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“What’s all this?” she asks. “Read the note,” he replies.

She opens the envelope and reads the card in which he confesses the game—and the drama reaches its resolution.

This game has never failed to elicit a response of tenderness, even from the most uninterested spouse. It can, of course, be played by most of the other types of couples described in this book. I have saved it for last because it is the most surefire game in the book—the one to try when all others fail.

*259/196/1*

“No, I didn’t feel raped.”

“I shouldn’t spear, though. I really shouldn’t. I’ll try to slow down.” “Just do it!”

“But isn’t it rude to stick my penis inside you like this? I’m sorry to invade your space like this.” “I want you to.” “You don’t feel assaulted?” “Shut up!”

“You don’t feel you’re giving in to a male oppressor? You don’t feel degraded?”

“Would you stop with the male oppressor stuff?”

“I just want to be politically correct.”

“What are you doing? Why are you saying these things? You’re mocking me!”

“I just want to make sure everything’s politically correct.”

“Stop it!”

“But I . . .”

“Stop it, I said, and fuck me!”

Obviously this game involves a kind of teasing by the husband—so it could go awry at any moment. If the wife becomes upset, the husband should drop it and attempt instead to discuss what has happened and what kind of feelings the game has aroused. On the other hand, the wife might find herself becoming both annoyed and passionate at the same time (as in the dialogue above). Her fears of losing control to a man, which she had been warding off through her demands that the sex be politically correct, are now assuaged and made to feel absurd by his ultracautious approach. She suddenly gets in touch with the most primitive well of her sexuality, like the heroines in books like Lady Chatterley’s Lover (by D. H. Lawrence) and movies like Swept Away (by Lina Wertmtiller). Down deep she wants to be swept away by passion, as all humans do—but she also fears it. This game helps her to become aware both of that fear and of how it usually is politicized.

*225/196/1*

“You can call me Mr. B,” the husband growls. He may wear some kind of costume or mask, or he may just use his own sourest expression and most menacing posture. “Come with me.”

“Why?”

“Because I made a deal with your father. I paid him a thousand dollars, and now you must be my wife.” “I will not be your wife. You are a beast.” “I said come!”

He “drags” her to the cabin. Once inside it, he asks her to take off all her clothes, and he removes his. He makes himself look as hideous as possible, playing up all the very features that his wife has generally criticized. For instance, if the wife has told him in the past that his belly is big and grotesque, he now protrudes it even more. If she has complained that he is too hairy, he is now twice as hairy (perhaps sporting a beard).

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He: “Oh, I see—the mysterious type. And what do you do, Kitty?”

She: “Well, you promise you won’t laugh? I’m a stripper. I work in the Hellcat Lounge.” He: “So this is called kissing?” She: “I think that’s what it’s called.”

They continue to stay in character throughout the night, making love in both old and new ways. The test will come in the morning. Each may want to run, but instead they must stay in bed and spend an hour or so talking about the experience—how it made them feel to play out their roles, and what they did not say to each other last night. During this part of the game, each partner becomes the other’s disciplinarian, preventing the other from running. The subsequent review will beneficially transform their sexuality.

*157/196/1*

Trichomoniasis is harder to diagnose in men than in women. Cultures can be taken from the urethra in men to make the diagnosis, although this approach often does not reveal trichomonas, even in men who have the infection. The only evidence may be white blood cells from a urethral swab test seen under the microscope on nongonococcal urethritis). Trichomonas infection is estimated to cause between 2 and 5 percent of cases of nongonococcal urethritis in men in the United States. Men most often seek treatment for trichomonas because their partners have been diagnosed with trichomoniasis rather than as a result of symptoms they have noticed in themselves.

*392\213\8*

It is during this time that most people develop antibodies to the infection, a process called seroconversion. Antibodies are proteins that the immune system makes in response to infections. It is also at this time that people have a large amount of the virus circulating in their systems, and there can also be a temporary drop in the number of circulating CD4 cells (the specific type of cell of the immune system that the virus infects), owing to direct damage by the virus. Because these symptoms are so vague, those experiencing them may seek no medical care at this time. If they do seek medical care, they may be diagnosed with HIV infection or misdiagnosed with one of the many other viral infections that can cause similar symptoms. Again, not everyone has these symptoms, and, certainly, not every cold or flu signals HIV infection. Soon after initial infection the body begins to succeed in keeping the virus in check, and a person remains symptom free, on average, for ten years. During this time, it is not uncommon for infected people to notice lymph node enlargement throughout the body. Lymph nodes, which are found in many locations in the body, may swell as a result of infections and malignancies, both of which stimulate the immune system. Because HIV infection involves constant stimulation of the immune system, the nodes are often swollen, even early in an infection. Indeed this may be the only symptom of HIV infection at this time.

