It’s Not Just Sex

A good approximation of how sex and intimacy is regarded by the U.S. Armed Forces can be summed up in the phrase I heard recently: “If you needed a wife…we’da issued you one.”

These days, the U.S. Army is perhaps the most chaste and constrained military organization on planet earth.  No drinking on duty, no sex, no pillaging, no cavorting…and go easy on the damn swear words.

Contrast this with the Russian Army, and German, which frequently serves beer with lunch; the harder stuff after dinner.  And numerous armies – no joke – provide prostitutes to their deployed troops.  Effectively, a little mini-platoon comprised of practitioners of the world’s oldest profession gets sent to war zones right along with the soldiers.  No doubt this idea  is regarded by these armies as a Godzillian leap up the ladder of human rights.  In the past, when victorious they just raped the women (and men) of their vanquished quarry.  At times, a veritable sexual bonanza was promised as the leading incentive to engage in vicious battle in the first place.

Members of the U.S. Armed Forces by contrast, seem expected to never have sex of any kind.  If sexual organs didn’t come already attached to the bodies of their troops, I’m rather certain the Army would have confiscated all tissue related to human reproduction – and especially the related pleasures of it – on the first day of basic training, relegating every appendage to iron storage boxes next to the gold bars in Fort Knox.  “You can have your clitoris back after your 20, soldier.  Until then, kill stuff.  And like it.”

I’m a happily-married, loyal-to-death-do-us-part, honest-to-a-fault type of husband who, with the perfectly understandable exceptions of Rachel McAdams and Jennifer Connely, can provide infinite assurances to his wife that she has minimal reason to fear infidelity (in kind, if she ever meets Johnny Depp in a smoky, sultry, bean-baggy, beatnik bar…she has my blessing).  That said, I think the “Hooker Platoon” is a great idea.  Presumably, said professionals are well-paid, in control of their lives, and free of drugs.  Like it or not, humans are sexual beings and they go about obtaining it in a myriad of ways.  Might as well make it safe, fair, protected and consensual, even if questionably moral.

But what about the ones who aren’t deployed?  Or the ones who, by choice, remain celibate as they await – with admirable fidelity – their dear lover back home?  What about the people who have returned from over a year’s deployment, waay beyond ready to re-start a healthy, loving sexual relationship with their spouses?

Unfortunately, many soldiers return from war zones with major emotional and physical damage – and major problems having sex.  PTSD, insomnia, chronic pain, depression and anxiety all affect sexual ability.  And these problems are like cockroaches…if you have one, you probably have others.  Worse, the meds used to treat the above problems often severely inhibit sexual function too.  Am I the only one who sees the Faustian irony in “You can be happy…OR you can have sex.  Not both.  Your choice.”  For many (including me), that choice is an oxymoron…emphasis on moron.

While not always the problem, erectile dysfunction is one of the more common issues I deal with.  Given the ubiquitous commercials displaying medically-enhanced virile men, one would think ED wouldn’t be such a problem.  And it is true…a pill can solve the problem sometimes.  Cool, right?  A nice, easy fix.  The problem is that sex is considered by the Army to be something of a sport.  Golf, but morally suspect and generally distrusted.  As if to clarify their position, one of the more odd policies I’ve seen is the meet-you-1/20th-of-the-way idea of providing 6 pills of Levitra per month for up to 3 months for erectile dysfunction.  6.  For 3 months.  Then…good luck.

But 6 pills?  A month?  I know they’re expensive – something like 10 bucks a pill – but who came up with a number like that?  Was he (or she…or it) ever in a loving, happy sexual relationship?  Had it already donated the entirety of its copulation gear to NORAD for weapons testing?  Turns out the decision comes from the Department of Defense.  Yep.  The guys buying fiber-plated bombers and infra-red rifle sights and inventing bombs that suck your inner organs out through your maxillary sinus, are also the ones who decided that 6 sexual encounters a month should keep the average couple happy.

Truth is, for many of my returning soldiers, sex and intimacy isn’t simply a nice addition to their lives after over a year of living in austerity.  It is life.  This seems to be especially true of the committed, married soldiers I work with.  Their marriage, and the love they share within it, is often the only salve on wounds that cover their bodies and souls.  Imagine falling into the yearning arms of your wife after 15 months alone, after encountering horrors on the battlefield you will never describe, only to have to say you’re sorry, you just aren’t the same as you were…even as a lover.

A patient recently said to me (to paraphrase), “My wife and I LOVE to have sex, doc.  It’s an every day thing, if not two or three times a day.  At least, that’s how it was.  Now we spend most of the time we would have spent in bed – or in the kitchen, or in the microwave, or in the neighbor’s tool shed, or on top of the dresser, or under the aquarium, or in the chimney, or dressed up as Tonto and the short curly-haired lady from Cheers – with a counselor, trying to figure out what’s wrong with me.”

