cool customer

I wrote most of this in 1988, a few days after the fact, banging it out on a typewriter while the details were still raw -- and then I set it aside and never finished it. I found it again this year, at seventy-one, and finished it at last, in the voice of the young father who started it. He isn't quite who I am now. But he's exactly who I was then, and I decided he'd earned the right to finish his sentence.

This is dedicated to my wife and three kids, all of whom I love and adore.

The 600 some dots in the ceiling tile above my head weren't much of a distraction as a needle was inserted into my scrotum. The pain lived up to expectations. And yet, I got what I asked for: a vasectomy. And I'm glad I did.

Ask any guy. He'll tell you. The scrotum and its contents, the testicles, are the most vulnerable part of a man's body. They are supported by jockstraps and shielded by cups. They are a prime target in self defense.

"Kick 'em in the balls. That'll slow 'em down."

Due in part to this vulnerability, but primarily because they are the sperm makers located behind the penis -- a man's pride and joy and one half the necessary equipment needed to create life -- the testicles are precious to man. They are not referred to as "family jewels" for nothing.

Without question the testicles are one of the most unique parts of the human body: male or female. Guys discover early how unique they are after doubling over in pain from being kicked, jarred or smacked in the area. No other part of a man's body is protected so fervently. Women have much to protect themselves, but nothing on their bodies rivals the dangling testicles.

Women can never know and fully understand a male's attachment and protection of their testicles. Just like men will never really know what it's like to undergo humiliating vaginal exams, experience the nauseous lows and ecstatic highs of carrying children and the tremendous pain of childbirth.

When my wife Paula and I first contemplated a vasectomy as a contraceptive alternative some 18 months ago, it was intellectually appealing. In comparison to minilaparotomy, laparoscopy and tubal ligation -- sterilization methods for women -- it was and is less expensive, quicker and easier to perform and has less potential side effects.

My father, brother and a friend were all vasectomites and recommended the procedure. Heck, some 10 million men in the U.S. have already had the operation and some 500,000 more do so each year. According to the most recent survey by the National Center for Health Statistics, one in every six married men has been intentionally sterilized.

Yet it was permanent and we wanted one more child, so we postponed making a decision until the recent birth of our son -- bambino number three. Shortly thereafter I went for counseling where the research I had already done on the procedure was verbally reinforced.

The pros and cons list Paula and I compiled also helped me answer the counselor's questions:

Did you know that this should be considered a permanent and irreversible procedure?

Yes.

What happens if for whatever reason, you decided you want more children? And what if, God forbid, something happens to your kids?

First of all, no one and nothing can replace my kids. I'm a father of three and that's all I want to have. If I do have a change of heart, however, there's always adoption, and one could work with kids in hospitals, schools and other places. I could find ways to fill the void.

And despite the threat of needles, incisions and cauterizations of my scrotum and its contents, I made an appointment for the big V. Reactions of non-vasectomite family and friends to my decision ranged from groans and pained faces to comments such as "You're too young to have that done!" and "Pat Robertson links sterilization to Nazism." Only the latter comment -- extraordinary in its ignorance -- was undefendable.

Confident that a vasectomy was right for me and my wife, we went about our business and were barely aware of the approaching V-Day. Taking care of a three-and-a-half-year-old, a two year old and a newborn can be time consuming and exhausting.

When I read the ominous "Shave scrotum" on the calendar the morning of the procedure, however, the reality of what was to happen set in. Following my instructions to the letter, I "carefully" shaved my scrotum. I had spent the last three days lathering my crotch with Phisoderm to help prepare for this 30 minute session and what was waiting for me later that day in the doctor's office.

After sharing a laugh at the completed project with Paula, I left the house for work with a comment of how "crotch conscious" I was. That was putting it mildly. Undoubtedly shocked and angry with the indignity of being shaved, my scrotum and testicles let me know they were unhappy the rest of the day. Without the buffer and security of hair, they seemed to bounce and slide at will inside my underwear. It wasn't a very productive day at the office.

