Sex, Sleep or Scrabble

by Hammond, Phil

  If you’re not quite brave enough to experiment on yourself, there’s always your children. Gerhard Domagk, a pioneer of sulphonamide antibiotics, tried them out on his daughter first, and Edward Jenner treated his son to an inoculation of cow pox liquid to test his vaccination theories. Both got away with it and to this day, doctors can be found giving their kids antibiotics when they tell everyone else to try Calpol.

  Has a doctor ever eaten a patient’s poo?

  We do it all the time, as a punishment for not washing our hands properly, but the only wanton poo-eater on record is Dr Joseph Goldenberg of the US Public Health Service. Dr G wanted to find out the cause of pellagra, a disease that sounds like a pasta dish but kills you with diarrhoea, dermatitis and dementia. In America, where pellagra had previously been rare, suddenly there were huge and totally unexplained outbreaks. Hundreds of people died. As the Journal of the American Medical Association concluded in 1914, it was ‘in all probability a specific infectious disease communicable from person-to-person by means at present unknown’.

  Like a good scientist, Goldenberg decided to prove pellagra was infectious by experiment. He started off gently, extracting blood from one of his pellagra patients and injecting it into his own shoulder. Then he collected phlegm and snot from the mouth and nose of the patient and rubbed it into his own mouth and nose. Nausea, vomiting, bloody diarrhoea, depression, psychosis and scaly skin awaited Goldenberg if his experiment worked. It didn’t.

  Goldenberg naturally concluded he hadn’t gone far enough. Three days later he decided to swallow some sodium bicarbonate to neutralise the acid in his stomach and maximise his chance of getting infected. Then he swallowed, in turn, samples of urine, faeces and skin taken from his obliging if slightly puzzled patient. Unsurprisingly he got one of the 3 Ds, diarrhoea, but he didn’t develop pellagra.

  A few days later he managed to persuade four close friends to join him in eating skin, faeces and urine from a pellagra patient. Must have been one hell of a dinner party. His wife was keen to join in but Goldenberg couldn’t face the thought of her eating another man’s skin and shit. So he injected her with blood taken from a woman dying of pellagra. But none of his posse got the disease.

  Goldenberg repeated this experiment an impressive seven times, before convincing himself that this was not an infectious disease. After many years of research, he tracked down a cure: brewers’ yeast. Pellagra was caused by a shortage in the diet of the B vitamin niacin and the reason for the outbreak also became clear. At the turn of the century people had changed their eating habits, going from wholemeal grain to fancier and finer ground grain. Unfortunately this process also removed some essential vitamins, crucially niacin. With niacin added back in, the pellagra epidemic disappeared. Good for Goldenberg.

  Why do men become gynaecologists?

  In the days when all doctors were men, all gynaecologists obviously were too. A few may have chosen the specialty for dubious motives but, having done a few gynaecology outpatient sessions myself, there’s nothing remotely titillating about it. Most of the male gynaecologists I’ve met just have a fascination for the subject.

  This enthusiasm was first documented by J. Marion Sims, a bloke despite the name, who practised surgery in Alabama in the nineteenth century and is credited as the founder of modern gynaecology. Of one patient with a fistula (an abnormal connection between vagina and bladder) he wrote: ‘Introducing the bent handle of a spoon I saw everything as no man had ever seen before. The fistula was as plain as the nose on a man’s face.’

  You might query his note-taking but it’s fair to say that Sims enjoyed his work. He may have liked looking, but with detached objectivity not lust. He invented a speculum, a catheter, several new surgical techniques and even kept a straight face when a patient ‘was embarrassed by an explosive sound of air’. A true professional.

  There are now far more women in medicine and gynaecology, and you’ve got a good chance of being treated by a female doctor, even more so if you ask. But the sex of a doctor is far less important than the manner.

  3

  Rude health

  A lot of people have hang-ups about what hangs down, which is a great pity because it’s usually based on misinformation and it stops you enjoying your dangly bits.

