Yikes! Nothing brings out the best and the worst in a guy than his having to go to the doctor's office for a routine physical. I learned this fact first hand last week when I faced the harsh reality of going in for my annual health exam. Getting a dreaded physical is one of the few things in life that men can't ask their wives to do for them. Needless to say, I was left to my own devices in calling my regular clinic. First, the female scheduler chirped "Really?!" when I said I wanted to see the doctor without having a medical complaint. Yes, believe it or not, this man wanted to see his doctor without having an apparent health problem. Thoughts of loving my wife and children kept dancing in my head and helped me stay on the line. Next, after convincing her of my seriousness I was passed on to a nurse who said that I ought to be proud of myself for being so conscientious. Actually, I was not reassured by her remark. Was I the only man to ever consult a physician for no apparent reason? Did I sound like a guy who needed pity? Although I appreciated her efforts, I was beginning to have some serious doubts about my own masculinity. Such worries only worsened when I arrived for my appointment and sat in a waiting room full of sick women and children--all certainly more deserving than I was. As I stared around the room at the flowery wallpaper listening to the sweet mood music, I asked myself, "What man in his right mind would put himself through this just to find out at best that there is nothing wrong with him?!" If I didn't question my sanity before seeing the doctor I certainly did while I was getting needle-pricked, x-rayed, lab-tested, groped in private places, and eventually referred on for yet more testing. With not a man in sight at my clinic or at least a moosehead hanging on the wall to console me, I was sure I had already gone down the road to perdition. Actually, I hadn't. In fact, when the dust cleared and my exam was over I felt like a bigger man for caring so much about myself and my family. Nevertheless, I also really understood why men hate going for physicals. Indeed, if it weren't for the warmth, savvy, and sense of humor of my regular male doctor, l'd probably avoid health checkups like the plague. After all, I'm just a normal guy!

Why do men hate going to the doctor?
Surely, I am not alone--many men hate going to see the doctor. Psychological difficulties and social factors both inhibit men from seeking medical help. Clearly men will get needed help when they are nearly on their death beds and then expect miracle cures after neglecting their health for years. Many of us guys carry a shield of invulnerability as a way of asserting our masculinity. We believe that bad things will not happen to us or if they do we will be strong enough to not suffer from them. Such unrealistic thinking is perhaps a carry-over from days when men fought in bloody wars or hunted dangerous wild animals for their families and needed to be somewhat clueless. Unfortunately many of us guys have not made the leap into the 21st century. We still believe that, when it comes to our health, what we don't know won't hurt us. Beneath our facades of toughness lies incredible fear of our own mortality--something few of us guys are willing to face. Also, all of us men don't have the regular monthly reminders of our own humanity that women do with their periods. We're simply not used to noticing the vulnerability of our bodies or relying on professional helpers to care for our bodies. We're supposed to not need help. Some young men are no better off as they typically engage in risky behaviors--reckless skateboarding and violent sports--as a way of being dense, hip and macho. Finally, our society just doesn't know how to appeal to men in attracting men to health clinics. The unisex approach of most health clinics ignores the special language and thinking of men and fails to get men involved in their own health needs. Typically men see health care as a feminine pursuit, which of course it isn't. Men respond better to symbols that speak to them as men and reinforce their particular health concerns. Having more male staff, hanging posters of male athletes who have conquered major health problems, educating men on how their health exams are vitally connected to loving their families, and making it cool for men to team up in groups for regular health checks are more promising ways to appeal to men. Ultimately, putting all excuses aside, each of us men has to decide whether it's better to hang on to our arrogant thinking that nothing will ever harm us or to embrace the humbling realization of our own vulnerabilities for the sake of honestly loving others. Tragically, too many of us men feel that avoiding our own health needs is our business alone and doesn't affect anybody else in the world.

Why men need health checkups
I'm sure you've been preached to enough about how an ounce of prevention is worth a pound of cure. Equally, you're probably aware that most serious diseases of men, when caught in early stages, are quite treatable and that you can expect to live well into elder years when you regularly consult your family doctor. In fact, new health statistics bear this fact out as men are increasingly getting screened for prostate cancer, hypertension and heart disease in larger numbers and living longer as a result! What you may not know is that we men need to go to the doctors even more than women do as we are the more biologically fragile gender. We have higher rates of psycho-neurological disorders, infant mortality, heart disease, immune system deficiencies, birth defects, alcoholism and suicide rates, reading and learning disabilities, violent murders, and we live on average 7 years less than women do. These rates are not explained by workplace stress as women in competitive workplace settings have more favorable health results than men in similar jobs. We men are in fact the weaker sex. The sooner we accept our weakness, the stronger we can be. Also, many of us men need health checkups because we have a hidden depression--manifested in our lives as a chronic irritability and reticence--that prompts many of us men to avoid doctors because we feel we are not worth their concern. Depression in men is linked to myriad serious health problems. Too many of us men commit a slow suicide by stubbornly avoiding doctors. All of us guys deserve physical health to enjoy the quality of our lives but we have to make the effort to bring it about. In fact, seeking physical health may be the start of something really good for us strong silent types.

Surviving the office visit
One of the neatest things about getting a regular physical with the same doctor is that after several yearly visits going to see the doctor is no big deal. Your physician can develop baseline data about your health and work with you on treatment plans that actually improve your health numbers. A lot of guys don't know what a kick it is to actually improve your stats when you work at your health with your treatment team. Getting an annual physical can be like the big game where you get to show what you are really made of. Even if the results are disappointing, you can always start over again and learn from your mistakes.

The hardest part of course is getting through the front door to see the doctor. It's best if you can ask some male buddies who they see or interview prospective physicians. Ask how they handle questions from their patients, what they know about men's health, and how thorough they are. It's best if you see someone who is communicative and exacting. Trust yourself and your reactions to helpers. It's fine to get somebody to go with you to your initial visit to help you feel comfortable. You will sweat when you wait to see your doctor. Remember what gives you pain also makes you stronger.

The sacred karma of seeing the doctor
Ask yourself: Is it better to die not knowing your health problems and have your family be upset about your neglecting your health or is it better to face the music now and no matter what happens to at least know that you've done all you can do for your health? What you decide models for your children how they will care for their own future loved ones. What goes around, comes around.

John H. Driggs, L.I.C.S.W., is a Licensed Clinical Social Worker in private practice in St. Paul and co-author of Intimacy Between Men (Penguin Books, 1990). He can be reached at (651) 699-4573.