Viagra and the culture of manhood

For millions of men who suffer from varying levels of impotence, Viagra has been a godsend. But for millions of others, it’s become the recreational drug of choice.

Photo Illustration by David Jayne

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Everybody wants some. I want some, too. That’s why I’m perched on an examination-room table, head bowed, shoulders slumped, feigning what I imagine to be some semblance of impotence, hoping to wheedle my doctor out of a Viagra prescription.

For millions of men who actually suffer from some sort of impotence—or erectile dysfunction (ED), as it has come to be known—Viagra and similar drugs, such as Levitra and Cialis, developed within the past decade have been a godsend, dramatically raising long-dormant members.

However, for millions of other men who have no trouble “getting it up,” Viagra has become the recreational drug of choice. Such usage is challenging cultural notions of sexual intimacy, the practice of medicine and what it means to be a man.

I fall into this latter group of men, those who have no problem with erectile dysfunction. Even if I had a problem, I probably wouldn’t tell you. Such is the nature of the beast, and, like many men, I’ve been curious about Viagra since it hit the market. In a culture where sexual prowess is akin to currency, who wouldn’t want to fatten their wallet—particularly when everybody else is doing it? Which is why I’m perfectly willing to lie to score some little blue pills.

The medicalized penis
Since the beginning of recorded history, man has searched for a more rigid tool, an aphrodisiac if you will. “Over time, there’s always been an emphasis on male sexuality,” explains Todd Migliaccio, a sociology professor who teaches a course in masculinity at California State University, Sacramento. “How do you prove your masculinity? Through sex. If you’re not having sex, then your masculinity comes into question.”

Thus, the historical quest for male sexual enhancement quite properly can be called an obsession, as evidenced by remedies for impotence from the past that most people nowadays wouldn’t eat on a dare: centipedes, rotten fish, rhino horn, bear bile and the crushed testes of various animals. Egyptians enjoyed rubbing crocodile semen on their genitals. Herbs such as yohimbe and horny goat weed have been used for centuries and are still available at your friendly neighborhood sex shop.

“Most of these do nothing, but people have persisted in using them for centuries,” says Richard, a Sacramento adult-book-store employee who asked that his real name not be used. “Hope springs eternal. It’s interesting to note that Viagra may save rhinos from extinction where all of the conservation efforts of environmentalists were failing.” Judging from repeat sales, Richard notes that his customers seem to be having success with ginseng, yohimbe and saw palmetto.

In stark contrast to such natural remedies are modern medical treatments for impotence first introduced in the late 19th century. Author David Friedman, in his probing cultural history of the penis, A Mind of Its Own, reports that such treatments included shoving a metal rod into the urethra, transplanting testicles obtained from apes into humans and shooting an electric current through the offending appendage. Shock the monkey, indeed.

Pharmaceuticals arrived with great fanfare in 1983, when Dr. Giles Brindley, at a conference of urologists in Las Vegas, intravenously injected the drug phenoxybenzamine into his own penis and subsequently displayed his fully engorged member to a live and somewhat startled audience. Through experiments conducted on himself, Brindley had discovered that injections of the drug promoted erections that lasted for hours.

Photo Illustration by David Jayne

“Never before had so many penis doctors seen another man’s erect penis,” Friedman writes. “In this singular moment, human sexuality, the healing profession, and man’s relationship to his penis underwent a huge transformation, the consequences of which are still being felt today.”

Or, as Migliaccio puts it, the penis became “medicalized.” Brindley’s discovery turned out to be a boon for impotence sufferers, and injections of the drug Papaverine (it turned out that phenoxybenzamine can cause priapism, erections that last more than four hours and can seriously damage the penis) became the preferred treatment for the next two decades. Obviously, sticking your penis with a hypodermic needle isn’t exactly for everyone. Fortunately, an accidental discovery by scientists at pharmaceutical giant Pfizer was just around the corner.

Erection perfection
That discovery was Viagra, sildenafil citrate, which debuted in 1998. The drug immediately sparked a frenzy as male patients suffering from varying degrees of impotency rushed to their doctors in record numbers. Up to 2 million prescriptions were filled in the first two months of its release; by 2005, 23 million men worldwide had been prescribed Viagra.

Pfizer, previously known as a manufacturer of cardiovascular medications, had truly struck the mother lode. With more than 100 million men worldwide estimated to suffer from different degrees of impotence, shares in the company’s stock quickly doubled in price. The blue, diamond-shaped pills retail for $10 a pop and account for billions of dollars in annual income.

