I feel kind-of foolish to ask this, and I certainly hope my question is not a terrible or offensive one. I'm just trying to understand exactly what you're dealing with, LI.
What I'm wondering is, what exactly did he cut off? Was it his testicles? If so, can't he still have sex? I apologize for my ignorance.

(As a complete aside - I love that Kerouac quote. The soul-mate cat of my life was named Kerouac.)