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This piece was originally published in April.
We are recirculating it now thatBeau Is Afraidis available on digital.
Warning: Spoilers ahead for the plot and ending ofBeau Is Afraid.
How stunted is the titular man-child at the heart of Ari AstersBeau Is Afraid?
And this is not an incidental detail.
This lack of release has had consequences on our anxious anti-hero, not just emotionally, but also physically.
Because of the decades worth of semen collecting inside of him, Beau canonically has enormous testicles.
(We see them briefly, which is enough.)
Even so, Beaus giant balls had me wondering about the real-world science at play.
It was actually humbling as a physician … Im not a psychiatrist, right?
Were told that Beau has made it into his late 40s without ever ejaculating.
The real question is, is ejaculation beneficial?
It probably has to do with reducing inflammation within the prostate.
But your question was, can what we see on screen actually happen?
I think it was more of a metaphorical tool.
You got big balls thats a phrase that connotes bravery, testosterone, virility.
This character is the exact opposite of all those things.
So, I actually think its a beautiful literary tool that theyve used grotesquely to subvert the audiences expectations.
There are medical conditions that cause very large scrotums.
Theres a condition called elephantiasis, which is really a lymphatic obstruction triggered by a parasite calledWuchereria bancrofti.
You have to get a drug called DEC, and the only entity that holds DEC is the CDC.
It is not unusual for a patient like that to show up with their scrotum in a wheelbarrow.
We dont see it often in New York, because we dont seeWuchereria bancroftiin New York all that often.
Have you come across any scientific literature about men whove gone their entire lives without ejaculating?Not really.
Usually temptation takes over.Yeah.
That drive to reproduce exists in everyone.
Whether they become asexual or they dont have interest in sex, thats a different story.
But the physical aspect of ejaculation, I dont think is going to be affected in that way.
That is a thing.
Could you have an electrophysiological defect that causes an arrhythmia in the setting of exertion?
And thats not by accident.
Hes not an alpha male.
Hes not even the beta.
You know what I mean?
The physiological changes that occur during sex are not just from the physical activity.
The adrenaline is really what it is.
Some of it has to do with the movement.
Is that possible?No, that is not possible.
Its not like if you dont ejaculate, the scrotum enlarges like that.
Thats not really a thing.
The sperm is actually not even stored in the testicles themselves.
So, you cant put more in there than what they can accommodate.
No matter what you see in the movies.
So, you have to start thinking about things that can cause that on both sides.
The rare things would be bilateral testicular tumors.
Thats sort of unlikely.
Those can get really large, and can be bilateral.
My record is 2.5 liters of fluid drained from someones scrotum.
!Yeah, 2.5 liters.
What you saw on screen is an excess of three gallons.
Im not sure thats all that realistic.
Okay, thats good for readers to know.A stitch in time saves nine.
I mean, even small hydroceles require intervention.
Testicular tumors obviously require intervention.
Theres a reason why there are still surgeons in this world in the age of ChatGPT.
Hopefully, one day not.
I always tell patients, The best patient is the one that doesnt need me.
Maybe the metaphor is that masculinity chained up is dangerous.
When its repressed, it takes a monstrous form.
Im not much of a philosopher.
Nor am I a psychologist.
Im just a urologist.
This interview has been edited and condensed.
