This is the second part of a three-part blog post about my vasectomy. Did you read the first part, yet?
My vasectomy was scheduled for Tuesday afternoon, so I left work early in order to cycle up to the hospital: my plan was to cycle up there, and then have Ruth ride my bike back while JTA drove me home. For a moment, though, I panicked the clinic receptionist when she saw me arrive carrying a cycle helmet and pannier bag: she assumed that I must be intending to cycle home after the operation!
It took me long enough to find the building, cycling around the hospital in the dark, and a little longer still to reassure myself that this underlit old building could actually be a place where surgery took place.
Despite my GP‘s suggestion to the contrary, the staff didn’t feel the need to take me though their counselling process, despite me ticking some (how many depends primarily upon how you perceive our unusual relationship structure) of the “we would prefer to counsel additionally” boxes on their list of criteria. I’d requested that Ruth arrive at about the beginning of the process specifically so that she could “back me up” if needed (apparently, surgeons will sometimes like to speak to the partner of a man requesting a vasectomy), but nobody even asked. I just had to sign another couple of consent forms to confirm that I really did understand what I was doing, and then I was ready to go!
I’d shaved my balls a few days earlier, at the request of the clinic (and also at Matt‘s suggestion, who pointed out that “if I don’t, they’ll do it for me, and I doubt they’ll be as gentle!” – although it must be pointed out that as they were already planning to take a blade to my junk, I might not have so much to worry about), which had turned out to be a challenge in itself. I’ve since looked online and found lots of great diagrams showing you which parts you need to shave, but the picture I’d been given might as well have been a road map of Florence, because no matter which way up I turned it, it didn’t look anything like my genitals. In the end, I just shaved all over the damn place, just to be sure. Still not an easy feat, though, because the wrinkled skin makes for challenging shaving: the best technique I found was to “stretch” my scrotum out with one hand while I shaved it with the other – a tricky (and scary) maneuver.
After sitting in the waiting room for a while, I was ushered through some forms and a couple more questions of “are you sure?”, and then herded into a curtained cubicle to change into a surgical gown (over the top of which I wore my usual dressing gown). The floor was cold, and I’d forgotten to bring my slippers, so I kept my socks on throughout. I sat in a separate waiting area from the first, and attempted to make small talk with the other gents waiting there. Some had just come out of surgery, and some were still waiting to go in, and the former would gently tease the latter with jokes about the operation. It’s a man thing, I guess: I can’t imagine that women would be so likely to engage in such behaviour (ignoring, for a moment, the nature of the operation).
There are several different approaches to vasectomy, and my surgeon was kind enough to tolerate my persistent questions as I asked about the specifics of each part of the operation. He’d said – after I asked – that one of the things he liked about doing vasectomies was that (unlike most of the other surgeries he performs) his patients are awake and he can have a conversation while he worked, although I guess he hadn’t anticipated that there’d ever be anybody quite so interested as I was.
Warning: The remainder of this blog post describes a surgical procedure, which some people might find squicky. For the protection of those who are of a weak stomach, some photos have been hidden behind hyperlinks: click at your own risk. (though honestly, I don’t think they’re that bad)
With my scrotum pulled up through a hole in a paper sheet, the surgeon began by checking that “everything was where it was supposed to be”: he checked that he could find each vas (if you’ve not done this: borrow the genitals of the nearest man or use your own, squeeze moderately tightly between two fingers the skin above a testicle, and move around a bit until you find a hard tube: that’s almost certainly a vas). Apparently surgeons are supposed to take care to ensure that they’ve found two distinct tubes, so they don’t for example sever the same one twice.
Next, he gave the whole thing a generous soaking in iodine. This turned out to be fucking freezing. The room was cold enough already, so I asked him to close the window while my genitals quietly shivered above the sheet.
- Iodine-soaked scrotum being injected with anaesthetic (not mine; from a medical textbook)
Next up came the injection. The local anaesthetic used for this kind of operation is pretty much identical to the kind you get at the dentist: the only difference is that if your dentist injected you here, that’d be considered a miss. While pinching the left vas between his fingertips, the surgeon squirted a stack of lidocaine into the cavity around it. And fuck me, that hurt like being kicked in the balls. Seriously: that stung quite a bit for a few minutes, until the anaesthesia kicked in and instead the whole area felt “tingly”, in that way that your lips do after dental surgery.
- Vas clamp pulling the vas to the surface (not mine; from a medical textbook)
Pinching the vas (still beneath the skin at this point) in a specially-shaped clamp, the surgeon made a puncture wound “around” it with a sharp-nosed pair of forceps, and pulled the vas clean through the hole. This was a strange sensation – I couldn’t feel any pain, but I was aware of the movement – a “tugging” against my insides.
