A Salamander's Tale

by Paul Steinberg

  There may be some bravery in loving and leaving, but there is even more bravery in figuring it all out and fighting it out over time. Not just bravery, but also a capacity and willingness to manage complexity. Species that are monogamous have larger brains than those that are polygamous. Species of birds that stay with one partner have brains that can handle the complications inherent in a single relationship—the struggles, the adaptations, the demands—unlike polygamous bird species. Easier, indeed, to follow one’s instincts, for males to go out and spread that seed willy-nilly; much harder to hang in there and manage the complexities.

  Who knew? A big working and adaptable and flexible brain—in both genders—may be more valuable than a big working and adaptable and flexible set of genitalia.

  Yet, with prostate cancer in the picture for Helen and me, that knotty and naughty synthesis—that combining of a sharing of passions along with grounding—became even more difficult, if not impossible. How do we describe a relationship that seems to be working, a relationship that is loving and life-giving and long-standing, a relationship that is able to adapt, that provides this grounding along with a genuine sharing of passions—without invoking clichés?

  I can see how someone diagnosed with metastatic prostate cancer might say, “Okay, just castrate me, just permanently take away my testosterone and all my androgens. Let’s simplify things.” For me, though, Helen has been that crucial driving and motiving force. Only through Helen is there this essential mantra: I will do everything I can to retain my lust and my passions. Who cares if it borders on lechery? Yes, so much better than sexual apathy. Yes, let’s get that stamen functioning again—working its magic on a hot swollen pistil. Through Helen’s passion I could move from being a piece of vegetation to a man again. What powers she has had—it was indescribable. She has brought me back to life.

  Yes, I simply follow Helen’s instructions, the urgings Cleopatra gave to a messenger in Shakespeare’s sexiest and most sensual play, Antony and Cleopatra: “Ram thou thy fruitful tidings in mine ears, That long time have been barren.” The avuncular eunuch comes back to life through Helen’s urging and cajoling, Helen’s loving and not leaving. A new kind of nursemaid, a new kind of passionate nurturing. The earth mother and the impassioned lover embodied all in one being.

  Was I putting Helen on too high a pedestal? Was I idealizing her inappropriately—my cupid, my eros, my earth mother? Absolutely. But I was a true believer. I believed in the sun even when it was not shining. And I believed in Helen even when the love temporarily subsided. And Helen believed in me even when I was eunichically incapacitated.

  Her consistent reassurances: I will be there for you with or without our sexual relationship. I am just so happy you are here with me, you are here walking and talking and living and recovering from each and every blow. You are lucky to be alive, and I am even luckier to have you alive. An unconditional love we rarely find beyond childhood, beyond our parents’ love.

  Resentments were pushed to the rear. Helen and I reserved our rage and resentments for the gods, not for each other. Our terror and rage at the vagaries of the universe pulled us together. A not unheady time. A time filled with a special kind of intimacy.

  To receive the explicit and implicit message that I did not have to regain my sexual capacities in order to be loved was lusciously liberating. It allowed me to, instead, want to regain my sexual capacities. No shoulding all over myself, as the cognitive psychologist Albert Ellis might say. I so much wanted to make love to Helen again and again; I did not have to.

  So many shoulds in our childhood—shoulds and musts from society, from parents and teachers and coaches, shoulds from religion. All these shoulds are essential for a functioning society. But when we have adequately learned the rules of society by the age of, say, eighteen, it is time to liberate ourselves from these shoulds and have-tos. We’ll follow the laws of that given society; we’ll try to treat others the way we wish to be treated. But it is time to change the have-tos to want-tos, to give as much credence to our desires as to our duties.

  Somehow many of us have failed to realize that we are controlled more by our inner lives and the shoulds in our inner lives than by any of the mandates from a government, from a congress, from a president. Instead, we may want to shut our own face, to change our own inner lives and all the inexhaustible shoulds in our inner lives. Even some dictatorships have fewer authoritarian shoulds and musts than our own inner lives. No more musturbation from someone who intermittently has been incapable of masturbation.

