Saving Lives, One Man at a Time
Men, I’m here for you. As a urologist, I love my job treating and taking care of men. I’m dedicated to saving men’s lives, literally. My top priority is for every man to experience his best health at all stages of his life. When men adopt and practice good health habits, starting as early as their teens, they’re making an investment in their long-term health with a significant payout of quality-of-life dividends.
But it’s the women in your life who can benefit from much of what I’ll discuss in this chapter. These women include your wives, girlfriends, mother, sisters, daughters, and all women who love you and only want the best for you. Statistics show women make 80 percent of the medical decisions in a household.1 That’s why I need to recruit an army of women who encourage men to live healthier lives. Women are simply better advocates of their families’ health. They are very good at prioritizing health. They get fired up on overseeing not only their own well-being but also the well-being of all men in their lives, from their fathers to their sons and husbands.
Before I get too deep into this chapter, let’s take a look at the differences between men and women that provide a little context. Do you remember the book Men Are from Mars, Women Are from Venus by John Gray, PhD? This 1992 bestseller boldly and decisively struck a nerve when it addressed common conflicts between men and how we each react differently to them. Because of these differences between us, it may sometimes feel as if we come from two different planets.
Have you ever gone shopping for clothes with your wife or girlfriend? All you want is a pair of pants. You know which store you want to buy them from and where they are in the store. This trip should be easy, right? Wrong, not if you’re shopping with a woman. The way women tend to shop is one example of how they make decisions differently than men do. What should be an easy in-and-out shopping trip might turn into a much longer and more expensive excursion than you were planning.
Now, I have the utmost respect for women. I strongly value their intelligence, insight, and sensitivity and believe we as men can learn a great deal from it. My point with the illustration is to demonstrate that women explore all options before making a decision. They compare and contrast what looks good and what doesn’t, what to buy and what to put back on the rack. This same instinctual method is also how women tend to approach healthcare decisions, including who should be the family primary care physician and what pharmacy to use. It’s probably also your wife who keeps accurate records of family members’ immunizations and upcoming checkups or preventive screening tests. Thanks to women’s detail-oriented brains and organizational skills that allow them to take charge of their family’s medical needs, each family member benefits from significantly improved health and well-being and increased longevity.
What Women Should Know about Men’s Health
Men’s health or lack thereof is a real issue. Every day I see men who have neglected their health for a long time. I have cared for men in their forties, fifties, and older who have not visited a doctor since childhood. Many men are hard-pressed to even remember their primary care physician’s name when filling out medical forms. In fact, if it weren’t for my take-charge pragmatic wife, even I would be a bad patient.
Not only will neglect put men’s health at risk, but when men are sick or inflicted with a disease, it affects the women in their lives as well. Caring for anyone who needs extra attention automatically adds stress, anxiety, and possible financial burdens to those women, and it gives them less time to pay attention to their own health. But together, we can turn that around. When men begin to make changes to improve their health with the women they love cheering them on, it makes a tremendous difference for both of you.
So, why do men have this natural tendency to put their health last? Why would a man avoid regular checkups or not do what it takes to be healthy?
One big reason men neglect their health is that life gets busy. There are bills to pay, food to put on the table, and not enough time to think about themselves. Therefore, going to the doctor is a waste of time, especially for regular screenings—who wants to sit in a waiting room thumbing through old magazines or watching HGTV?
I can attest from years of experience that a consultation with a man takes less time than a woman’s visit with her doctor. Not because men are healthier or have fewer medical concerns, but primarily by their own choosing. Men are often in and out of the exam room within a matter of minutes. They provide few specifics and usually answer the doctor’s questions with a simple yes or no. Men also ask few questions and want just the facts without going into detail. They often figure the less time spent perched on the exam table, the better.
Another big one is that men are problem-solvers. How many times has your wife or significant other felt frustrated when you’re lost and won’t ask for directions? Or when you refuse to see a doctor when you aren’t feeling well? Most people would say these frustrations exist because women are emotional while men are logical. But logically speaking, if a man knows he’s not feeling well, why wouldn’t he seek a doctor’s help to figure it out? Because he’d rather handle it himself than be bothered seeing a doctor who will try to educate or instruct him on a health issue.
Remember boys who couldn’t sit still in school? They wanted to move around, experiment, and find solutions for themselves. Just because a man has grown up doesn’t mean that restless boy inside is gone. Men like to figure out what the problem is on their own, so going to the doctor might humiliate them and make them feel like a loser.
And that brings us to another reason men avoid the doctor—they love being a winner. Many men thrive on success. That’s why so many men enjoy sports and why they admire winning teams. Men having a health problem does not feel successful. If a man with this mindset is pressured to see a doctor, it can backfire with him avoiding the situation even further.
And of course, men don’t like to be told what to do. They figure they’ve come this far in life without paying attention to their health or seeing a doctor. Besides, what if the doctor does find something wrong? It likely will make him feel vulnerable and that he needs to change. Change is difficult. Most men want to act strong, hoping time heals all things. But sticking your head in the sand and pretending like a health complication doesn’t exist doesn’t help anyone avoid it.