- Vas pulled through a hole (not mine; from a medical textbook)
A quick snip removed a couple of centimetres from the middle of it (I gather that removing a section, rather than just cutting, helps to reduce the – already slim – risk that the two loose ends will grow back together again) and cauterised the ends. The cauterisation was a curious experience, because while I wasn’t aware of any sensation of heat, I could hear a sizzling sound and smell my own flesh burning. It turns out that my flaming testicles smell a little like bacon. Or, if you’d like to look at it another way (and I can almost guarantee that you don’t): bacon smells a little bit like my testicles, being singed.
Next up came Righty’s turn, but he wasn’t playing ball (pun intended). The same steps got as far as clamping and puncturing before I suddenly felt a sharp pain, getting rapidly worse. “Ow… ow… owowowowowow!” I said, possibly with a little more swearing, as the surgeon blasted another few mils of anaesthetic into my bollocks. And then a little more. And damnit: it turns out that no matter how much you’ve had injected into you already, injecting anaesthetics into your tackle always feels like a kick in the nuts for a few minutes. Grr.
The removed sections of my vas, on a tray (actually mine)
You can see the “kink” in each, where it was pulled out by the clamp. Also visible is the clamp itself – a cruel-looking piece of equipment, I’m sure you’ll agree! – and the discarded caps from some of the syringes that were used.
The benefit of this approach, the “no-scalpel vasectomy”, is that the puncture wounds are sufficiently small as to not need stitches. At the end of the surgery, the surgeon just stuck a plaster onto the hole and called it done. I felt a bit light-headed and wobbly-legged, so I sat on the operating table for a few minutes to compose myself before returning to the nurses’ desk for my debrief. I only spent about 20 minutes, in total, with the surgeon: I’ve spent longer (and suffered more!) at the dentist.
By the evening, the anaesthetic had worn off and I was in quite a bit of pain, again: perhaps worse than that “kick in the balls” moment when the anaesthetic was first injected, but without the relief that the anaesthetic brought! I took some paracetamol and – later – some codeine, and slept with a folded-over pillow wedged between my knees, after I discovered how easy it was to accidentally squish my sore sack whenever I shifted my position.
The day after was somewhat better. I was walking like John Wayne, but this didn’t matter because – as the nurse had suggested – I spent most of the day lying down “with my feet as high as my bottom”. She’d taken the time to explain that she can’t put a bandage nor a sling on my genitals (and that I probably wouldn’t want her to, if she could), so the correct alternative is to wear tight-fitting underwear (in place of a bandage) and keep my legs elevated (as a sling). Having seen pictures of people with painful-looking bruises and swelling as a result of not following this advice, I did so as best as I could.
Today’s the day after that: I’m still in a little pain – mostly in Righty, again, which shall henceforth be called “the troublesome testicle” – but it’s not so bad except when I forget and do something like bend over or squat or, I discovered, let my balls “hang” under their own weight, at all. But altogether, it’s been not-too-bad at all.
Or, as I put on my feedback form at the clinic: “A+++. Recommended. Would vasectomy again.”
(thanks due to Ruth, JTA, Matt, Liz, Simon, Michelle, and my mum for support, suggestions, and/or fetching things to my bed for me while I’ve been waddling around looking like John Wayne, these past two days)
No children. My vasectomy’s next week. Took a little persuasion to get my doctor to sign off on the operation, but got there in the end.
My story (in a self-post because I don’t want to look like I’m reaping karma for doing something that billions of men should consider).
Thanks for helping to remind people why this kind of stuff is important, /r/overpopulation.
I’d like to start with a joke:
Is there a difference between men and women?
Yes! There’s a vas deferens.
What’s no joke, though, is the human population explosion. There’re just too damn many of us, as I explained last year. That’s the primary reason behind my decision, held for pretty-much the entirety of my adult life, to choose not to breed.
I’m fully aware that the conscious decision to not-breed by a single individual – especially in the developed world – makes virtually no difference to the global fate of humanity. I’m under no illusion that my efforts as a vegetarian are saving the world either. But just like the voter who casts a ballot for their party – even though they know it won’t make a difference to the outcome of the election – I understand that doing the right thing doesn’t necessarily have to have a directly quantifiable benefit.
That’s why I’m finally taking the next obvious step. Next month, after literally years of talking about it, I’m finally going to put my genitals where my mouth is (hmm… maybe that wasn’t the best choice of words)! Next week, I’m getting a vasectomy.
