Saturday, August 11, 2007


Three years ago tomorrow I was diagnosed with colon cancer. Five days later I had surgery to remove the two-inch tumor that a colonoscopy had found just above my rectum. I was 31 years old, fresh out of graduate school, and dating but unattached.

On the day of the surgery I was still stunned from the diagnosis. I had high hopes that the cancer was localized and could be removed without permanent damage that would curtail a long and ordinary life. But as I woke from sedation after the surgery I learned that the news was much worse. The cancer had spread and was probably incurable. There were unremovable tumors throughout my pelvis and abdomen. To protect the remaining two-thirds of my colon, the surgeon diverted it to an opening in my abdominal wall rather than reattaching it to my rectum. My bowel movements would now exit through that hole into a plastic bag that I must wear, and without a sphincter I would be unable to control when gas and stool would make its exit.

Still, I didn't feel like I was dying. I hoped that chemotherapy or further surgery would yet buy me months and years of good health. I wanted to continue with my life on the path I had been taking before: work, education, recreation, and relationships. I was still young, ambitious, curious, and horny. As I learned about the changes in my body I wondered, "Can I still walk and work and travel like a normal person? Will anybody find me attractive again? And if they do, can I still function sexually?"

That's a big worry for a young man. It might be true that 20% of a man's waking hours are spent thinking about sex. Probably more if you count the time a man spends trying to make himself more attractive in the hopes of winning a mate (grooming, exercising, earning money, improving education, gaining power). It's far from the only important aspect of a relationship, but it would be a big blow to my identity if removed completely.

The worry was fueled by the fact that during my three days in the hospital I never had an erection. Any female reading this will probably laugh, but that's the longest that organ had gone quiet since age 12. A day or two after I got home from the hospital, while I was still in pain from surgery and in shock from everything, my curiosity drove me to test it manually. I was relieved to discover that I could still get an erection and achieve orgasm but, strangely, there was no ejaculate.

I thought it might be a temporary change. After all, my body was full of painkillers and that general area had received some startling rearrangement with a scalpel. Maybe it had reverted to how it worked when I was 12 and would regain full function after a few weeks' recovery.

I didn't ask my surgeon about this symptom. How could I? He was telling me how poor my prognosis was and that in the best case scenario I would need months of chemotherapy, a heroic surgery, and still be left with a brief and uncomfortable life. Should I say, "Yeah that's all fine, and I know that I'm unmarried, but what really worries me is that I can't ejaculate?"

Three years later the situation remains. I have a girlfriend now and appreciate that most things work. And it is convenient to have less mess and no need for extra birth control. But it does make orgasms less intense, and as a man it makes me feel less potent and powerful. And it means I won't ever by having kids, at least not without major medical intervention.

I'm not sure I wanted kids anyway. And I don't think it's responsible for me to try when it still appears unlikely that I would live long enough to raise them. I see my peers becoming parents and it looks like an enormous burden. I know that it's rewarding, but maybe I'm better suited to be a teacher and an uncle than to be a father myself.

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