THE INVINCIBLE MAN SYNDROME: ‘DON’T WORRY ABOUT ME, I’LL BE FINE’
Some men won’t allow themselves to be ill. They may feel awful and know they are ill, but they won’t let it show outside the home. For political, psychological or financial reasons, they believe they cannot afford to be seen to be sick. Look at how Boris Yeltsin used to behave. After years of prevarication, he finally came clean and admitted he was ill. The Kremlin has a long tradition of concealing illness for political reasons but it is not alone.
After Georges Pompidou’s dramatic illness as president, Francois Mitterrand made a public vow always to disclose the state of his health to the French people. But when his prostate cancer was diagnosed, he swore his physician to secrecy.
In many male-dominated occupations illness is equated with weakness and men go to great lengths to cover it up.
Consider barristers. They are in the business of being tough and resilient. They can’t afford chinks in their armour, and in an adversarial situation even a mild illness may be perceived as a weakness. There are barristers who wouldn’t admit to a head cold.
Doctors are serious offenders too. Many report for duty when they should be home in bed. While men will tell their partners they feel awful and accept a little sympathy, they will usually reject all suggestions that they stay home to recover. For one reason or another, they definitely need to go to work and over their shoulder say to their partner, ‘Don’t worry about me, I’ll be fine.’
In most cases they are. They power through and survive. They defeat their illness by sheer determination.
Every day, men battle on because work or financial pressure won’t allow them to take time out. Some imagine they are indispensable, some can’t afford to lose earnings and some are worried about what might happen in their absence. Recently a chef was brought to a Sydney teaching hospital with three crushed toes. A heavy pot had fallen on his foot. Doctors treated the blue, swollen foot and told him to go home, elevate the foot and rest for the remainder of the week. ‘I’d love to,’ he said, ‘but I can’t.’ And with that, he hobbled back to work. While he had a perfectly legitimate reason to stay home, he also had a new job that he didn’t want to risk losing. Emergency departments see many cases of self-employed men who won’t allow themselves to take time off. They usually fall into two categories. First, there are the men suffering moderate trauma. Their injuries are not life threatening but they have lacerations, sprains, burns or, like the chef, broken bones. Once they have been treated, it is difficult to persuade them they need time to recover.
With his bruised and broken toes, that chef would have been only half-efficient at work. He would probably have developed some secondary swelling in his ankle, and because he had returned to work too soon, he would have been disabled for a week longer than he would have been had he followed the hospital’s advice.
A plumber with a lacerated shin went the same way. Cuts on the front of the leg are notoriously slow to heal because the blood supply there is relatively poor and there is little fat or tissue. Because of the nature of plumbing, there is an increased risk of infection, and this man needed to take his wound seriously. But he insisted on returning to his job immediately. He worked for himself and was in the middle of a contract that had to be completed. He had no alternative. The wound never healed and he later went into hospital for a skin graft.
Men in the second category arrive at hospital with less visible problems, such as chest pain. Even if they are assessed as being at risk of a serious event, it is sometimes difficult to persuade them to remain in hospital. Some require a huge amount of encouragement before they will agree to stay, and in the final analysis, sometimes doctors have to make the decision for them.
Consider the case of a man of retirement age who went to a hospital emergency department with suspicious chest pain. The medical staff wanted him to be admitted for further investigation but he said he would do this only if he could take his car home first. It was in the hospital car park and he was obsessed with the need to get it home. It is not unusual for men in this situation to transfer their anxiety from themselves to something
trivial. After considerable discussion, the staff managed to persuade him that his car was of secondary importance and that they could make alternative arrangements for it.
But there are men in this second category who resist all pressure to remain in hospital. They see no evidence of gross illness and convince themselves that the investigation can be postponed. These men are worried enough to come to hospital, but they are too worried to stay.
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