Love and Other Dangerous Chemicals

Anthony Capella

• Publisher: Corvus
• Year: 2012
• eBook ISBN:
  9780857890269
• Print ISBN:
  9780857890252

Dr. Steven J. Fisher is a young and brilliant biochemist (special subject: the female orgasm). He's invented a Viagra-like pill for women—now he just needs his results to be perfect. Annie is an orgasmically-challenged arts student (special subject: Victorian semicolons). She's just volunteered to be one of Fisher's case studies—but for some reason his miracle treatment isn't working. As scientist and subject bond over romantic meals lit by the flickering glow of a Bunsen burner, Dr. Fisher is surprised to find his feelings taking a most unscientifc turn. . . What if love is one thing science can't explain?

CONTENTS

Female sexual dysfunction: some research issues

1.1

2.1

3.1

4.1

5.1

6.1

7.1

8.1

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10.1

11.1

12.1

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18.1

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25.1

26.1

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29.1

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35.1

36.1

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54.1

Female sexual dysfunction: some research issues

by Dr Steven J. Fisher, Department of Molecular Biology, University of Oxford. International Journal of Sexual Biology 2008 May; 29(3):701-50

ABSTRACT

BACKGROUND: Male sexual dysfunction has been well described in the literature. The compound sildenafil citrate, marketed by Pfizer under the brand name Viagra, has created a market estimated at over $1billion annually. This has led to speculation that a drug targeted at female sexual dysfunction or FSD will be “the big pharmaceuticals’ next miracle cure” (Newsnight, June 2007). However, the existence of FSD, and therefore of a treatment to combat it, remains controversial.

METHOD: The author describes a project to investigate a possible treatment for FSD, and cautions that some previously unconsidered factors may affect clinical outcomes. He describes in particular the case of Miss G, a research subject.

DISCUSSION: This paper was first presented at the conference “Towards a Sexual-Dysfunction-Free Future 2008”, sponsored by Trock Pharmaceuticals, where it provoked a lively response (see, for example, the correspondence pages of this journal, passim).

INTERESTS: The author acknowledges the generous funding of the Trock Pharmaceuticals Research Foundation. This funding has since been withdrawn.

1.1

Twenty-eight women have now participated in the sexual dysfunction research project here at the Department of Molecular Biology, Oxford University. Our approach is empirical: that is to say, the treatment, a synthetic enzyme codenamed KXC79, is adjusted in response to each set of results. All the participants are volunteers and are assessed by my colleague Dr Susan Minstock using a number of standard evaluations (the Derogatis Sexual Functioning Inventory, the Locke-Wallace Marital Adjustment Test, the Female Sexual Function Index, etc) before a decision is made as to whether they are suitable for inclusion. It is always explained to the volunteers exactly what the study will involve; to date, thirty-one potential subjects have subsequently declined to take part. Nevertheless, early results have been encouraging (see, for example, Fisher, S.J and Minstock, S, 2007: KXC79 and female sexual dysfunction: some encouraging early results).

Miss G was slightly unusual in that she was a postgraduate student here at the university who heard about the project from one of our research assistants.¹ Strictly speaking, this was a breach of our selection protocol. However, Miss G worked in a completely different field, English Literature, and in all other respects fulfilled our criteria: she was anorgasmic and had previously consulted a doctor “to make sure it wasn’t just a virus”. (Notes were kept from initial and subsequent interviews: in addition, like all our volunteers, Miss G was encouraged to keep a record of her subjective responses during the trial.) She had also experienced relationship problems:

It wasn’t just that I couldn’t have orgasms – it was the fact that sex was such a big part of his life, and I couldn’t share that. I simply had no interest in it. Almost as if I were going out with a football fan, but was bored by sport.

Based on this discussion and the questionnaires, Dr Minstock made a provisional diagnosis of Hypoactive Arousal Disorder and accepted her onto the study.

I myself met Miss G for the first time when she came to the lab for her induction. As this meeting, apparently so ordinary, was in some ways the beginning of the whole fiasco, I suppose I should at this point pause to note my initial impressions of her – as a person, I mean. The truth, though, is that I did not really have any. If I may be allowed a small subjective observation of my own, what I recall most is being somewhat annoyed she was there at all: my understanding was that the data-collection phase of our study was completed, at least for the time being, while I prepared our findings for publication. This was work that required a great deal of concentration, and when Dr Minstock showed someone into the lab I did not, at first, look up from my computer.

“This is where the hands-on part happens,” my colleague was saying. “When I say hands-on, of course, I don’t necessarily mean that literally. We’ve got toys to suit every taste.”

