Cialis And The Empty Bathtub Problem

If my evening news watching is any indication, impotence is very much on men's minds. There's a commercial for some cure at least once per half-hour of Brian Williams. These days it's a commercial for Cialis, the drug that provides a 36-hour window for "spontaneous" penetration, that runs around 5:52pm EST.

As an advertising professional, I'm in awe. This is a truly bizarre concept -- a man and a woman occupying separate bathtubs in various outdoor locations -- made as universally recognizable as the McDonald's arches. At first, we all rebelled. Why would a couple destined for sex lie on the beach with thick porcelain between them? The Internet lit up with complaints decrying the ads' logic. But overnight, the two-bathtub image was imprinted on our collective public mind.

Today, Cialis uses only a tiny silhouette of the individually bathtubbed couple holding hands. They've locked it up with their wordmark and it's genius, I tell you. Advertising that uses paradox to make us pause and file information away.

What's more, the campaign is friendly and non-threatening. It makes erectile dysfunction seem even a little playful. Funny, like the kind of mix-ups you see in romantic comedies that all get resolved in the end. Are there not rugged, silver-haired men in their mid-40s cavorting with slim younger ladies and slipping into pre-coital bathtubs all over America?

If these fine and enviable guys pop a little Cialis and go on to screw 30-year-old runway models, what's the harm in a little ED?

It turns out, however, this is not how most men feel.

There are, as I've written before, many erotic scenes in The Forever Marriage -- and a number of different sexual themes emerge. While writing the book, I relied on some pretty basic personal knowledge. But there were some things I needed help understanding.

For instance, I spoke to women about their experience after treatment for breast cancer. We talked about breast surgery and how it affected the nerve endings that went to their nipples. We discussed chemotherapy and tamoxifen, the chemical menopause they trigger, and what can be done to ease the resulting vaginal dryness. These conversations were generally open and easy. In fact, I collected so many helpful personal stories, I published them in a piece titled "Sex Without Nipples" (for which I apologize -- please see my post on today's tabloid media mentality) in 2009.

Then, I turned to men and tried to speak to them about performance issues. What happens in your head when you can't get it up? How does it become (as I've heard it can be) a self-perpetuating problem? I'm close to literally a dozen fine, garrulous older men. But when I broached this topic, every one of them turned red and stammered and then was struck mute.

A few of them gulped and recovered and tried to explain. "It just becomes this...." "You know, if it happens once then all you're thinking is..." But every time, they would break off and gaze skyward and look as if they wished they were anywhere else on earth. Which, I ultimately decided, was as good an answer as I was going to get.

Unless a man is drunk (which seems to be the only legitimate excuse in their minds because being wasted will soften even virile 21-year-old guys), ED appears to be a confidence killer of the highest order. Here is the real paradox: We're all running around with the theme music from the Cialis commercials top of mind. We can recite the "If you have an erection for more than four hours" warning. We can talk about the drug.

But impotence itself still makes most men hide.

One of the things I regret about that Salon story is that I wrote it before I fully understood the impact of impotence on men.

In it, I compared the sexual research and resources for women recovering from breast cancer to the help available for men who've undergone prostatectomy. My conclusion was that prostate cancer survivors hold the advantage; they have access to pills, pumps, support groups and hope.

I was deluged with messages from men telling me -- in very strong language -- that I was wrong.

This is one case where I think those angry letter writers were correct. I had no business making such a flip judgment. And if the men who responded were any indication, even buckets of Cialis can't bring their penises back to life. Once the nerves have been cut, they have. And prostate surgery appears to be less science than art. Urologists are kind of like those bomb-disposal guys in The Hurt Locker: snip the wrong wire and nothing else matters. Game over; you're done.

The most poignant notes I received were private, and many of them came from men (straight and gay) who weren't sure if they'd been damaged. They were trying to come back from prostate surgery: taking Cialis and masturbating on schedule, but the results were...poor. Problem was they didn't have partners to help them test the equipment. And they wondered, these guys as young as 45, if they would ever have sex again.

You see, it's not just a matter of function. There's also that universal red-faced, skygazing quality that impotence inspires. This is no way to enter a dating relationship. And while there are, indeed, countless online forums and support groups available to couples in the aftermath of prostate cancer, there is absolutely nothing geared toward single men.

I'm not a big fan of the sex trade. I think it's dangerous business, even when regulated, that tends to victimize women and children. But if ever there were an argument for sexual surrogates, in my mind this is it. Men who've had nerve-detonating surgery need the warm touch of another human being in order to know how -- or if -- they feel.

What to do when the other bathtub is empty? It's a big problem and, potentially, a hell of a campaign. Perhaps this is something that Cialis, with its multi-million dollar advertising budget, may be willing to underwrite.