The compulsive gambler

-“Doctor…My husband is addicted to gambling—he’s destroying us.”

Maria X. is an educated and charming middle-aged lady with a caring husband and two teenage daughters; unfortunately the successful car dealer likes to visit almost daily all the gambling options available in South Florida to try his luck. He has won big several times but his losses are even greater. Slowly he is eroding the good financial standing of the whole family and only the firm determination of his wife prevented him from mortgaging their colonial style mansion in South Dade to pay off some outstanding debts.

The basis of this addiction is that gambling stimulates the brain’s reward system like drugs and alcohol, being closely related to some personality disorders like highly competitive, restless or easily bored individuals. Sometimes it is only another behavioural manifestation of mental health disorders like depression/anxiety, bipolar disorder, obsessive-compulsive disorder, attention deficit/hyperactivity disorder or substance abuse. It used to be much more common in men but women are catching up quickly; it appears in middle age but when it does in later stages, it worsens rapidly.

As we have already discussed in our previous articles about alcohol abuse and compulsive shopping, the addicted individual needs to increase the amount he/she/sie invests in order to maintain the same level of satisfaction. Oftentimes it is an escapist attitude to cope with family or work problems that cannot be easily shared with the individual’s intimate circle. When the addicted persons try to control or stop this addiction, they feel restless and irritable with the inevitably nefarious social and professional consequences. In a consumerist society like the USA with plenty of physical and virtual opportunities to wager on almost any kind of sports or gaming tables, this addiction is fast becoming not only a personal but also a public problem.

There are some American civic personalities that are questioning the spread of state-sponsored lotteries with the purported aim of funding education; they claim that they prey on the poor and gullible without helping them.

What do you think? Please tell us.

Don’t leave me alone.

Crying alone in the bathroom

-“Doctor…At nights I hide in the bathroom—so my children can’t hear me cry.”

Veronica X. is a nice, attractive, intelligent and hard-working mother of two small children who has had to shoulder the entire burden of her household all alone as her husband is serving a two years-sentence for a minor offense. Her family cannot help her economically and only her mother is pitching in. Oftentimes feeling overwhelmed by all her responsibilities, she puts her kids to bed, finishes her household duties and then locks herself in the bathroom to well up at ease. It is an almost daily ritual that she needs to go through in order to decompress her strained psyche and get some needed sleep.

When she was telling me that anecdote in my office, I immediately felt the surge into my conscience of a stampede of sweet-sour childhood memories. In 1965 my father Mario—God bless his soul—was arbitrarily jailed for a few months to force him to pay an outstanding debt—a barbaric maneuver. My dear mother Gladys became extremely depressive and our grandmother Yolanda took us in her large suburban home so she could rest and recover. My brother and I were only 10 and 11 years old at the time but we knew that something was sorely amiss, especially when we heard her crying in the loo late at night. Those memories were painfully seared in our subconscious.

Modern women, who are employed full-time in demanding jobs, usually have to return home to complete the family tasks with little or no help from their live-in partners; to make maters worse they might not have the support offered by the female friendship. They decided to stoically hide their deep feelings of angst from impressionable children and from some relatives that might not completely share her opinions. In our digital age where most of the rooms in a house are invaded by a pinging or noisy device, they have to retrench to the bathroom as the improvised refuge for a safe, solitary exteriorization.

As sons and spouses of these most devoted women there is something we can do. We can wait until they get out of their hiding place and hug them tenderly in silence. We can tell them how much we appreciate their work and what a difference it makes in our lives. We can give them a lot of affection and moral support. And yes, we can offer to share more of the burden of homemaking with her. Chose the way you want to help (I love to cook for example) but do not ignore her suffering and extend her a hand. She’s waiting.

What do you think? Please tell us.

Don’t leave me alone.

The fat girl

-“Doctor…People stare at me all the time in the street—because I’m fat.”

Rhonda X. is a charming young woman that just happens to be overweight. She has all the right attributes to become the enchanting partner of any man, yet she is still stubbornly single, as she cannot meet a match of her liking. She attributes it to her excess weight and the social stigma attached to it. As someone who has lately battled with obesity her plight sounds very familiar.

In modern nations there is a rise of the obesity’s indexes due to many socio-economic factors that influence the diet, usually saturated with sugar and fat. Even though there are laws that prohibit the discrimination against obese people, in fact there is widespread reluctance to employ and house them. Even the airlines have joined the fray by charging extra to customers that cannot fit snugly into their ever-shrinking seat planes—a cynical diversion.

In ultra-conscious about physical appearance-France, a young obese woman called Gabrielle Deydier became a celebrity after she published a book called “On Ne Naît Pas Grosse” where she narrated her daily vicissitudes. In a country where most people pride themselves in their good image, the rising rate of obesity is a taboo subject in the mass media and in the private sphere. Following the trend of all EU nations, the French youth is eating less healthy dishes in favour of the processed preparations and commercial junk food.