I first asked a doctor about the possibility of vasectomy about a decade ago. He remarked upon my age, and said – almost jokingly – “Come back in ten years if you still feel the same way!” I almost wish that I still had the same GP now, so that I could do exactly that. Instead, I spoke about a year ago to my (old) GP here in Oxford, who misled me into thinking that I would not be able to get the surgery on the NHS, and would have to have it done privately. Finally, a second doctor agreed to sign off their part of the consent form, and I was good to go. The secret, it seems, is persistence.
I’m sure that this is a decision that won’t be without it’s controversies. And believe me: over the course of the most-of-my-life-so-far that I’ve hinted at or talked about doing this, I’m pretty sure I’ve heard all of the arguments. Still: I feel like I ought to pick up on some of the things I’ve heard most-often –
What if you change your mind?
Even despite medical advances in recent decades in vasectomy reversal, vasectomy should still be considered a “one way trip”. Especially when I was younger, people seemed concerned that I would someday change my mind, and then regret my decision not to spawn children.
I suppose that it’s conceivable – unlike my otherwise potential offspring – but it’s quite a stretch, to believe that I might someday regret not having children (at least not biologically: I have no problem with adopting, co-parenting, fostering, or any number of other options for being involved in the upbringing of kids). I honestly can’t see how that’d come about. But even if we do take that far-fetched idea: isn’t it equally possible that somebody might ultimately regret having children. We take risks in our lives with any choice that we make – maybe I’ll someday regret not having taken my degree in Law or Chemistry or Rural Studies. Well then: c’est la vie.
Do you just not like children?
Children are great, and I’d love to get the chance to be involved in raising some. However, I don’t define myself by that wish: if I never have the opportunity to look after any kids, ever, then that wouldn’t be the worst thing in the world: I’d just spend my years writing code in a house full of cats. I have no doubt that raising children is great (for many people), but just like there are plenty of people for whom it’s not great, there are also plenty of people – like me – who could be happy either way. No biggie!
There are those who have said that this laid-back “take it or leave it” approach, especially when coupled with the more-recent act of rendering myself infertile, will make me less attractive to women. Leaving aside the implicit sexism in that claim, wouldn’t a fair retort be to point out that a woman who is looking for monogamous breeding probably isn’t my “type” to begin with!
But you should be breeding?
This argument’s usually based on the idea that I’m somehow genetically superior and that my children wouldn’t be such a strain on the world as somebody else’s, or that mine would have a significantly better-than-average chance of curing cancer, solving world hunger, or something.
And let’s face it, any child of mine would be just as likely to be the one to build a really big bomb. Or create a super-virus. Or just engineer the collapse the world’s economies into a prehistoric barter economy in a technophobic future anarchy. Attaboy.
In any case, I’m pretty sure that my personal contribution to the betterment of the world ought not to be a genetic one. I’d like to make a difference for the people who are around right now, rather than hypothetical people of the future, and I’d far rather leave ideas in my wake than a handful of genes. I’m sure that’s not the case for everybody, but then – it doesn’t have to be.
Or are there some arguments that I’ve missed? If you’re among the folks who feel really strongly about this, then you’ve got about seven days to make them, and then it’s off to the clinic for me! Just remember: what’s right for me isn’t necessarily what’s right for you, and vice-versa. Just because I use Emacs doesn’t mean that some other, inferior text editor might not be the right choice for you.
I wonder what my surgeon might say to the possibility of me live-tweeting the process? Would anybody be interested? (I promise not to include any photos.)
(with thanks to Nina Paley for permission to use the comics)
[disclaimer: this post appears just days after some friends of mine announce their pregnancy; this is a complete coincidence (this post was written and scheduled some time ago) and of course I’m delighted for the new parents-to-be]
In October, the world population is expected to reach seven billion. Seven fucking billion. I remember being a child and the media reports around the time that we hit five billion: that was in the late 1980s. When my parents were growing up, we hadn’t even hit three billion. For the first nine or ten thousand years of human civilisation between the agricultural revolution and the industrial revolution, the world population was consistently below a billion. Let’s visualise that for a moment:
How big is our island?
Am I the only one who gets really bothered by graphs that look like this? Does it not cause alarm?
We have runaway population growth and finite natural resources. Those two things can’t coexist together forever. Let’s have a look at another graph:
This one is taken from a wonderful comic called St. Matthew Island, about the real island. It charts the population explosion of a herd of reindeer introduced to the island in the 1940s and then left to their own devices in a safe and predator-free environment. Their population ballooned until they were consuming all of their available resources. As it continued to expand, a tipping point was reached, and catastrophe struck: without sufficient food, mass starvation set in and the population crashed down from about 6,000 to only 43. By the 1980s, even these few had died out.
There are now no reindeer on St. Matthew Island. And it looks like this 40-year story could serve as a model for the larger, multi-century, world-wide population explosion that humans are having.
