- Confidentiality is one of the core duties of medical practice, and a doctor must always ensure it is upheld.
- Breakfast could wait as I granted the caller time for the phone consultation.
It was a bright Sunday morning. My family had gathered at the dining table for breakfast. Suddenly, my phone rang loudly, disrupting the morning flow.
“If I cannot talk to you now, I will never call you again,” came the voice. “It has taken me a whole year to amass the courage to call and I don’t think I can do it again.”
I had requested the caller to talk to me later after he said he wanted to discuss a private medical matter.
I obliged at his seemingly non-compromising stance and walked out of the dining room, encouraging him to go ahead with the conversation.
Confidentiality is one of the core duties of medical practice, and a doctor must always ensure it is upheld. Breakfast could wait as I granted the caller time for the phone consultation.
“I cannot have erections and my wife is about to leave me” he said, “do you have medicine that can make my lion roar immediately?”
I reminded him that erection problems are complex and needed physical consultation including examination and tests. I asked him to come to the clinic the next day.
He grudgingly accepted. It is normal for people with erectile dysfunction to ask for instant solutions because the condition is quite stressful.
The next day, he arrived at the clinic at 7.30am. John, 40, was an accountant at a local NGO. He had been married for seven years to Ann, an interior designer. The couple had one child.
John had been having weak erections for three years. The condition worsened over time until he was unable to have penetrative sex. When he called me, he had not had sex for close to two years.
“I wanted to see a doctor over this problem but I have always been embarrassed,” he explained, “my wife has always made me feel worthless and useless, and I have never revealed my weakness to another person in case they treat me the same way.”
John was a man in distress. He had symptoms of depression. His self-esteem had crashed. He had drenched himself in alcohol.
His work performance had terribly deteriorated, and his employer was not happy. He had been served with two warning letters for poor performance.
Actually, he was about to be dismissed. He was two months in rent arrears and the landlord was threatening to evict him.
Further, he had not paid school fees for his children. “Doctor, please don’t think that I am careless,” he defended himself, “I am stressed, I can’t think straight, I feel like dying.”
NO PHYSICAL PROBLEM
I examined John and could not identify any physical problem that could have led to erectile dysfunction.
I ordered for tests and they were all normal. I went deeper into discussing John’s relationship with his wife.
They had been going through a difficult time. His wife thought he was a failure. She compared him with some of his age mates, who were doing better economically.
Poor communication was adding salt to the injury. There was a serious personality clash, Ann being dominant and combative and John being rather calm and withdrawn.
The interaction between the two made John lose confidence and self-esteem. Ann always seemed to have her way while John was unhappy but unable to argue his case.
Overtime John became less and less authoritative. The power balance in the relationship was skewed, with Ann dominating John.
I explained my findings to the couple. John nodded all the time while Ann remained quiet. When I finished, Ann asked to see me privately. She explained that she had been hard on John “in good faith”.
She believed that behind every successful man there’s a woman. She had therefore purposed to push John to the highest limit in his profession. She had made him feel inadequate so ‘he could work harder and achieve more’.
“Unfortunately this tactic has ended up destroying your man,” I interrupted her, “he is in a state of depression and his sex life is long dead.”
“Do not worry doctor,” she replied, “with the same measure that I destroyed this man, I will rebuild him. He will regain his ego and confidence. I am the medicine that he needs, not those drugs for depression.”
Two months later John called to thank me. His sexual function had returned to normal. “That happened too fast. How did you manage?” I asked.
“My wife accepted me back as I am, I feel great once again; she respects me and has realised that I am the head of the house.”
It was yet another confirmation that your partner plays a big role in the sex problem you may be having, and that his or her support is critical in healing.