, to recognize that this dead detritus is worthy of nourishment, we’ll tackle the scarred tissue directly.” For the first six months, Wu put needles exclusively in my back, in the intervertebral spaces, as I lie on my stomach.
Months later as I lay on my back, he put needles directly into the scar tissue in my lower abdomen. “The needles produce a histaminic effect,” he noted confidently, “not unlike a mosquito bite. Each needle insertion is like a mini-surgery that activates a healing response from the body. With this little prick—no pun intended—your blood stream goes into action. Your red cells, your white cells gravitate to the area of this tiny, tiny injury. If we tried to break up the scar tissue with a scalpel, we would simply be wreaking more havoc and creating more scar tissue. With these tiny needles we may even be inducing the creation of new blood vessels that can then perfuse this heavily scarred tissue. We’re creating new canals, new conduits to nourish this decaying tissue.”
A new image took hold—scarred, hard brown tissue becoming pink and soft, well oxygenated and revascularized. A mantra came with it: I will do everything I can to bring these pelvic cells back to life, to make them pink and soft. Pink and purple, those colors again, reflecting verve and vibrancy. With each treatment the discomfort in my pelvis was changing ever so slightly, and the pain in the left testicle was gone forever.
I have become a convert, a true believer. The relief of torture will do that to you.
No one knows definitively how acupuncture works. For musculoskeletal problems it works just as well on animals as it does on people. In 1986 as I was continuing acupuncture treatments, I came across research from A. M. Schoen showing that acupuncture relieves symptoms and increases activity in 80 percent of animals with degenerative joint disease—disease previously unresponsive to conventional treatments. X-rays of the involved joints before and after treatment suggest some regeneration in the damaged joint cartilage.
Others are more dismissive, claiming that acupuncture simply activates a placebo response. “If you believe it, it will come.” In essence, they are saying it is purely a psychological response, not a physical one. Again Susan Sontag’s point: When phenomena are poorly understood, we apply psychological reasoning—it is all in the person’s head—to explain both poorly understood illnesses as well as poorly understood healing experiences.
If it is a placebo, I am going for it. Let’s bottle it and use it and benefit from it.
Wu and other traditional Chinese practitioners did not help their case with their narratives and language. Twelve meridians or channels, fifteen collaterals, eight extra channels, and hundreds of acupuncture points defined by these channels and collaterals. My eyes glazed over as Wu described the five basic elements from which the universe and man himself is made—wood, earth, water, fire, and metal.
“Each organ of the body corresponds to one of the elements,” Wu pointed out. “
For example, the liver corresponds to wood, and the heart corresponds to fire. Each of the five elements is a subdivision of yin and yang: The solid organs are considered yin while the hollow organs, like the intestines, are considered yang.”
Okay . . .
And then the feeling of the radial pulse. We Western-trained doctors feel the pulse to determine how the heart is functioning: Is the pulse too fast or too slow, are there irregular beats, is the strength of the pulse too thready? The Chinese peasant doctor feels different kinds of pulses over the course of one centimeter of the radial artery along the wrist. These pulsations, they claim, may reflect imbalances in, say, the liver or kidney, not just the heart.
Wu reminded me all the time that my kidney pulse was quite weak. This kidney pulse reflects the energy level along the kidney meridian controlling sexual function and activity. No surprise there.
The simplicity of this approach may be half its appeal. Just feel the pulse and examine the tongue—a more primitive and personal approach to medical care. No hammerings of the magnetic resonance imaging, no excessive and unnecessary radiation from CAT (CT) scans, no ultrasounds, no blood tests.
So, how did acupuncture develop 5,000 years ago, with metal needles coming into play 2,300 years ago? Surely not by trial and error. One would have to take guinea pig status to absurd levels to imagine a host of human beings willing to let a crazed needle-wielder put hundreds of needles all over their bodies in an effort to see which points were useful.
A Salamander's Tale Page 7