  HIS BITS

  Penis or Tummy Banana?

  Penis, definitely, or one of the non-threatening alternatives. Telling your son that he’s growing a tummy banana sows the seeds for later inadequacy (unless you banish bananas from the house, which would be a shame because they’re an excellent source of potassium). If you can’t manage a penis, there’s a plethora of relatively harmless substitutes in the willy mould. Chipolata is easy enough to live up to (if it grows, it grows). Avoid anything that suggests aggression, even if you are a butcher (pork-sword, lamb-dagger, mutton-cudgel, beef-bayonet). Some women have an unfortunate habit of giving the penis a proper name as if it had a mind of its own. This is just about tolerable, apart from Justin, which is clearly an insult. Generally men and boys are happy and relaxed about naming and fondling their genitals. Indeed, they’re so important that the cricket box was introduced a full century ahead of the safety helmet (1874 vs. 1974). It pays to look after your penis, but it’s not much use without a brain. Or maybe it’s the other way round.

  Should I prick my pearly penile papules?

  No. If you pull a young man’s foreskin back (TIP: ask first), you may find a row of small white pimples, like pretty maids, around the base of the glans (i.e. the bottom edge of Darth Vader’s helmet). They’re perfectly normal glands that help lubrication and they don’t benefit from any interference.

  What do 90% of British men have that 70% of American men don’t?

  A foreskin. Or an appreciation of irony. Score one mark for each. A foreskin contains most of fine touch receptors of the penis. Ironic, then, that anyone would want to chop it off. If you’re lucky enough to still have one, hold onto it.

  What’s a Helix mark?

  It’s a little red line about an inch across, just above the base of the penis. Most adolescent men go through a phase of ramming a six-inch ruler into their pubic arena in the hope of convincing themselves that their erection nudges six inches. The term was coined by the sports’ journalist, Old Etonian and Guinness-trial lawyer, Will Buckley who assures me that the practice was widespread at his old school. It is also endemic in state schools, although it tends to be more of a communal affair as there is rarely more than one ruler per classroom.

  Why does my scrotum look fifty years older than I do?

  Because you’re still a young man, you lucky bastard. The scrotum has wrinkles for air-conditioning, which keeps the testicles a degree or so cooler than the rest of the body and makes your sperm less likely to fall asleep on the job. The scrotum also provides a handy test for stress, sleep deprivation and premature ageing. It’s a simple comparison to make. Get the little fellas out, look in the mirror and spot the difference. If you can’t, slow down and catch up on your sleep.

  NOTE: Dr Phil’s Scrotal Discrimination Test is not endorsed by anyone official, but it’s a lot cheaper than BUPA health screening and it doesn’t cost much to set up a testicular drop-in centre. Or you can just share them with friends. Pass them round the cabinet, Gordon. Maybe a hasty reshuffle. Now get some kip.

  Why is my scrotum covered in chicken skin?

  Evolutionary confusion. Your bollocks hang down like the front end of a turkey, so why not take on its skin? You could also cover them in bread sauce for a Christmas treat. Just go easy on the stuffing.

  Does my penis have higher blood pressure than I do?

  When it’s erect, yes, which is why we measure blood pressure around your arm and not your penis (otherwise you’d all be on medication and we’d all be up before the GMC). A normal resting human blood pressure peaks at 140 mm of mercury, but a really firm erection can manage ten times this. A bull’s penis apparently bulges at 1,700, a stallion does 4,000 and the mighty goat comes in at a
staggering 7,000 millimetres of mercury. For more information on how this is measured, see Reproduction in Domesticated Animals by Gordon James King.

  Does a penis always look smaller from above?

  Yes. Unless you’ve got it on the wrong way round.

  Are erections powered by laughing gas?