When Paula and I left for the Planned Parenthood of St. Louis clinic in Florissant that afternoon, however, the 45-minute drive passed quickly. We laughed at the last-minute discouragements from a few well-meaning friends and also enjoyed planning an upcoming business trip for me.

I was so distracted that I almost forgot to carry in my vasectopackage consisting of a supporter, an insurance form and payment for the procedure.

I signed in at the receptionist's desk and forfeited the money and insurance form. Before relocating in the waiting room, I found a men's room. No sense in risking something embarrassing happening during the operation.

Still happily planning my business trip, ten minutes of waiting passed quickly until a nurse called my name. Scrambling for my supporter and giving Paula a knowing smile, I scurried off into a small room where I was weighed, had my blood pressure taken and blood drawn. We talked briefly about how low my blood pressure was and what a lucrative business rubber glove manufacturing was. I didn't need my supporter as I was directed back to the waiting room.

A few minutes later a different nurse called my name and once again I dug out my supporter, shared a goodbye glance with Paula and disappeared behind closed doors. It was another false alarm on the supporter, as the nurse simply listened to my heart and lungs and quizzed me on current and past health problems.

I got concerned -- and relieved in a sense -- when I thought she had detected irregularities in my heartbeat. Too bad, I thought, we'll have to cancel the procedure. No such luck as my suspicions were unfounded and the nurse cheerfully declared me ship-shape and directed me back to the waiting room armed with post-care instructions.

A pleasantly surprised Paula greeted me upon my return, only to moan "Oh" when informed that nothing "substantial" had happened.

Looking around the now jammed waiting room, I tried to guess the mood of the other soon-to-be vasectomites. There were three other couples. One of the men sat quietly beside his wife in a corner, staring blankly at nothing in particular. I guessed he was tense. Another man made not-so-quiet jokes about what was about to happen. I sympathized with his method of coping, as I too had shared many light moments regarding my vasectomy in the past several weeks. I knew it was probably masking apprehension. I couldn't gauge what the third man was feeling. He seemed normal, not cracking jokes but not biting his nails, either.

I stopped my not so subtle looks around the room when it occurred to me that they were probably trying to figure out how I was feeling too. That in turn got me thinking more about what was going to happen. I really got introspective.

Meanwhile, Paula was busy describing our newborn's latest escapades. Bits and pieces of "the baby did this" and "the baby did that" filtered through and interfered with my own thoughts. Scrotum: needle, pain; incision, pain; pain, pain and more pain.

Suddenly, magnified sounds of chewing from the woman next to me joined the now maddening bombardment of thoughts in my head. A conversation between the woman and her husband didn't help matters.

"We're last and the doctor's late," she said. "We won't get out of here until midnight."

"Who cares," her husband said with an impressive nonchalant shrug.

"I do!" the woman replied. "I wanna get out of this joint!"

My head was spinning out of control. "And then the baby ..." Snip, cut, pain ... and "chomp, chomp, chomp ..." My face must have reflected the overload, because Paula half kiddingly asked me if I wanted her to shut up. I nodded yes. Bad mistake.

Her well-deserved hurt from rejection didn't help the situation. Now I was mad. Here I was worrying about having my scrotum sliced open -- my scrotum for goodness sakes! -- and now I had to worry about apologizing to my wife. I was in no mood for that.

The waiting dragged on and on. Fortunately this allowed things to thaw out between Paula and I, allowing me to focus all my energy onto the matter at hand.

Muffled greetings of "hello doctor" in the hallway made the room quiet. At last he had arrived. A short time later the door opened and a male nurse named John said "Gary?" All eyes followed "Gary" out of the room. This was a new development. No one had seen John before. Was this the real thing? "Gary" did have his supporter with him.

I didn't have to wonder long, as John returned. This time he called for me. Once again, I scrambled for my supporter and once again Paula and I looked at each other briefly. We both knew this was it. Any last-minute doubts were ignored as my legs carried the rest of me through the doorway of sterility.