Needless to say, I did not respond to this, either. Dr Minstock’s jocular manner, which she frequently assures me is simply a psychological stratagem to put test subjects and co-workers at their ease, on occasion strays – it seems to me – into flippancy. Great scientists of the past – men such as James Watson and Francis Crick, when they were engaged in their revolutionary work on DNA – never felt the need to be flippant. But Dr Minstock, as a sexologist, does not have quite the same regard for scientific method that I do.

“That’s Dr Fisher, who’s in charge of the biochemical side,” she added in a deafening whisper. “Working away, as usual! Don’t worry, we won’t disturb him if we’re quiet. Over here’s the photoplethagraph – basically it’s like a little light we pop inside so we can see what’s going on –”

“Photoplethysmograph,” I said, still without raising my head.

“What?”

“That is a photoplethysmograph, not a photoplethagraph. It calibrates reflected light. The darker the flush, the greater the vasodilation.”

“Oh, yes,” Dr Minstock said brightly. “Photoplethysmograph. Of course.”

“What’s ‘vasodilation’?”

I did look up then. There was something about the voice that had just spoken – something wry, ironic even; as if the speaker were somehow mocking herself for not knowing the answer.

Or – it occurred to me a fraction of a second later – as if she were somehow mocking me for knowing it.

In short, I thought I had discerned in the way our visitor had spoken a spark of real intelligence, an impression only partially dispelled by her appearance. I did not at that point know Miss G was an arts graduate, but I could probably have deduced it. She was attractive; strikingly so – I might as well make that clear at the outset. But she was striking, if this makes sense, in an entirely unremarkable way. A pleasant face, torn jeans, a cashmere pullover, a book bag, a knitted cap; and, spilling out from under the cap, a fine mass of chestnut-brown hair, as squeaky-clean and glossy as a freshly-peeled conker. One could imagine that if one were to touch it, the hair would be expensive and soft, just like the pullover. Clearly, she was not part of the university I inhabit, bounded as it is by the Rutherford Laboratories on one side and the Science Parks on the other. Hers was another Oxford entirely, a city of drama societies and college balls and open-top sports cars roaring of for candlelit meals in country pubs. In that Oxford, which overlaps mine while barely impinging upon it, girls like her are . . . I almost want to say “two-a-penny”, but of course they are considerably more expensive than that: their cashmere pullovers, their poise, and even their places at Oxford are the products of costly private educations.

So I glanced at Miss G and immediately thought that I knew her type; a type which was both as familiar and as alien to me as if she were a member of another species.

In this, as it later turned out, I was quite wrong.

“Vasodilation,” I said, “relates to blood flow. Specifically, engorgement of the surface capillaries due to physiological stimulation.”

“Anything you want to know about the technical stuff, Steve’s your boy,” Dr Minstock said, with a little roll of the eyes which clearly suggested that knowing about the technical stuff was a long way down her own list of priorities.

“Actually,” Miss G said, “there was something...”

“I just need to check that file,” my colleague said quickly. “Back in five.” As she left it seemed to me that she gave the other woman a pitying look, as if to say “I warned you”.

I sighed as I turned back to our visitor. “What did you want to know?”

“This treatment of yours,” Miss G said hesitantly. “It’s something like Viagra, presumably?”

I regret to say that even before she had finished this question I was smiling slightly at its naivety. “Not in the least, no. Viagra would be completely the wrong approach for any problem you might have.”

“Why’s that?”

“Well, I can tell you if you like,” I said. “But I very much doubt you’ll be able to grasp the answer.”

She looked at me then in a rather level way, and I thought I detected a slight tightening of her jaw.

“Dr Fisher,” she said carefully, “I have a double first class honours degree from Bristol University, an MPhil from Cambridge, and I’m three-quarters of the way to completing a DPhil here at Oxford. How about you try me?”

1.2

My explanation will undoubtedly seem rather simplistic to my present audience, but for the sake of establishing exactly what I said to Miss G, I will repeat it here. “The active ingredient in sildenafil citrate, or Viagra, is a specific inhibitor of phosphodiesterase 5,” I pointed out. “This cleaves the ring form of cyclic GMP, a cellular messenger very similar to CAMP. The inhibition of the phosphodiesterase thus allows for the persistence of CGMP, which in turn promotes the release of nitric oxide into the corpus cavernosa of the penis.”

She nodded slowly. “You’re quite right.”

“Of course. The mechanism is relatively well underst...

Table of contents

• Cover
• Title page
• Copyright page
• Dedication page
• Contents
• Acknowledgements
• Endnotes