How Hard Can It Be? Understanding Erectile Dysfunction

As part of my series on the Aging Male, Love and Medicine will tackle erectile dysfunction (ED) – failure of the penis to remain erect in order to reach sexual satisfaction. Most men have experienced this at one time in their lives.  Men are embarrassed, anxious and depressed when their penis isn’t working.  They report frustration because they can’t please their partner. For men in healthy relationships, their partner’s needs matter a lot.

I interned in a sleep lab in graduate school. Sleep studies were used to differentiate psychogenic ED from physiological ED. A normal man spends about two hours in a tumescent state while asleep, having three to four erections a night. A man with psychogenic ED would probably be not far from the norm; a man with physiological ED would remain soft. Diabetic men spent nights in the sleep lab while erections were recorded and it was there that the first correlation between ED and diabetes was discovered.

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Have a Peaceful Weekend


On the road again. Embracing every day, trying to get exercise, eat healthy and maintain grounding when everything is fluid.

I feel like I’m in constant alert-mode. There isn’t a bunch of chit-chat. There are few phone calls, mostly incoming texts that could be life altering at any moment. That’s my life lately. Is that how it is for everyone?

Sitting in a cafe on this cool sunny morning listening to the conversations around me: nine men and two women in their upper eighties were talking about everything from the 6 Day War, to recent hospitalizations, and on to the latest Premier league games. At the next table, a woman talking to her mom was caught saying “its me, your daughter Yael”. She then turned to her friend to report “my own mom doesn’t recognize me”. Then there were the scattering of ubiquitous Game of Thrones conversations.

I just started watching Game of Thrones, as a result of both intrigue and peer pressure. It’s popularity reminds me of The Girl With the Dragon Tattoo novels that at one time were bestsellers in 48 different countries at the same time. They are examples of entertainment that obliterate geographic, age and gender boundaries. They they make the world a smaller, more intimate place.

I’m not exactly enjoying the series. I like sex and violence, but not this kind. But I’m giving it a chance. I’m on season 2, episode 2. Admittedly, it brings me down and then I need to break it up with an episode or two of Rita ( a delightful Danish series on Netflix) before I dive back in for more GOT.

My daughter is making dinner tonight, no doubt something exotic and amazing. What a cook.

Looking forward to being nurtured, sleep, long walks and sunsets. I should be able to hit two out of the four. Maybe three.

What are your weekend plans?

Yes, Look Back

In this society, looking back is considered very uncool. We are encouraged to be in the present. The past is seen as an obstacle to moving forward. Reminiscence is considered a nostalgic waste of time.

We should be looking ahead at the next new path.

I believe most of us are not looking back enough.

How much do you know about your family history? Maybe you know where your parents were born but what about your grandparents? Your Aunts and Uncles? Can you picture their family life?

I am going to tell you about an incredible experience. I’m going to talk about a pilgrimage, for lack of a stronger term. This word denotes a journey to a sacred place. Actually it can be a simple exploration of one’s lineage. My brother Steve, sister Rita, and I set out on a true pilgrimage to my dad’s birthplace. Steve, an extremely knowledgable historian/Holocaust researcher prepared the groundwork for us. He had fastidiously mapped out our father’s town to the point of fairly accurately locating his exact house. He outlined the path the family took to the concentration camp. My cousin Richard came along as our guide. His presence was invaluable for his multilingualism, personal experience and high entertainment value.

We bid farewell to our new families and set out to explore our old one.

The four of us crossed the ocean from our respective homes and met in Budapest, which was the center of culture and commerce back in the day. My grandfather (or sometimes my dad) would take the overnight train to Budapest to buy leather, as my grandfather was a shoemaker. Later my dad was taken to slave labor in Komarom, a short distance from Budapest. He lucked out and worked as a shoemaker. “I had a good deal there”, he says. He spent weekends with relatives in Budapest. He had a “sweetheart” there too. People traveled to Budapest after the war to find each other, to look for surviving family members. The day the Japanese bombed Pearl Harbor, my dad was there. He woke up and heard on the radio.

My dad is from the mountains of Subcarpathia in what was Czechoslovakia, now part of Ukraine. We headed there next. Passing the border was not easy. Rental cars need extra insurance for Ukraine. We were refused entry at the Záhony crossing. Richard sweet talked the cute Polish UN observer into telling us we could cross via Slovakia.