John led me to a similar examining room like the ones I had been in before. They must have dozens of these rooms, I thought. This one was different than the others, however. Equipment and surgical supplies were laid out neatly on a worktable beside the patient's table. A small pouch was rolled up in the middle. I imagined a sterilized, shiny scalpel inside, just waiting to slice my scrotum open.

"Get undressed down to your shirt and lie on your back on the table," said John, as he turned and left the room. As I undressed, I noticed the table had no stirrups. I had imagined them strapping me in as if I was getting a vaginal exam. I thought maybe they would have straps for my arms too. After all, I theorized, most guys probably flinch and flail around when a needle is stuck in their scrotums.

Once undressed I climbed atop the table and laid down. Even without the stirrups I thought this must be what it was like to be a woman waiting for her gynecologist to arrive. Half naked and vulnerable, waiting to be humiliated.

I heard voices next door. They were faint so I concentrated hard on listening. It was "Gary" talking with John. I couldn't hear everything, but Gary appeared to be quizzing John on what was going to happen.

I was surprised Gary didn't already know. I knew, or thought I did. First the shot containing the local anesthetic. Pain with a capital P. Then the single incision, just beneath the base of the penis. Each of the two vas deferens that carry the sperm from the testicles to the penis would then be pulled out one at a time. "Pressure" was what I was told to expect here. Each would be cut, cauterized and tied off. Then I would be sewn up with dissolvable sutures. Supposedly all done in 15 minutes.

Maybe Gary was better off not knowing until now. Was ignorance really bliss?

I heard the door open next door and the doctor introduced himself to Gary. I didn't recognize the name. Just then John returned to my room and began saturating my crotch with an orange colored antiseptic.

"What happened to the doctor who was supposed to be here?" I asked.

"Something came up so he couldn't make it," John replied.

"Oh," I said. Great. Now I'm stuck with a sore-armed reliever.

John draped a sterile paper dressing over my crotch. My now orange scrotum jutted majestically above the hole in the dressing.

"The doctor will be in in a few minutes," he said as he left the room.

I laughed nervously out loud as I imagined a series of small rooms with patients like myself in each. Assembly line vasectomies. Hopefully this set up isn't like a lot of car manufacturing plants where many of the workers get drunk or high in order to get through their monotonous day.

A loud groan came from Gary next door, and then a mumbled, "Relax. It hurts more when you tense up." My hips tensed up in sympathy and my testicles moved closer to my body, desperately looking for somewhere to hide.

"The worst part is over," I heard the doctor say. More groans from Gary.

Carly Simon's song "Anticipation" began to play in my head. My body twitched as I imagined the upcoming procedure. Needle, incision, yanking, cutting, burning, sewing. I felt like a tea kettle on a hot stove about to whistle that it has had enough.

A few deep cleansing breaths helped break my collision course with panic. I focused on the dot pattern on the ceiling tile looking to be distracted. I was ready. I was more than ready. I just wanted to get it over with and stop the waiting. I had never been a good waiter, even when it was for something good. Like the time I cashed in a $2 lottery ticket.

"That's it," I heard the doctor say. A door opened and closed, and I then heard him outside my room talking with someone. "My stomach is really upset. It's been a tough one."

Swell, I thought. The man is tense and tired and is about to slice open my scrotum. Why couldn't I be the first patient of the day when he's still fresh and relaxed instead of wound up like a cheap watch?

The door opened and the doctor walked in and introduced himself.

"You ready for this to begin?" he asked.

"Let's do it," I replied in the cheeriest voice I could muster.

"You sure you want to do this, right?" he said, opening his goodie bag of sharp tools laying on the work table.

"Yep." I said. "So you thought you were off tonight, huh?"

"What?" he asked.

"Another doctor was supposed to be here, wasn't he?" I said.

"Yes, but he had a meeting to go to, but it's not a problem," the doctor said.

"Oh no, no problem at all," I said defensively. Good move. Now I've insulted the man.

The doctor -- Dr. Blath, a name that meant nothing to me -- either hadn't heard my crack about his being off tonight or had long ago stopped caring what nervous men said to him from flat on their backs. He rolled a stool between my knees. A nurse materialized at my hip and slid a cold sheet of metal beneath me.

