The sense of tumescence lingers without the equivalency of action. A haunting thought or reminiscence that would have previously aroused me is no longer a precursor but now, a reminder of what once was. I have had a radical prostatectomy.
The disassociation I feel is multilayered. I was not unwell—or, at least, I didn’t think I was. My GP’s suggestion to see a specialist after finding that my prostate specific antigens (PSA) had risen was a little bewildering. The reading wasn’t particularly alarming as the PSA is not a reliable indicator, though it can suggest the presence of cancer. In answer to his questions about whether I had to relieve myself in the middle of the night or had difficulty emptying my bladder, I was able to confidently answer ‘no.’ And the disquieting finger poke to check the condition of my prostate suggested nothing was awry. He couldn’t feel anything untoward. All the same, he sent me to a specialist.
The specialist was systematic in asking questions, but they were the same ones my GP had asked. My responses were the same. His physical check of my prostate was far firmer. He felt some resistance on the left-hand side but concluded that this could simply be the body pushing back. There were no obvious indicators of cancer but he could only be certain if a biopsy was done. This was an invasive procedure. An MRI could be taken but that wouldn’t be conclusive. My other option was to have the PSA levels evaluated over time.
I can’t say what made me opt for the biopsy. Maybe it was a case of wanting to know for certain and eliminating all notions of anything being amiss. The biopsy revealed a Gleason Score of seven. And here begins my second encounter with disassociation. I couldn’t quite fathom the resulting diagnosis of cancer. My health was being summed up in numbers. Moreover, my seven was made up of a four and a three. The alternative combination of a three and a four was less concerning but mine was troubling. It required radical intervention. Despite reading the literature I was given, the reduction of my well-being to an equation was inconsistent with how I saw myself, how I felt and my sense of who I was.
The ensuing PET scan confirmed the presence and extent of the cancer. Something had to be done. But I didn’t feel unwell. Added to that, I was now in the hands of medical professionals whose word I simply had to take for granted and whose approach, while professional, lacked an emotional intelligence. They knew the science but not the person. My equivocation did not match their certainty and confidence they had in their own ability. I was no longer in control of my own life.
The third point of disassociation was not the recovery after the surgery. The robot-assisted operation reduces the degree of intrusiveness allowing for a more rapid recuperation from physical injury with which I am more familiar. I have a healthy future and one that could well prove rewarding. If all goes well, I have, perhaps, another thirty years ahead of me. If it’s anything to go by, my father is 93. But questions remain.
That thirty years is a lifetime and one for which I haven’t emotionally or professionally prepared. In jest, I mentioned to my GP that, without the aid of modern medicine, I would have been dead before retirement. His concurrance rather took the wind out of my sails. The specialist’s evaluation of the pathology of the cancer he removed suggested that it would have been a completely different story if I’d waited twelve months. Biologically, those thirty years have been graced to me by chance, fate, destiny, divinity or unearned luck. Those questions one asks at the end of one’s life contrast with questions I have about my future. There are two worlds whose expectations and attitudes don’t necessarily coincide nor are they, by default, compatible. I will not be reflecting upon or living my life to account for past mistakes nor will I be forging a new path as a fully functioning and intact participant. In an existential sense, my record of experience will keep accruing despite my body having exceeded its natural use-by date.
Oddly, for me, my current state of health is just as confusing; physically, I have nearly returned to my former shape and vigour. I am what I was before the surgery which I hadn’t realised I needed. It leaves me wondering what I have recovered from. The issue of incontinence has virtually been overcome via exercising the pelvic floor muscles. My penis is, literally, shorter. When the prostate is removed, the section of the urethra that passes through it is also excised. The reconnection of the ensuing ends makes this outcome inevitable.
If those facts do not produce enough disassociation, then what remains is that echo of tumescence. Many deride men for thinking with their pants but, in my view, like breasts for women, it’s hard to deny that the penis is an integral part of the male identity. The embarrassment in childhood when we become aware of how it reacts to thought, the adjustments that are necessary on occasion, the crippling tear-watering moments when it’s hit, the dream-world response in the middle of the night, the physicality of sex, or the morning erection that nothing more than mere thought arouses. It is a reassuring sign of one’s emotional and physical well-being. I still have those thoughts. I still have those memories. But the lifetime ahead of me will no longer include that responsiveness. The fine blood vessels are damaged during the operation and there is no guarantee of the same functionality. What I grew accustomed to through childhood and adolescence is no longer part of me. The expectations, trepidation, failures, embarrassment, satisfaction, triumph and the sense of explosive release are more memory than elements with which I must now negotiate.
This is the final disassociation. My world has changed. My state of health says it is not so. My memories and desires tell me it is not true. But modern medicine has exacted its price and determined a new reality—a reality for which nothing can truly prepare me.
David McLean is an actor, author, broadcaster and educator. His articles have appeared in The Age and Overland. He was shortlisted for the 2016 Neilma Sidney Short Story Prize. He also has the delightful task each week of interviewing national and international authors on 3CR’s ‘Published or Not’. When not writing he frequents Melbourne’s thriving theatre scene as a reviewer and amateur performer.