medical history


Proof In The Pants: A Pivotal Moment In Pre-Viagra History

Dr. Abraham Morgentaler, author of the new book, "Why Men Fake It: The Truth About Men And Sex." (Courtesy Henry Holt)

Dr. Abraham Morgentaler, author of the new book, “Why Men Fake It: The Totally Unexpected Truth About Men And Sex.” (Photo: Adrien Bisson, Courtesy Henry Holt)

I can’t remember the last time a piece of important medical history made me gasp, drop my jaw and then explode into disbelieving laughter. But such was the effect of the passage below from Dr. Abraham Morgentaler’s new book, “Why Men Fake It: The Totally Unexpected Truth About Men And Sex,” which will be officially published April 16.

Now, I don’t blame you if you find it a tad hard to believe that a prominent scientist at a major medical conference would in fact drop his pants and ask audience members to check his “degree of tumescence.” (Oops. Spoiler alert.)

But I found confirmation from a second source in a medical journal, this similarly hilarious account in the journal BJUI, formerly known as the British Journal of Urology: How (not) To Communicate New Scientific Information: A Memoir of the Famous Brindley Lecture.

(AP photo/Daniel Roland)

(AP photo/Daniel Roland)

Just to set the scene: We’re back in the 1980s, the not-so-distant dark ages for erectile dysfunction, when little was understood about its biological underpinnings, and psychological explanations ruled. Dr. Morgentaler writes that therapists offered “an endless set of psychological causes” to explain erectile dysfunction, from early bedwetting to an unexpected childhood glimpse of people having sex.

Meanwhile, researchers were beginning to understand more about how erections worked, particularly the key role of the “corpora cavernosa,” anatomic structures whose spongy innards hold “‘cavernous’ spaces that are lined with smooth muscle.”

But enough background. Let us jump to 1983 Las Vegas, and a memorable moment in pre-Viagra history…

Keep Your Pants On [Excerpted with permission; all rights reserved.]

Advances in medicine and science do not necessarily move forward in a series of considered steps, with each study adding to our knowledge incrementally. More often than not, science, like evolution, is propelled by major disruptions. In the world of male sexuality, that disruption was caused by an eccentric British neurophysiologist named Giles Brindley, who in 1983 gave a lecture that would change the field forever. Over the years I’ve asked several of my colleagues who attended what it was like, and they all smile and shake their heads in wonder.

Finally, he says, ‘Oh hell,’ or whatever the British equivalent is, and says, ‘I guess I need to demonstrate this for you.’

Recently, at a meeting of the Sexual Medicine Society of North America (yes, such a society really does exist!), I sat down with Irwin Goldstein, MD, accompanied by his wife, Sue, to talk about the shift from the Masters and Johnson psychological model of erections and ED to the physical model that followed. Irwin has been, in my opinion, the single most important figure in the world of sexual medicine over the last thirty years. During that period, wherever and whenever there was something important happening in the field, Irwin was there, often as the leading figure. A high-energy, enthusiastic, irrepressibly cheerful man, Irwin trained dozens of individuals who went on to achieve their own academic prominence. Several years ago he moved to San Diego, where he established the first department of sexual medicine in the country at Alvarado Hospital Medical Center.

“Before Giles Brindley,” explained Irwin, “we knew erection must be controlled somehow by smooth muscle. But we didn’t know whether smooth muscle in the penis caused erections by contracting or relaxing. Actually, the scientific community at the time was divided into two camps: ‘the vascular relaxation camp’ and ‘the vascular contraction camp.’ After Brindley, there was no more discussion. It was settled.”

“Were you there?” I asked.

“Of course,” he replied. “I was one of the speakers on the same program.”

“What happened?”

“It was incredible. Continue reading