A report published by the Inserm, the French equivalent of the National Institute of Health, showed that almost 16% of the population was obese in 2016 compared to 12% in 2008. In the USA, the CDC found that 36% of the population had a body mass index (BMI) of 30 or higher in a 2014 report. The worrying social trend has prompted the American media to deal with the reality of millions of Americans and to foster reasonable ways to remedy it. There is a good discussion of the dietary value of foods and the need to limit the intake of noxious material and unhealthy additives in our foodstuff. This public discussion is just beginning in France, where they are still in denial.

What do you think? Please tell us.

Don’t leave me alone.


The “shameful” menstruation

-“Doctor…We would never allow her to use that contraption—a devilish invention.”

Those harsh words—reminiscent of a tirade from Savonarola in a Firenze public square during the Inquisition—were uttered when I questioned a lady why she had not instructed her daughter how to use a tampon during her menstrual period. Due to uncontrolled bleeding she had brought her to the Emergency room where I used to moonlight for long week-ends in an isolated, quaint small town in the northern hills of Georgia. Fortunately the local gynecologist was making rounds in the hospital and he took care of the situation immediately, including a long talk with the mother.

Women menstruate and have always needed ways to contain the bleeding. There are numerous accounts sine Antiquity of several types of material used to insert in the vaginal cavity and limit the blood flow, which were also used to avoid pregnancy. Egyptian women used papyrus, Greek women used gauze, Roman women used wool—materials that were highly absorbent. In our age a tampon has of a core made of cotton covered with polyethylene. The patriarchal institutions were always leery of that necessary practice as it was solely carried out by women without any manly supervision or control.

In the beginning of the 20th century, Earle Cleveland Haas designed the first commercial tampon to help his wife, a ballerina, to control her bleeding. In 1931 Gertrude Tendrich bought his patent to create the Tampax brand; the inclusion of millions of American women in the World War II factories prodded the use of the device, in spite of the silly puritanical resistance to it. A few years later Judith Esser-Mittag, a German gynecologist, designed one that did not require an applicator, which she dubbed as “o.b.”(ohne binde)

Paradoxically, in our age of women’s liberation from the social prejudices, we can still see the resilient stigmatization of menstruation in the media. TV or radio ads about tampons tend to emphasize their “hygienic” and “aesthetic value” as if that natural biological process were a shameful disease to cure.The feminine care industry has exploited that irrational “sense of dirtiness” to relegate the use of tampons to the sphere of intimacy, not to be discussed.

Menstruation is an integral part of the uniquely marvellous biological cycle of mammals that enable us to create new life and perpetuate our species. The mendacious demeaning of women’s functions must stop in the public sphere.

What do you think? Please tell us.

Don’t leave me alone.



Dating a younger man

-“Doctor…Only with him I can be my true self—with my imperfections included.”

Kimberly X. is a divorced, attractive, middle-aged mother of two children who is steadily dating a younger lad who seems to push all her right buttons. While she enjoys his furious stamina in bed and his obsequious attention, there is much more at play than mere physical attraction according to her. She feels totally different in his presence, much more at ease and relaxed. More confident, less defensive, definitely happier.

Before she started that relationship she used to show up in my office with a clean but slightly negligée look that included a way too frumpy long skirt; she spoke in short sentences, mostly avoiding my gaze and even stuttering. Sensing that she needed a change of lifestyle I did encourage her to go out with friends or even on her own. She met her beau in a casual visit to a bar.

After the event, she became a completely different woman with great looks and the relaxed confidence of someone who was in charge of her destiny. Her long years as a serious spouse had seared the need to spin all her stories, becoming predictably polished and protective of the image she provided. Spontaneous showing of emotions was frowned upon in her social circle and she chose not make waves for his staid accountant-husband. When he finally dumped her for his young secretary, she felt an immense sense of relief. She confessed to me that for the first time in her life she was experimenting new poses for making love with her beau and that she was enjoying it to the hilt.

Her exhilarating experience of “feeling free to express herself” reminded me of an event that had occurred to me in Italy years ago and that I never shared with anyone, except with the readers of my novel. Maurizio, one of the three main characters, is visiting the city of Torino with his grandfather and before leaving town he goes out to buy souvenirs, including a very special one to Renata, his clandestine sexy lover. It goes like this:

“They went back to the hotel to fix their belongings for the trip back.While Antonio packed the suitcase, Maurizio went out to buy the souvenirs. He found a rounded kiosk, staffed by an old woman who was sitting inside. He walked around it, gazing at the big display, trying to make up his mind. He breathed deeply and approached the old lady that was ignoring him.

-“Can you get me something that’s on the other side?” Maurizio said.

She stared at him for a second; she grabbed a bunch of keys and stood up. Going around, he pointed at a glossy German magazine titled “Anal Love” showing some young women in trance with an irrepressible carnal pleasure.