There’s no question that for millions of men, most of whom are above age 40, the price is worth it. Viagra and other ED drugs work for approximately 70 percent of the men who try them.

According to the Massachusetts Male Aging Study conducted in 1994, age is a leading indicator for ED. The study examined men ages 40 to 70 and found that 52 percent experienced some degree of impotence, ranging from mild to severe. The severity increases with age, with just 5 percent of men in the 40-year-old bracket reporting complete impotence, compared with 15 percent of the 70-year-olds.

Viagra works by permitting smooth muscle tissue within the penis shaft to relax, increasing blood flow into the organ. This in turn crimps the veins that allow blood to flow out of the shaft, and voilà! Instant woody. Researchers discovered the effect while testing sildenafil citrate as a treatment for angina. Impotence can be caused by vascular disease, diabetes, certain cancer treatments and high-blood-pressure medications—conditions usually experienced by men over age 50 that reduce the blood flow to the extremities.

Nevertheless, Pfizer and other pharmaceutical companies have been marketing their wares to a progressively younger and less-impotent audience. Crusty septuagenarian former Senator Bob Dole was Viagra’s original spokesman, 41-year old NASCAR driver Mark Martin joined the team in 2000, and 37-year-old major-league baseball star Rafael Palmeiro (accused earlier this year of illegal steroid use and lying to Congress) signed up in 2002. “More than half of all men over age 40 have difficulties getting or maintaining an erection,” advertises Viagra’s Web site, yet the handsome stud currently depicted in the ad could easily be in his late 20s.

I’d be lying if I said such advertising hadn’t had an effect on this 40-something. Even though I don’t have a problem (and wouldn’t tell you even if I did), I’m sitting in my doctor’s office in part because I’m a rabid NASCAR fan. Others in my age group and below have been similarly affected. According to a 1998-2002 insurance-industry study of 5 million men ages 18 and older, the 18-to-45 bracket constituted the fastest growing segment of Viagra users. Although men over age 56 filled the majority of prescriptions, the survey also found that use of the drug for “an underlying medical reason declined in all age groups over the five years,” indicating the “increased use of Viagra as an enhancement or recreational agent.”

One reason Viagra has become so popular with men who do not suffer from impotence is that it can decrease the refractory period—the amount of time it takes to get another erection after orgasm. All night long becomes a very real possibility. Still, for some, enhanced performance doesn’t necessarily justify the use of Viagra by those who otherwise don’t have erection problems.

Roseville marriage therapist David Chervick believes the rapid pace of modern life is increasingly stressing our sexuality. “People have no downtime anymore,” he said. “We are the most exhausted country in the world.”

Photo By Larry Dalton

Roseville marriage and family therapist David Chervick enthusiastically supports Viagra use for those who medically require it but believes that what appears to be recreational use of the drug by some patients may actually be abuse. “It’s not the drug,” he stresses. “It’s the reason for their participation in recreational drug abuse—and it is drug abuse. It’s just like any other drug they would experiment with and abuse.”

Some insurance companies are leery about filling expensive Viagra prescriptions for recreational purposes, and the practice has drawn the ire of social critics as well, including Meika Loe, an assistant professor of sociology at Colgate University and author of The Rise of Viagra: How the Little Blue Pill Changed Sex in America. Borrowing a term from sociologist George Ritzer, she suggests that Viagra and other ED drugs are contributing to the “McDonaldization” of sex.

“McDonaldization refers to this idea that the ethic that underlies fast food has pervaded our culture, and so even the realm of sexuality has become McDonaldized, meaning that we want to serve it up fast and hot, efficiently,” she explained in an interview with Mother Jones last year. “So, then, the question is where is the nutritional value for our souls?”

Chervick notes that the rapid pace of modern life is increasingly stressing our sexuality. “People have no downtime anymore,” he says. “We are the most exhausted country in the world. We’re also the most productive and the most creative, but that doesn’t mean that it doesn’t have an effect on family and sexual life.” Instead of dealing with the issues that underlie sexual problems, now there’s a quick fix: Viagra. “It’s a panacea for any sexual problem. Anybody can use it, and their problems go away.”

A Big Mac is the same, whether you buy it in Sacramento or Saskatchewan. Today, that goes ditto for your dingus. Says Migliaccio: “If you’re fighting about money, and your sex life declines, you say, ‘We’re not having sex. What does that mean?’ Now, someone comes in and does the job for you, masks over the underlying problem. It’s good—but is it as fulfilling as a homemade burger?”