Most (not all) healthy, vital, loving relationships are comprised of sex more than just once a week with an occasional “two-fer” on the weekend.  Especially if one of the partners has been gone for over a year.  If returning injured soldiers have anything to look forward to, for many of them it’s their longsuffering, waiting, pent-up, willing spouse.  Divorce is a catastrophe, especially when it’s between a broken soldier and the person who typically is the last one standing in their corner when the world is running down.  Seems to me that we could forgo a couple of those useless air-to-air combat fighters everyone’s arguing about and use the money to give these soldiers as many nights of intimate bliss as we possibly can.

It Takes A Village…And Cash

Hilary Clinton popularized the phrase ‘it takes a village’ a few years back by using it to entitle”her” book (actually written by Barbara Feinman).

Today I participated in my first group visit for pregnant adolecent teens.  I must say I loved the experience.  Included in the group of providers are residents like myself, a family medicine faculty member, a social worker, a nutritionist and one of our extremely competent medical assistants.

Into this healthcare provider mosh-pit are thrown anywhere from 2 to 15 pregnant teenagers.  We sit in a circle and spend the first half-hour talking to them in a group about any of a number of topics germane to teen pregnancy.

We then break up the group and the patients are seen individually.  The residents evaluate their medical issues.  Then the social worker checks in, helping with other issues such as depression, abuse, post-partum care and support networks.  At some point the nutritionist sees them to offer advice on how to take care of themselves and eat right, etc.

The kids really seemed to like the program, and I enjoyed feeling like like I might actually be helping someone instead of just making insurance millionaires richer.

That said, I was struck by how much such a program must cost.  Doctors, each with at least 12 years of education, a social worker with Master’s level education, and a nutritionist with at least as much education as well.  Plus, all of our salaries, the facility, the ultrasound machines, etc.  It’s quite an operation, and all of it costs money.  Just thinking through our collective salaries for that day is an exercise in money-pondering (pun intended).

Sitting there watching these patients, it became clear to me that premarital sex isn’t just some arcane religious dictate.  It costs YOU money.  Think of an average day at work (for those of you still at the grindstone).  Think of all the crap you deal with because of the pressure you feel to afford your life.

I don't drag myself to work at too-early in the morning so I can pay for kids to do this.
I don't drag myself to work at too-early in the morning so I can pay for kids to do this.

Now think of a couple of bored, hormonal, overly-sensual teenagers romping on any horizontal surface they can find.  Think of the fact that, according to ‘Village’ theology, you are partially responsible for the fruit of that short-sighted quest for pleasure.

Teenagers have a hard time thinking about much other than self-pleasure.  I’m not blaming them; I was no different.  But their pursuit of pleasure does need to be met with some societal consternation.  It isn’t judgemental to be critical of promiscous behavior; it shouldn’t take a village very often.

The right thing to do for these sweet but immature and penniless patients is exactly what we did.  But millions of teenagers who aren’t in need of our high-intensity service don’t deserve to be told that their actions don’t matter.  They do.  And often the cost of their actions are unfair to everybody.

How Do We Stop Child Molesters?

I spent 3 years in Israel. There is very little pedophilia in the Middle East. Very little reported anyway. I remember returning one year from Israel and passing through the Salt Lake City airport. Plastered on every wall and window were pictures of a young girl named Elizabeth Smart – abducted right out of her own home in the middle of the night. I remember those fliers conjuring a number of feelings in me…including resentment at the fact that so many of my fellow Americans told me aloud how unwise I was for taking my wife and kids to such a dangerous place like Israel. In fact, I only got tense about the safety of my family once I’d crossed back into the States.

Pedophilia isn’t a strictly American problem. The curse spans the globe and may very well be more rampant in countries other than this one but simply less well-reported. Still, the practice is alive and well in the States and – fair or not – I have this sneaking suspicion we lead the way in terms of numbers and severity of the problem.

The hardest thing for me about pedophilia is that I don’t really understand it. One half-glance at Angelina Jolie, or – insert scantily-clad, photoshopped, verneer-toothed, 1000 bucks/month hairstyle babe or hunk here – and I can understand the allure of adultery. That’s easy, actually.  Example:  I’m out walking my dog…well, actually I’m out pooping my dog.  When I take out my dog (Fetch) often all I want is for him to just not BM in my yard.  I take him all over the rural trail behind my house in the hopes that he’ll go there instead.  He snifs and prifs around forever, but it’s worth it.  It saves me from having to pick up – gagging – endless piles of dog poop and dumping them into a bag that gets disgustingly heavier as I find ever more gifts from my “best friend”.  Let’s pretend, then, that there I am, pooping my dog.  I’ve been working all day.  Dinner’s burnt (actually, my wife never burns anything, but we’re in make-believe).  I have lots of sick patients in hopeless situations in the hospital.  I haven’t worked out since bench-pressing was invented and the idea of being adventurous is as foreign to me as the click consonants of Zulu.  Unexpectedly, a woman jogs – no, gllliiides – up looking painfully lonely which is inexplicable because her face is airbrushed to perfection and she’s moving around all silky-like in her tight jogging stuff and looks just like a magazine cover. In fact, I think I see the word “Elle Magazine” hovering mistily just above her head.