-“You’re too young to peruse this—”

-“Oh, no…It’s for my Uncle Pasquale—he’s Neapolitan.”

-“Those ‘terrones’ should better learn to work!” she said, opening the rack. “They only sit on their butts, sipping Fernet and bad-mouthing girls…”

She took the magazine out and handed it to him. He paid her and ran away.

In the next rendez-vous, he gave the present to Renata; she perused it.  After her first orgasm, she turned around. “My ass is yours—take it.”

Like a condor perched atop an Andean peak, she is ready to deploy her wings, soaring across the azure sky, to reach yet another summit.

She raises her arms. “Vaffanculo a tutti politici di Roma ladrona.”

What do you think? Please tell us.

Don’t leave me alone.


The swinging couple

-“Doctor…My husband likes to watch me making love with another man.”

Lucy X. is a nice looking middle aged professional who had consulted me a few years ago for the treatment of an anodyne lower urinary tract infection. She spontaneously told me that her unusually active sexual lifestyle as a member of a local Swingers’ club had probably produced the “wear” effect. Her husband, another successful professional, had prodded her to join the daring experience as he was getting bored of their couple’s sexual routine. His prolonged lassitude was a source of emotional frustration for her.

One of the commonest sexual fantasies of adults is that “our significant other” has sex with another person but it usually stays in our dreamworld. In order to execute that fantasy there must be audacity and an unequivocal understanding of the pre-arranged parameters of such an encounter. Those that participate in the swinging lifestyle usually have had extensive chats with each other where the ruleS of interaction are clearly defined in advance.

According to the prevalent “swinger’s credo” the traditionally assumed fidelity of the monogamous couple prods the bored members to “try a tryst” with the inevitable emotional frustration when the truth inevitably surfaces.  Swingers claim to maintain their emotional allegiance to one particular partner but expressly allow the sexual experimentation with other people. Their sexual arousal often depends on the double role of actor and spectator in the sexual act, i.e. the “voyeur”, which is essential for their satisfaction. Their occasional partner becomes a true “object of pleasure” in their minds; in French swinging is called “échangisme”, which typifies an objectification.

The use of adequate protection like condoms to avoid mishaps is mandatory as well as the tacit understanding that a partner can say “no” anytime. The practice with non-vetted partners is discouraged. Except on a few occasions.

Long, long time ago (before I became a monk of Medicine) one of my dates suddenly looked at me in the eye in the middle of dinner at a resto. She said:

-“Hey, my married twin sister is arriving in town later tonight.”

-“Really?” I casually replied. “Should pick her up at the airport—”

-“Thanks darling,” she said caressing my face.” Mmm…do you mind if she stays with us for the week-end? She freaks out if she has to sleep alone..Don’t deny me!”

What do you want me to say? In the arduous slogging of that insomniacs’ night my generous predisposition to be a Good Samaritan got the very best out of me…

What do you think? Please tell us.

Don’t leave me alone.

The surrogate family

-“Doctor…The money is not bad….And I missed that sense of inclusiveness.”

Deborah X. is an attractive middle-aged lady that became a widow some time ago and who has been living alone in a large house since her two children left for college a few months ago. She decided to downsize by selling her house in Kendall and buying a two-bedroom apartment in Miami Beach. Being in a quarter with many retirees she signed up to work part-time as concierge help instead of staying at home to watch TV or organizing sales. She rejected calls to become a “cosmetics lady” because she figured out that those companies would not compensate all the time she had to invest in the task. Moreover she wanted to find something more fulfilling than peddling merchandise.

An article in the New York Times analyzed the trend of “elderly concierge” industry where the semi- and fully retired transfer to continue working for the steady stream of baby boomers that need help in their twilight years. “Some 43 million people already provide care to family members—either their own parents or children—according to the AARP, and half of them are “sandwich generation” women, ages 40 to 60.all told, they contribute an estimated 470 billion a year in unpaid assistance.” The elderly concierges do not supplant the care professionals like physicians, nurses and assistants as they usually take care of home errands, minor housekeeping tasks or provide company to an elderly person that wants to “feel connected” to others.

Deborah X. goes twice per week to the apartment of an eighty years-old retired teacher who likes to chat with another lady. She helps her prepare her breakfast, reads the newspaper for her and answers the telephone. When the lady has a physician’s appointment she accompanies her, as her children are busy professionals. When they come back home she calls her two daughters to give them updates about their mother’s condition and treatment schedules. They also go to see a movie once per month with a pre-showing nice dinner. Deborah believes that she has become her “surrogate mother” and her client also feels that there is a strong bonding between the hitherto lonely ladies.

Perhaps that is an example of how we will evolve in the last leg of our lives. We’d better get started in locating the kind, patient lady that’s going to read and write for us in our twilight years. Any volunteers out there?

What do you think? Please tell us.

Don’t leave me alone.