The complex interplay between masculinity and health care

About 25km outside of Sao Paulo, Brasil, in a small city called Barueri, lies the grave of my mother’s cousin. Henrique was the Brasilian version of Mr. T — a larger than life character, he spent his days on the pitch as the starting goalie of a local football club. “Senhor Henrique” was well known.  He had three major trademarks:

  1. His favorite words to opposing players were “tenho pena de tolo” (I pity the fool).
  2. When he wasn’t spending time with his family or volunteering in the community, he was riding through the city on his ’89 Harley.
  3. He had a vine tattoo encircling his massive upper biceps with the inscription, “a ignorância é felicidade” (ignorance is bliss).  Honestly, my “uncle” was the coolest dude in town.

Other than my father, he represented the ultimate definition of masculinity and was instrumental in teaching me how to become the man I am today. When my mom told me about his sudden death from testicular cancer, I was shocked.  A few years later in my medical school pathology course, I learned that testicular cancer is one of the most curable forms of cancer, with early detection and surveillance being the keys to survival.  People usually don’t die suddenly from a relatively curable cancer.  His case highlighted the importance of essential diagnostic and therapeutic features for a common malignancy seen primarily in young men.

As responsible as my uncle was in taking care of his family and his job on the pitch, he did what most men do: He neglected to take care of himself.  It is almost as if manhood is defined by what you do for others and not yourself.  Little did I know how this ironic conundrum would apply to me.

As someone in the medical profession who has had my own recent health problems, I am mindful of the fear people have of going to the doctor.  As trite as it sounds, even as a physician, I hate going to doctors. Perhaps in my own ideology, I failed to realize how destructive this stance could be until I too was diagnosed.  Like my uncle, I lived an active, balanced lifestyle. I felt both invisible and invincible. I was wrong.

While this piece was not meant to be a sociology study, it is worth expanding upon the complex interplay between masculinity and health care.

A man’s health and his decision to seek medical attention should not be predicated on the ever tenuous balancing beam between vulnerability and self-reliance. Men not only tend to avoid talking about health problems, but they also are less likely to consult health care professionals even when help is needed. Somewhere in the process of developing body awareness and self-reliance we as men oftentimes become our worst health care advocates.  We are quick to act on behalf of our loved ones, taking them to the hospital or doctor’s office when needed, but our own health takes the back seat.  This is a call of action to do better.

A recent study focusing on masculinity’s effect on men’s perception of self and health care revealed five main themes: body awareness, the creation of self-reliance, feelings of freedom, the process of self-care awareness and, finally, feelings of vulnerability. These themes tend to affect men’s seemingly antagonistic relationship within the health care system.

Increasing health care awareness among men involves the efforts of everyone in health care — all physicians, providers, and policymakers — but it starts with confronting this rooted ideology and understanding that awareness and prevention is power.  When it comes to one’s health, ignorance is not bliss.

Olutoyin Okanlawon is an anesthesiology resident a member, public health committee, resident and fellow section, American Medical Association.

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