Humans are – in theory at least – smart enough to see what’s coming. If we continue to expand in this way, we risk enormous hardship (likely) and possible extinction (perhaps). Yet still the vast majority of us choose to breed, in spite of the overwhelming evidence that this is Not A Good Thing.
But even people smart enough to know better seem to continue to be procreating. And perhaps they’re right to: for most people, there is – for obvious evolutionary reasons – a biological urge to pass on one’s genes to the next generation. During a period of population explosion, the risk that your genetic material will be “drowned out” by the material of those practically unrelated to you. Sure: there might be a complete ecological collapse in 10, 100 or 1000 years… but the best way to ensure that your genes survive it is to put them into as many individuals as possible: surely some of them will make it, right? Just like buying several lottery tickets improves your chances of hitting the jackpot.
On a political level, too, a similar application of game theory applies: if the other countries are going to have more people, then our country needs more people too! Very few countries penalise families for having multiple children (in fact, to the contrary), and those that do don’t do so very effectively. This leads to a “population arms race”, and no nation can afford to fall behind its rivals: it needs a young workforce ready to pay taxes, produce goods, pay for the upkeep of the retired… and conceive yet more children.
The same tired arguments
Mostly, though, I hear the same tired arguments for breeding [PDF]: cultural conditioning and social expectations, a desire to “pass on” a name (needless to say, I have a different idea about names than many people), a xenophobic belief that the world needs “more people like us” but “less like them”, and worry that you might regret it later (curious how few people seem to consider the reverse of this argument).
For me, the genetic problem is easy enough to fix: if your children’s genes are valuable to you because of their direct relationship (50%) to your genes, then presumably your brother’s (50%) and your niece’s (25%) are valuable to you to: more so than that of somebody on the other side of the world? I just draw the boundary in a different place – all of us humans share well over 99% of our DNA with one another anyway: we’re all one big family! We only share a lower percentage with other primates, a lower percentage still with other mammals, and so on (although we still share quite a lot even with plants).
The similarity between you and your children is only marginally more – almost insignificantly so – than the similarity between you and every other human that has ever lived.
If you’re looking for a “family” that carries your genetic material: you’re living in one… with almost seven billion brothers, sisters, cousins, uncles and aunts! If you can expand your thinking to include the non-human animals, too, well: good for you (I can’t quite stretch that far!). But if you’re looking to help your family survive… can you expand that thinking into a loyalty to your species, instead, and make the effort to reduce population growth for the benefit of all of us?
The other argument I frequently see is the “replacement” argument: that it’s ethically okay for a breeding pair of humans to have exactly two children to “replace” them. This argument has (at least) three flaws:
- The replacement is not instantaneous. If a couple, aged 30, have 2 children, and live to age 80, then there are 50 years during which there are four humans taking up space, food, water and energy. The problem is compounded even further when we factor in the fact that life spans continue to increase. If you live longer than your parents, and your children live longer than you, then “replacement” breeding actually results in a continuous increase in total population.
- Even ignoring the above, “replacement” breeding strategies only actually works if they’re universal. Given that many humans will probably continue to engage super-replacement level reproduction, we’re likely to need a huge number of humans to engage in sub-replacement level or no reproduction in order to balance it out.
- It makes the assumption that current population levels represent a sustainable situation. That might or might not be true – various studies peg the maximum capacity for the planet at anywhere between one and a hundred billion individuals, with the majority concluding a value somewhere between four and ten billion. Given the gravity of the situation, I’d rather err on the side of caution.
“Do you not like children, then?” I’m sometimes asked, as if this were the only explanation for my notion. And recently, I’ve found a new analogy to help explain myself: children are like bacon sandwiches.
Children are like bacon sandwiches for five major reasons:
- Like most (but not all) people, I like them.
- I’d love to have them some day.
- But I choose not to, principally because it would be ethically wrong.
- I don’t want to prevent others from having them (although I don’t encourage it either), because their freedom is more important than that they agree with me. However, I’d like everybody to carefully consider their actions.
- They taste best when they’re grilled until they’re just barely-crispy. Mmm.
Now of course I’ve only been refraining from bacon sandwiches for a few months: that’s why this is a new analogy to me… but I’ve felt this way about procreation for as long as I can remember.
The reasons are similar, though: I care about other humans (and, to a much lesser degree, about other living things, especially those which are “closer” family), and I’d rather not be responsible, even a little, for the kind of widespread starvation that was doubtless experienced by the reindeer of St. Matthew Island. Given the way that humans will go to war over limited resources and our capacity to cause destruction and suffering, we might even envy the reindeer – who “only” had to starve to death – before we’re done.