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doubtful of experiential explanations. But his sexologist colleague at Hopkins and at the mansion, Greg Lehne, told me that the link to Jacob’s second-grade classroom made “perfect sense. People’s sexual interests are very specific. Scientists now are inclined to look at genetic or prenatal issues, but why people become lovestruck at certain qualities, why we’re taken with a body type, or a shape of mouth or what a person’s nose looks like, or an aspect of warmth or a sadistic side—where do these interests come from? They must come through experience, through the senses.”
    Lehne, with graying hair combed tightly back from a padded face, talked about how the prevalence of certain fetishes shifted with changes in the prevailing culture. Rubber fetishes had faded after the era of rubber training pants; hair fetishes had become less common as mothers and older sisters no longer made a ritual of letting down their tresses and brushing a prescribed number of times. It was impossible to quantify such shifts precisely, impossible to cite numbers for particular paraphilias, he said, but the changes could be traced by studying pornography and the hungers it catered to.
    Lehne didn’t fully discount the genetic, the prenatal, but the physiology of the brain was, he suspected, profoundly affected by what the mind took in. He studied paraphilias as a way to peer in at the workings of all desire, and mostly he saw the directions of eros as learned, not inborn. “The lovemap cartographic system,” he had written, borrowing language from the legendary Hopkins psychologist John Money, “may operate like a multi-sensory camera that episodically takes photos of the immediate environment and stores them as depictions of the sexual terrain.”
     
     
    A young married couple had led Berlin to his career in sex. When he’d been a general psychiatric resident-in-training at Hopkins in the mid-seventies, a husband and wife had walked onto his ward. The husband carried a wooden club, about a foot long, with a heavy chain attached to it. They told of a guillotine-like hole he’d cut in their bedroom door. No permanent injury had been inflicted yet, but his fantasies were brutal, and their fear, Berlin remembered, was that “this was about to get very out of hand. He was afraid he would kill his wife, and she was afraid it could happen. They were simple people. She wasn’t even sure how many couples did or didn’t do this kind of thing.”
    When he tried to discuss the case with his supervisors and fellow residents, Berlin ran into trouble. They seemed repelled by the subject, and Berlin was criticized merely for quoting the man’s crude language from his case notes, for reciting the phrase “jerk off.” Acutely he sensed the particular taint that attached itself, even amid a group of psychologists and psychiatrists, “to anyone who acknowledged something different about their sexual makeup.” He sensed a visceral unease with sex in general.
    And hearing Berlin relate this story reminded me of an interview I’d done with a couples’ counselor in Manhattan. She told me that she and a group of colleagues spoke often about the fact that not only in individual but in marital counseling sex is frequently the last thing the therapist asks about—and that the subject may never be raised at all.
    Berlin still kept the club the husband had turned over. It lay in a hulking antique safe in the basement of his mansion. He’d treated the man with an anti-androgen, and, he said, the patient reported that his sadistic fantasies had faded away but that he could still become erect and function sexually. It was a long time ago, and it was impossible to know to what extent this had been true. That anti-androgens could attack the sex drive in such a way as to neutralize a paraphilia while leaving some degree of conventional desire and potency intact was unusual but known to happen. Nothing about the brain’s and body’s system of arousal