Philip Roth, with his focus on the male libido and the testosterone-driven lust of red-blooded American men, saved my life.
When I discovered I had a large prostate tumor—a highly malignant cancer—back in 1984, at the ripe young age of 35, I went through the typical treatments available then, including a nerve-sparing surgical removal of my prostate—nerve-sparing in order to retain my potency—and subsequent radiation. Five years later, there was clear-cut evidence of metastasis, with a rising prostate-specific antigen (PSA). The only explanation was a recurrence; the only treatment, insisted upon by every specialist I consulted, was immediate and permanent surgical castration. Since prostate cancer is fueled by testosterone, the elimination of testosterone could stop the cancer in its tracks, at least temporarily.
Given the steady chorus of prominent physicians calling for my castration, I desperately needed someone to offer a contradictory point of view. The writing and work of Roth fit the bill. In my early 30s, I had taught an honors course at the University of Maryland on psychiatry and literature, as a college-health psychiatrist. The course, titled “The Inner Life: The Nature of Dreams and Passions,” was simply an excuse to teach Roth novels. Sure, we started with a bit of Franz Kafka and even John Updike, but we finished with Portnoy’s Complaint, The Professor of Desire, and The Breast.
Through Roth I was able to stay in touch with my inner skirt chaser. In the face of permanent castration, I refused to become a eunuch or a walking parody of the professor of desire. My life as a man was not going to be cut short by castration, even if my forgoing treatment was going to cut short my actual life. Because of Roth, my mantra became, “Give me libido, or give me death.”
Ultimately my persistence in avoiding castration paid off. Through luck and persistence, I found out about Nicholas Bruchovsky, a doctor in Vancouver who was working on an intermittent chemical castration rather than a permanent one. He had realized that less is more—that permanent castration is counterproductive.
So, it has been win-win: I still have my life as a man, with lust in my heart, as well as lust in action. I also have my life. I now have lived 25 years with intermittent castration. I have learned that I can live reasonably well as an asexual being for a time, as long as I know that I can eventually recapture my capacity for dreams and passions.
Ironically, one of Roth’s few blind spots in his writing is his lack of understanding of prostate cancer. One of his narrators, Nathan Zuckerman, is diagnosed with prostate cancer, and he undergoes treatment for it. But nary a word about the impact on one’s inner life from Zuckerman in Roth’s trilogy of American Pastoral, I Married a Communist, and The Human Stain. Even Roth’s considerable imagination could not come up with a way to comprehend the impact of prostate cancer on a man’s inner life.
We men are generally not comfortable talking about prostate cancer, especially if it involves castration. The sense of shame and vulnerability can be overwhelming. No wonder Roth never figured out how to describe the prostate cancer experience of Nathan Zuckerman.
To combat the silence associated with prostate cancer—and to educate Mr. Roth—I have fashioned a work of creative nonfiction, A Salamander’s Tale: My Story of Regeneration—Surviving 30 years with Prostate Cancer. Wit and humor can carry the day, even when we face metastatic prostate cancer. This disease forces us to confront virtually every aspect of the human condition, whether it is sex and lust, or time, death, and the gods.
Roth once pointed out that “nothing that befalls anyone is ever too senseless to have happened.” Who would have believed that a novelist’s focus on the testosterone-driven passions in a man’s life —with all the humor and pathos that come from those passions—would ultimately save a man’s life? And who would have thought that the senselessness of human existence, as reflected in prostate cancer, could not be imagined by arguably America’s finest living novelist?
But who cares about Roth’s blind spot? The Talmud tells us that to save a life is to save the world. Roth saved my life. His writings drowned out an onslaught of demands for my castration—an intervention that would have led to my premature death, not to mention the death of my spirit and passions. Pretty darn good for a novelist.
Paul Steinberg, a psychiatrist, is the author of A Salamander’s Tale (Skyhorse).