*299\213\8*

1. Class I

CIN system: normal

Descriptive system: no abnormal cells seen, or negative

Bethesda system: within normal limits

A follow-up Pap smear is recommended in one year.

2. Class II

CIN system: normal, with a description given of any findings that may be unusual

Descriptive system: atypical cells, as seen with cervicitis and other infections

Bethesda system: infection, reactive or reparative changes seen, or atypical cells of unknown significance (ASCUS)

Although this is still a “negative” Pap smear in terms of cancer screening, either infection or “atypical” cells may be seen, and these may or may not be precancerous. Any infection must be identified and treated and a follow-up Pap smear performed, usually in three to six months. If no infection is present, another Pap smear in three to six months is still indicated. In addition to infection, some other causes of these changes may include atrophy (thinning) of the tissues as seen postmenopause and the presence of an intrauterine device. If the abnormalities persist or progress on the follow-up smear, then a colposcopic examination of the cervix is in order.

3. Class III

CIN system: CIN I-III

Descriptive system: dysplasia (mild to severe)

Bethesda system: squamous intraepithelial lesion (low- to high-grade squamous intraepithelial lesion [SIL])

This category encompasses a wide range of possible Pap smear results. In general, the lower the grade or number, the lower the need for concern, although close follow-up is recommended for all women whose Pap results fall into this category. About two-thirds of the lower-grade lesions resolve without treatment.

For the lower-grade lesions (CIN I, mild dysplasia, or low-grade SIL), a follow-up Pap smear should be performed in three to six months, or a colposcopy could be done at the start. If a total of three follow-up Pap smears at six-month intervals come back as normal, then a schedule of yearly Pap smears can be resumed. A colposcopy and a biopsy of suspicious lesions are recommended if the changes do not resolve on their own or if the changes progress to a higher-grade lesion.

*209\213\8*

Another option for oral-female genital or oral-anal sex is cutting open a condom or a latex glove and using it in the same way. Again, since spermicide tastes bad to many people, unlubricated condoms are a better choice for this method than lubricated ones. Condoms can be purchased in most pharmacies and grocery stores, and latex gloves are also available in most pharmacies.

There are plastic options as well. Plastic may offer better sensory stimulation, since it is thinner than latex yet it probably provides the same degree of protection. It is a good option for those who have a sensitivity to latex. The newer plastic condoms can be split down the middle and placed over a partner’s genitals or anal area to permit the performance of safer oral sex. Another alternative is household plastic wrap. Although there aren’t any scientific studies to show that plastic wrap offers good protection, it is better than no protection, and it offers the option of using as big a piece as you need. You may want to use more than one layer of plastic wrap for extra protection. Plastic barriers can be used with water- or oil-based lubricants, and putting a small amount on the side that touches your partner can enhance his or her pleasure.

*118\213\8*

There are many good reasons to overcome embarrassment and fear and seek medical advice if you suspect that you may have a sexually transmitted disease. Someone who is infected but doesn’t know it, for example, can still infect his or her sexual partners, and pregnant women who are infected with certain STDs may pass the infections to their babies during the pregnancy or at delivery. There are infections of the reproductive tract that can cause infertility in both men and women if they are not detected and treated in time. Some STDs can cause cancer or death. Many infections are curable, however, so early detection and treatment are essential for your long-term health.

If you are convinced of the importance of early detection of sexually transmitted infection, and if you are committed to being vigilant about your sexual health, what should you do? You may decide that you want to be tested on a regular basis, say every six months to a year, especially if you are sexually active and not in a steady, monogamous relationship. People who are in steady, monogamous relationships may want to be tested before they become intimate. You may want to make STD screening part of your annual physical examination. These are all good ideas, and so is getting tested after any unprotected sexual contact with a partner whose status for infection is unknown.

*48\213\8*