Drop Dead Healthy

A week later, I’m in his sleek Park Avenue office, sitting across from him at his desk.

“The penis is the dipstick of the body’s health,” says Fisch. “What’s good for the heart is good for the penis. It’s all the same blood vessels. Should we do a checkup? C’mon, let’s do a checkup.”

We walk to the exam room next door, and I drop my pants as Fisch snaps on a glove. While he examines me, I turn my head and look off into the distance, like Obama in that Shepard Fairey poster. It’s my attempt to retain a smidgen of dignity.

Fisch stands up. He’s not going to sugarcoat it.

“You have old-man testicles, my friend. Low-hanging fruit.”

The problem, he says, isn’t just aesthetic. It’s that these may be a sign of low testosterone.

“You came in and thought you were healthy,” he says. “You’re not. I mean, you’re fine. But you could be a lot healthier. It’s about prevention. Twenty years down the road, you’ll be like this.” Fisch slopes his shoulders and shuffles along.

Before we decide on a course of action, Fisch says I should get a semen analysis.

“Okay. Who should I call to set one up?”

“How about now?”

Turns out, there’s a lab right next door and they have an opening. I was unprepared, but it’s hard to say no to Fisch.

At the lab, the technician gives me a cup and leads me to a small room. Maybe it’s my low testosterone, but this room seems like the least erotic place in the world. I don’t think all the maca powder in Peru could help me here.

I shut the door—and am alarmed to find out the walls are far from soundproof. It’s probably my imagination, but the walls seem to amplify the sound, as if there are woofers and tweeters hidden in there. I listen as the staff chatters away about delivery times and appointment switches. I notice a small table loaded with a stack of Playboys, which is thoughtful, I suppose. But these Playboys are faded and wrinkled, dating back to an era when Hugh Hefner didn’t need Pfizer’s help to have sex.

It took a while. I’ll skip the details, but let me put it this way: I was in there so long that when I emerged, the guy at the lab said, “Congratulations.”

A few days later, Harry called.

“Your testosterone is low!” he says.

His tone was so confident, almost upbeat, it made me unsure how to react. My testosterone clocks in at 245. The average for a man my age is 300 to 1,100.

Low testosterone sounds bad, and embarrassing. But on the other hand, so what? What’s the problem with being a little on the, shall we say, artistic side? I’m not looking to join the New Zealand rugby team.

Fisch says low testosterone can cause cardiovascular problems down the road. It’s also linked to fatigue, depression, and decreased muscle mass. Here’s how Fisch writes about it in his book: “Men with levels below 300 ng/dl (a condition called hypogonadism) tend to have little interest in sex and are usually nonconfrontational, socially inhibited, and physically weak. They are also often very intellectual, creative, expressive, and likable.” The intellectual and creative part sounds good. The socially inhibited, not so much. “Men with higher-than-normal testosterone tend to be just the reverse: Obsessed with sex, competitive, aggressive, extroverted, physical and tending toward more action-oriented activities or careers.” A mix would be nice.

How’d my testosterone get into such a sorry state? Several factors play into it.

It’s partly genetic, of course. But your testosterone level drops when you get married. It drops again when you have kids. It drops every moment after your thirtieth birthday—men lose about 1 percent of testosterone a year. (Though estrogen increases, “which is why we get man boobs,” says Fisch.) It drops when you have too much fat, especially abdominal fat. (I’m still working off my stomach.) I also have a vein-related problem down below called “varicocele.”

The good news, says Fisch, is that there are natural ways to boost your T. First, a healthy diet: walnuts, salmon, whole grains, the usual suspects. I’ve been eating this way for months, so I can’t rely on that. Fisch says that moderate exercise helps. Extreme exercise doesn’t, which is why, according to Stanford professor Robert Sapolsky, professional soccer players have lower-than-average testosterone. I’ve been exercising moderately for months, so I have that covered.

“I once read that you can boost your testosterone just by holding a gun,” I tell Fisch.

“That’s true, but that’s just a temporary fix,” he says.

He says we should think bigger: supplements.