  Helen’s acceptance of my deficiencies allowed me to gain a freedom from any shoulds and have-tos, to unleash all my energies and enthusiasms and motivations to keep myself going as a sexual being, as just a being. No musts and got-tos to clog up my efforts.

  In the weeks after the initial surgery, we brought our daughters on board. A marriage is not simply an extended love affair; it is also a working economic union, a means to bring the next generation into the world and begin to train them for survival and fulfillment.

  We found a way to be open and honest with our then four-year-old and six-year-old daughters. No point in their hearing from their friends some weird inadvertent comments, “I heard your dad is sick,” “I heard your dad has cancer,” “Is your dad going to die soon?”

  So, shortly after my return home after surgery, Helen and I sat down with them to discuss my medical situation—not without some intense rehearsal. Yes, guys, I do have cancer. And you do not have to live in fear of the “C” word in the way that my generation has lived. I will be able to live with cancer; our whole family will find a way to live with cancer. And cancer does not have to be a death sentence. It is a serious illness with serious implications. But I am planning to take an active stance with it, to do everything I can to deal with the disease and its treatments.

  The message: Life may be different postdiagnosis and posttreatment, but that difference does not necessarily make life worse or better for us as a family, just different. I am going to face this setback in life head-on. And I hope that, whatever setbacks you may face in life, you’ll be able to face them head-on as well.

  Yes, “Facing it, Captain McWhirr,” as Joseph Conrad puts it in Typhoon. “Always facing it. That’s the way to get through.”

  For me and Helen, a remarkable moment: We had turned something potentially ruinous into a teachable moment. We had avoided the potential fiasco of secrecy. We were a lean mean fighting machine, a unit working to help me, currently its most vulnerable member, face the ramifications of prostate cancer.

  Let’s not forget that my daughters have been a potent and sustaining life force as much as Helen. Yet, after one has survived prostate cancer for a number of years, the heady and the heroic can become old and tired. We can fully ripen and even rot; relationships can ripen and rot. But so much better to be a ripened or even rotted old lounge singer in a Las Vegas club than to die in electrifying vibrancy at the Fillmore East.

  Clichés, yes. But no irreverence or cynicism here: I love Helen so, so much; she loves me (I think). I love my daughters so, so much; they love me (I think). All is right with the world—for now (I think). I am so overjoyed to live my life as a cliché.

  CHAPTER 17

  A Meditation on Lust and Sex, Time and Death

  Give me that man

  That is not passion’s slave.

  —William Shakespeare, Hamlet

  Love is a conflict between reflexes and reflections.

  —Magnus Hirschfeld, Sex in Human Relationship

  Arnost Lustig, a novelist, short story writer, and survivor of three concentration camps, was standing in front of a group of us in our living room. Helen had invited a group of colleagues and students whom she was working with at American University to come to our home to meet Arnost, to talk about literature and life. It was the early 1990s, and I was dealing with the first of many intermittent castrations.

  “Fucking and eating,” he boomed out bluntly. “That’s how we surviv
ed the camps. That’s all we thought about—what we were going to do when got out of this damn place. What we would eat and all the women we would fuck. Our imaginations were the only thing that kept us going.”

  Who knew? Damn, even a guy in a concentration camp had a healthier and richer fantasy life than a guy like me going through an androgen blockade. Unlike Arnost as a teenager in a concentration camp, I was no longer able to be a slave to passion. Who knew that slavery could be life-sustaining?

  What a screw-job, what a double-bind, what a catch-22. We now know that the touch from a sexual relationship is more beneficial, more crucial, more life-giving for a woman with breast cancer than any other touch, than any other encounter. The touch from a sexual relationship increases oxytocin levels and a sense of attachment in a way that no other touch produces. These higher oxytocin levels and levels of attachment appear to be associated with longer survival rates.

  Who knew? Damn, even women with breast cancer can experience that wonderful sexual touch in a way that a guy like me going through an androgen blockade could not.

