"Still taking the medication, Jim?"
"Yes, Doctor."
"Any side effects experienced with use of the medication?"
"Well, yes. It seems to postpone ejaculation and at times, I don't know, eliminate the milky-white eruption entirely."
"Anything else?"
"Yeah. I'm shitting water. I haven't taken a solid dump in three weeks."
"On a scale of one to ten, how would you rate the severity of these side-effects?"
"Look, my bunghole has gone from a loaf-pinching posterior to a highly-pressurized liquefied dookie super-soaker and my dick has become a rock-hard, backed-up meat missile. I stroked the damn thing for two hours last Thursday and it's like the government torturing some mute terrorist suspect. Getting his attention isn't difficult, but no matter how hard or long you beat the motherfucker he won't be coughing anything up, you know? So I'd, like, give it an eight point five on the severity scale."
"The occasional inability to ejaculate is common. Weeninoblo syndrome. Did you ever have this problem prior to medication?"
"No. Never. Previous to this, sausage strangling has always had a grand old prize at the end."
"Masturbation? You're not sexually active?"
"I have been, but more often than not I have been a victim of circumstantial abstinence."
"What circumstances force you into abstinence?"
"Social ineptness. Difficulty talking with women. Paranoid thoughts involving pregnancy or catching a social disease. More or less the inability to get laid."
"This is familiar in the psychological community."
"Really? They have a name for the state I perpetually find myself in?"
"Yes. They call it Alakapussi Syndrome."
"Interesting."
"Any other sexual issues? Erectile dysfunction?'
"No. No problem getting it up. I did have the issue with the scar."
"The scar?"
"Yeah, one evening I jacked off so long and hard I damaged myself. I scraped off a bit of skin at the top of the shaft near, you know, the mushroom tip. So I tried to stop masturbating until it healed. I couldn't. So I tried just to not rub in that area, but that didn't work, either. So I just kept inadvertently scraping the scab off. It hurt, but when you're horny, hurt is good, you know? It doesn't hit you until the high wears off. So it took it longer to heal than it should have, but it finally healed. Anyway, so what about the shits?"
"The diarrhea? Is it really severe?"
"Look, once upon a time I'd feel that fullness building in my guts and I'd let it pile up, I'd let the pressure build, and then I'd come home from work, make some coffee, pour myself a mug full of that rich and consciousness-enhancing java and I'd sit down on the pot and sip from my mug, take drags off my cigarette and read a book for an hour as the poop slowly glided out from between my cheeks and coiled or otherwise collected in the bowl."
"Okay."
"And look, I'm an atheist, and though we're certainly open to what I'd call spiritual experiences there are only two things that constitute a religious experience for us in our lives. The first thing is sex, and the second thing is taking a good, hearty dump."
"So this is a good thing."
"It was, but this tale doesn't have a 'happily ever after', because ever since I started popping those goddamned pills you prescribed me I've felt that fullness in my gut, let it build up for some quality time on the shitter and sat down just to have a aqua-poo blast out of my asshole in firehouse fashion. It's over in five minutes, tops. I don't get to finish a cigarette or get more than three pages into a book. So fuck yes, it's really fucking severe."
"Ah, I see. So you poop like you piss?"
"If my piss was a cloudy brown, my bladder held the Atlantic Ocean and my urethra yawned as wide as the Hubble Space Telescope."
"Your asshole is that gargantuan?"
"No. It's called poetic license."
"Ah, I see with full clarity now. This isn't good, I should tell you. This watery butt-dumping means your body is passing the medication right out of your system. Consequently, the drug you're taking is having no effect whatsoever."
"But my mood has improved. And my poop... and my incessant manual labor without ejaculatory compensation..."
"That's a psychosomatic response."
"What?"
"It is due to your belief that the medication is having effect, not due to the effect of the medication, because the medication is having no effect, because you're fire-hosing it out through your asshole."
"So, like, why are you telling me?"
"The medication isn't working. That's clear. And I'm a psychiatrist. My job is to get you on medication that works for you."
"But regardless, I'm better in terms of mood. And isn't maintaining my belief that the medication's working necessary in order for me to continue feeling better?"
"In order to do that it would be necessary for me to lie to you."
"It would be a beneficial lie."
"But still a lie. The medication isn't working."
"But if I'm feeling better and the medication isn't doing it, doesn't that imply that I don't require the medication?"
