Why Patients Lie

77 percent of doctors say their patients aren't being honest. A male health writer offers his take on why men can't quite bring themselves to let it all hang out.

I was 23 years old, invincible in my ignorance, when I took a kneecap to the groin playing football. The next morning my testicles were the size and color of an eggplant. But I didn’t seek medical attention. Instead, I fell back on the advice of my high school coach and iced it.

Later that day, still denying it was serious, I hobbled to my job as a sportswriter at the local newspaper. But I never made it through my shift. Noticing I was sweating and in pain, my editor ordered me to the ER, where I told the admitting nurse I’d had a “little football accident.” The X-rays showed otherwise. My right testicle was shattered, and I underwent immediate surgery.

From what I can gather, such a response is common among guys. Men die of heart attacks every day after denying all the telltale symptoms. And in a 2009 survey of healthcare providers, 77% said they’re lied to by patients nearly a third of the time.

So what is it that makes us ignore our failing health and even deceive our doctors about it? After spending the last 30 years as a health-and-wellness journalist and, yes, as a man (despite that brush with eunuch-hood), I have some theories:

Ego:

The healthcare industry is designed to humble men. From doctors who make us wait without apology, to nurses who insist we don those humiliating gowns, to exams that require us to bend over for digital inspection, to pharmacists who make us look up at them as our prescriptions are filled, to health-insurance companies who send us indecipherable bills. At every juncture, men are made to feel subservient. No man wants to admit he’s flawed, injured, sick, or below another man. No matter how Neanderthal that mentality sounds, it lies at the heart of our evolutionary wellbeing. Once we admit to weakness, we expose our flank in the age-old battle of survival of the fittest. Something deep inside every man knows and resists this.

Fear:

There’s an actual medical condition called “white-coat hypertension,” in which a patient’s blood pressure rises just from being in a doctor’s office. The fear of blood, needles and surgery is also very real in men, though most would never admit it (see previous reason). Whereas most women are accustomed to seeing gynecologists from a young age, having their bodies bleed every month and delivering babies, men have no such intimate experience with their physical selves or the healthcare system. And, frankly, it scares the bejesus out of us.

Communication:

Discussing health concerns, whether physical or emotional, is not as easy for men as it is for women. It’s the old “feelings” discussion coming back to haunt us. We have neither the training nor the vocabulary to handle it. That’s why when a doctor asks if we’re experiencing erectile dysfunction we start complaining about the contractor we hired to put on that addition.

Control-anxiety:

Men don’t like to let someone else drive, call a handyman, or ask for directions. We are able captains. We can fix that. We can get you there. That’s why our first reaction to a body breakdown is to troubleshoot it ourselves. Six months ago, a buddy of mine started peeing blood, and he just now told his doctor about it. In the interim, he went down a checklist that included eliminating everything red from his diet and giving up jogging (too jarring, he reasoned). Unfortunately, the Internet has given us the fodder to believe we’re all able doctors.

Embarrassment:

This is the real reason I waited so long to go to the hospital. I was ashamed of my stupidity, and I was dreading dropping my drawers for a bevy of doctors and nurses. I was raised by a military man who actually told my mom to “Take it like a Marine” when he dropped her off at the hospital to deliver me. So I was never a crybaby. I always sucked it up. I never wanted to disappoint him, not then and not now (even though he’s been dead for 20 years). I suspect lots of men still have father figures like that lurking behind them.

Self-delusion:

Each month at Men’s Health Magazine, where I worked for more than a decade, we’d put essentially the same promises on the cover (Get Six-Pack Abs, Lose Weight Fast, Have Better Sex Tonight…) and millions of men would buy the issues again and again. That’s because even after our abs have long since turned to flab and the only time we want sex twice is before we’ve had it once, men still believe they’re better than they actually are. It’s what keeps us going in a world determined to tear us down. Yes, we are watching what we eat! Yes, we are exercising regularly! And yes, we only have one drink per day! In our male brains and in our mirrors, we see the ideal. Take that away from us and the lying becomes something much worse; it marks the dying of our spirits.