  How does a guy with prostate cancer increase his chances of greater longevity if he is denied the possibility of that life-enhancing sexual touch, a touch that is distinct from a motherly touch, from a friend’s touch, from a sisterly or brotherly touch—with any sexual touch of mine or Helen’s curbed by the treatment itself, curbed by the chemical castration?

  How important is sex to the average adult male? Our best clue might come from our evolutionary cousin, the chimpanzee, whose more formal Latin name used to be Pan Satyrus. Here is Frans de Waal’s understated scientific observation of a stable group of chimpanzees in captivity:

  It is untrue to say the life of the group is dominated by sex but this does not mean that sex is unimportant. The adult males, for example, may refuse to eat for days on end when one of the females is in her estrus period. When I see them early in the morning, in their sleeping quarters, I can read the excitement in their eyes. They have a covetous look, which they also have when they get something especially tasty to eat. It is clear that they are anticipating the pleasures of the day ahead.

  Perhaps Wilhelm Reich had it right all along. He was more in touch with our inner Pan Satyrus than the rest of us. What is the point of life without that sexual touch, without the orgasm—or at least the promise of the orgasm? Food and sex and perhaps some ecstatic religious experience—and very little else—have the capacity to produce an orgasmic experience for us primates. And even food loses its cachet in the face of sexual opportunity.

  Man, I hope to get lucky tonight. And if I am incapable of acting on my luck tonight because of an androgen blockade, I hope to get lucky six months from now. No interest in or need for food for days on end if I have my full complement of androgens. Ah, the hope, the promise, the desire—all sometimes fulfilled. Ah, an intermittent androgen deprivation—so much better than a permanent androgen deprivation.

  Only when we lose something do we appreciate its meaning and value. Otherwise we take it for granted. Testosterone, dihydrotestosterone, estrogen, progesterone—the sexy hormones: We assume they will always be with us. When they are gone—damn it, we hardly knew ye.

  We men are prisoners of sex, prisoners of our hormones. Free will?—gone as soon as we reach puberty, as soon as those hormones start surging, as soon as we start experiencing full orgasms. As teenagers we may think we are joining a rock band because we love the music—partly true, but we join mostly because we want to get laid. So too do we develop our athletic skills, our scientific chops, our novel-writing craft, so much to respond to those sex-driving hormones.

  The timing of these testosterone surges is critical. Male rats castrated at birth or just prior to birth fail as adults to show the mounting behavior so typical of males in the presence of receptive females. Even if they are later given appropriate amounts of testosterone, they are incapable of engaging in this mounting behavior—the die has been cast. If these same rats are given estrogen and progesterone as adults, they assume the same sexually receptive posture as female rats in heat. Free will—gone, kaput.

  Young male monkeys engage in more rough-and-tumble play than do young female monkeys—all related to testosterone levels and the effects of these levels on brain development. Among us humans young girls who have inadvertently been exposed prenatally to unusually high levels of androgens because of a congenital condition prefer the same play as boys. So, even the type of play we engage in is beyond our control.

  And suppose we guys want to develop a deep baritone male voice during our teenage years and beyond. Forget about it if we happen to have a sweet and soothing soprano voice in boyhood in sixteenth- and seventeenth-century Italy. We will be castrated before puberty; we will become a castrato; we will never develop that deep male voice we may have wished for.

  Timing is everything. I can vouch for the fact that any castration done after puberty will have no effect whatsoever on our regaining or retaining any high soprano voice from boyhood.

  Evidence is accumulating that the timing of male hormone surges and female hormone surges may have an effect on male and female sexual orientation. Gay or straight: Our hormones—and the timing of these hormone releases—tell us who we are sexually. Free will and choice and preference have virtually no say at all.

