1.1 Twenty-eight women have now participated in the sexual dysfunction research project here at the Department of Molecular Biology, University of Oxford. Our approach is empirical: that is to say, the treatment, a synthetic enzyme code-named 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 declined to take part after these initial conversations. Nevertheless, early results have been encouraging; see, for example, S. J. Fisher and S. Minstock, “KXC79 and Female Sexual Dysfunction: Some Encouraging Early Results” (2007).
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. 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 sports. Based on this discussion and the questionnaires, Dr. Minstock made a tentative 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 sorry fiasco, I suppose I should pause at this point 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, what I recall most is being somewhat annoyed that she was there at all: my understanding was that the data-collection phase of our study was completed, at least for the time being, whilst I prepared our latest findings for publication. It 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. “Well, 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 from the past—men such as James Watson and Francis Crick, say, 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 always 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. “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 the 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 sweater. Clearly, she was not part of the university I inhabit, bounded as it is by the Rutherford Laboratory on one side and the Science Park on the other. Hers was another Oxford entirely, a city of drama societies and college balls and open-top sports cars roaring off for meals in country pubs. In that Oxford, which overlaps mine whilst 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 was clearly meant to convey that knowing about the technical stuff was a long way down her own list of priorities.
“Actually,” Miss G. said, “there was one other thing—”
“I just need to check that file,” my colleague said quickly. “I’ll only be a few minutes.” 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 the visitor. “What did you want to know?”
“I was just wondering,” Miss G. said hesitantly, “if your treatment is something like Viagra.”
I regret to say that even before she had finished this sentence I was smiling slightly at its naivetÉ. “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.
“Try me,” she said.
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 understood.” I turned back to my laptop.
“No, I meant you’re right that I didn’t understand. Not a word. Mind you,” she went on, almost to herself, “it’s got a sort of music to it, hasn’t it, and I don’t always understand a piece of Tennyson or Keats when I first hear it either. Sometimes you have to sort of … feel the meaning before you can work out the details. Let’s see … so what you’re saying is that once the phospho thingy, the phosphodiesterase, is taken out of the equation, and the cyclic GMP does its stuff, it’s basically a question of nitric oxide, which must be a gas, so it’s really just about hydraulics.”
I must admit, I was quite surprised that she had managed to work out the gist of what I was saying from so little actual knowledge. “Approximately, yes. Women’s sexual responses are rather more complicated.”
“Ah. Now there, perhaps, I can correct you. You mean ‘complex.’”
I frowned. “It’s the same thing, surely.”
She shook her head. “‘Complicated’ means something difficult but ultimately knowable. ‘Complex’ implies something which has so many variables and unknowns it can only be appreciated intuitively—something beyond the reach of rational analysis, like poetry or literature or love.” And then, somewhat to my surprise, she recited what I took to be some lines of verse:
“When two are stripped, long ere the course begin
We wish that one should lose, the other win.
And one especially do we affect
Of two ...