There’s a long history of men trying to turbocharge their testosterone. Even before scientists discovered the chemical testosterone, they knew that the testes had more than a little to do with manliness. In the 1920s, a French surgeon named Serge Voronoff made a fortune with his “rejuvenation” techniques, which were rather extreme. He grafted chimpanzee-testicle tissue onto the penises of men. He promised a longer life, a higher sex drive, and better eyesight. Another doctor offered the same procedure with goat testicles. You’d pick your goat, much like you pick your lobster at a restaurant today, writes Pope Brock in his book Charlatan. Amazingly, none of the animal transplants worked as promised.

Now we have a more scientific wave of rejuvenation techniques. Thousands of men take testosterone supplements, either with gels, creams, or injections. The promises remain the same, except for the better eyesight part. The questions about treatments’ efficacy remain as well. Data are mixed. Some studies show testosterone shots increase muscle mass and energy. Others—including a major study published in The Journal of the American Medical Association in 2008—indicate that men taking testosterone did not improve in mobility, strength, or quality of life.

Skeptics also say we don’t know the long-term effects. One doctor I talked to said that the current vogue for testosterone supplements reminds her of the hormone replacement therapy trend in the 1990s. Millions of menopausal women underwent HRT to combat low libido and energy, only to find out later that it can raise the risk of breast cancer and heart disease.

Fisch says he’s not doing testosterone replacement therapy. He calls it “testosterone normalization.” He recommends against the testosterone gels and creams for me. I have children, and if I hold my kids against my gelled-up chest, the testosterone could rub off. Next thing you know, Jasper needs to borrow my Gillette Mach3.

Instead, Fisch recommends a drug called clomiphene or Clomid. This will make me produce my own testosterone. Oddly, this drug is usually used by women to boost fertility, but it also works in men to increase hormones called FSH and LH, which spur testosterone creation. Also, Clomid resets your baseline testosterone level, so you don’t have to keep taking it the rest of your life, Fisch says.

When I get home, I tell Julie.

“What are the side effects?” she asks suspiciously.

“Well, it’ll increase my sex drive.”

“I think your sex drive is just fine.”

“There’s a chance it’d increase my baldness.”

“That’s not good.”

I tell Julie many doctors are leery, seeing as the science behind it is new, and we don’t know all the side effects yet.

“No, I think it’s a bad idea.”

“I should at least try it.”

“No, don’t do it.”

She shut me down. So for a week, I didn’t pursue it. Which I thought was appropriate, in a way: You can’t get much more testosterone-deprived than having your wife forbid you from taking testosterone supplements.

But in the end, I defied my wife, just to see what a higher testosterone level can do. I start popping 50 mg of the chalky-white pill every day.

The blogger Andrew Sullivan wrote a story in The New York Times Magazine several years ago about his experience of injecting synthetic testosterone to counteract the effects of HIV. For him, it was like a magic potion that transformed him into a Nietzschean Übermensch. His energy, confidence, and libido exploded.

My transformation is more subtle. If Sullivan’s testosterone shots were a double espresso, my pills were a mild chamomile tea. Since I began taking them two weeks ago, I do feel slightly more energetic. My three miles on the treadmill at the gym seem easier. I don’t get the postlunch hunger for a nap.

And yes, my libido is higher. The sexual thoughts bubble up even more relentlessly than usual. I try to read Esquire, since it’s my job and all, and I get sidetracked by a photo of a Barcelonan model named Claudia Bassols. She seems interesting. She was in a film with Jean-Claude Van Damme and has been a judge on Iron Chef. I should probably check out her website, as an Esquire employee. Thus commences ten minutes of clicking through her photos.

I’m not allowed to give details of Julie’s and my sex life, but I’ll say this: We are definitely ahead of the Japanese average.

Am I more aggressive? Well, the other day, I’m on line at the subway station to buy a Metrocard. There are three Metrocard machines, but a single line that feeds into all three. Everyone’s taking their turn. It’s civilized.

Then this guy in a charcoal suit walks right up to the machine on the left, cutting all eleven of us on line.

“Excuse me,” I say. “There’s a line here.”

“The line’s only for those two machines,” he says, pointing to the other two.

“Really?” I say. “You’re really going to cut all these people?”