Me, I’ve got no problem with McDonald’s, though to be honest I prefer Quarter Pounders with cheese to Big Macs. Does my planned recreational use of Viagra equate to drug abuse, as Chervick suggests? I don’t think so—that’s why I’m seeking my prescription from a licensed physician. As a former engineer, I’ve got no problem with efficiency, but then what do I know? I’m just some idiot sweating it out in his doctor’s office.

In Loe’s view, the efficiency of Viagra replaces genuine intimacy, reducing a man to his “erectile potential.” Men have literally become dicks, which will cause some to quip, “What else is new?” The throbbing Viagra-enhanced penis is the new normal, leading to increased anxiety in those men who don’t measure up. In fact, researchers in Australia have found that the ubiquity of Viagra commercials Down Under has created sexual anxiety in men who previously suffered no such malady.

For its part, Pfizer claims that it has never marketed Viagra for recreational purposes, maintaining that the drug works only on the physical aspects of impotence and does not alter brain chemistry. Those who believe the penis has a mind of its own will no doubt question this assertion, but, at any rate, treatment for ED, which formerly necessitated a somewhat embarrassing examination by a urologist, is now as simple as popping into your primary-care physician’s office and picking up a “six-pack” sampler of Viagra.

The six-pack is one facet of an ingenious marketing campaign that has harnessed the trifecta of American maleness: alcohol, sports and sex. Today, no stick-and-ball broadcast is complete without a Viagra, Levitra or Cialis commercial. Viagra billboards decorate our freeways and stadiums. Mark Martin’s Ford Taurus zips around Daytona done up like a giant blue diamond-shaped pill. Driven into a frenzy by such advertising, men have stampeded into physicians’ offices, demanding prescriptions whether they need them or not.

Not that a prescription is necessary to score Viagra. A booming black market for the drug sprang into existence almost immediately upon its release. Viagra and other ED drugs of dubious purity can be purchased on innumerous Web sites, often without a prescription, for prices as high as $100 per pill. The 23 million Viagra users cited earlier are men who have obtained the drug through prescriptions. Various studies indicate that the portion of men obtaining Viagra without a prescription ranges from 57 percent to 83 percent. Therefore, no one really knows for sure how many men are using it.

Photo Illustration by David Jayne

Incredibly, it’s estimated that 25 percent of all “spam” consists of unsolicited Viagra pitches. I’ve been receiving a daily Viagra e-mail from one online pharmacy for the past two years; despite my best efforts, I haven’t been able to stop it. I’ve grudgingly come to appreciate the random subject lines of each missive, designed to combat e-mail filters: “Re: You speak by jerkin”; “that bring the sole”; and my all-time favorite, “Jesus: Time to know.”

The downside of scoring Viagra off the Internet is the aforementioned purity issue. This is particularly true of the overseas online pharmacies, some of which offer wares cut with everything from benign filler to thermogenic ephedrine to psychoactive ecstasy. I’ve got no wish to accidentally relive my long past club-drug days, another reason why I’m pursuing Viagra through my primary-care physician.

Penile servitude
By now, it should be abundantly clear that men are, as Vancouver, B.C., punk-rock legends the Subhumans suggested in the late 1970s, slaves to their dicks. However, the prison of the penis can be somewhat paradoxical. Spend any time in the company of men, and the conversation inevitably turns to heightened tales of sexual prowess and all manner of buggery. But suggest that this prowess is somehow inflated by, say, Viagra and be prepared for vigorous denial or outright silence.

“Any kind of medical condition for men has always been a private issue,” Migliaccio elaborates. “It’s a breakdown of the body, and so much about being a man is ‘What can I do?’ It’s an even greater issue when your penis breaks down.”

Even those in the business of fixing broken erections, urologists, seem reticent to talk about Viagra, at least for publication. I called every urologist in the Sacramento Yellow Pages for this story—some a half-dozen times—and not one was willing to be interviewed. Medical office managers insisted the docs were just too busy, but I suspect a certain lack of cojones. They were not alone. Most of my queries to friends and colleagues on the sensitive subject were quickly rebuffed.

Dennis Hof, proprietor of the Moonlite Bunny Ranch, the legal brothel located in Carson City, Nev., has no such qualms. After all, erections are his business.

