July/August  2004

The Zen of Science

Sex (Now do I have your attention?)

By Marc Ringel, MD

      I loved the biology class I took as a high school freshman from Mr. Burdine. His passion for the subject shined through every lecture and lab exercise. Though I experienced it 40 years ago, I especially remember the unit Fred Burdine taught about the polygraph (lie detector). The theme was the physiologic correlates of emotions.

      Our teacher explained that it's the impact of an emotionally loaded question that sets the polygraph's styluses atwitter, allowing a skillful operator to separate truth from lie. Telling a lie takes a bigger emotional toll than telling the truth. And that toll is reflected by involuntary changes of pulse, respiration and skin moisture that are recorded by the machine. (Today I don't really believe in the polygraph as a lie detector, but the connection between emotions and physiology still holds.)

      Mr. Burdine claimed he could demonstrate the impact of emotional charge with just a stopwatch. I was the unfortunate guinea pig chosen to assist him in bringing home this point. My teacher sat me at the front of the classroom, on a chair facing his, and said, "Now, Marc, this task is called 'word association.' I'm going to say a word and you respond to me with the first word that comes into your head."

      "Cat," he said.

      "Dog," I answered immediately. And so on:

      "Red..."

      "Blue."

      "Shovel..."

      "Spade."

      "Rain..."

      "Snow."

      "Sex..."

      Silence. I said nothing. Nothing came to mind. He stopped the stopwatch after a near eternity (measured in seconds), then mercifully allowed me, in full blush, to reclaim a desk among my snickering peers.

      Skip ahead a dozen years, from 9th grade to 21st grade. I'm an intern at Cook County Hospital in Chicago . My younger brother has just moved back to the city. He asks me, "So, how're the Marx and Freud?"

      "Huh?" I respond.

      Paul explains, "'Marx' refers to the material conditions of your life: School, work, money, apartment. 'Freud' is about how it's going emotionally, especially with regard to sex." "How's Freud?" was a code for eliciting very personal data including, but not limited to, that old, politically incorrect question, "Gettin' any lately?" For many years, my brother and I referred to the Marx and Freud categories in most every personal discussion we had.

      My answer often was, "Marx is pretty good. Freud's not so hot." Sex and relationships seemed always to be a problem.

      Why is sex so troublesome? I don't know. When it comes to talking about sex, I still feel a little like that tongue-tied 14-year-old on display at the front of Mr. Burdine's biology class.

      I've lived a much larger share of my life as a sexually active person than I ever spent as a virgin; been married almost a quarter century; have three nearly grown children. As a family doctor, people come to me for help with their sexual problems. And still I'm not sure what to say to you, faithful reader, on the subject of sex. So, I'll tell another story.

      It's about a mentor. He was one of the wisest, most respected and respectful people I've ever been privileged to know. And he was an idiot about women. I like to think that I saved him from at least one horrific heartache when, late in life, I helped to dissuade him from pursuing a severely needy, disturbed woman 30 years his junior, for whom he'd fallen head over heels. This man, so clearheaded when it came to everything else, was right back to acting like a gaga adolescent when faced with a big dose of Freud.

      Why, then, is sex so problematic? I believe it's because sex is both necessary and unnecessary. I am reminded of the title of a book by James Thurber and E. B. White, Is Sex Necessary? Sex is one of those drives, hardwired into our biology at least a billion years ago, that is necessary to the survival of our species but a drive that, individually, we can live without.

      Nobody would write a book about the respiratory drive, entitled Is Breathing Necessary? Of course it is. Try not to breathe for a minute or so and you'll know you cannot do without it. How about, Is Eating Necessary? It might take you several days or, if you're adept at fasting, several weeks, to answer that question in the affirmative. On the other hand, you can live forever without sex. (I certainly lived without it for what felt like forever from the onset of puberty until I finally "got some.")

      It's the species that cannot survive without sex, leaving a lot of wiggle room between the biological imperative and individual behavior. Priests and nuns live to old age without sex (though we do know that, for many celibates, biologic urge sooner or later overcomes celestial vows.)

      In the complicated modern world we inhabit, smart, healthful sex is about as hard to accomplish as is smart, healthful eating. Our inborn feeding programs, elaborated over eons of evolution, tell us, as the biologic organisms that we inescapably are, that we ought to gorge on high-quality nutrients at every opportunity because competition for scarce resources is nature's rule. Now that the bounty of civilization has turned the scarcity rule on its ear (at least in the developed world), it takes a huge individual effort to hold our gluttonous programming at bay. Judging by current rates of obesity and of spending on ineffective weight loss strategies, what we've learned in the 8000 years since the beginning of the agricultural revolution hasn't yet come close to trumping the lessons about eating imprinted in our DNA.

      Since sex contributes to survival only on a species level, not an individual one, it's even easier to disconnect sex from its biological roots than it is to confound eating and health. Thanks to modern technology, contraception has allowed us to uncouple completely sexuality from reproduction, while advertising has connected the sexual urge to all sorts of unrelated things like sports cars and shampoo. Ancient brainstem structures, where basic drives originate, are bombarded by inputs from the evolutionarily recent (maybe just a million or so years old) neocortex, where "higher" functions like language, planning, values and culture reside.

      I certainly don't mean to plea for a return to the good old days on the African savannah, when the brainstem was king, women were women, men were homo erectus, and everybody knew instinctually when and how to have sex so as to maximize their chances of perpetuating the tribe's genes. We don't have a clue about what that primal pattern of human coupling might look like, anyway. An ethnographic world survey wouldn't help clarify things either because we'd find monogamous, polygamous, and polyandrous (women with multiple husbands) cultures, and unimaginable other sorts of sexual unions, with women's and men's roles, powers and responsibilities mixed and matched every which way. Each of those solutions must work just fine for the culture it pertains to, at least in the sense of assuring the survival of the group, its individuals, and their particular genes, or else that culture wouldn't be here.

      I was around at the inception of the women's liberation movement. If there's one thing I learned from my feminist comadres, it's that I shouldn't assume what is a woman's role, nor what is a man's. That's another reason why the Freud part is especially hard these days, because the old ways of doing things don't automatically work. We're finally recognizing with sex (as we are with food) that it's going to take new solutions, personal and political, to promote our joy and our health in today's world.

      One more thing: I'm sorry to have taken so long to get around to the word "joy" in an article about sex. It's where I really ought to have begun. But I couldn't have gotten here if I hadn't first given voice to that mortified 14- year-old.