The names of the patients in this column have been omitted, not because of the need for protection of the patients, so much as the need for protection of the spouses who ratted on them . . .
There should be this disclaimer as well: Not all men are terrible patients. Not all men regard being ill as a reflection on their masculinity. That being said, however, the hypothesis is this: Men are terrible patients.
"Tell me about it," sighs a woman whose husband has been sick -- cough, fever, ill temper -- off and on for weeks. Only after he got a pain in his chest did he hie himself to a doctor. Diagnosis: pneumonia.
"He's never been sick a day in his life and he wants to go to work.
"How is he? Well, last night he threw his dinner at me. All the way across the room."
Yes, that old pain in the chest will do it, says Dr. Gary Roggin.
"Every male walking around out there is always worried about when they're going to get their chest pain. And the day it strikes is the day you don't have to tell him to get to a doctor."
Dr. Roggin is a gastroenterologist. He got to musing on men and their tendency to deny almost any symptom, shortly after the advent in the area of GUTLINE, the American Digestive Disease Society's call-in program. To the astonishment of all involved with the program, including Dr. Roggin, 42 percent of the callers were men, mostly between the ages of 30 and 49.
"It's true about men patients," he says. "It's absolutely true.I often kid them because frequently the sequence in my own practice is that the female will come in -- either on her own or referred by her own physician -- and then it's only a matter of time until her husband comes in -- totally under the stimulus and direction of the woman."
"But given the male's own initiative to enter a doctor's office -- unless he has one of the catastrophic symptoms like bleeding or chest pain -- it is virtually impossible to get him in the door."
"It's simply because men don't wear pajamas," theorizes a man we know who spent some time in a hospital recently, leaving his family to hustle up a quick pair of jammies.
"You simply can't get sick and go to the hospital, because you'd have to wear those skimpy gowns . . ."
A limp excuse in this particular cases: The man waited six weeks for the numbness in his hand to go away. It was only when he couldn't use his fingers to button his shirt . . .
A woman psychiatrist-neurologist thinks for a minute. "Well," she says, "it is true that in my psychiatric practice about two-thirds of the patient population are women . . . My impression is that the well-balanced man would be more likely to underplay (symptoms).
In a family situation, she says, women often come in much before the men. "The psychiatrists comply so they can ease the men in . . . and assuage the male ego and reinforce this delusion . . ."
It was around Christmas time, the woman recalls, and her husband "just sat around grumpily and didn't help at all with the tree. Not at all like him." She worried. In fact, he had changed so much that she was terrified. He had gone to the doctor recently, but there seemed to be nothing wrong. He was a writer, but seemed suddenly unable to type. She didn't know what to think. She called a relative of his out of town, a psychiatrist.
When she was finished talking to him, she recalls, she felt like there was something wrong with her. Finally, in desperation, she called their own family doctor and arranged for him to call "just to see how things were going."
After that call, her husband agreed to go in for "another look," and was found to have a rather rare type of central nervous system inflammation.
Says Dr. Roggin, "I think part of it is the difference in the way they (men) have been trained medically. Women have been used to having periodic examinations and except for the military, the male is really not into that mode at all.
"Possibly, they see it as a sign of weakness to admit that they have a significant illness that requires some additional help."
"How are you today?" the neurologist asks the male patient hospitalized for treatment of a mild stroke. Response from the male patient -- who had, only minutes before, complained to his wife that his arm was getting worse: "Fine, thank you. How are you?"
"No, no," cries the wife, "he"s not. He's worse."
The neurologist shoots a look at the wife that fairly shrieks "hysterical female," writes something on the chart and leaves.
The next morning the man's arm was paralyzed.
It was, Dr. Roggin speculates, perhaps the "protective anonymity" of the GUTLINE that permitted many of the men who called to face up to their symptoms.
In any case, he says it is important "to entice the reluctant individual through this format, or any other. To have this (sick) person out there, and for whatever reason, right or wrong, he may choose not to avail himself (of medical help) affects all of us -- the economy, productivity, all sorts of far-reaching things."
The man with pneumonia got better. So did the stroke victim, hysterical wife or no. So did the man with the central nervous system inflammation. Through no fault, it may be said of their own. CAPTION: Illustration, "Your body's trying to tell you something!" by Weber; Copyright (c) 1977 The New Yorker Magazine, Inc.