Cut From Steel

He looked harmless. He solved every case anyway.

Peter Falk played Lieutenant Columbo on NBC from 1971 to 1978, then again on ABC from 1989 to 2003. The show broke the rule every other mystery followed. You watched the murder happen in the first ten minutes, and you already knew who did it. The only question left was how one man would prove it.

Columbo arrived in a rumpled beige raincoat, driving a battered Peugeot 403. He carried a cigar that never seemed to get finished. Every suspect took one look at him and relaxed. That was the whole trick.

He fumbled through his pockets and pulled out a grocery list. Then he asked to borrow a pencil. Something on the wall distracted him. And while the clever people around him were busy feeling comfortable, he was reading the room and filing everything away.

Columbo saved the real question for the doorway. He would say his goodbyes, reach for the handle, then stop and turn around. “Just one more thing.” That line became his signature across more than thirty years of television. The question behind it was never small.

You can borrow the method this week. Columbo never took the obvious answer, and he never settled for the first explanation a room offered him. The obvious suspect is rarely the right one. Your own answer may be sitting on a shelf in your bathroom, in a bottle with your name printed on the side.

You blamed the wrong thing

You noticed it a while back. The reliability went first, and the confidence followed it out the door. You decided the cause was age, because that is the explanation everybody hands a man over fifty. And you never questioned it again.

I want to stop you there, before you spend another year on that assumption. Harvard Health estimates that 25% of all erectile dysfunction is a side effect of drugs. In other words, roughly one case in four begins on a prescription pad rather than in the calendar.

You may be carrying the cause in your pocket right now.

Three bottles worth a second look

I will give you the three that come up again and again. Read them as questions for your doctor, not as instructions. You do not change a single dose on your own.

01 / Blood Pressure Pills

Harvard Health links thiazide diuretics and loop diuretics to erectile trouble. It names older beta blockers too, with atenolol given as the example. The suggested mechanism is reduced blood flow. That same source says ACE inhibitors rarely cause the problem, so a switch may be possible. Your doctor makes that call, not you.

02 / Antidepressants

Mayo Clinic lists trouble getting and keeping an erection among the known side effects of SSRIs. The effect is common enough that prescribers expect to hear about it. Mayo also warns that stopping an antidepressant suddenly can bring on withdrawal-like symptoms, and it tells you to lower a dose slowly, with your clinician. You raise this at the appointment. The decision belongs to the two of you.

03 / Finasteride

Finasteride treats hair loss at one dose and an enlarged prostate at another. The FDA label for the 1 mg version reported erectile dysfunction in 1.3% of men in the first year, against 0.7% on placebo. Those numbers look small on paper. The same label also records post-marketing reports of sexual problems that continued after men stopped taking it. Nothing stops you from asking whether you still need it.

Do this before your next appointment

You can do the useful part tonight in ten minutes. Put every bottle on the kitchen table, including the over-the-counter ones. Write down each name with its dose. Add the month you started it, then set that column against the month things changed.

I have to be blunt about the next part. You do not stop anything you are taking. MedlinePlus, the patient service run by the National Institutes of Health, states it plainly. Never stop taking any medicine without first talking to your provider. Some medicines can cause life-threatening reactions if they are stopped or changed carelessly. Blood pressure pills and antidepressants are exactly the sort it means.

You hand the list over and you ask one question. Could anything here be causing this, and is there an alternative? An alternative often exists. Timing can be adjusted, and a dose can sometimes be lowered. Those are decisions for the two of you together.

Columbo would not let you leave it at that, and neither will I. Mayo Clinic notes that erectile trouble can signal a health condition that needs treatment, and that it is a risk factor for heart disease. So the appointment earns its place either way.

I will leave you with this. The suspect was never your age. Go and identify the real one.

— Travis

Insider Member's Corner

6 free habits that keep the blood moving:

You didn't put in 45 years to settle for beige.

01 / Watch · Omega Speedmaster Professional Moonwatch

NASA qualified this watch in 1965 as the only one approved for all manned space missions and extravehicular activity. Buzz Aldrin wore his on Apollo 11. The steel Moonwatch on a steel bracelet starts around $7,800 at Omega, with the sapphire-crystal version around $9,000. You are not buying a status symbol here. The appeal runs deeper than that. An engineer tested this one on the assumption it would fail.

02 / Motorcycle · Triumph Bonneville T120

Triumph named this bike after the salt flats in Utah. Johnny Allen ran a two-way average of 193.3 mph there in September 1955, on a streamliner called the Devil’s Arrow. In 1959 the T120 arrived carrying that name and a 649cc parallel twin. The modern T120 runs a 1200cc twin and starts around $13,995. You ride it on a Sunday morning because you finally can.

03 / Home · A Firepit You Built

Nobody delivers this one. You dig the hole and level the base yourself, and the ring goes in over a weekend. Check your local burn rules before you start, and keep it well clear of the house and anything overhanging it. The men who end up sitting around it will never ask what it cost. They will remember that you made it.