“Oh, what a wonderful dog! Look at him pooop!” She exclaims, clearly impressed beyond belief at my dog-training skills.  She looks at me with unabashed admiration, flutters her eyelashes and demurrs, “Maybe we could take him to meet my dog and they could poop together.”

My answer in each of these type of bizarre fantasies is a gallant, loyal and banal, “No. I’m in love.” But why would I have the fantasy? Actually, this particular dog-pooping fantasy is just made up for you, dear readers.  Never dreamed up anything much like that except now, to make a point. And that point is that I can at least relate to the people who do have unhappy marriages and do run into some scantily-clad potential mate, and do fall into the very bad choices one can make in those circumstances. I get it. Haven’t done it. Don’t want to. But I get it.

Not so with pedophilia. I can’t make up a scenario that makes me say, “Well, it isn’t for me, but I guess I can understand it.” It just doesn’t make sense – even theoretically – to me.  Because of this, I fear it more than other things like leukemia or car wrecks.

Aside from fearing what I don’t understand, it makes sense to fear pedophilia because it is much more common than many other calamities that can befall kids. Bike helmets? Statistically useless.  Severe head trauma is almost non-existent compared to the risk of being sexually molested. Guess how many (I’d insert some funky little poll here that you could click on if I knew how to work the tech stuff, but I don’t.)? The depressing answer is at least one in every 4 kids will be sexually molested by the time they are 13! That’s 25% of the American child population. Additionally, a random survey waaay back in 1988 (so things are probably worse now) found that close to 1 in 10 men admitted sexually molesting a child at some point. This is a mind-boggling number. Please, if you have kids, let that number boggle your mind.

So, if you forget the bike helmet once in awhile (little more than peer pressure in head-shaped foam, I say), no big deal. But don’t forget, or neglect altogether, to teach your kids about sexual predators.

Here are some things to know:

– If done well, you won’t scare your kids by talking to them about sexual predators.
– Give your kids – even as young as 5 or 6 – the right words to describe their sexual organs. It doesn’t have to be “penis” and “vagina” exactly, but it does need to be specific to the areas.  They need to be comfortable talking about this area of their bodies.
– Educate on what is acceptable touching in those areas. It’s pretty limited (doctors, parents), so this should be a short conversation.
– Roll play. Kids like this because it’s imaginative. Be as creative as you can in your stories. Tell them you’re going to try to trick them, and then do it (“Hiii little girl, I have an extra Polly Pocket in my car that my own little girl doesn’t want, would you like it?). Most kids will think it’s fun, but be as persuasive as you can. Believe it or not, this is a great dinner-time conversation. The message to them is simple: NEVER BE ALONE WITH ANYONE UNLESS YOUR PARENTS KNOW ABOUT IT.

teacher.jpgHere’s a couple of known strategies of pedophiles:

– They’re usually known – personally or visually (janitor, or teacher across the hall, etc) to the child.
– They usually start small. Always be wary of a present given to a child from an adult.
– Their push is always going to trend – eventually – toward being alone with the child.
– Molesters tend to know what your kid likes and dislikes. They’re often very current on child trends.
– They often speak harshly about molesters.
– They are often charming, good-looking, in leadership roles and work with children.

I recently saw a child who had been molested by another older child. The molester was 12, and already had a strong addiction to porn and a fetish for oral sex. Naturally, this kid was almost certainly abused at an earlier age, and now has a very grim life to look forward to. The prognosis for the younger kid is actually good, if he continues to get good treatment. Bravo to the parents for listening to their child and believing him when he made a few off-hand comments that were out of character.

Lately I’ve wondered if my response to pedophilia is similar to the medical establishment’s response to homosexuality 60 years ago.  They said it was aberrant.  It was a psychological disorder.  They were opposed by a committed group of people (mostly gay themselves) who insisted the practice was normal.  Today, the docs of that generation are considered to have been in error and homosexuality is accepted as a normal variant of human sexual relations.  Perhaps this is my generation’s bias.  Maybe we’ll look back in 60 years and think of people like me as close-minded fascist prudes.  There are actually a number of groups that promote pedophilia (replacing my ominous language with terms like ‘love’) and see it as completely normal.

maddie.jpgWhile I’m open and often intrigued by the myriad ways that people think and behave, I don’t think I’ll ever see pedophilia as anything other than strength preying on weakness, leading ultimately to complete destruction.  I see it as an evil and a horror and a practice that must be opposed in every way.  

I suppose I’m just a bigot like that.