02 Apr 09 MALE HEALTH: ATTITUDES TO ILL-HEALTH

In our society, we are constantly faced with images which teach us that we should strive for peak physical fitness. We learn that good physical health is highly desirable, not just from the point of view of our personal well-being, but also because of the overall picture it promotes of us as individuals: strength and good health are prized and admired.

At the same time, women’s health issues have been receiving increasing attention in newspapers and magazines, in books and on television and radio programmes.

Women have been positively encouraged to learn more about, and to take responsibility for, their overall physical well-being. This doesn’t just mean keeping fit through physical exercise and by eating a balanced diet, but encourages self-awareness and attendance at screening programmes, for example. Furthermore, responsibility for health matters within the family has tended to remain the province of women. Men, in general, are not as comfortable talking about health issues, whether minor or serious, as many women. This is not a matter for criticism so much as a reflection of the way in which attitudes towards health in our society have evolved.

And there is some evidence of changing attitudes. Until relatively recently, the specific health needs of men have been somewhat neglected. Now there are numerous general interest health/fitness magazines for men.

Although their health and medical issues are often covered from a general ‘lifestyle’ viewpoint (‘look after your body and become more attractive’), specifically male medical matters such as prostate problems and testicular self-examination do receive an airing alongside the broader issues. These magazines are largely aimed at and read by the younger adult male population, leaving a gap in older age-ranges which is less easily filled.

A serious hurdle for many men to overcome is the traditional social pressure to be ‘strong’ where physical (not to mention emotional) health is concerned. This perceived need to be – and to be seen to be – strong is a major obstacle to an open and constructive approach to health problems. Many of us know of men who lead largely sedentary lives yet take enormous pride in over-exerting themselves in the gym or on the squash court, followed by large quantities of beer in the bar afterwards. These men seem to have a need to proclaim to their peers that regardless of their general fitness, their bodies can withstand the same exertions as when they were 18 years old. External pressures to be seen to be strong can manifest themselves in many different ways, from a denial of illness to an obsession with physical fitness regimes.

The same underlying problem is evident in many men’s reluctance to seek help if they become unwell. A certain pride in never visiting the doctor, or declaring that ‘I’ve never had a day off work sick in 30 years’ is fine – up to a point. It is still very important to recognize when a visit to the doctor is called for, or when a few days off work would lead to a faster recovery from a niggling virus. There is still a tendency for an admission of illness to be equated with unacceptable and ‘unmanly’ weakness. Many men would rather suffer in silence than admit to ill-health and run the risk, however unconsciously, of being perceived as weak. Sometimes, different attitudes can prevail depending upon the nature of the problem. An injury sustained while involved in a very physical activity – a dislocated shoulder on the rugby field, for example – is regarded somehow more positively than a bad bout of ‘flu. The former is still connected with a display of physical strength, the latter with physical weakness.

For similar reasons, even admitting to the symptoms of illness can be difficult. The hope that they will go away by themselves may become a reality, but sometimes these symptoms can be the precursor of a much more serious health problem. You may try to shrug off an annoying cough which refuses to go away, a lump which you can’t explain or increasingly severe discomfort which has no apparent cause. It is tempting to ignore these symptoms in the hope that they will just resolve themselves. Perhaps they can be diagnosed as a straightforward problem which can be readily sorted out – but only if you admit to the problem and consult your GP. If a more serious health issue is at stake, it is even more important to get advice and help as quickly as possible. Of course, you do not want to be heading for the surgery in a state of panic every time you sniff or sneeze, but recognizing when your body is sending messages that something more serious is afoot – and doing something about it -can make a huge difference in the longer term, as Neil discovered.

This is a period in which I do not feel any pride in my actions. I think I acted like far too many men by really making no attempt to come to terms with the changes which were obviously physically affecting me.

I had become conscious of some small but certain changes in my health but put them down to the general hassle of our everyday life running a small business and the after-effects of a personal trauma which my partner and I had suffered a month or two earlier. I further subsumed myself in work and physical activity for some bizarre reason, probably of a displacement nature. I was now swimming nearly a mile several times a week. My health was not improving and I now had some low level discomfort in my abdomen and the odd bout of nausea. This became gradually but persistently worse until I was having difficulty eating.

It was now obvious – to everybody but me – that I needed medical help. I had to be dragged the four hundred yards from home to the doctor’s surgery by my partner who was determined not to leave my side until I had seen a doctor. Even then, I tried to play for time! We may have lived in the same house for eight years, but had I ever got around to registering with a GP? Why did I, a fit and healthy thirty-something man, have any need for the medical profession? So I even tried to put off this appointment by a couple of days. The doctor examined me, made a brief referral note and sketch, and instructed us to go straight to our local Accident and Emergency Unit – me, an A & E case! I think I realized then that I was about to enter the bowels of the health service and that it might be some time before I emerged again.

Whether you have a small, niggling health problem or a suspicion that it might be more serious, a cancer diagnosis is probably the last – although most feared – outcome you expect. It plunges you into a new world of blood tests and scans, physical examinations and technical terminology, fears and worries for the future. You have to get to grips with the prospect of treatment, the implications and the potential effects on your life in a very short time. It can be frightening and throw you entirely off balance at a time when you need all your reserves of strength to cope.

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