"Only as long as you believed the medication was doing something. Now that you know it's doing nothing you require medication that does something."
"But it was doing something. I mean, at least psychologically..."
"Damn it, Jim, I'm a psychiatrist, not a psychologist. And your improvement was not due to dependency on external factors but on a delusional belief generated internally out of the fertile soil of your optimistic expectations."
"But I believed myself better."
"Then believe yourself better again. You did it once."
"But my knowledge now prevents me from taking advantage of the lie that previously intoxicated me into normality. It can't be consciously enforced, I needed to believe it was some external source causing this transformation."
"You would still be shitting liquid and masturbating to the point of callouses as a side effect of your delusion."
"You could have tweaked my expectations and therefore the reactions inspired by the placebo. You could have told me that there was another medication available that would have the same positive effects but wouldn't produce the negative side effects. You could have then given me nothing more than a bottle of sugar pills. I would have never known, I would be free from the ill effects, maintain the positive effects and you would have made your money and had a good conscience."
"That's a good idea. Let's do that."
"It won't work now, goddamn it, because I know the truth. You fucking ruined it."
"Well, on the other hand it is possible that the medication had some minimal effect. I could renew your prescription and give you a drug to take in tandem that would eliminate the side effects that are worrying you."
"You're fooling me. Do you think I'm a fucking moron? Your act of enlightening me to my delusions has produced in me an unwavering suspicion, previously non-existent and presently incurable, so this won't work. You ruined it, ruined it, ruined it. Like I don't know you're just going to replace my current medication with sugar pills and then give me another bottle of sugar pills."
"No, no. Really, this isn't a trick."
"Yes it is. I'm not stupid."
"Believe yourself into stupidity. And anyway, you believed the medication was helping you when you were just pooping it out. Is that any less stupid?"
"Of course! Before I had perfectly good reason to think the drug was helping me. Now I'd just be a naive dipshit to believe in anything along those lines, at least after all this."
"Okay, stop taking the medication, take a good, solid shit, go out and have some healthy, premarital sex and be sure to call my secretary and make a follow-up appointment for next week."
"I can't believe this."
"A recurrent dilemma, evidently."
"Yes, Doctor."
"Any side effects experienced with use of the medication?"
"Well, yes. It seems to postpone ejaculation and at times, I don't know, eliminate the milky-white eruption entirely."
"Anything else?"
"Yeah. I'm shitting water. I haven't taken a solid dump in three weeks."
"On a scale of one to ten, how would you rate the severity of these side-effects?"
"Look, my bunghole has gone from a loaf-pinching posterior to a highly-pressurized liquefied dookie super-soaker and my dick has become a rock-hard, backed-up meat missile. I stroked the damn thing for two hours last Thursday and it's like the government torturing some mute terrorist suspect. Getting his attention isn't difficult, but no matter how hard or long you beat the motherfucker he won't be coughing anything up, you know? So I'd, like, give it an eight point five on the severity scale."
"The occasional inability to ejaculate is common. Weeninoblo syndrome. Did you ever have this problem prior to medication?"
"No. Never. Previous to this, sausage strangling has always had a grand old prize at the end."
"Masturbation? You're not sexually active?"
"I have been, but more often than not I have been a victim of circumstantial abstinence."
"What circumstances force you into abstinence?"
"Social ineptness. Difficulty talking with women. Paranoid thoughts involving pregnancy or catching a social disease. More or less the inability to get laid."
"This is familiar in the psychological community."
"Really? They have a name for the state I perpetually find myself in?"
"Yes. They call it Alakapussi Syndrome."
"Interesting."
"Any other sexual issues? Erectile dysfunction?'
"No. No problem getting it up. I did have the issue with the scar."
"The scar?"
"Yeah, one evening I jacked off so long and hard I damaged myself. I scraped off a bit of skin at the top of the shaft near, you know, the mushroom tip. So I tried to stop masturbating until it healed. I couldn't. So I tried just to not rub in that area, but that didn't work, either. So I just kept inadvertently scraping the scab off. It hurt, but when you're horny, hurt is good, you know? It doesn't hit you until the high wears off. So it took it longer to heal than it should have, but it finally healed. Anyway, so what about the shits?"
"The diarrhea? Is it really severe?"