"What's that for?" I asked.

"It grounds the current," she said, which explained exactly nothing.

Weird, I thought. But by then I'd decided that "weird, but okay" was the only workable attitude for a man in my position -- which was flat on his back with an orange scrotum rising through a paper window while strangers calmly arranged their tools.

The nurse took hold of me and drew the scrotum taut, the way you'd stretch a balloon before tying the first knot.

"You're going to feel a pinch, and then some pain," Dr. Blath said. "This'll be the worst of it."

And there it was -- the needle, and above it the 600-some dots in the ceiling tile I'd been describing to myself for eighteen months without ever once having seen them. The pain lived up to expectations. I'd told this part of the story in my head so many times that arriving at it felt almost familiar, like walking into a room you've only ever seen in photographs. So, I did the one thing I'd planned. I stared straight up, and counted.

One, two, three, four. The dots blurred and I started over. I didn't flinch. I didn't moan. I didn't give Gary next door the satisfaction -- though Gary couldn't hear me and wouldn't have cared -- of so much as one wet groan. I just counted, and the worst pain I would feel came and crested and went, and I never made a sound.

"You're a cool customer," Dr. Blath said.

I don't think I'd ever been prouder of myself. Somewhere out there was a man who flailed and had to be strapped down -- I'd imagined the straps. Instead, I lay there like a guy waiting on a bus, counting dots, quietly pinning a badge of honor on my own chest.

"You'll hear a buzzing," he said. "It won't hurt. I'm cauterizing now."

The buzz came, a small electric hum somewhere below the horizon of the paper drape, and he was right, it didn't hurt. One vas deferens down. I felt, absurdly, like a ballplayer at the seventh inning stretch with a comfortable lead.

"You'll feel another prick, and some more pain," he said.

This is where the badge slipped. I'd assumed the second side would be a rerun of the first, so I'd relaxed -- and relaxing is precisely the wrong thing to do when a man holding a needle says "some more pain." I was surprised to put it mildly. My whole lower half seized up.

"You felt that one," he said.

"Yep," So much for the cool customer.

He drew the second tube out -- pressure, exactly as advertised -- cut it, buzzed it, tied it off.

"That's it. We're done," he said. "You did very well. John will be in to help you get dressed." He peeled off his gloves and was gone -- out my door and, a few seconds later, in through the next one, where I heard the muffled overture, I now knew by heart: a knock, a pause, and "Hi, I'm Dr. Blath. How are you doing?" The line kept moving. Somewhere down the hall my replacement was already drawing back his own paper window.

When John came back, he stopped in the doorway and frowned, because I wasn't lying obediently on the table waiting to be collected. I was sitting up, and was writing. I'd grabbed a paper towel from the sink and the pen out of my pants, and was scribbling as fast as my hand would go -- the metal plate, the buzzing, "cool customer," "you felt that one," the knock next door -- getting it all down before any of it could fade. Because even then, woozy and weak-kneed and freshly and permanently sterilized, I knew one thing for certain: this was going to make a great story.

John helped me down off the table. "Spots in your eyes? Dizzy?" he asked. A little, I told him -- weak-kneed was the honest word -- but okay. He helped me into my jock strap, and here I'll tell you something true about the male mind under duress: as I was lowered into that supporter, my chief worry was not pain, or fertility, or the permanence of what I'd just signed up for. It was whether the orange antiseptic or any stray blood would stain the elastic. The supporter I'd hauled in and out of my pocket all afternoon -- through three false alarms, two waiting rooms, and one knowing smile from Paula -- had finally been called up from the bench, and I was fretting over its laundering. Who thinks about that at a moment like this? I do, apparently.

For the record, I said almost nothing the entire time. I answered when asked a question and otherwise kept my mouth shut -- not out of bravery. I kept quiet because Dr. Blath was cutting and burning the ends of two tubes routed through the most jealously defended real estate on my body, a deliberate double whammy so no enterprising sperm could ever leap the gap and surprise us. It struck me as a poor time to break his concentration.

