One of the most common complaints in a physician’s office is one of fatigue or malaise, but few clinical complaints are as hard to fully qualify and understand as these.  Inherent in the words are a degree of vagary, a lack of a true description or roadmap by which the clinician can be guided.  When the appointment sheet reads “rash”, or when the patient presents with a “broken finger”, the clinical approach is immediately clear.  “Shortness of breath or severe chest pain” obviously demands immediate attention.  But too often when the doctor is faced with the patient who complains of a lack of energy, there is often a state of confusion or indecision that is encountered; not the razor-sharp “aha” that we would expect from the other examples shown. 

One need only turn on the television set these days to see what the consumer marketers are plying upon men on this country.  The image is one of either a rugged looking guy doing something manly like freeing his horses from a bog (Cialis).  Or it is one in which the fit, slightly greying man is receiving a salacious, come hither look from his equally ‘hot’ and grey-streaked wife (Viagra).