Likely, the most basic reason men are reluctant to go see the doctor is they will feel out of control. In case you haven’t noticed, men like to be in control. From controlling the TV remote to deciding what restaurant to eat at, feeling in control makes men feel confident and self-assured.
Whatever the reason men avoid the doctor, a common attitude might include, “See a doctor? What do you think I am, sick?”
How many men do you know who suffered a serious injury but did not see a doctor for it? They dug in their heels, refusing to get the injury treated and adamantly believing they could deal with it on their own. Maybe they got lucky and it did heal. Or maybe the wound became infected, forcing them to seek medical help and leading to a longer, more complicated recovery. Why trust luck when you can’t guarantee it will always be on your side, though?
Men should remember that no matter their age, none of us is invincible. For example, I had a patient in his early twenties who had originally gone to the doctor for episodes of blood in his urine. The doctor dismissed him, saying he was too young to have anything serious associated with this symptom. Six months later, this same young man was still experiencing bloody urine and made an appointment with me. After a thorough examination and diagnostic testing, the final conclusion was not what any of us expected—a large bladder cancer, very unusual for someone so young.
No one should ever take their youth or health for granted. While serious medical conditions can strike unexpectedly at any age, there’s a greater chance of beating them back when caught early.
The Impact of the 2020 Coronavirus Pandemic on Men
I would be remiss not to mention the enormous impact of a novel coronavirus that started in Wuhan, China, in late 2019 that would greatly impact men’s health. Caused by SARS-CoV-2, the World Health Organization (WHO) gave it the acronym COVID-19, which stands for coronavirus disease 2019. As this book was being written, the unprecedented, historic pandemic was sweeping around the globe, shutting down businesses and leaving them in financial ruin while claiming far too many lives. COVID-19 posed a great danger for everyone, especially the elderly. However, it also took a noticeable and concerning toll on men. Not only did men of all ages contract the illness at a higher rate than women, but they were also more likely to have severe illness or die from it.
This was not the first time men were hit hard by a pandemic infectious disease. In 2003, even though more women than men were infected by the SARS outbreak, the death rate among men was significantly higher than women’s. The MERS outbreak in the Middle East in 2012 infected men at a rate of 32 percent compared to 28.5 percent of women.2
Why would men be more vulnerable to developing more severe cases of and dying from an infectious disease? Perhaps as more data is gathered after COVID19 has moved on, there will be a clearer answer. Until then, here are interesting possibilities of why this virus profoundly attacked men more than women:
• It’s speculative, but despite men’s tough exterior, our immune response against viral infections may be weaker than women’s. Women appear to have a stronger immune response, reducing their susceptibility to viral infections. Thanks to their genetic makeup—women have two X chromosomes, men have one X and one Y chromosome—women may have a wider diversity of immune response.
Men, especially those sixty-five and older or living in a long-term care facility, had far worse outcomes. If these same men had preexisting uncontrolled health conditions, including heart disease, diabetes, obesity, chronic lung disease, asthma, liver disease, chronic kidney disease, or being immunocompromised, they also paid a dire price. This same pattern was also similar to that of the MERS outbreak. Men during that illness who had chronic comorbidities (two or more chronic medical conditions simultaneously) tended to have weaker immune functioning and died at higher rates.3
• While smoking rates have gone down, US men still outpace women in lighting up (15.6 percent versus 12.0 percent).4 Smokers have higher rates of pneumonia and chronic obstructive pulmonary disease (COPD), which increases the severity and complications of an infectious disease.
• Remember, there are plenty of men who simply don’t like going to a doctor.5 They will delay treatment, ignore symptoms, or be in denial when feeling sick. Men who wait too long before they are properly diagnosed and treated generally face a worse outcome.
During the coronavirus pandemic, some men displayed a false sense of security, believing they could “tough it out” or that it wasn’t as bad as believed. These men may have also ignored safety recommendations such as frequent handwashing or maintaining social distancing to protect themselves and others from contracting the virus.
• Black men disproportionately were disadvantaged by both contracting and dying from COVID-19 at higher rates.6 Theories at this time blame several factors: poverty, segregation, crowded living conditions, or limited access to, putting off, or avoiding seeking healthcare. Here’s another factor to consider: black men working essential jobs put them on the front line of greater exposure to viruses. These jobs include bus drivers, cashiers and stockers in busy big-box stores, nursing home health aides, and law enforcement and public safety jobs.
Pandemic or not, we should guard our health by practicing healthy lifestyle habits that can improve our chances of preventing chronic medical conditions while bolstering our immune functioning.
Speaking of the immune system, boosting it to ward off illness makes sense. Yet there is much to learn about the intricacies and interconnectedness of this complex system and the immune response. That’s why more research is required before we can prove there’s a link between healthy habits and their influence on enhancing our immune system.7 But that does not give us men (or anyone) a green light to neglect healthy habits. We know good health habits matter. The single best step to keeping our immune functioning strong is to live a healthy lifestyle. Doing so typically results in less illness, both acute and chronic, and improved overall health. I’ll address these healthy lifestyle practices more thoroughly in other chapters of this book.
