For these women and my wife, there had to be the perfect confluence of events for sex to happen. My wife’s requirements were that her job had to be going well, the children didn’t need her attention, the house had to be clean, the temperature had to be between 76 and 84 degrees, and the Democrats had to control at least one branch of government.

Her patients would ask if there wasn’t some pill that would let them ignore the externals and give them back their desire. Karen would assess the acuteness of the concern and try to offer a solution, but she knew there was no magic pill. All she could do was commiserate.

She would come home and tell me how typical we were and that I would just have to deal with my oversize libido like all the other unsatisfied married men out there.

Then we learned she had Parkinson’s.

Suddenly we were faced with new challenges that completely outweighed any issue of unequal sexual desire. Our fantasy of the next 35 years had included Karen staying in a job she loved for as long as she wished and then for the two of us to shift to a retirement of travel and newfound hobbies.

That image was replaced by one depicting her early exit from the job she loved and a retirement filled with financial concerns, frequent doctor visits and uncertain health.

Our first adjustment was to try to live in and enjoy the present. It took a few months of finding the right medication and dosage, but since Karen’s Parkinson’s was in the early stages and could be controlled, it wasn’t long before her natural optimism took over.