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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  • ninguem

    The Brazilians have a public health campaign to combat testicular cancer.

    And yes, they have a mascot. Senhor Testiculo. Here he is at a Brazilian health fair, next to booth about Dengue Fever. See if you could pull this off in the USA without getting arrested.

  • buzzkillerjsmith

    Good luck with all that.

    There is no cure for normal.

    Again, O.O., there is no cure for normal. And there is no medicine that most of us would want to take to neutralize our normal maleness, even if women find some of our behavior suboptimal.

    Perhaps you should read a bit about male overconfidence before you post. There is a considerable literature on the topic.

    A century from now, along with the flying cars and the Mars colonies, we will have O.O.’s successors still writing about this.

  • SteveCaley

    We are completely stuck with peopleness in people. I would be hard set upon to come up with any unique discriminator that helped me understand an individual better, based upon their “type.”
    I suppose I could write about macho de Hibernio (Brazilians speak a strange spinoff of good Castilian Spanish), or a hundred years ago, the blood quantums of the various races. But all that would be gross, offensive nonsense.
    I am a lumper, not a splitter, I fear. In spite of the tremendous progress we have made in categorizing and classifying other human beings, I’m have a terrible time in seeing them as anything but unique. If they are similar to someone else, that’s fine. But “Someone Else” is not here in the room for the clinic visit.
    There are really only two types of people whom I cannot understand – women, and men. Other than that, I get the rest (except for children.) :-)

    • Patient Kit

      As a cancer patient, I recommend docs avoiding the use of the word “lumper” in a sentence. ;-). Just kidding. My surgery got my cancer out without touching my admittedly out of control sense of humor. Just don’t lump me in with any humorless peeps please. :-p

  • Eric W Thompson

    We have women’s clinics. Females can prefer female doctors. Males on the other hand are supposed to ‘suck it up’. Prefer a male provider and staff and you are either whiney or prejudiced against women. Every hear of a ‘run for the cure’ for testicular cancer. What color do we wear to support the fight against testicular cancer? Most men outside of health care would not know what you are talking about.

    • Ed

      Exactly, until they experience it in the flesh (pun intended); never again!

      • DoubtfulGuest

        All the extra special attention and extra people around women’s health care and their women’s parts, can be a double-edged sword for actual women. But I agree with you, it isn’t right.

    • Patient Kit

      I think most men are aware of testicular cancer thanks to Lance Armstrong and his battle with the disease and his organization, Livestrong, aren’t they?

      • Eric W Thompson

        Not really. No talking about it. If you asked they might vaguely remember it. Breast cancer is always at the top. You would be unable to find a woman or man who is not aware of it and the runs for the cure. Not that i guess it matters. I actually don’t care. People can start taking care of and worrying about themselves. I am done.

        • Patient Kit

          Really? That actually surprises me. A major athlete like Lance Armstrong going public about his testicular cancer and I would think many men would remember it, even if they don’t want to talk about it. I also think that prostate cancer has had a lot of publicity and awareness. But. I agree that pink ribbon breast cancer remains the most successful cancer campaign. As an ovarian cancer patient myself right now, I do what I can on that front. Teal ribbons for OVCA, btw.

          • Eric W Thompson

            Teal. Good to know. I do have a mother, two sisters and two daughters who mean more to me than myself.

          • Patient Kit

            I’m sure all those women in your life care very much about you and your health. As a woman, I’ve never really understood why it is so hard to get so many guys to go to the doctor, assuming it’s not the urologist. Teal is a great color. To me, it’s the color of the Caribbean Sea, in which my mermaid ashes can be scattered one day (hopefully, not too soon).

          • Eric W Thompson

            Beautiful words.

  • Patient Kit

    While I understand and empathize with everything you are saying and in no way mean to minimize how you feel, I just want to say that I wouldn’t trade my male gynecological oncologist for anyone. He’s a great doc and a wonderful person. Gender doesn’t have to matter. I’m amazingly used to him saying “You’re going to feel my finger in your this or your that.” He’s amazingly respectful and gentle while doing that. And we talk so much that I barely notice the physical exam. And I have to have pelvic exams every 3 months. The trust that builds when a doc saves your life and gets you through major surgery without complications goes a long way.

    But I do acknowledge that many men may feel the same way that you do and doctors should be aware of that and make you as comfortable as possible. Male staff in urology practices headed by male doctors who mostly see male patients makes tons of sense. As a woman, I support anything that will get our guys to seek healthcare more regularly and certainly when they are experiencing something with their bodies that they know in their hearts can’t be good.

    • Ed

      I agree with you but you didn’t have to deal with a single male ancillary staff member during your oncology appointments did you? Would you be okay with a male chaperon or assistant during your pelvic exams?

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