/ 1 March 2003

Politicians’ problematic prostates

A puzzle for you: name a truly brave politician. One of my nominations would be Robert J Dole. In 1998 Pfizer Corp recruited the senator for the launch of their new wonder drug, Viagra. Dole (born 1923) had recently flopped as a presidential contender. Young Bill Clinton (born 1946) wiped the floor with his superannuated opponent: outdicked him, in the vernacular of the locker room.

As it happened the Clintonian member (thanks to Monica Lewinsky) was prominently on the front pages in 1998 (was it bent? Tattooed? Presidentially large?). The I-word terrifies men, however brave. Pfizer came up with the Spielbergian euphemism ‘ED”: short for erectile dysfunction — the droop, in locker-room speak.

‘It may take a little courage,” began Dole, as he addressed the nation in the 60-second television ads. He had, he confessed, been dysfunctional in the erectile department since his prostatectomy, seven years earlier. Now, thanks to Viagra, he was again in full working order. Off camera Elizabeth Dole confirmed (‘with a chuckle”) that indeed he was.

Dole didn’t need Pfizer’s money. And he foresaw that the ads would make him a ‘standing” (heh, heh) joke. But he was doing his bit for his cohort: the old guys. Without Dole’s makeover of the senior politician’s image, Washington would not, as it now is, be run by ballsy grizzlies like Secretary of Defence Donald Rumsfeld (70) and Federal Reserve chairperson Alan Greenspan (76).

Europe is old and flaccid. These American veterans are standing tall; erect even. The boy Bush stopped using Grecian 2000 (the lotion which ‘gradually returns lost colour to greying hair”) a few weeks ago. The White House is now the Grey House. And potent with it.

The Democratic front-runner for 2004 is John Kerry. The senator for Massachusetts is tall, lean, tan, mop-haired, morally upright and enjoys rollerblading. Like Dole (who lost an arm in World War II), he is a decorated war hero. Certified brave. Unlike George W Bush and Clinton, Kerry took his lumps in Vietnam. His political career began when, still a 27-year serving officer, he demanded of a senate foreign relations committee, ‘How do you ask a man to be the last man to die for a mistake?” Kerry is the only senior politician in the craven Democratic ranks with balls enough to query Bush’s ‘mistake” over Iraq.

Kerry’s balls are, as it happens, in the spotlight. A couple of weeks ago, his press office announced that he was having a prostatectomy. The prognosis was confident: 97% chance of eliminating the cancer; 99% chance of avoiding incontinence; 90% chance of retaining full sexual function.

Lucky him. Apparently up to one in 10 ‘successful” operations leaves the patient incontinent and as many as half result in (some) impotence.

Much depends on the surgeon’s skill. Kerry did his homework and chose Dr Patrick C Walsh, of Johns Hopkins hospital. Walsh has spent 15 years developing a surgical technique, which he calls an ‘anatomical approach to radical prostatectomy”.

It involves carefully untangling the bundle of nerves around the affected gland while plucking out the diseased tissue. One slip of the knife and the consequences don’t bear thinking about.

The best surgeons are, one gathers, the deftest and those who keep their hands in, so to speak, with two or more operations a week. There aren’t that many.

There are many patients. Prostate cancer is spreading at epidemic rate. Kerry’s openness, like Dole’s, is admirable. His example will save lives.

But an American senator enjoys privileges denied most 59-year-old men. He is powerful enough to select his physician (having researched his track record) and rich enough (about $50 000, if you are interested) to afford the best. Easy to feel brave with 90% odds.

Statistically, a third of the men over 50 reading this will need their gland seen to. Do you feel brave? —