Sunday 29 September 2013


Be aware, be very aware...


On Tuesday everything will go pink: t-shirts, mineral water bottles, cricket whites, websites, feather boas. Yes, October is Breast Cancer Awareness month, and breast cancer charities are again encouraging women around the world to raise money for research, and to be aware about breast cancer.
The following month, everything is going hairy: November is Movember – and this time it will be men who are encouraged to be aware of prostate and testicular cancer whilst sprouting facial growths.

Also during October and November, we’ll also have our heartstrings and purses tugged by Lupus Awareness Month, World Mental Health Day, World Sight Day, World Arthritis Day, World Osteoporosis Day, International Stammering Awareness Day, World Psoriasis Day, National Stress Awareness Day, Food Allergy Week and World Diabetes Day.

Quite understandably, health charities are constantly calling out for our attention. They want to raise awareness so that people who have certain conditions are treated properly and people who don’t have them don’t get them. They’re extremely adept at using marketing principles to engage us in all sorts of ways (even by growing Village People style moustaches).
But to those on the receiving end it’s confusing. So many conditions that need our “awareness”. So many that might affect me or my family. Which are most deserving of my attention? The marketing, and the statistics thrown around, makes them all sound a priority. 
Journalists like myself are constantly appealed to by charity PR people. Recently the Rarer Cancers Foundation told me that rare cancers are as deserving of our attention as breast cancer because together they make up half of all the cancer cases in the UK. I looked into it. The figures added up. I believed them, and start wondering about my chances of having myeloma, myelodysplastic syndrome or gastrointestinal stromal tumour.
Then I saw an impressive report from the Institute of Alcohol Studies which said that more people are dying of liver disease than ever before, and that men who drink every day are particularly at risk. That sounds like me, and many men I know. So that sounds worth worrying about too.
And now as Movember approaches, I’m being told that a man dies every hour from  prostate cancer and I should be more “aware”. But I’m not sure what that means for me.
This brings a new type of hypochondria. We want to make sense of all those scary statistics, but have no idea how to compare them. Subconsciously, we end up a bit scared of everything and go into denial. Perhaps some of us men pretend we’re immortal so that we can ignore it all.
This isn’t the organisations’ fault. They’re all doing their best to raise their voices above the clamour. But when you combine their messages with newspaper articles about health (mea culpa), academic and research institutions trying to convince us that an issue is important because they need funding, and a neighbour telling you how awful it was that her brother in law dropped dead from an aortic aneurysm, it all becomes overwhelming. We start jumping to random conclusions. 
Public appeals aren’t tailored to our own needs, our lives, our genetic make-ups. All these appeals have no “us” context. What do we do with them?
  1. ignore them all, and live oblivious until we get very ill
  2. take heed of them all, and live on our nerves until we get very ill (probably a bit later)
  3. work out what each one means mean for us. Somehow.



Wednesday 25 September 2013

Episode 2: Testing times for Danger Man

The story so far: John Drake has reluctantly visited the doctor to have a health once-over.

It was four o’clock on a Friday evening, and this was the fifth time Dr Sixsmith had tried to catch Drake by phone in three weeks. There was a tired inevitability about the ring tone. Any second it would break into the click and hiss of the answerphone. 

“Hello. Drake here.” The voice was loud and abrupt. Definitely not the answerphone.

“Mr Drake? Dr Sixsmith.” He flicked through the windows on his computer to find Drake’s test results.

“Oh. Yes. What do you want?

“I’ve been trying to catch you for a few days Mr Drake. I have your results. Have you been away? I left several messages.”

“Yes. Business you know.” He sounded defensive.

“I understand Mr Drake. Well look, I just wanted to fill you in on these results myself. Absolutely nothing to worry about, but just a couple of things you should know.”

“Hmmm. Look, I’ve just got back, is it really necessary? I feel absolutely fine and to be honest, if there’s nothing life-threatening...”

“No, no, nothing life-threatening, but I just wanted to tell you your cholesterol is slightly raised. What that means is that you should try and cut down on foods high in saturated fat – meat pies, butter, stilton, ghee – that sort of thing.”

“Hmmm.”

“We’ll keep an eye on it and if it doesn’t get better we’ll consider putting you on a statin.”

“If you say so Doc.”

“Right. Your blood pressure reading was satisfactory, but a little high for a man of your age.”

“Well my line of work is quite stressful doctor, particularly at the moment. I don’t know if I told you that it was my employers who wanted these tests in the first place and to be honest...”

“Yes, I do understand that Mr Drake.” Sixsmith looked at the clock on his computer. He was already late for the practice administrative meeting. “Anyway, it’s nothing to worry about but I think we should put you on an ambulatory blood pressure monitor for a couple of days...”

“A what?”

“I’ll explain it when I see you Mr Drake. There’s one other thing. I’ve been looking at your notes, and see that your father died of prostate cancer...”

“Yes.”

“So it might be a wise precaution if we just checked you out for that.”

“By doing what, may I ask.”

“I’ll explain when I see you. Absolutely nothing to worry about.” Dr Sixsmith heard heavy breathing at the end of the line. He wasn’t sure whether his patient had developed asthma, was angry, or had a large dog at his elbow. 