  Loss and then recovery—I was constantly playing catch-up sexually in response to prostate cancer and its various treatments. First surgery, the removal of the prostate—a nerve-sparing procedure that with time would allow the nerve tissue that feeds the genital area to recover. A loss of potency initially, a loss of jism, that creamy fluid that keeps the generations flowing, that keeps the species evolving. And then the start of a gradual recovery. But first, radiation—6600 rads to that same fragile area. Each blow was worse than the previous one. Potency was again lost. The nerves and muscles of the pelvis were unable to move and fire. The healthy seizure-like ecstatic quiverings of my penis dissolved in a heap. Hyperbaric oxygen gave hope that recovery was possible. Then acupuncture began to break up scar tissue—tiny needles allowed new blood vessels to form, oxygen to reach into the former prostate bed, and muscle and normal tissue to replace scar tissue. The salamander was regenerating his third leg.

  Orgasmic joy, orgasmic relief. Sperm and ejaculant were gone. Fertility was gone. But potency returned. Libido was still there. My sex drive was as strong as ever. That life-giving and life-enhancing sexual touch between Helen and me kept me vibrant and aquiver. The prostate cancer was in retreat, and I was in full plumage.

  The PSA test became available. My PSA was rising. Castration loomed. All the salamander’s efforts at regeneration may have come to naught. My life as a man may have come to naught. Impotence, I can deal with; temporary anorgasmia, I can deal with; infertility, I can deal with; dry humping, I can deal with. But loss of lust? Castration? No way.

  Intermittent castration—I can learn to live with it. The hope, the promise, the return of desire. Sign me up.

  Death of the pelvis on the installment plan. Each installment was worse than the one before, but I was still standing, my penis was sometimes still standing, my pelvis was sometimes still thrusting.

  But how does one regenerate after the loss of the orgasm, after castration—temporary or not? The newly blind man develops his other senses—his auditory strengths, his olfactory and gustatory senses. The newly castrated man—how does he compensate? What other senses evolve and regenerate and reverberate?

  If, as W. H. Auden pointed out, lust is less a physical need than a way of forgetting time and death, then the temporarily though repeatedly and intermittently lustless man develops a capacity to contemplate time and death. Sex and lust may not be the most dominant force in human and primate existence, but it is not unimportant, says Frans de Waal. Time and death: There is nothing more important. But we deny time, we deny death. We cannot face them head-on.

  The average adult, whether forty or sixty or eighty years old, sees himself or herself as a t
wenty-five-year-old. We deny aging. Yes, we all watch the clock. Yes, we celebrate yearly occasions—birthdays and anniversaries and holidays. But we deny that a day has passed, a year has passed, a decade has passed.

  Instead, lust and sex distract us and allow us to forget time and death. It can be porn, it can be fantasy, it can be Dancing with the Stars—and it can be the real deal. It can be manual manipulation, oral stimulation, genital animation. Our lustfulness heads off any listlessness. We are alive, we can conquer the world, nothing can stop us. Death and dying do not exist.

  A seventy-five-year-old with a terminal disease—be it cancer or heart disease or liver failure—may have no choice but to face time and death. Yet this facing of time and death may be cut short by death itself. But how many thirty-six-year-olds face a deadly illness—prostate cancer—that we can possibly make into a chronic, in some ways nondeadly, illness that gives us years to live and also takes away lust? We have no choice but to face time and death. Again, “Facing it, Captain McWhirr. Always facing it. That’s the way to get through,” says Joseph Conrad in Typhoon. But most of us, with the help of lust, do not face it. I was unable, in contrast, to forget time and death.

  A new kind of sense—a nonsexual sixth sense. A look at the world with a different set of eyes. The masculine turns into the feminine, the feminine turns into the masculine, the sexual turns into the asexual, the asexual turns into the sexual—all without a sex or gender change. No transgender, no transsexuality. The transgendered know who they are gender-wise: We are men stuck in women’s bodies, or vice versa, they point out, but we know who we are gender-wise. They can take the appropriate hormones to solidify that gender identity. But how many people see their manhood or womanhood alternate and fluctuate and mutate—and then regenerate—all in a thirty-or-so-year period?