How the search for a little joy in this miserable world can kill you

Curious the stigma that attaches to employing the services of a prostitute if you are not Graham Greene
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Another sad week in the history of mankind; in particular, I thought, the story of the octogenarian yet still libidinous "Mr Cooper" (false name) as reported in this paper, but as told originally by the psychiatrist Dr James Barrett in the British Medical Journal, a publication to which, if only by report, I am increasingly drawn. All human life, and not a little human death, is there.

The death in Mr Cooper's case is hurried on by a prim and agelastic social services intolerant of sexual appetite in one so old. That's the sadness. But then again, what an inspiration Mr Cooper is, aflame with longing until the very end. The other inspiration is Dr Barrett, who rescues the fleshliness of Mr Cooper from any imputation of squalor.

It all begins when the local authority residential home, where Mr Cooper lives, asks Dr Barrett to take a look at him. The letter of referral from Mr Cooper's general practitioner paints a picture of what I suspect many a woman will instantly recognise as her husband - frail, deaf, catheterised, demented, and sexually persistent. The only difference being that what a man can get away with in the lordly privacy of his own home becomes more problematic when he is in care. "Inappropriate" was the word used of Mr Cooper. But then sexual behaviour is always deemed inappropriate when it isn't welcome, and the hard part of ageing for most men, especially if they are attached to a catheter, is that the welcome mat is put out less frequently than it once was.

Initially, an elderly female friend had visited Mr Cooper and accepted money from him for sexual favours. Whether - as there is no reason to doubt, since sex is seldom much fun on its own - the money covered companionship and conversation as well, we aren't told. But when her visits stopped, Mr Cooper turned bothersome. Entirely to his credit, it seems to me - because it would surely have been easier for him to lock himself away in his room with a copy of Loaded and speed up the ruination of his eyes - Mr Cooper continued to want sex with another human being. A prostitute was his own solution, but when they denied him that he began to importune the female staff. Their own fault. They should have granted him the prostitute. His money, his choice, and, even at 80, his libido.

There were several reasons why the institution, viewed as a moral entity, found it difficult to countenance prostitution on the premises, for all that the premises, as Dr Barrett pointed out, were Mr Cooper's home.

They were not sure of its legality. They feared offending other residents.

They were reluctant to allow "someone like that" into the building. And some, would you credit, even saw it as exploitative of women. As for what was exploitative of Mr Cooper, consider the logic, which Dr Barrett conscientiously unpicks, of social services fearing that regular sex with prostitutes might turn out to be so beneficial to Mr Cooper that once he had exhausted his savings on them the NHS would have to go on picking up the tab. Imagine the financial implications of that - the NHS inadvertently discovering how to make the old live longer through the accident of cheering them up.

Curious, the stigma that attaches to employing the services of a prostitute if you don't happen to be Baudelaire or Graham Greene. Partly the prostitute's own doing, I concede. In particular English prostitutes who make little effort with their appearance and even less, I would imagine, with their conversation. For some reason that I never got to the bottom of, prostitutes used to ply a morning trade outside the polytechnic I once taught at in the Black Country. Nine o'clock in the morning, there they'd be, mingling with the commuters and the lecture-goers, carpet slippers on their feet, curlers in their hair, and bacon-bespattered pinafores under their coats. I will not make a fool of myself by wondering why any man would want sex at such an hour with such a person - there is no fathoming the perversities of male desire - but without doubt the ancient profession of hetaerism would be better served in this country if the filles de joie put a little more joie into it, affected sensuality even where they did not feel it, thought about the basics of enticement, took a few tips from Trinny and Susannah (who specialise in making respectable housewives dress like trollops), and generally got out more.

Mr Cooper, meanwhile, not getting any, went into a decline. Because Dr Barrett had refused to lower his libido with bromide, an extra male member of staff was hired to shadow it day and night. Not let it out of his sight.

Not for a second. Until someone, somewhere, finally relented. That we are able to enter into Mr Cooper's excitement at the prospect of seeing a prostitute after all is thanks to Dr Barrett's humanity. He is thrillingly poetical on the subject. Mr Cooper - and this is the heartbreaking part - grew "tremulous with anticipation". Heartbreaking, because Mr Cooper was almost in the taxi - spruced up, no doubt, with a flower in his buttonhole - when social services suddenly changed its mind. No prostitute today, sorry, but maybe one another day, in an "in-patient setting", where her effect could be scientifically monitored. Too late for poor Mr Cooper, who developed pneumonia and died.

"I wonder," Dr Barrett speculates, "whether the months of indecision, close observation, and frustrated tension contributed to his decline." Of course they did. They killed him. The most unwanted thing on the planet - desire in a frail old man. Tragic in Tolstoy, but then Mr Cooper isn't Tolstoy. There's a grandeur about him, though, and a nobility, thanks to Dr Barrett, in the telling of him. If we have trouble with an 80-year-old being so passionate that his libido must be under constant watch, and so romantic that he trembles at the prospect of a prostitute's embrace, that's our miserable fault.