The next few days were spent in my dad’s neighborhood. We located his Svalava street, by the landmarks that Steve provided. Then the highlight of the trip: we found the legendary house. I never believed it would still be standing or that we would be able to identify it. A lovely place on a quiet street right across from the Svalava river. We were lucky to find a woman in the yard. Richard explained the story and although she was in a hurry, she allowed us to come in and look around. She kept reassuring us that she purchased the house, that it was not taken.  When we sent pictures home to our dad he responded “Oh!..Oh!…they’ve remodeled!”

We saw the train station, a place so central to life at the time. We wandered into Nelipeno to find his mother’s house but it was gone. We found an old Jewish cemetery. We absorbed the landscape, the trees, the smells where our father spent his childhood. There was a full social and cultural life here. People were working, kids were out playing.

It made the idea of the Nazi’s coming in just unthinkable. What went through their minds as they extinguished this thriving community? What went through my grandparents’ minds as they were taken away?

My dad came from a family of 8. His mother was put on a train with his two youngest sisters. They went directly to the ovens in Auschwitz. His father and sister died at some point during the Holocaust. The three eldest survived.

Following the path of my grandmother and her two youngest daughters, we drove to Poland, to the Auschwitz concentration camp. We saw the train tracks in the entrance where they stepped off the cattle cars. Those two little girls must have been terrified. They had never been so far from home. You have probably seen these or similar pictures. I was shocked at how enormous it is – larger than 5,000 football fields. Auschwitz was made up of three camps; an extermination camp, a slave-labor camp and a prison camp. Most of the people who arrived there were of no use to the Nazis and went directly to the gas chambers. There were four large crematoria composed of a disrobing area, 8 large gas chambers and 46 crematorium ovens. Those sent to slave-labor dug the deep trenches we saw around the camp. They worked on expansion of the grounds, forced to build their own death camp. In the span of 5 years about 1.5 million people were killed there.

We left Auschwitz feeling spent, dusty and anguished. We wanted to toss whatever clothing we were wearing and never wear it again.

We arrived in the lively city of Krakow in a daze. Richard left us at that point, heading back to Czech to see his mom. What a mensch for taking this trip with us!

There is no way to unsee what we witnessed on this trip. There was life before the Holocaust for these Czechoslovakians. One that is too often overlooked. They were all just going about their business. For many centuries the Jews practiced openly and attended synagogue. They were free.

Each one of us responded differently to what we experienced. Rita was more demonstrative/external, Steve was quiet/internal and I was somewhere in between. Just as you would expect knowing our personalities dating back from childhood.

I needed to make this trip to understand and enrich my life, but only once. I won’t be going back. I feel it will take years for me to fully integrate and fully understand how it impacted me.

While our dad was very moved that we made the trip, he has no desire go back. He’s getting up there, he was born in 1920. We are glad we did this now, while he is still around.

I would encourage all of us to look back. I used to see my parents as these people who raised me and were always old. I never gave much thought to their childhood, to their lives before me. We need to be curious. This is our DNA! Ask the questions. They may say that they don’t have a story. Everyone has a story.

Visit the small town in Idaho, or the county in Ireland or wherever your roots lie. It may not be Cancun or the place you dreamed of vacationing but this is a different type of travel. This is a pilgrimage.

How To Throw A Great Wedding

I’ve been many things in my life before, but never an M.O.B (Mother of the Bride). I’m far from a big wedding expert, but I’m passing on a few things I learned from my daughter’s wedding last week.

I openly wanted them to elope….that wasn’t what they wanted…

Incorporate your own traditions.

While it can be comforting to stick to the classics it’s fun to throw in something personal and unique. My daughter chose to go with handmade Hawaiian leis instead of rings.

Choose your right Officiant

My daughter chose her first cousin to perform the ceremony. After following the steps to become ordained in Hawaii and meeting with a Rabbi, he led a service that totally set the tone for the rest of the night. Striking the balance between humor and seriousness, while incorporating Jewish traditions, was crucial in pulling off this event.

The Music

We gave our Irish musician free reign to choose what to sing during the procession, after he rejected all of my ideas. The River is Wide was a perfect ballad for this setting. As long as the song reflects the nature of the relationship, anything goes.