How Women Can Help Improve Men’s Health
Most men who pay me a visit are usually accompanied by their wife, daughter, or girlfriend—usually after those women have convinced, bribed, or begged them to go. All doctors everywhere thank women for that.
As we’ve alluded to, women are much more proactive regarding their health and well-being. They often anticipate health issues and therefore are more likely to practice preventive measures to get and stay healthy. Women are usually armed and ready to fire off multiple questions, with no question going unanswered by the time they leave. Women like detail, too, and they demand—and deserve— detailed answers.
Women understand that good health doesn’t just happen. It requires taking personal responsibility for your own life—unless you’re that uniquely and genetically blessed soul. This includes going to annual checkups, staying up to date on immunizations, seeing a doctor when sick, and living a healthy lifestyle.
Unlike most men, women rarely hesitate to seek regular medical care when they feel it’s needed, whether for a minor ache or pain or a major health issue. However, men do come see me for a medical issue they care about. Issues that, if not resolved—and quickly—can convert even the most die-hard doctor avoider. What are these issues? Any sort of problem involving prostate and sexual functioning. That’s when I become their go-to guy, helping resuscitate their sex life or protecting and preserving the prostate’s purpose.
This brings up an important point. Every man should have a urologist, and women need to remind them of that. At some point, most men will experience erectile dysfunction, painful urination, or some other medical issue involving the male urinary or reproductive system. Believe me, a man who can’t get it up for a sexual rendezvous or is waking up three times a night to pee will beg to be taken to a urologist.
For any women reading, this is where you and I can take advantage of the situation. Once you get them in the door, I can not only address urinary issues or sexual problems but also talk about other health problems often associated with their symptoms. For instance, erectile dysfunction can point to type 2 diabetes, while clogged arteries can indicate heart disease. Even though medical issues such as diabetes or heart disease are not my specialties, I can help arrange appointments with experts in these fields of medicine to assess those conditions thoroughly. By identifying such needs for further evaluation, we can get your man the care and medical attention he deserves but just doesn’t know it yet.
The concept of using urologists to assess broader health concerns for men is gaining acceptance. If a woman can’t get her guy to see his primary care physician, but if he will go to a urologist when his love life is falling apart due to erectile issues or lack of libido, that’s even better. Improving his health through addressing his erection concerns may be the only way to get him to make better lifestyle choices.
So, women, if a man you love is neglecting a chronic illness, has been ignoring worrisome symptoms, or hasn’t had an annual checkup in years, here are pointers you can use to begin the conversation about taking care of his health:
• Avoid making him feel guilty. Let me repeat—do not make your man feel guilty. This is a big mistake. Guilt is a motivator for no one and is likely to make your man feel defensive. Besides, using shame to bring him to a doctor is not a great tactic for building a good relationship with his healthcare provider.
Avoid being controlling or nagging. Ultimatums, nagging, or threats are another turn-off for men. This approach can backfire due to complete opposition. Also, during a doctor’s visit, avoid speaking for him. Building trust with his doctor is key to an effective doctor-patient relationship. This is his visit; let him talk with his doctor to build that trust and help allay his fears.
• Remind him how much he means to you. Remember, honey attracts more flies than vinegar. Start the conversation by telling your man what your relationship with him means to you, and then lead into how you’ve been concerned about his health. Keep it positive with an emphasis on how special he is in your life. It also helps to use “I” rather than “you” statements, such as, “I’m concerned about your health,” instead of “You are not taking good care of yourself.”
• Make it easy. Schedule an appointment with a doctor you trust and who you think is a good fit. Make the time convenient for him, and go with him if he wants.
• Be prepared. Help him develop a list of questions he wants answered, any symptoms he is experiencing, and his medical history, including his family’s medical history. Remind him to be honest with the doctor about his lifestyle habits, such as diet, exercise, sleep, smoking (cigarettes, e-cigarettes, cigars, marijuana), and consuming alcohol.
• Remind him why he should go. Sometimes men are reluctant to see a doctor because they don’t want to take time away from their job. Remind him, though, that keeping healthy should be a top priority. Many health conditions are “silent”—high blood pressure, diabetes, high cholesterol, and prostate problems often have few if any symptoms but do require treatment. Tell your man that investing in his health by establishing a good relationship with a trusted and experienced primary care physician during his twenties, thirties, and beyond will be the most important and life-changing investment he will make. And that investment will have a huge payoff of good health, less chronic pain, less medication use, fewer doctor visits and hospitalization stays (and therefore less time off work in the long run), a longer life, and—oh, yes—great sex.
• Use common sense. Remind your man that delaying seeing a doctor for pain or other symptoms that indicate an advanced stage of a disease likely will make treating it more difficult, time consuming, and costly. This is where being prudent, practical, and logical can win him over to make the right decisions.
Together, let’s do this. Let’s get your man into the doctor’s office, taking care of himself, and experiencing the best health he’s had in years.