"Look, once upon a time I'd feel that fullness building in my guts and I'd let it pile up, I'd let the pressure build, and then I'd come home from work, make some coffee, pour myself a mug full of that rich and consciousness-enhancing java and I'd sit down on the pot and sip from my mug, take drags off my cigarette and read a book for an hour as the poop slowly glided out from between my cheeks and coiled or otherwise collected in the bowl."
"Okay."
"And look, I'm an atheist, and though we're certainly open to what I'd call spiritual experiences there are only two things that constitute a religious experience for us in our lives. The first thing is sex, and the second thing is taking a good, hearty dump."
"So this is a good thing."
"It was, but this tale doesn't have a 'happily ever after', because ever since I started popping those goddamned pills you prescribed me I've felt that fullness in my gut, let it build up for some quality time on the shitter and sat down just to have a aqua-poo blast out of my asshole in firehouse fashion. It's over in five minutes, tops. I don't get to finish a cigarette or get more than three pages into a book. So fuck yes, it's really fucking severe."
"Ah, I see. So you poop like you piss?"
"If my piss was a cloudy brown, my bladder held the Atlantic Ocean and my urethra yawned as wide as the Hubble Space Telescope."
"Your asshole is that gargantuan?"
"No. It's called poetic license."
"Ah, I see with full clarity now. This isn't good, I should tell you. This watery butt-dumping means your body is passing the medication right out of your system. Consequently, the drug you're taking is having no effect whatsoever."
"But my mood has improved. And my poop... and my incessant manual labor without ejaculatory compensation..."
"That's a psychosomatic response."
"What?"
"It is due to your belief that the medication is having effect, not due to the effect of the medication, because the medication is having no effect, because you're fire-hosing it out through your asshole."
"So, like, why are you telling me?"
"The medication isn't working. That's clear. And I'm a psychiatrist. My job is to get you on medication that works for you."
"But regardless, I'm better in terms of mood. And isn't maintaining my belief that the medication's working necessary in order for me to continue feeling better?"
"In order to do that it would be necessary for me to lie to you."
"It would be a beneficial lie."
"But still a lie. The medication isn't working."
"But if I'm feeling better and the medication isn't doing it, doesn't that imply that I don't require the medication?"
"Only as long as you believed the medication was doing something. Now that you know it's doing nothing you require medication that does something."
"But it was doing something. I mean, at least psychologically..."
"Damn it, Jim, I'm a psychiatrist, not a psychologist. And your improvement was not due to dependency on external factors but on a delusional belief generated internally out of the fertile soil of your optimistic expectations."
"But I believed myself better."
"Then believe yourself better again. You did it once."
"But my knowledge now prevents me from taking advantage of the lie that previously intoxicated me into normality. It can't be consciously enforced, I needed to believe it was some external source causing this transformation."
"You would still be shitting liquid and masturbating to the point of callouses as a side effect of your delusion."
"You could have tweaked my expectations and therefore the reactions inspired by the placebo. You could have told me that there was another medication available that would have the same positive effects but wouldn't produce the negative side effects. You could have then given me nothing more than a bottle of sugar pills. I would have never known, I would be free from the ill effects, maintain the positive effects and you would have made your money and had a good conscience."
"That's a good idea. Let's do that."
"It won't work now, goddamn it, because I know the truth. You fucking ruined it."
"Well, on the other hand it is possible that the medication had some minimal effect. I could renew your prescription and give you a drug to take in tandem that would eliminate the side effects that are worrying you."
"You're fooling me. Do you think I'm a fucking moron? Your act of enlightening me to my delusions has produced in me an unwavering suspicion, previously non-existent and presently incurable, so this won't work. You ruined it, ruined it, ruined it. Like I don't know you're just going to replace my current medication with sugar pills and then give me another bottle of sugar pills."
"No, no. Really, this isn't a trick."
"Yes it is. I'm not stupid."
"Believe yourself into stupidity. And anyway, you believed the medication was helping you when you were just pooping it out. Is that any less stupid?"
"Of course! Before I had perfectly good reason to think the drug was helping me. Now I'd just be a naive dipshit to believe in anything along those lines, at least after all this."
"Okay, stop taking the medication, take a good, solid shit, go out and have some healthy, premarital sex and be sure to call my secretary and make a follow-up appointment for next week."
"I can't believe this."
"A recurrent dilemma, evidently."