Honor the Seniors

Making this trip for an older person is no small feat! Being lucky enough to see your first grandchild get married is nothing short of a miracle for some.

Casual dress = more fun.

Our dress code was “Aloha casual” – that threw some people off. Despite the confusion, the men were super comfortable in their Hawaiian shirts, as were the women in their flowy dresses and sandals.

Costco Hawaiian Shirt collection in Lihue, HI 

Serve good food and not too much.

Think quality over quantity when it comes to the meal. Don’t fill everybody up on appetizers!

Kauai Blackened Mahi Mahi

Leave enough time for dancing.

Following a good hora make sure you leave time for the Electric Slide. In our case, the Australians stunned us all with Eagle Rock. Eagle Rock is a 70s Australian rock song by Daddy Cool. When that song is played at an event, Aussie men in particular instinctively drop their trousers and dance with their pants around their ankles.

Offer pre-wedding yoga.

This was a highlight at our event. Even laid back weddings can be stressful. Yoga is a perfect break from the formalities. The ancient practice brings the group together and kicks things off on the right foot. Dedicate the class to the newlyweds.

Keep it green

Say no to confetti (unless it’s made of dried leaves), paper invites and plastic straws.

The Couple

No amount of flowers can mask an unhappy relationship. They need to be truly deeply in love for a wedding to soar. Everyone is down for celebrating when two people find each other, fall in love and choose to share it with the universe.

Big shout out to my daughter Lia for contributing to this article. And to my daughter Ayla, who made being the M.O.B. easy by being the most relaxed happy bride ever.

What do you think makes a great wedding?

I’m Changing My Name Again And Here Is Why

I am quite happy with my first name. At birth, I was given the name Ann, an English variation of the Hebrew name Hannah, named for my father’s mother who was killed in the Holocaust. I changed the spelling to Anne to mark a milestone in my life – loyal readers of Love and Medicine know all about it, wink-wink. Anne, or Áine is also the name of an Irish Celtic Goddess. I’m good with Anne.

As an aside, Ann’s height of popularity was in 1959. It has now fallen from the 539th most popular name to an abysmal 1299th…

When I became a writer, I considered pen names like Soferet Tova – I know, so bad, but I was 10! I also considered pseudonyms like Irene Drive – for the subliminal message. A pseudonym was tempting as a writer with young children wanting to write about racy stuff. By the time I finally published my first word on Love and Medicine, my kids were old enough.

Under the 14th amendment, every U.S. citizen is guaranteed the right to change his or her name at will.

I never for a second considered changing my name when I got married. I can’t understand why any woman would choose to follow that patriarchal custom. But let’s move on…

My father was born in Czechoslovakia and given the Slavic name Ludwig Kopolović, pronounced Koplovich. He entered this country in 1947 after WWII. He spelled his name Ludwig Kopolowitz “because they didn’t know how to soften the C”. Americans can’t deal with accent symbols. Right all you Esmé’s out there?

A few years later his brother Benzion Kopolowitz  shortened his name to Bernie Koplin, at the urging of his wife who felt Kopolowitz was too long.  It was important to Bernie that as brothers they share the same name. My dad was reluctant but eventually changed his name to Koplin.

Koplin has always been a pain.  No matter how many times I say “with a K”, it is spelled with a C. It is invariably pronounced cop-lin but it is supposed to be cope-lin.  It has no meaning whatsoever. I feel no connection to the name. It’s not bad, it’s not good, it’s just nothing.

The name Kopolovic, on the other hand, “immediately places your origins in Eastern Europe,” according to my dad. It has depth, history, meaning. My sister, brother and I are seriously considering a name change to Kopolovic. Our kids aren’t thrilled and have no plans to change theirs. That’s fine with me. We don’t have the same last name now either.

My dad might secretly like the idea but gives his usual poo-poo reply “eh, too much trouble, what do you need it for?” That is his response to anything related to the past; like my idea to pursue EU citizenship based on his country of birth and to finally request reparations from Germany that he deserves as a holocaust survivor.

According to research on name changes later in life, it is best to start using the name prior to pursuing it legally. Once we get a consensus on how to pronounce it, you may see my new name appearing first in my writing. My sister is starting with her doorman. In New York, when in doubt, the doorman is a good place to start.

Have you ever considered a first or a last name change?