That’s Men: How we see the GP: first port of call, or last resort?

He sat at a coffee table behind me in a hotel in Manchester as I tried to read a newspaper in peace. He was telling his companions about his various illnesses. He went into detail. The word “reflux” figured rather a lot.

I give up the battle to read as he described his doctors and related an illness saga that had more twists and turns than Game of Thrones. His companions emitted polite English noises, which suggested strongly that they wished they were anywhere but there.

Other people trying to read their iPads, their books and their newspapers glanced wearily in his direction from time to time as they became unwillingly dragged into his medical world.

Life would have been simpler for all of us – and maybe even for him – if he had been one of those people who are extremely reticent about their illnesses. At the extreme end – and I knew such a man – these people will keel over before they admit to being ill or they will hold off until they are in ridiculous levels of pain. The man I knew even went to his GP – because his wife made him go – and told the doctor about everything except the serious stuff. It is generally only eagle-eyed doctors with a sixth sense, and eagle-eyed spouses, who eventually get these individuals into treatment.

I encountered these two people not only in different countries but at different times, and I put them together in my head only when I was reading The Emotional Life of your Brain, by Prof Richard Davidson and Sharon Begley in which they talk (among many other things) about the structure called the insula, which has a sort of map of the visceral organs (heart, liver, stomach, and so on).

If the insula is extremely active, we ourselves are extremely aware of our bodily and emotional states. If it is extremely underactive, we are relatively unaware. We can assume that our man in Manchester had an overactive insula: no doubt he would get a lot of mileage out of such information. And we can assume that our reticent man had a very underactive insula.

Reactions to illness

The point is that reactions to illness and disease can differ between people regardless of their gender and for reasons that are heavily influenced by their physical make-up. People with one type of make-up will stay away from the doctor until the undertaker has them pencilled in, and those with the other type are as happy as clams whenever they find themselves sitting in a doctor’s waiting room.

That said, it seems fair to say that men in general are more reluctant than women to visit the doctor. Indeed on my own infrequent visits to the doctor’s waiting room I’ve noticed that almost all my companions are female.

I wonder, though, if women who work full-time are more or less likely than men to visit the doctor? For many, a trip to the surgery could mean the loss of a half-day or full-day’s income.

Another factor is the attitude of doctors. For instance, European research suggests that women with rheumatoid arthritis are referred to arthritis clinics later than men; and that osteoporosis may be underdiagnosed in men.

So differences in how we approach the whole business of health and of getting something done about our symptoms depend on a great deal more than the prospective patient’s gender. Culture, time demands, assumptions and physical make-up are all part of the mix.

I fall towards the reticent end of the scale myself in the matter of running off to the doctor. I empathise with those men who, in one small US study, noticed they had symptoms consistent with a heart attack but put off a trip to the emergency room until the end of the football game they were watching.

A stupid thing to do, no doubt about it, but I could see myself doing it. And guess what? There might be more women than you think who would do the same stupid thing.

pomorain@yahoo.com

Padraig O'Morain is a counsellor accredited by the Irish Association for Counselling and Psychotherapy. His latest book is Mindfulness for Worriers. His daily mindfulness reminder is free by email.