  Not quite. Laughing gas in nitrous oxide, N20, has two nitrogens attached to one oxygen. The most important molecule in kick-starting an erection is nitric oxide, NO, which has just one atom of each in its molecule. It’s a subtle but important difference – if laughing gas was released immediately an erection appeared, then the erection would likely wilt and the human race would die out. Instead, N20 is used to power rocket engines, but also works as a pain-killer, anaesthetic and – in combination with oxygen – it helps you laugh through and forget childbirth (and it’s not just for dads).

  NO is such an important chemical messenger in mammals that it was named ‘molecule of the year’ in 1992. It’s responsible for smooth muscle relaxation that allows blood to rush into the penis. It does this by activating a guanylate cyclase second messenger system. This converts guanosine triphosphate into cyclic guanosine monophosphate (cGMP), which in turn activates the sodium pump and opens potassium channels, causing a decrease in intracellular calcium which facilitates smooth muscle relaxation. Erectile dysfunction drugs selectively inhibit PDE5, a cGMP-specific isoenzyme that normally breaks down cGMP. In doing so, they increase the amount of cGMP triggered by the NO pathway. It would be so much simpler if we had a bone in our penis.

  Why don’t men have a bone in the penis?

  A lot of mammals do have a penis bone that make them good to go at any time but primates have evolved theirs out, relying instead on a few spongy tubes and a ridiculously complicated system of hydraulic pumping that requires the full cooperation of both the cardiovascular and nervous systems to get a decent head of pressure. Unsurprisingly, it’s prone to all sorts of mechanical failure.

  This is either God’s little joke, or a clever process of natural selection that allows women to spot the healthiest men. Men who have no trouble getting an erection are generally psychologically and physically healthy and would make a good father (if only they could learn to keep it in their loin cloth). Conversely, those with erectile dysfunction (ED) often have psychological issues, physical illness, financial worries, a ten-gallon cider habit or are just getting on in years.

  Fortunately, we now have a remedy for evolution in the shape of assorted pumps, injections, implants and pills, but ED remains a good marker for other illnesses so it’s worthwhile going to a doctor and getting an MOT rather than buying cheap blue tablets over the internet that are half horsehair, half pigmy-elephant droppings.

  NOTE: The main argument against a penis bone is that some men and women might want sex all the time, and that could get slightly tedious. Maybe evolution isn’t so stupid.

  Can a normal knob be bent and twisted?

  Yes. It’s all a matter of degree. If you get your protractor out, you’ll find most erections have a slight curve (not that many men will let you measure it). Penises often also have a slight twist (usually anti-cockwise). One in a hundred men bend more than 25 degrees and have Peyronie’s disease, named after the physician to King Louis XV. But banana man is as old as the hills, proudly depicted in sculptures dating back to the 6th century BC.

  Whether you do anything about it depends on whether it hurts or spoils your enjoyment. Sometimes it straightens itself in time, but if yours won’t, take a digital photo of your erection and share it with your GP (far easier than showing what you mean in the flesh). Most penises can be straightened out by surgery.

  Do most men have moobs?

  Man boobs are pretty much the norm as we’ve got progressively plumper. Not only do the breasts get fatty, but the fat makes oestrogen which causes the breast tissue to grow. Alcohol lowers testosterone and raises oestrogen, so overweight drinkers can have quite large breasts, but they shrink back if you cut down.

  Healthy teenage boys often get temporary moobs, because of fluctuating testosterone levels which aren’t always high enough to balance the oestrogen. The breasts tend to shrink again from fifteen onwards. It’s also common to feel a firm, tender, rubbery disc at the back of the nipple on both breasts. A lump or enlargement on one side needs checking out – it’s rare, but even men can get breast cancer. Some drugs cause moobs, and if yours are huge, your GP may check your hormone levels or refer you to a specialist.

  Older men get moobs as our testosterone levels fall and more of the body becomes fat. These are hard to shift, but actually quite attractive if covered with a thick coating of ginger hair.

  Why do men pee all over the floor?

