Viagra. Warning: this is a story about viagra.

So, I have to give a little bit of a warning here. This is more or less a transcript of a video presentation I recorded about a month ago. I think it's funny, but it is, well, about viagra, so if you are squeamish or prudish or whatever, just don't read this one, okay?


So, about a month ago a woman friend of mine said that since I am as I am now, were I to take viagra, I would be "Superman". That's what she said. Since I wanted to see what it would be like to be Superman, I decided to follow said friend's advice and ask my primary care physician about it (actually, my friend, who is bossy, said that I should demand that my primary care physician[pcp] provide me with either samples or a scrip).

So, I go in to the clinic, and my pcp hasn't seen me in about two years, and the last time I met with her I was separated but not divorced and having an affair with a married woman not my wife, and I was so depressed by that that I asked my pcp for treatment -- she referred me to a psychologist who might have been very effective with other people but who did not work out for me -- and at the same time I was being treated for rabies because a skunk had bitten me while I was freeing it from a trap set for groundhogs (I have a soft spot for skunks, thanks to my now ex-wife). So, you know, her experience of me is as a rabid depressed adulterer. Physicians have to put up with a lot.

So, this is my first complete physical in like three or four years, and she's asking me about one thing and another and somehow smoking comes up. I guess it says on my chart that I used to smoke, and she says, "how many packs did you smoke a day?" and I was like, "none, 'cause I used to smoke pot." So, I could just see her picture of me expanding: rabid, depressed, pothead adulterer. Physicians have to put up with a lot. I just know somewhere that patient confidentiality thing is being tested to its limits.

So, I have a whole list of ailments and conditions. Two years ago when I was so depressed I also had lumbago. Usually people talk about lower back pain, but lumbago to me always had such a cool sound to it: sort of like Tobago, so this sort of Caribbean thing going on, and then the lum part is like lumbering around or maybe even like rum, which goes well with Tobago. But Benjamin Franklin had lumbago as well as gout and whatever else, but these seemed to me like old-fashioned terms for old-fashioned diseases from which no-one suffers anymore. Not so. Since it was my lumbar spine that was out of whack, I suffered from, according to the medical records, lumbago. So, that was two years ago, and after two years of physical therapy and six months of a better mattress, I am not in daily pain.

We got past that, on to my specific questions. First, I have a lot of trouble focusing my attention, and I think I might have ADD; there is a family history of this, so the pcp writes out a referral to a psychiatrist. Next, I started working out regularly and I want to be sure that my diet is sufficient. She wants to know whether I am seriously pumping iron or using nautilus machines or whatever, so I say, No, I'm just using ten pound dumbbells. So, she says I could use a protein shake, but it doesn't need to have any added lycopene or anything like that.

So, next, I ask her, should I be concerned about the mole beneath my lip? So she looks at that. Then there is the weird little thing on my nipple, so I lift up my shirt and she looks at that. Okay, so she writes out a referral to a dermatologist. Now it must have seemed to her that I was doing some sort of strip tease, because the next thing I wanted her to check out is what I think may be a hernia -- a bulge in my groin, which, since you are already interpreting this wrong, is to the left and above my penis, not the penis itself. So, I explain away the fact that I am shaven (which probably also is being discussed in a mild breech of patient confidentiality) by saying (and this is true) that it is easier to see what I am talking about without the hair over it. So, I say, should I show you? And she says, "Well, we have to do the prostate exam anyway, so let's just do that and get it over with." So, we do. And she says, "Maybe this was the bad day to choose not to wear underwear." But what she doesn't realize is that it's rare that I chose TO wear underwear. But such is the life of unclear, assumptive thought. So she hands me some kleenex to wipe myself and it's a little awkward, but what the hell, do I really care? So, I've got like four kleenexes between my ass-cheeks and I pull up my jeans, which of course have to be button fly, but anyway...

So, she kind of checks that out weird little lump or bulge or whatever with direct palpation (which, I might add, she did not use when she was examining my lumbago two years ago. Do you think I should report her to someone?) and declares that she does not think that it is an inguinal hernia. Well, that's a relief, I guess. But what the fuck IS it, then? She doesn't know, and doesn't write any more referrals.

So, now we get to the question about viagra. You know, here is this shaggy-headed, shabbily-dressed dude who says he thinks he may have some sort of DSM-IVtr condition, a rabid, depressed, marijuana-dependent adulterer who doesn't wear underwear and shaves his pubes. Maybe this is normal.That would actually be kind of cool, don't you think? but anyway...

So, I say, "This woman friend of mine says that since I am the way I am now, if I were to take viagra, I would be Superman, and I kind of want to find out what it would be like to be Superman, but I'm concerned about whether that would be a problem because of blood pressure or whatever." My friend says that physicians love it when you self-diagnose and tell them what to give you, and that might be true. Or maybe the pcp was just tired from the long list I had to discuss. Or maybe she thought that I was going to add something even more bizarre to my list and just wanted to move things along, but anyway she says something like this: "Well, I'm not a guy, but my supervising doctor is, and he says that with some of his male patients he finds that when they have difficulty with an erection it's because they have some doubts or fears about the relationship." And see, my thing is, I'd love to have sex eight times a day and my partner does, too, and she has no trouble keeping up, but I do. But I didn't say that to the pcp. In the end, she wrote out a scrip for me for viagra, for twelve pills with two refills.

So, I go directly from the clinic to the pharmacy, which is in a grocery store. And I give them the scrip and they kind of go off for a minute, and I'm waiting for them to tell me when they can have it filled. Most times when I go to a pharmacy, the scrip won't be filled for hours. But here the guy pharmacist is over at the counter counting out doses with his little stainless steel scraper, and I say, "Oh, do you have some right on hand?" And he kind of looks at me and grunts. And he brings over the bottle, you know, in the white paper bag with the instruction sheet on the outside, and I pay him and sign for the pills and he hands me the package and says, "The prescription lists twelve pills, but we only give out six at a time."

So, I'm like, "Well, that's fine." I don't care if they give me six at a time or twelve at a time or any other multiple of three. 'Cause I'm not going to take more than one at a time, although I did kind of wonder why they wouldn't just fill the prescription the way the pcp made it out. But I don't pretend to understand these things. And, like my friend said to me later that day, what am I going to do, stand there in the grocery store and shout at the pharmacist, "No, damnit, I want my other six viagra RIGHT NOW!" Or maybe even worse, in a whiny voice, "Oh, please, please, give me the other six viagra I reaaaallly neeeeed them!" Not very cool or manly, you know?

So, I walk out of the store and make it as far as my van before I open up the package to check out the bottle, and here it says on the label six doses with two refills. Now, I'm not great at math, but the way I read this, that's a total of eighteen doses. Eighteen.

So, my pcp gave mea scrip for thirty-six doses and the pharmacist gave me a bottle labelled like I could get no more than half that. And the real kicker was at the bottom of the label, which listed the date the prescription was filled, 4/28/09, and a note that said, "2 refills by 4/28/10". So, the way I read that, I can only have two refills IN A YEAR.

Okay, so if this is true, my pcp thinks that in three-hundred-and-sixty-five days I'm going to want viagra thirty-six times. Think about this. That means she thinks that EVERY TEN DAYS I'm going to get it on, or at least take a viagra. This seems to me like a pro-abstinence stance to me.

But the pharmacy is even more abstemiously-oriented: they seem to think I'll only be needing the stuff EVERY TWENTY DAYS!!! Come on, now, guys, that's almost like when I was married!