“Everyone wants to be bigger and harder,” he says of Viagra. “It’s been a real boon for our business.” Hof was among the first men to sample the drug. Penthouse magazine invited the procurer to Amsterdam in 1998 for an expense-paid tour of the local brothels. “I’m done,” Hof said after a couple of trysts. Then he was turned on to some Viagra. “I ended up partying with six different girls that night,” he said.

Hof has seen an increase with young and old customers alike. “The young guys wanna be studs; they want to be heroes,” he says. “If you see some young guy partying with seven or eight girls a night, you know he’s popping Viagra like Tic Tacs.”

“The old guys are back,” he continues. “It’s great to see the old guys out having fun.” He says the girls first noticed the effects of Viagra when “the guys who used to come in here with their [penis] pumps no longer had their pumps.” Instead, they now crack Viagra jokes. It’s like Disneyland—a one-hour wait for a three-minute ride.

One of my more hedonistic pals also admitted to using Viagra recreationally—not that he needs it. “A slight breeze, the feel of fabric through my pants, gives me an erection,” he half-joked. He sought Viagra from his physician, just for kicks. “I kind of hinted at it, and he handed me a six-pack. It was kind of funny.” Viagra had little effect on my virile friend. “I’d felt like I’d taken some kind of medicine, but, other than that, nothing.”

Photo Illustration by David Jayne

Richard, the local sex-shop clerk, says his customers have had better luck with the drug. “I’ve had a number of customers tell me they have tried Viagra,” he informs. “Most report positive results. Some of them have reported headaches and even that it can mess with your vision.”

The gay community is almost always ahead of the cultural curve, and recreational Viagra use is no exception. A San Francisco Department of Public Health study by Dr. Jeffrey Klausner found that gay and bisexual men are inclined to use Viagra recreationally four times more often than heterosexual men—and are more likely to engage in unsafe sex when doing so. The drug is frequently used to counter the effect of methamphetamine, which induces impotence. The Viagra-meth cocktail can lead to frighteningly long sexual encounters, as described vividly by former gay-porn-industry worker Richard Gallo in the Boston Globe earlier this year.

“We’re talking days. Days, not hours,” Gallo said. “Ten days in a row … no eating, no sleeping.” Just, well, you get the picture.

However, my gay friend Matt questions the efficacy of the cocktail. Matt and his partner frequently travel to San Francisco on the weekends to enjoy the club scene, which, Matt complains, is being destroyed by methamphetamine use. He knows men who’ve used the cocktail to no avail. “What happens is that speed constricts the blood vessels. Viagra does the opposite; it relaxes them. They cancel each other out, so they’re just wasted.

“I remember when Viagra first came out, people were really gung-ho about it,” he continues. “Girls were taking it. Boys at sex clubs were selling it for $20 a hit. But it’s kind of gone by the wayside. If they’re taking it, they’re quiet about it.”

Matt says some men have turned to Cialis, which lasts days compared with Viagra’s one hour. He’s tried Viagra, but though it definitely gives him a harder erection, he isn’t exactly fond of it.

“Some people are more affected by Viagra than others,” he explains. “I’m one of those people. My vision shifts to blue. I can feel my blood pressure drop.” He will take it in moderation. “I don’t mind it for one night. Have you tried it? You really ought to.”

I’m working on it, bro.

Harder, faster
No pharmaceutical product can match the speed and depth with which Viagra has penetrated the national consciousness. In seven short years, it has transcended its own marketing and is now firmly ensconced in the culture at every level. For example, state and federal legislators, which dispense Viagra through Medicaid, have been forced to make moral decisions as to who gets the drug, with predictable results: Both the men who need it the least—high-risk sex offenders—and those who need it the most—senior citizens—have been denied access to the drug.

In the American lexicon, Viagra has replaced steroids as the superlative de jour and serves as shorthand for our hypersexualized society. Liberal pundit Jim Hightower describes the Bush administration as “extremism on Viagra.” California first lady Maria Shriver titled one chapter of her book, Ten Things I Wish I’d Known Before I Went Out Into the Real World, “Superwoman is Dead … and Superman May Be Taking Viagra.” Oddly, the chapter contains no reference to Viagra or Shriver’s oversexed husband. The drug has become a staple of risqué jokes, like the one about the Viagra computer virus—it turns your 3.5-inch floppy disc into a hard drive.

California State University, Sacramento, sociology professor Todd Migliaccio believes Viagra can reinforce the attitude that sex is a biological issue and not a social or psychological issue.

