You can cope with many of the problems of old age if you try, perhaps with some help from your friends and other old people. The major barrier to coping is society’s attitude to old people, because old people begin to believe that they should behave in the way old people are expected to behave. If society believes that old people are white-haired, toothless, wrinkled, bent, asexual, inactive, unemployable, incompetent, deficient in intellect, docile, whinging, and prejudiced, old people will have problems because they are being made into non-persons. If society believes that the only occupations of old people are grumbling, sitting, eating, watching TV, reminiscing, and sleeping, old people will have problems, particularly if they want to prove that this stereotype is a myth or, worse, if they believe in the myth. If society believes that most old people need to be in hospital or in institutions, old people will have problems because they may acquiesce and enter an institution long before they need to. And once inside, they lose their independence, their dignity, and their will to live fully.

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Perhaps this is what Doris Odium meant by ‘understanding and forbearance’, although her words imply a passive, submissive woman. If she meant that the couple should try to talk with each other, so that the hidden resentments, the anger, the anxieties, the fears, and the misunderstandings can be ventilated and exposed, the couple have a stronger chance of renewing their regard for each other and strengthening their relationship.

Sometimes the loss of a man’s sexual interest may be due to the competing demands of his occupation, or his male-directed interests. The latter vary from playing golf, drinking with his mates, or watching sport. The competitive world may become all-consuming to him, and, if he believes that he has to work hard and long to provide financially for his old age and for the security of his family, he may be so exhausted by his job that he avoids sex. This is encouraged if he believes the myth that sexual intercourse is weakening. As mental, rather than physical, fatigue is the greater deterrent to sexual responsiveness, and as he may be under some mental stress from the responsibilities of his job, his sexual drive suffers. Physical fatigue may also be a factor, as few middle-aged men are physically fit. Most men are overweight, over-indulge in food and alcohol, and take little exercise.

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It takes about three weeks for the defences to be mobilized, which is why the person who has been infected with syphilis has no symptoms or signs for three weeks. Then the sensitized blood cells attack the treponemes, which are still multiplying in the tissues of the beach-head – in this case the mucous membrane of the penis. This attack causes the first sign of syphilis, a raised pimple on the penis. In the next few days many of the treponemes are killed, as are many of the white blood cells, with the result that a zone of hard tissue develops around the pimple. It also leads to a reduction in blood supply to the pimple, so that its centre dies and sloughs off leaving an ulcer. The infected person has a hard chancre. In time the ulcer heals, leaving a scar. This takes from 3 to 8 weeks. Unfortunately, in some cases, the ulcer is quite small, or is not even noticed, so that the infected person does not seek treatment.

At the same time as the white blood cells are being mobilized, the treponemes which have invaded the bloodstream cause another reaction. They induce the blood to make a chemical substance called an antibody. The formation of antibody to the treponemes is a slow process, but 4 to 8 weeks after the primary infection, it can be measured by taking a sample of blood from a vein. Once formed, the antibody to syphilis tends to persist for years, unless the syphilis is cured, when it usually disappears from the blood over a period of about a year.

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After a few experiences of this kind, the man usually finds he can ejaculate more quickly, and he is now ready for the next stage of retraining.

In this stage the man is stimulated to a high level of sexual desire, until he reaches the first part of the orgasmic phase when ejaculation is nearly inevitable. At this moment, in the female-superior position, the woman slips his penis into her vagina, continuing to stimulate it manually at the same time. Once his penis is inside her, she thrusts actively against him. Usually this is sufficient to produce his orgasm, but should it fail to occur quickly, she lifts herself off the man and begins to stimulate his penis with her hand once again. As his sexual urge rises to the stage of ejaculatory inevitability, he tells her and she again mounts him. If he ejaculates during the process it does not matter, at least for the first few times, for he is learning that he is able to ejaculate near, if not within, a vagina. His psychological block is beginning to break, and soon he will be able to ejaculate within the woman’s vagina. Once he feels confident, he can adopt the man-on-top position, and his problem has ceased.

It will be obvious that ejaculatory incompetence is the obverse of premature ejaculation. In both instances the man gets an erection. In premature ejaculation he comes too quickly, while if he has ejaculatory incompetence he cannot come at all. But, at least, in both types of sexual disorder an erection can be obtained. The impotent man is not so lucky.

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The expectant father’s support begins when the woman is aware that she is in labour and feels that she should go to hospital. The man takes her there and smooths the administrative details which, for some reason, hospitals insist be completed before a ‘patient’ can be admitted. Most of these could be completed during pregnancy, but this only occurs in a few hospitals. Once the woman has been admitted to the delivery floor, the man’s role increases, provided he has been trained during pregnancy and understands what he has to do. He acts as a spokesman for his partner with the attending staff. He helps the staff by recording the duration of, and the interval between, the uterine contractions, and by generally helping the woman. If she has chosen to have minimal analgesia to dull the pains, he can help her by massaging her back, by stroking her abdomen, and by caressing her. He acts as her helpmate, participating and encouraging her during the hours of childbirth and reinforcing her breathing and relaxation patterns.

In the second stage of labour, during which the baby is pushed out into the world, the man encourages the woman, as she uses her muscles to force the baby lower and lower in her birth canal.

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