  A few men pee on the floor deliberately, knowing some poor sod will mop up after them, but we inadvertently miss the target through any combination of haste, desperation, excitement, distraction, poor aim, prostate problems, cold weather, a wart bang in the end of a hole, a side hole, failing memory, a killer loo seat or a foreskin with a mind of its own. We then pretend not to notice what we’ve done or, just as worrying, genuinely don’t notice that the next occupant will have many rivers to cross.

  Some problems are easier to fix than others. A loo seat that might fall and decapitate you at any moment is a clear disincentive to raising it, so you end up with pee on the seat, as well as splatter on the floor (and further run-off if the seat is raised afterwards to hide the fact it’s been peed on and you’re too lazy to wipe it off). A dodgy seat can generally be sorted with refastening an inch or so forwards so it has more lean-back. And a wart can be frozen off.

  Peeing with an erection is always a challenge. Nature closes the wee gate to open the sperm gate, so it can take a while to come through but there may still be enough upward elevation to send the stream a good foot high. Sitting down and pressing down can help. Emptying the bladder before (and after) sex is a good idea for both men and women.

  Men’s aim and concentration is easily improved by giving them something to aim at. At Amsterdam’s Schiphol airport, there are flies beautifully engraved into the target area of each trap in the gents’ urinal. Without realizing it, you’re prompted to hit the spot, a tactic which has reduced spillage and splash-back by some eighty per cent.

  Foreskins and end-holes can occasionally get gummed up with normal secretions, causing a split stream that then usually settles into one. The stumpier man may get a pubic hair caught in the end, which can divert the stream sideways but is easily picked off. Permanent split streams happen when the opening or urethra is scarred or damaged, and needs a medical opinion. Ballooning of a tight foreskin can play havoc with a boy’s aim but circumcision is rarely necessary and most foreskins go back in time. It may just be a case of sitting down to pee until it does.

  Most men have an opening at the end of the penis but some are born with it on the underside and if their parents miss it, they’re often too embarrassed to seek help. It can be fixed, but you need to find a specialist. (see Does anyone else have a hole on the underside?) Prostate problems are probably the commonest cause of poor aim and even incontinence in men, but there’s plenty that can be done for that too (see Can I examine my own prostate?).

  Men tend to focus on one thing at a time, so a quick pee taken during the ad break is likely to end up half in the pan, half out; no flush, no hand-wash and no realisation of the carnage left behind. A strict policy of mopping up your own pee is worth a shout, as is a big sign with ‘please don’t piss all over the floor’ (although a man’s aim may go awry as he lifts his head to read it).

  Are some men genitally unaware?

  Self-pleasure aside, some men seem blissfully unaware of what’s going on down below. How could anyone expect you to put something in your mouth that looks and smells like a pensioner’s leg smeared in last year’s Stilton and stored in a hot tent? But we all know someone who does.

  A friend of mine leaves two bars of soap by the sink in the master en suite, one la
belled ‘for hands’, the other ‘for foreskin’. It’s a nice touch that may one day clinch the sale of the house, but from a hygiene point of view it’s a step too far. Rigorous soaping in both men and women can lead to a chemical irritation that mimics an infection (see Are some men genitally too aware?). Foreskins just need gentle peeling back in water, a removal of the white stuff and then a dabbing dry, or airing of the glans, before replacement (fungus tends to thrive where it’s damp and moist).

  Testicular cancer is the commonest cancer in men between the ages of twenty and thirty-five, but it’s often women who spot it first, when they’re down that way and trying to hurry things up a bit. Less than four per cent of scrotal lumps turn out to be cancer, but they all need checking out, sooner rather than later. The normal scrotum has a bag of worms in it (a combination of sperm collecting tubes and sometimes varicose veins), but cancer occurs in the testicle itself, often starting out as a grain of sand before developing into a definitive lump. Or you may just get a sharp pain, a dull ache or a general heaviness in the scrotum. Either way, show it to a doctor – preferably in the surgery, not the supermarket (although some supermarkets have doctors in them now. And check-outs for six symptoms or less).