Photo By Larry Dalton

Sex, drugs and rock ’n’ roll enjoy a close association, so it’s no surprise that Viagra deeply permeates the world of popular music. Consider that Pfizer sponsored the European leg of Earth, Wind and Fire’s tour in 2001. A Muddy Waters imitator croons “I’m Ready” on Cialis commercials. Rap star Eminem’s animated cartoon series, The Slim Shady Show, featured punch bowls filled to the brim with Viagra. Numerous musical parodies have popped up, including Alan Friedman’s “Viagra Song,” sung to the tune of Frankie Avalon’s “Venus” and featuring the lyrics “Penis if you will / Please wake up when I take this little pill / Today there is so much sex everywhere / Why shouldn’t we get our share?”

Thanks to Viagra, the flaccid penis has all but disappeared from porno films; the drug reportedly has become an industry mainstay. Directors no longer have to wait around for the male star to get it up, a “talent” that once separated the men from the boys. Nowadays, anyone with the proper endowment can become a porn star. Just pop a little blue pill. This has rubbed stars from porn’s golden age, such as Jamie Gillis, the wrong way. “The whole idea of Viagra in porn cancels out the notion of helping someone out in sex, of attending to someone,” he told Spectator, a porn-industry magazine. “At that point, it’s all just about ‘I’m workin’; you’re workin’.’”

Perhaps the greatest tribute our culture has paid to Viagra is to bestow it with its very own 12-step program, Viagraholics Anonymous, which has a Web site located at www.viagraholics.com. There, you’ll learn that signs of Viagra abuse include “exhaustion; sleep deprivation; chafed, sore, swollen, and red genitalia; and strained groin muscles.” Bottoming out on the drug can be devastating. “I couldn’t go into the office because I couldn’t control my erections,” confesses Jack, a Viagraholic whose story can be found on the site. “When I lost my job, I just stayed home all day, taking Viagra and masturbating.”

(Admittedly, it’s difficult to tell whether Viagraholics Anonymous is an authentic organization or simply a well-designed Internet spoof. E-mails to the Web site were not returned.)

Viagra use is not confined to our culture and is truly worldwide in scope. Even Islam is getting in on the action. Pfizer’s Dubai office reports that sales increase dramatically during the Eid al-Fitr festival, the breaking of the fast after Ramadan. “Naturally, married couples want to express and show their love for each other at these times,” notes Pfizer spokesman Ahmad Hakim in a press release. “So it is not surprising that the demand for Viagra, a medication used by men all over the Middle East to improve their relationships and quality of life in general, should increase.”

Middle Eastern Viagra usage is by no means confined to the pious. Recall that when Qusay and Uday Hussein were gunned down by U.S. troops in 2003, Viagra and pornographic tapes were found among their personal effects. Apparently, they fought hard to the end.

What goes up
Can 23 million Viagra users be wrong? Probably not. And that’s a comforting thought sitting here waiting for the doc (where is this guy?). There’s comfort in numbers, unless, of course, you’re talking about lemmings. That’s not to say that some haven’t suffered adverse side effects from taking Viagra. Such effects range from direct to indirect, physical to psychological, and mild to potentially fatal. Although the drug is considered relatively safe and enjoys the full approval of the Food and Drug Administration (FDA), many of these side effects are worth considering before filling a prescription.

Two of the most common side effects have been discussed already: headache and blue vision shift. The drug also can cause flushing from slightly reduced blood pressure. Some users actually enjoy the vision shift (blue, after all, is a rather sexy color), but my friend Matt finds the minor side effects reason enough to avoid taking Viagra.

After Viagra hit the market in 1998, there were widespread reports that the drug induced fatal heart attacks. However, since heart disease is a leading cause of impotence, these reports turned out to be unfounded. Rather, Viagra indirectly caused heart attacks by permitting men in questionable health to engage in the physical activity of sex. Also, although Pfizer included a warning that men who take nitrates for heart conditions should not take Viagra, former pharmaceutical rep James Reidy writes in Hard Sell: The Evolution of a Viagra Salesman, that many patients lied about their nitrate use to obtain the drug.

In early 2005, the FDA announced that 50 men who had used Viagra had become blind due to a decrease in the blood supply to the eyes, a condition known as non-arteritic ischemic optic neuropathy. However, these men also suffered from diabetes or heart disease, which can cause both impotence and blindness. Despite the seriousness of the matter, dark jokes circulated claiming that what your mama always told you about sex had turned out to be true.