I dressed slowly and walked out the way I'd come in, only gingerly now, like a man carrying something fragile. Which I was.

Earlier, while Paula and I sat in that grim, hushed waiting room full of pale husbands, a man had come out from the back, crossed the lobby, and announced to his wife in a high pitch, helium voice, "Everything went fine, honey. Let's go." For one beat nobody moved. Then the whole room broke up. As jokes go, it was a home run. We got it and appreciated it, especially the men.

Now it was my turn to make that walk. Every face in the room came up as I came through the door. I didn't have a joke in me. I gave Paula a weak smile and said, "Let's go," and we left, and I hoped my own unremarkable exit bought some other terrified guy the same five seconds of relief that stranger had bought me.

Paula said I looked pale. I didn’t say anything and walked out of the office ahead of her. She brought the car around and I lowered myself into the passenger seat one vertebra at a time. "Does it hurt?" she asked, wincing on my behalf. Yes, I said. I put on the seatbelt gently, careful to make sure it wouldn’t somehow press against my junk. We debated--briefly and absurdly--whether to stop for fast food or go straight home. We chose the latter. On the ride there every pothole was a jolt to my groin.

We picked up the kids from Paula's folks, who'd been watching them for us -- the three-and-a-half-year-old, the two-year-old, and the newborn whose arrival had set this whole business in motion. My father-in-law had spent months teasing me about the appointment. He liked to say I'd never give him another granddaughter, that it still wasn't too late to change my mind. He liked to tease and I liked to be teased, so I'd never minded. Now I walked into his house determined to give away nothing -- upright, smiling, a man with nowhere in particular that hurt. It worked. He looked me over and silently seemed to agree that I appeared fine. Mission accomplished.

At home I went straight for an ice pack. My daughter came over and raised her arms to be lifted into my lap, the way she did every evening of her life. I had to look down at this small person -- the very kind of person I'd just gone to such trouble to make no more of -- and tell her no. Not tonight. Daddy can't. I'm sorry. It was the hardest thing I said all day. Harder than "Let's do it." Harder than "Yep."

That night I slept with my feet propped up on a pillow and the ice pack standing watch. I use "slept" loosely. My whole lower half had resolved to clench and would not be talked down from it; I lay half asleep, tense and aching. The aspirin helped, but not enough. When morning came I worked up the courage to survey the damage -- one small incision at the base of the penis, bloodied and gross looking -- and immediately wished I hadn't. Over the next few days, the right side of my scrotum swelled up and turned black and blue, and the ache learned a new trick, shooting up into my lower abdomen.

I went back to work too soon. None of my co-workers knew where I'd been. I walked the grounds of the Missouri Botanical Garden, my employer, on unsteady legs. At lunch I propped my feet on my desk for some relief and -- I'll just say it -- managed to pee on myself a little, a detail I've carried privately for 38 years and am now, apparently, admitting to the world. Coworkers passed my open door, saw a grown man reclined with his feet up in the middle of the workday, looked puzzled, and moved along, not one of them guessing the truth.

That afternoon, out on the grounds, I ran into a reporter I knew, and for reasons I still can't entirely defend, I told him what I'd done. He flinched -- actually flinched, a full-body cringe -- and looked at me as though I'd confessed to a crime against nature. "How," he asked, "could you do that to yourself?"

And there it was again, the oldest male reflex there is, the one I opened this whole confession with: protect the family jewels at all costs. Ask any guy. He'll tell you.

Was it worth it? Well, I told you on the very first page it was. At least that’s how I felt back in 1988.

Paula and I got the thing we were after -- each other, without the pill and all the side effects. We'd paid for it, too: $180.50, real money to us back then, scraped together and run through my medical insurance plan. Three kids was the number we'd settled on. Truth be told, I was the one most sure of it, and Paula reluctantly agreed. She'd have gladly filled the house with more. A lot more. Bearing and raising kids was what she was born to do. Even back then I understood that "enough" cost her something it never cost me.

But that's another story, and a longer one, and it has no business intruding on a day I spent counting dots on a ceiling.