He pecks away at the keypad. I’m not just annoyed, I’m furious. What a selfish liar.

“I can’t believe what an asshole you are. I mean, I hear about people like you, but I rarely see it in person.”

I’m not the confrontational type, so my words are startling even to me. The other people on the line look at me with what seems like a mix of gratitude, embarrassment, and nervousness.

The line-cutter makes some response, but I can’t hear it, perhaps because the blood is pumping in my ears. Plus my hands are shaking. That can’t be good for me.

I’m guessing the T had something to do with my uncharacteristic rage. There’s clear scientific data that links testosterone and aggressive behavior. But, of course, I never underestimate the placebo effect. Especially when it comes to my slightly higher energy and confidence. It turns out the evidence linking those to testosterone is flimsier.

A few weeks later, I take another testosterone test. When the e-mail with the results pops up in my in-box, I don’t want to click it. What if I’m lower? But I man up and open the document. Yes! Four hundred and sixty-five. I’m higher, and in the normal range. I am officially masculine. After two months of pill-popping, my testosterone rose to 650, which, I told Julie, is somewhere between lumberjacks and Italian prime ministers.

But it occurs to me, maybe this is the worst time in history to be upping my testosterone. As Hanna Rosin points out in The Atlantic, perhaps modern society is better suited to women. “For the first time in American history, the balance of the workforce tipped toward women, who now hold a majority of the nation’s jobs . . . The attributes that are most valuable today—social intelligence, open communication, the ability to sit still and focus—are, at a minimum, not predominantly male. In fact, the opposite may be true.”

So maybe I should be taking estrogen supplements instead. In fact, I recently read a study that women’s language skills are at a peak when they are ovulating and the estrogen levels are highest. So maybe estrogen injections would make me a better writer.

For now, I’m going to get off the Clomid. In part, because I’m sick of checking my temples to see if I’m getting balder.

Checkup: Month 21

My grandfather’s back in the hospital, this time because he’s having trouble breathing. I take a cab up to visit him.

“Oh, the hospital,” says the driver, when I told him the address. “Hey, what’s the difference between a doctor and God?”

“I dunno.”

“God doesn’t pretend he’s a doctor.”

What is it with taxi drivers and doctor jokes? I smile politely. I’m not the best audience for Borscht Belt comedy right now.

I board the elevators filled with low-talking visitors and get out on the ninth floor. I make a right at the flower display, and a left at the end of the hall, and end up in room 134.

There’s my grandfather. He’s lying on his right side, propped up by three pillows. He’s got a white-and-blue hospital gown, an oxygen tube under his nose, and eyebrows as bushy as ever.

His mouth is open in an oval shape and his lips seem to have all but disappeared.

“Look who’s here!” says his daughter Jane. She’s slept here the night before in her blue tracksuit. “All these visitors are better for you than antibiotics!”

“Hi, grumpy Grampa,” I say. He breathes heavily and shallowly and looks at me through half-lidded eyes. He lifts his hand about half an inch off the bed—it seems so small and limp now, almost ladylike—and I take it in mine. He squeezes my fingers. Or maybe that was my imagination. I can’t tell.

Jane is holding a stick with a moist cubic green sponge on the end, and is dabbing it around his mouth to keep him moist. She leans over and kisses his cheek.

Bloomberg business channel plays on the television. A businessman till the end.

I feel like I should try to entertain him. That’s my job. So I tell him stories about my sons and my work. I tell him about my Esquire interview with George H. W. Bush, during which the former president said, off the record, that a certain politician’s wife had a “pickle up her ass.” I tell him in a loud and upbeat voice, because Jane says he responds better that way.

He doesn’t laugh, but he nods slowly, and his big eyebrows twitch a bit.

The hospital gown doesn’t cover his legs, which are red and yellow, veiny and sausagy. I hate those gowns.

My sister, Beryl, knocks on the door and comes into room 134. Her face goes a little white when she sees his body, which seems so shrunken. “Hi, Grandpa,” she says, shakily. “How are you doing?” She then excuses herself to go to the bathroom. A couple of minutes later, she comes back red-eyed.

“The foliage is beautiful nowadays,” says Jane. “We have to get you out of here so you can enjoy it.”

