L'Homme Rouge, Part Deux

In the last article we looked at the problem of men not taking care of themselves as well as women. This flight around the field we shall explore why this happens and what they can do to effect change.

There are two elements to this problem. First, encouraging men to seek preventative care, such as regular blood pressure and other cardiovascular risk factors, and second, creating a space where they feel comfortable to disclose “embarrassing” symptoms that might hint at an underlying serious disease.

There have been some brilliant awareness campaigns like those encouraging men to check their testicles and celebrities talking about prostate cancer; regardless, on average, men visit their doctors only four times a year in comparison to the six times a year for women.

Men view avoiding doctors as being self-reliant; they eschew behaviors they see as representing weakness. They want to be superheroes. And yes, fear of a negative outcome plays a part – like the kid hiding their face in a corner outside the teacher’s office – “If I can’t see them, they can’t see me.”

Men need to take ownership of their health with the same commitment they show to their aircraft; you would not defer getting an annual done, right? Learn to understand the benefits of early diagnosis. For instance, cancer is the second-leading cause of death for men, and screening for prostate, lung and colorectal cancer helps. In my experience if I talk to a woman about considering a screening colonoscopy, she will listen, ask sensible questions and get it done. A man? He will make some sarcastic joke and be out of there like a rat out of a sewer. An appropriate analogy, I think you would agree!

Why not “hangar fly” a visit to your doctor and work through the difficult phases of this particular flight – make a checklist if you like:

  1. Write down any symptoms you are experiencing – this helps you remember to mention them and allows you to read them out rather than having to deal with that troublesome eye contact! And include anything, anything that might be troubling you – sleep issues, depression, anxiety.
  2. Prepare your family history – it may affect you more than you know.
  3. List all the medications you are taking and ask if you need to still take them.
  4. Ask what screening tests might be appropriate given your age, health and family history.
  5. Be calm – you can fly an airplane, after all; this is a walk in the park in comparison!
  6. Take notes of what the doctor said – we know that patients remember only about 1/5 of what they are told. Imagine only recalling and reacting to 20% of what ATC tells you to do!

Let’s be honest here. Women are more prone to volunteer information to their doctors and tend to discuss health issues with their peers. Men? No way! No guy is going to talk about his varicose veins, constipation or hernia over a beer with his golf buddies. It ain’t happening!

Counterintuitively, one study found a correlation between men with strong ideals around masculinity as more likely to accurately disclose the more ‘embarrassing’ symptoms such as diarrhea and depression to a female physician rather than a male counterpart. Maybe that suggests being comfortable in their skin?

This is clearly a much more deep-seated problem in our culture, with man-to-man conversations rarely centered around points of vulnerability.

Straddling both of these issues is the matter of men’s mental health. Men are more than three times as likely to die from suicide than women, with 2019 sadly marking a new high of recorded suicides and with Covid, that is going up. I have lost colleagues to suicide and recently picked up on some signs in a pal which worried me – the right amount of prodding and he opened up and I could then help support him. Please do the same.

With the pandemic largely changing interactions between patients and doctors to the virtual world, doctors have had to raise our awareness for the subtle signals of mental health issues in men. Ask yourself about irritability, sudden anger, loss of control, risk-taking, and aggression or an excessive or increased use of alcohol and drugs. Don’t be shy to ask if a family member can be brought into the conversation. No, we are not good at asking for directions when driving, but when help is at hand, we are smart enough to accept it!

More employers are investing in digital mental health services, which may be a far more attractive option for men than visiting a mental health professional in person. In the US, a “healthcare-at-home” option was deployed to help those battling addiction who were worried about being seen entering a facility.

The message is clear; we must do more to raise awareness of the disparity in health outcomes between men and women and make men aware of the dangers of not seeking medical attention. Doctors have responsibility in this regard, but so does everyone else. Again, consider the aviation parallel; while ATC, ground staff and maintenance crew play their part, you are PIC of your plane. Try being PIC for your health.

There’s an old adage that men must be the ‘stronger sex’– but this ideology is not only outdated, it is dangerous. Men should hang up their superman capes and report health concerns promptly and accurately. Just as society has demanded – appropriately – that women must get equality on pay and other aspects as their male counterparts, men must get the same healthcare – for themselves and those who rely on and love them.

If nothing else, I want to honor the memory of Richard, David and Tom – you were good friends, guys, and I am so very annoyed you are not here. Although different diseases were the pathology, the root cause was hubris. Let’s ensure that the only red man is the Swedish menswear company of that name, and not fellow men embarrassed by a disease that could kill them.

Fly well!

You can email Jonathan at [email protected] with suggested topics for future articles or any questions which he will endeavor to answer. You can also listen to Jonathan’s weekly podcasts on medical matters at the EMG Health Podcast available on iTunes, other podcast platforms and

Jonathan Sackier
Dr. Jonathan Sackier is an expert in aviation medical concerns and helps members with their needs through AOPA Pilot Protection Services.
Topics: Pilot Health and Medical Certification, Pilot Health and Medical Certification, Pilot Health and Medical Certification

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