30 years on: 
Dad, men's health and me

I can’t quite believe it, but it’s 30 years since Dad died, at the ridiculously young age of 62. He had prostate cancer. It’s his illness and death as much as anything that set me on my course of health journalism: I wanted to do something that might help reduce the chance of other families having similar experiences. Looking back today, it amazes me how much some things have changed for the better. But it also shocks me that some things remain stubbornly the same.

I’ve never forgotten my Mum’s look of desolate, desperate abandonment minutes after Dad’s doctor had pulled her aside during a routine hospital visit to brusquely tell her there was nothing more to be done: Dad had weeks, possibly days to live. And though I know that prostate cancer now has a much higher profile and that support services for patients and families are much better than they used to be, I also know that many thousands of patients, families and loved ones are still left feeling desperate.

Having written about cancer for two decades, I’ve seen the remarkable scientific advances that have been made. Had my Dad been in a similar position today, I have no doubt that he would have had months or years to live, not weeks. 

But there have not been similar advances in understanding or addressing the psychological impact of cancer and other illness. What concerned me then, and still concerns me now, is not so much illness in itself, but how how illness affects us in our heads, how it shapes our whole outlook on the world. Illness is grim.

In fact, I’m more concerned than ever. Because not only are people made sad and anxious by illness, they are increasingly becoming sad and anxious because of the prospect of illness. In the past 30 years, policy makers, doctors, researchers may have have striven so hard to give us all physical health, that they’ve forgotten what the objective of their work is: to allow people to lead happy, fulfilled lives. 

Now, it seems, we’re making people unhappy with unnecessary worry about their health, unnecessary tests, unnecessary treatments – treatments that in turn can lead to illness. I’m particularly worried about men. There’s a lot of finger-wagging that goes on when it comes to men’s health: “Men should look after themselves better.” “Men should visit the doctor more often.” “Men should talk about their health like women.” 

What it adds up to is that men are being encouraged to worry about their health. Which might have some merit if they were told to worry about the right things. But they’re not: they’re being encouraged to do and think things that have little or no evidence behind them. As this blog progresses, you’ll hear more about that. 

I suppose what I'm saying is that when I started out as a health journalist, I was concerned about acts of omission in health services. Now I'm just as concerned about acts of commission.

Oh the irony. Here I am, a health journalist worried that we’re becoming too obsessed with health. Bang goes the day job.

Here's me and Dad, in his prime, in 1968.





Thursday 19 September 2013

Episode one: Danger Man’s doctor

“Ah, Mr Drake, Good Morning.”

“Good morning doctor.”

John Drake had aged since Doctor Sixsmith had last seen him. Yes, four years ago it was, according to his notes, for a broken toe. Drake was still tanned and muscular, clearly a fit and active 40 year-old. But he looked more care-worn than Sixsmith remembered, his laconic smile now bent to a frown, his eyes dark and deep.

“What can I do for you today Mr Drake?”

Drake sat head bent, looking at his clenched hands.

“How’s work?” offered Sixsmith. “Still backwards and forwards to Washinton?”

“There have been... questions asked,” Drake eventually answered. “About my fitness...”

“Fitness?”

“Yes...”

“From Mrs Drake?”

Drake raised his steel blue eyes, and fixed them on the doctor, an eyebrow raised.

“From my employers” he said.

“Ah.”

“They would like you to run some tests.”

“Well Mr Drake, at your time of life, and given we haven’t seen you for some time, it probably would be a good idea. Now let’s see, we could obviously check your blood pressure, test your cholesterol, blood sugar. Given your family history, I'm wondering about checking your prostate...”

“Mrs Drake as well.”

“I’m sorry?”

“Mrs Drake would like me to have a check-up.”

“I see.”

“She read some article, in a ... magazine.”

“Good, good. Well just step behind the curtain Mr Drake.”






Wednesday 18 September 2013


Live long, prosper, and eat broccoli

What are the top five things men should know if they want to live longer? Groan. How many times have I been asked to write that type of feature in my career as a health journalist, and how many times have I grudgingly produced a list something like this:
  1. Don’t smoke
  2. Exercise regularly 
  3. Reduce your fat intake
  4. Eat lots of roughage
  5. Get married and be happy
That’s the boring version – so boring that it induced groans in my editor too. So there’s a more exciting version:
  1. Read food labels
  2. Believe in something
  3. Look after your teeth
  4. Get a dog
  5. Eat broccoli
No, I’m not proud of that one either, and I refuse to do these kinds of piece any more. Even as I wrote them, I realised there was a problem with combining scientific authority with something the reader would find remotely interesting. But there was also something else niggling at the back of my mind every time I had to produce something like this: men weren’t listening anyway.

Why would you listen? Would I pay attention to a hack telling me to do this but not that, to change my nasty lazy habits and start behaving in the way other people do so that I can live a long life focused on the doctor’s surgery and my own navel?

What if... men don't react well to florets of broccoli being waved in their face? What if doctors, politicians, policy makers, wives are concentrating on the wrong things if we want to help men lead fulfilled and happy lives? What if writing lists and shouting at men to change their ways isn’t going to get anyone anywhere?

And what if expecting them to worry about their health, go for regular testing and "know their numbers" is an approach that does more harm than good?

Let me introduce you to Danger Man’s Doctor.