The Big Lad’s $30,000 Big Lad Problem

Normally, I would be the last person on earth inclined to write about another man’s plumbing problems. First of all they are none of my business and secondly it would be hard to find a more boring subject to write about than whether another man can pee properly or not.

But Gerry Adams put the issue of his prostate problems into the public domain when the US-based Friends of Sinn Fein (FOSF) filed routine papers with the US government outlining the party’s expenditures of US funds in Ireland, an obligation forced upon the party during the Clinton years, when SF came in from the cold.

Why precisely his prostate procedure concerned the US government is not entirely clear from the reports but it may be because his return flight to the US, which included a board meeting of FOSF as well as the hospital visit, was covered by party funds raised from American sympathisers.

Anyhow, whatever the truth, the story is out and it has, predictably, caused a storm among Sinn Fein critics who leveled the charge of hypocrisy against the party’s president for abandoning the ailing health care systems on either side of the Border for expensive treatment in New York.

“It is disappointing that senior figures opt of the NHS and choose to avail of treatment elsewhere”, complained SDLP Assmbly member Conal McDevitt in today’s Irish News. “In terms of socialism and social democracy this is against SDLP values of not seeking better treatment simply because you have more money”.

A writer on the politics.ie website wrote: “The height of hypocrisy from Adams to pontificate about the difficulties in the health service for Joe Public….and to fly off to the US for laser treatment….” There will be more of this for sure as the week unfolds.

But people are attacking Adams without knowing a) what the procedure was and what it was for and b) how much it cost.

Well FOSF itself has answered one or two important questions for us that will help us figure all that out. Often the most worrying issue when dealing with the prostate gland, is cancer but according to FOSF, Gerry Adams did not and does not have cancer. The group also let us know that he was kept overnight at a hospital and then spent nine days recovering in a friend’s apartment.

Hospitals and doctors are much happier in America answering question about their business from the likes of me than they ever would be in Ireland or Britain. So I rang the office of one of Manhattan’s top laser surgeons, attached to one of the city’s most prestigious hospitals and asked the very helpful receptionist what sort of laser procedure for the prostate would require one overnight and eight or nine days recovery?

As I expected, the principal candidate was the most common of prostate problems, the enlargement of the gland known technically as  Benign Prostatic Hyperplasia or BHP for short. The Prostate is a gland underneath the bladder whose function in life is to provide much of the white liquid in male semen. It is a very sensitive sexual gland and orgasm can be achieved just by stimulating it.

The problem with the prostate is that it has a tendency to enlarge as a man gets older. It occurs, with varying seriousness, in nearly half of men over 55 years old and between 80-90% of men aged 80. One medical site describes the symptoms thus: “As the prostate grows, it begins squeezing the urethra creating uncomfortable and inconvenient urination problems, such as frequent urination, especially at night, a hesitant and intermittent flow, urgency, dribbling, and a feeling that the bladder is not emptied.” It also plays havoc with sex life.

The traditional treatment for BHP, the sort that would have routinely been the only one on offer in the NHS when I lived in Belfast, was the surgical removal of the prostate. The effect of this can be devastating. From not being able to pee when you need, the patients can’t stop peeing and sometimes the problem is so bad that men need to wear nappies. And the removal of the prostate can, with many men, bring their sex lives to a shuddering halt. You can read more about that here; although the article deals with prostate cancer the sexual problems caused by the prostate’s removal are much the same.

I remember once going for an unrelated urological exam on the day of the regular weekly or monthly outpatient clinic at the City Hospital in Belfast for prostate surgery. There were scores of men seated on lounge chairs in an anteroom, recovering from the procedure – which must have been carried out like a car assembly line – each with a cup of tea in one hand and a plate holding a buttered scone and strawberry jam in the other. They sat staring at the floor, deep in thought. The room was as silent as the grave. I shuddered and got out as fast as I could.

Not surprisingly, medical science has been searching for alternative treatments for BHP that have less injurious effects on a man’s ability to urinate and allow patients to resume an active and normal sex life.

Well in the laser, they found it. And in America laser surgery is more or less the standard treatment now for BPH, at least for those who can afford it.

The most popular treatment, the one SF leader Gerry Adams probably received, is called Greenlight (you couldn’t possibly make this up) Laser Photoselective Vaporization of the Prostate and essentially it works like this: imagine the prostate as an enlarged orange. Well, a hot laser beam gets into the orange and scoops out all the flesh leaving just the outer skin intact which then collapses in on itself. Nerve damage, the thing that destroys sexual activity in other procedures, is avoided. You can see it at work here:

So, how much would this set you back if you had it done in a New York hospital? Well, my friendly receptionist in Manhattan provided the answer. If I was coming from Ireland for Greenlight laser treatment and I had no insurance and was going to pay out of my own pocket, how much would the procedure cost me? “$30,000.00”, came the immediate answer.