Grandpa doesn’t say anything. Just keeps breathing loudly. Is he really going to get out of here? It’s that crucial balance between delusional optimism and realism.

I get out my laptop and show him some videos of our family, including one of Beryl’s daughter playing a mouse in a musical based on The Wind in the Willows. She looks so purposeful in her red hat and red coat, gazing off into the horizon as she sings.

A doctor comes in to inspect the rash on his arm where the IV enters.

Another knock on the door, this time his longtime secretary, Valerie. “Hi, Chief!” she says. Her friend is with her, and wonders if she could say a prayer. She clasps his hand and asks God to help heal this man. Does my grandfather understand what is going on? What does he, as a lifelong agnostic, think of the prayer?

As I leave, I tell my grandfather, my voice as chipper as I can manage, “I love you, Grandpa. I’ll see you soon!” He tries to say something, but it just comes out as a moan.

He died two days later. There was some sort of delay at the hospital, so my late grandfather’s body lay there for six hours on the bed. A strange fate for a man who was always on the move.

Marti told me, “He looked so calm and peaceful lying there, it was hard to remember that he wasn’t just taking a nap.”

We held the funeral for my grandfather at a Westchester cemetery on a sunny and brisk day. There were only fifteen of us gathered around the grave, just the immediate family. A public memorial would be held later.

A little black amplifier rested on top of the pink headstone. One by one, we came up, picked up the mike, and said our goodbyes as the wind rustled the red leaves on the tree behind us.

We talked about his civil rights work. About his love of family, justice, apple cider, and Alice’s Adventures in Wonderland. About his trips to Ghana for its liberation and the time LBJ grabbed him by the lapels for a photo op.

Marti read a letter he wrote that showed he was a sucker for silly word games: “This letter is being written without a salutation, since you know who you are and it is silly therefore to tell you who you are. And to call you dear when everybody knows you are very cheap.”

After the speeches, four cemetery workers lowered the coffin into the ground with thick straps. Most of the family walked to the nearby grave of my late aunt to pay respects. But a couple of us stayed behind, including me and my cousin Rachel, a psychology student from Baltimore.

We picked up the two shovels stuck handle up in the pecan-colored dirt. We didn’t talk. Rachel began by tossing a shovelful of dirt onto the coffin. It landed with a soft thud.

I bent my knees and tossed in a shovelful, as well. It thudded, and the dirt skittered across the coffin.

We needed something useful to do. We needed to have a purpose, even if that purpose was pointless since the workers would do it if we didn’t. Or maybe it wasn’t. Maybe Grandpa would have appreciated it. One last show of affection from his grandchildren. It felt like tucking someone into bed for the final time.

We worked silently as the dirt made a collection of mounds on the coffin. I was bending deep at the knees, putting my back into it. Every shovelful a heaping one. This work was physical, and physical felt good right now. I was starting to sweat under my suit. Grandpa was not a man who did things half-assed. Neither would I.

The next day, The New York Times ran an obituary of my grandfather. It was the obituary he would have wanted. It called him a “peacemaker,” which is a pretty great noun. It talked about his passion for resolving conflicts, quoting an old New York Times Magazine article that said, “Some men look at Gina Lollobrigida and are set aflame. Kheel gets the same reaction by exposure to a really tough strike situation.”

And it made him sound like James Bond. “Even though Mr. Kheel handled disputes for bakers, garbage collectors, plumbers, subway conductors, tugboat captains and undertakers, he was an unabashed bon vivant, fond of fast sports cars and fine food.”

The photo showed him holding two phones, one pressed to each ear, in the middle of a negotiation between labor and bosses—maybe the bus drivers’ union, maybe the symphonies’. It didn’t say, and it didn’t matter.

Julie clipped the obituary and pasted it onto a piece of cardboard, which I thought was a lovely, nostalgic gesture in these digital times.

There was a short video on the Times website. They must have interviewed him just a couple of years ago, and he must have known it was a pre-obituary Q&A. They filmed him, gray-haired and still articulate, against a black background.

“How do you want to be remembered?” he is asked.

My grandfather laughs. “I don’t want to be remembered,” he says. “I want to stick around for a while longer.”