Wednesday, May 16, 2012

The Mass Media & Men's Health
by Joel Sherman MD

This article was chosen for reposting on KevinMD.

CBS Cares - About my prostate !
The mass media has a long history of covering medical dramas and rarely doing so with any realism.  We’ve gone from Marcus Welby MD to a host of shows dedicated to portraying medical personnel in the most salacious ways possible.  But at least with all these dramas it is understood that they are fictional.  There are now though a host of shows which pretend to show real life medical stories which are even more perverse. 
Some of the most egregious examples come from Untold Stories of the ER, a Discovery Health Channel production which is sporadically rebroadcast on The Learning Channel.  A prime example from this show is episode 4 from season 5, ‘Grandma’s Back.’  This episode can be downloaded from Amazon .    One of the incidents portrayed is that of a young man entering with priapism, an erection which won’t subside spontaneously.  This is a relatively rare occurrence as a side effect of Viagra.  But can also be associated with serious underlying clotting disorders and malignancies.  After an episode of priapism men are frequently left impotent.   In short, the condition is a serious one and anything but a joke.  It’s about as intrinsically funny as female infertility. 

The vignette portrays a young man coming in the ER with a prominent bulge in his pants accompanied by his mistress.  His wife later shows up and the two women fight as neither was apparently aware of the other.  The patient is portrayed as being in great pain and whining for relief while trying to fend off the two women who turn against him.   The whole episode is one of comic relief in contrast to the other 2 episodes in this hour show.  The other two tales in this episode concern critically ill women, one young and attractive, the other elderly but well preserved, both of whom ultimately do well.   Needless to say, both are treated sensitively as if a miracle had taken place without a hint of mockery.

The doctor in the priapism story is identified and I was able to call him.  He said the season was filmed in Vancouver, in a defunct medical clinic, which the network rented out for the month.   Of course all the patients and likely most of the staff are actors, but the identified physicians are real.  The priapism tale is one the physician suggested based on a real experience from his residency.  In commenting on the filming, the doctor said that ‘sex sells.’

A further episode portrays a man who came in with testicular pain.  A testicular ultrasound is ordered, but a mix-up occurs and an orthopedic patient is sent instead.  The patient who underwent the mistaken testicular ultrasound by a woman technician of course is later shown to have thoroughly enjoyed the exam.   Two other episodes make a point of showing men being embarrassed to be treated by female physicians or nurses.  Needless to say, I’ve seen no episodes ( though I haven’t seen them all) where women are portrayed in such a mocking disrespectful way.

The attitude taken on this show towards male health problems is reflected throughout society.  It is routine on TV and in movies for the portrayal of men being hit in the groin to be used as a comic event despite the fact that serious injuries occur.  The media treatment  of the John Wayne Bobbitt case is an extreme example.  There are many sites devoted to jokes about the incident.  It’s inconceivable that mutilation of a woman could be treated similarly by the media.

Men’s reluctance to obtain routine health care is also routinely treated as a joke.  Even physicians have done this.  An example quoted before on these blogs' is Dr Sharon Orrange’s article  on the 10 reasons men don’t go to the doctor including you are afraid we will put our finger in your butt” and “you are afraid we will examine your balls.”   This same physician has never treated woman’s issues with levity. 
Even when the motives are unquestioned, the media frequently uses humor and sex to try and encourage men to receive medical care.   CBS has run a series of public service announcements to entice men to receive prostate exams.  Some are directed to women rather than men, a common strategy.  Some of these ads use a young alluring woman to give the message with a smile (pictured above).   Can you imagine an ad to promote Pap smears using a young handsome man?  I don’t think you’ll ever see one.   Why not use an ad from a former athlete who may have had prostate cancer himself?  There are lots of them.  Johns Hopkins was featured in an ABC TV series in 2008 purportedly to show real life situations in medicine.   One episode featured a female urologist coaxing a minimally reluctant  older man to submit to an exam.  He is shown from the back lowering his pants for her.  There was no point to this episode except to introduce some sex and male embarrassment into the show.  There are many thousands of women physicians in this country who do thousands of exams on men every day.  Why feature men for embarrassment?  Women get just as embarrassed,  but that’s never a matter for humor.  That’s treated as a serious concern.  On an opposite but analogous theme, a play called, ‘Midlife Crisis, the Musical’ has one scene showing men sitting reluctantly in a doctor’s office waiting for their appointment.  But they are then told that the provider has been changed to a young pretty female physician, and the men now jump up with eagerness to get their exam.  So men are either reluctant to have an exam or eager, depending on what seems more humorous in the setting.

In short, the media has always portrayed medical situations in sitcoms and dramas in a way to sexualize and dramatize the entire episode.  It is highly variable whether any pains are taken to get medical facts correct; often they are totally inaccurate.    But at least it’s apparent that these dramas are fiction.  The so called reality shows are worse in that viewers are more likely to believe that they are actually witnessing valid portrayals of modern medicine.  Male patients are usually not shown as being capable of making intelligent choices about their health care.  They either need their wives to push them into it or the medical encounter needs a pretty provider to attract them.  Frequently they are embarrassed to seek help.  Now these characterizations do fit some segment of the male population, but why are they the only segment shown?  No humor is portrayed when women  need to be pushed into obtaining needed medical care.   The majority of men who need chronic health care, predominately middle aged and older men, would be better served by intelligent and factual reminders of what is needed.  Some professional organizations like the American Cancer Society do provide this, and there are serious health segments, especially on cable news, but in general the popular mass media fails miserably.  I see no organized protest about this.  Groups such as the AMA could improve the situation if they tried.