Photo Illustration by David Jayne

By far the most frightening side effect that can be caused by Viagra and other ED drugs—particularly in individuals who up the dose beyond doctor-recommended levels—is priapism, an erection lasting four hours or longer. What at first sounds like a benefit can actually lead to permanent penile damage and a frightening series of emergency medical procedures. First, a drug such as pseudoephedrine is administered to decrease the flow of blood to the swollen member. If that doesn’t work, the blood is drawn directly out of the shaft using a large needle. If that fails, a shunt is installed. The final option is man’s greatest fear this side of death: potential removal of the damaged organ.

Fortunately, such extreme cases appear to be rare. By and large, the physical benefits of Viagra far outweigh the side effects for most users. Psychologically, however, the impact of Viagra has been more mixed.

On the plus side, impotence is no longer the taboo topic it once was. “It’s an OK thing to talk about, and that’s good,” said Migliaccio. “It’s OK for men to have a problem. It’s not an un-masculine thing.” As some ED drug commercials point out, “Even your co-workers will still like you.”

While Migliaccio believes that many feminists appreciate the fact that talking about male sexuality in public has become more acceptable, the downside is that Viagra reinforces the attitude that sex is a biological issue and not a social or psychological issue. “It perpetuates this myth that there is only one kind sex: male penetration,” he said.

As marriage and family counselor Chervick points out, the sexual desires of both men and women go beyond the mere mechanics of the act. Many people lack romantic skills. True intimacy, which he defines as “deep emotional love,” often must be learned. Yet, since the advent of Viagra and other ED drugs, Chervick says he and his colleagues have seen a decline in couples seeking help for such issues. The belief is that a little blue pill can solve all sexual problems. That’s not necessarily true.

“As the baby boomers age, these medicines are being used and becoming more useful,” Chervick said. For those suffering from impotence caused by real physical problems, such drugs are indispensable. But those using Viagra recreationally have an option. “Some patients fear that we’re all going to be on medication when we’re old. I say that to point out we don’t have to jump aboard when we’re young.”

There are signs that the public is beginning to heed such messages. The New York Times recently reported that this year, sales of impotence drugs have declined for the first time since Viagra was introduced in 1998, despite the $400 million or so that pharmaceutical companies spent on advertising. The Times speculated that disenchantment with side effects and high prices may account for the decline, but perhaps there’s another explanation. Maybe people are beginning to realize there’s no such thing as a magic bullet.

Not that any of this information has dissuaded me from seeking ammo for my own love gun. Waiting on the examination-room table, I squirm a little, slightly excited about the enhanced sexuality I’ll soon be experiencing. A little too excited, actually, considering the lie I’m about to tell. Hopefully he won’t look. I’m not exactly keen about showing my kit to strangers.

He enters the room, staid, doctor-like, dressed in the traditional white smock with a stethoscope hanging around his neck. We exchange perfunctory greetings. My appointment isn’t for Viagra; I have other issues, 45-year-old issues. A pain in my hip. A funny mole. He refers me to X-ray for the hip and says the mole isn’t cancerous. The table is cold under my butt as I attempt to formulate my phony request.

“Doc, I was wondering if you had any of those Viagra samples.”

“Oh really,” he says doubtfully, eyebrows jutting up. Damn. He’s on to me already. “Why is that?”

“Well, it just doesn’t get as hard as it used to,” I fib. “Not that it doesn’t get hard. It gets hard, just not as hard as it used to.” I’d decided against claiming total impotence, in part because I don’t want to be referred to a urologist for a bunch of humiliating tests but also because I just couldn’t admit to a serious deficiency with my manhood, even a made-up deficiency. Immediately, I realize that hedging was a mistake.

“I don’t know,” he says. “I’ve got 22-year-olds coming in here asking for the stuff. You’re a pretty healthy guy. It doesn’t sound like you have too much of a problem. I’m hesitant to prescribe it to anyone who’s marginal.” He suggests I’ve been victimized by Pfizer’s multimillion-dollar ad campaign before he finally turns my request down. “It’s for the best.”

“It’s for the best,” I agree forlornly.

So, that’s it. Later, I tell my hedonistic friend about my failure to score Viagra. “Man, your doctor sucks!” he replies. But I’m not so sure. Perhaps it’s good to have a physician who hasn’t jumped on the pharmaceutical bandwagon. Maybe he’s ahead of the times. Besides, I don’t need it anyway. Not that I’d tell you if I did.