The Doctor Will See You Now!
Men have good reason to hate physical exams. But running from the doctor can be a serious mistake.
 
There are three statements that seem very difficult, if not impossible, for most men to make:
 
I am lost and I need directions.
 
I’m afraid I can’t fix this leaky faucet.
 
I think I need to see a doctor.
 
As a physician, it is this third one that intrigues me most. I have known men to delay evaluation of a hernia until it grew from the size of a grape to the size of a grapefruit. I have known others whose prostate glands enlarged to resemble bowling balls, both in size and consistency, before admitting there was the possibility of a problem.
 
Then there was the fellow who sat at his kitchen table and attempted to remove his ingrown toenails with a pair of pliers and a Xacto knife. He was forced to discontinue his surgical training only when the pain and bleeding claimed his consciousness. As I stood over him in the emergency room, I asked why he hadn’t let me take them out for him.
 
“Are you kidding?” he blared. “That numbing medicine you guys use really stings!”
 
Still, one of my all-time favorites is a fellow I treated some time ago named Harold, a proud member of the Physician Avoidance Hall-of-Fame. When we first talked he told me his last physical was sometime around 1963, just after his discharge from the service.
 
As he gazed around the exam room I could sense he was impressed with all the new advancements in modern medical technology, like tongue depressors and adhesive bandages. I thought for a moment about introducing him to aspirin and penicillin, but I didn’t want to overwhelm him on his first visit.
 
“So, Harold, what brings you to our office today?”
 
“My wife made me come,” Harold offered sheepishly. “She thinks I need a physical I guess. I’m sorry to waste your time on something like this. If you’re real busy we can do this another day.”
 
“No, that won’t be necessary, Harold. We’ve got plenty of time today reserved just for you. Now, let’s get to that exam, OK?”
 
Though he was visibly anxious, Harold nodded his consent and his first exam in more than four decades was underway. At first I expected to expose Harold as the poster child of middle-age pathology, but much to my surprise he appeared quite healthy. Other than a moderate case of hypertension he had no obvious signs of any major illness.
 
We talked for a moment about the medication he was to take for this and discussed his return in a few weeks for a recheck. It was about that time when Harold made his big mistake, foiling his scheme to hide the truth from me. As he was walking down the hallway toward the exit, his wife stepped through the door, and Harold paused to introduce us.
 
“So good to meet you, Doctor,” she said as she spun back toward her husband. “Honey, you did remember to tell him about your chest pain, didn’t you?”
 
Harold said nothing as his eyes closed and chin dropped to his chest. Like a scolded schoolboy he quietly marched himself back into the exam room to come clean about the real reason for this visit.
 
“Well, Doctor, I really didn’t think it was that important… hardly worth mentioning to you. I guess what my wife is talking about are these sharp chest pains I’ve had for the last couple of years, that’s all.” During his confession I could do little but roll my eyes.
 
“Are these pains coming frequently, Harold, or only with exercise?” I asked.
 
“To tell you the truth, Doc, they stay with me most of the time. I just kept thinking maybe they’d go away on their own. I guess you’re going to tell me we need to do some testing, huh?”
 
“Yes, Harold. I think that would be a good idea.”
 
That afternoon, Harold was admitted to the hospital for a full cardiac evaluation and a thorough series of tests. To our delight, the evaluation of his heart showed it to be quite healthy. His problem, instead, was an irritated stomach ulcer, which responded nicely to medical treatment. Two weeks later Harold was back in the office for a follow-up visit.
 
“Doc, I want to thank you for everything you’ve done for me. This medication has totally taken away my pain! To think I’ve been suffering with this trouble for over two years, and all I needed was a few pills to get me straightened out. Thanks again, Doc. You can’t imagine how great I feel!”
 
Harold’s blood pressure had also returned to normal and his energy level was better than it had been in years. My only regret was the amount of time he’d suffered before finally admitting he needed help.
 
I wish I could say Harold’s story is an isolated incident, but it happens all the time. It’s especially frustrating in the male population where fear of the unknown, or fear of finding something wrong, stops men from getting quick and accurate diagnoses of potentially serious medical problems.
 
Often times hypertension, diabetes, prostate disease, heart disease, even many cancers can be treated with tremendous success if only we detect them at an early stage. Left untreated, however, they claim the lives of many men each year, and significantly reduce the quality of life for many others.
 
The reason for this remains one of the great enigmas of medical science. If we could only learn to give our attempts at lowering weight and cholesterol the same attention we give our golf handicaps, we might improve both quality and quantity of life.
 
If we could realize that weakness of the force of our urinary stream is not the equivalent of a weakness of character, then death due to prostate caner might greatly diminish. If we could change our perspective to identify disease, not the doctor, as the enemy, we could all enjoy a greater level of health.
 
Yet we are men, and admitting we need medical help is inherently hard for us to do. Here are a few suggestions for getting started on your road to recovery.
 
Find a physician whom you trust and with whom you feel comfortable. This is by far the most important step. If your physician doesn’t meet these criteria, then you have the wrong one.
 
No matter how much your doctor knows, if you don’t have that comfort level you will never obtain the level of care you want and deserve. You will also have constant doubt that the recommended treatment plan is appropriate. Start by finding a physician you can give your full confidence. Once this is done you’re off to a great start.
 
Learn to report any physical changes or any unusual, persistent symptoms. While most changes are benign, any significant change in eating pattern, sleeping pattern, bowel pattern, or urinary pattern may be a warning sign of a potentially serious illness.
 
Remember, a negative evaluation provides great peace of mind. But if there is a cause for concern, an early check-up is your best chance for a cure. Needless to say, such problems as chest pain or shortness of breath always require immediate attention.
 
Have a periodic check-up to ensure you are practicing good preventative medicine. I know, going to the doctor when you’re sick is hard enough. Going when you’re not sick sounds insane, but bear with me, there is a method to this madness. Many potentially serious problems are uncovered during routine physical exams.
 
This is a great opportunity for your doctor to give undivided attention to concerns that might not be discussed during other visits. It also provides a wealth of baseline information, which can be used for comparison if problems arise later.
 
Whether you do this yearly of more often will depend on your special health issues, but don’t neglect this as an important part of your health maintenance. An ounce of prevention is worth much more than a pound of painful cure.
 
Take care of yourself for yourself. Busy days, late meetings and hurried deadlines may threaten to push this one to the back burner, but don’t let that happen. Remember, no procedure, pill or poultice can never replace a personally designed program of exercise combined with a well-balanced diet. The best way to treat most disease is to prevent it. Enough said.
 
Lastly, when all else fails, listen to your wife. Yes, this was the hardest one for me to accept, too. But like it or not, women often pick up on changes in our well-being that are not easily detected by us.
 
When she makes her suggestions, be open-minded to the fact that she might have noticed something significant. She probably has your best interest at heart. After all, the alternative is that she gets to enjoy the big insurance policy you’ve been paying for all this years.
 
Now, I think we’ve made some real progress here. The next step is to practice saying our new motto without hesitation or embarrassment:
 
“I am a man, and I can ask for help.”
 
Your recovery is already well underway. Give yourself time and be patient with your progress. Your body will thank you for it.
 
As for me, I’m off to fix that leaky faucet.
 
By Dr. David B. Wilhelm, a family practice physician in Birmingham, Alabama.