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Urology Pearls

The art of straightening a banana

Shahar Madjar, MD

Editor’s note: This story, the first of a two-part series, is from Dr. Shahar Madjar’s upcoming book “Take Love Twice Daily: Essays, Tales, Love Poems.”

‘I am terrified of my barber,” my friend, Dr. Daniel Doom, who is a general surgeon, told me.

“And I am afraid of death,” I said laughingly.

“Seriously, Shahar, if you only knew how dangerous these people have been, believe me, you would be afraid of your barber too.”

“Is this another one of your riddles, Dan?”

“A challenging puzzle this time,” he said.

“There are four hints to this riddle,” Dan said with a teasing look of mystery in his eyes. “My fear of barbers is rooted in a ‘feud that took place more than a century ago.’ My fear of barbers is also related to ‘a French doctor,’ ‘a company of barbers’ and ‘the art of straightening a banana.'”

I rummaged in my mind for barber memories and for terrifying barber memories in particular. I remembered the barber in my childhood’s neighborhood on Mount Carmel. He was short and bald, which was funny, I had thought back then, for a barber. He was a kind, always smiling man whose razor, which he applied to the back of my neck at the conclusion of every haircut, was extremely ticklish. He wasn’t at all terrifying. In Marquette, it is Kevin from Classics Barber Shop who gives me a marine-style haircut that makes me feel razor-edge cool. His shop is a museum that treasures artifacts of nostalgic value–a price list from decades ago when a haircut was 25 cents, advertising signs for long-gone hair products, and a collection of antique scissors and razors that Kevin’s father, also a barber, had used at the same shop. When I sit in Kevin’s antique barber-chair, my heart fills with a bittersweet longing for a past of which I had no part. He cuts my hair with confidence, his hands are moving swiftly and efficiently like those of a master-surgeon. And I don’t feel terrified. Not at all.

Other barbers came to my mind: the lovely Figaro from the opera “The Barber of Seville” by Rossini; and, in sharp contrast, the completely fictional but still very convincing Sweeney Todd, whose patrons died through a unique sequence of events: they sat in his barber chair; he pulled a lever; a trapdoor opened; they fell backward, sliding into the basement of his shop; on their way down, they broke their neck; then, with a steady hand and a sadistic smile on his face, Sweeney Todd slit their throats with a sharp razor; to dispose of his customers, Sweeney Todd collaborated with Mrs. Lovett, who prepared meat-pies from their fresh flesh. Visualizing this bloody scene, I quickly concluded, “Thank God for Kevin.”

I then directed my attention to other hints in Dan Doom’s puzzle. I let my imagination fly, I let it circle around the word “French.” I could see Paris on a cold, rainy night. I could climb the Eiffel tower. I could smell a fresh baguette and feel the crunch as I bit at its crust, or eat a croissant on the Avenue des Champs-Élysées. And closer to home, I could see myself at Michigan House in Calumet, Michigan, where I often dip French fries in a mountain of ketchup. I then considered the word combinations “a French doctor,” and “the art of straightening a banana.” I asked myself, “Why would anyone want to straighten a banana?” And BOOM, I realized that I was on to something.

“In ‘French,’ Dr. Doom must have been referring to a French doctor, Francois Gigot de Peyronie, who, in 1743, was the first to describe Peyronie’s disease,” I thought. Peyronie’s disease affects 1 in 100 men between the ages of 40 and 70 years, resulting in a penile curvature, or a bent penis. It is believed that the condition is caused by an injury to the penis during intercourse. The body tries to heal the injury by forming a scar. Unfortunately, scars tend to contract, and therefore the affected area becomes shorter and narrower, resulting in a deformity, or a curve, that deviates in the direction of the injured area. Men affected by Peyronie’s disease present with penile pain, penile curvature, a penile plaque (hard scar) that can be felt along the penis, and sometimes with erectile dysfunction.

In some men the condition spontaneously improves, typically over six to 12 months. Some men would benefit from oral medications, stretching and “modeling” of the penis, or from injection of different substances, such as collagenase into the penile plaque (collagenase is an enzyme that breaks down scar tissue). But in many other men, the curvature may persist, creating not only emotional pain, but a functional problem as well (in the more severe cases, the curvature is so severe that it makes penetration difficult, even impossible). In these men, and only after the disease has been stable for six to 12 months, surgery may be indicated. A surgery on a curved penis, as Dr. Doom alluded, is an exercise similar to “straightening a banana.” Looking at a banana you would notice that it has a longer side and a shorter side. Straightening it would require either shortening of the longer side or lengthening of the shorter side. And that is exactly what is done during the surgery to correct penile curvature: the shorter side of the penis is lengthened by removing the plaque and adding a larger graft (like a patch), or by shortening the longer side–by making several longitudinal incisions that are closed horizontally.

I felt some relief knowing that I have managed to solve at least a part of Dr. Doom’s puzzle. On my list I added a check mark next to “a French doctor” and another check mark beside “the art of straightening a banana.” That night I couldn’t fall asleep. As I was tossing and turning in bed, I was asking myself, “What the heck did Dan Doom mean when he mentioned ‘a company of barbers,’ and what was the ‘feud’ that led him to fear them so much?” I shall return.

Editor’s note: Dr. Shahar Madjar is a urologist at Aspirus and the author of “Is Life Too Long? Essays about Life, Death and Other Trivial Matters.” Contact him at smadjar@yahoo.com.