The man who prescribed himself Viagra

            I was Consultant Surgeon at the NHSL, Colombo when I was called in to see a patient in a nursing home as an emergency. He was a well built man in his early forties. He was dressed in shirt and white sarong and had biggish gold rings on his fingers. He was wearing smart sandals. It was obvious that he belonged to the business community in Sri-Lanka, who had amassed fortunes in the wavering consumer market. He also seemed to savoir the good things in life. I asked him to be seated and relate his story.

            He related how he was settled down in life and had a good income, a nice house, a devoted wife and two children in their teens. He took an occasional drink but never smoked. Of late he had found that he was not getting a good erection. The wife never complained but he felt that he was not performing well. He had discussed this with his friends. They had told him that there was a drug called ‘Viagra’ in the market which would bring on a good erection and make him perform well. He had asked them whether this drug could be bought over the counter and they had said yes but it was pricey costing about Rs.900/, per tablet. He was over-joyed at this news. He went and bought about five of these. They had told him that one of these was enough but it had to be taken one hour before attempt at intercourse.

            The moment he got the tablets at about 3pm he swallowed one tablet to see the taste. It tasted OK. When he was about to go home at about 7pm after closing the shop he took another one so that he would be ready for intercourse in one hour. When he went home he found that the children had to go for a party and he had to accompany them. It was ten o'clock at night when he came home. He had then taken another two tablets as he found that he was not getting much of an erection.  As he went to bed with his wife at about 11pm and the wife started to caress him he found that he was very rigid. He went a first round. He performed to the point of physical exhaustion to the maximum thrill of his wife and to his amazement he found that there was a very rigid penis at the end of two sessions of intercourse.

            Now he kept going but the wife started getting sore and told him that was enough. The penis remained rigid. The wife beat him and in exasperation beat the penis with her hands but it remained erect as a flag-pole. That was the state of affairs when I saw him. I examined him and the rigid penis. I told him that the diagnosis was a clinical condition called ‘priapism’. Viagra might have caused it. The over dosage might have been a factor causing it.

            The treatment of priapism is very complicated but there is a residual percentage that gets impotence after an attack of priapism. The problems of drug sale in present day Sri-Lanka is very problematical. There are laws which restrict prescription of most drugs. These are observed in the breach than otherwise. As an example the State Drug Co-operation dispensed ‘Sildenafil’ only on a doctor’s prescription and production of the Identity Card issued by the state. A photo-copy of the ID card and the prescription were retained in the ‘Osu-Sala” sales point. But the drug was freely available outside as you can see in this tragedy.

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