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.


Suzy Furno-Maricle said...

"In commenting on the filming, the doctor said that ‘sex sells.’"

The doctor was not being totally honest. They were not just selling sex, but rather; sexual humiliation. There is a wide variant, and sexual humiliation seems to be the current sanctioned mass social fetish.
Society needs to consider why they find this gratifying, and media needs re-dress as to why they pander to it.

Joel Sherman MD said...

I agree with you Suzy. But humiliation is used as a source of humor. It is frequent in movies that male exposure is used for a laugh. The more embarrassing, the funnier. It's much less common involving women.
I've never quite understood that kind of humor.

Doug Capra said...

Great article, Joel. It points out that this idea of the double standard is widespread in the culture. It bleeds into health care is just part of its meandering route through social institutions. But the stereotypes and assumptions about men in general and modesty in particular are so pervasive in our culture that we don't even notice it unless it affects us or someone we love directly. We certainly see that in health care. It only becomes an issue to most health care providers when it's them or their mother or their brother or their son. At that point, the word "dignity" in relation to patient modesty takes on a whole new meaning.
I would disagree with you on one point, Joel. I think the media, esp. in film, has depicted the naked female in humiliating and embarrassing situations much more often than it has males. This has changed in the last few decades and now more men are shown. With women, though, the embarrassment and vulnerability fits more into our cultural ideas about female modesty. With men, it goes against the our cultural notions. The naked male body as strong and wild and dangerous becomes pathetic and even more humiliated in the kinds of situations depicted.

Anonymous said...

Where do you think the media get their ideas, from the
female dominated health arena.


Doug Capra said...

Sorry, PT. The problem with your reasoning is that it's reductionist. You reduce everything to the female dominated health care industry. It's much more complicated than that. It goes deeper into cultural structures that are ancient. I'm not saying there is no merit to your argument -- but it isn't foundational.

Anonymous said...


These medical shows hire consultants and who
are the consultants, female nurses. Where do they
get the plots,female nurses. I can prove this and
furthermore this mentality has been going strong
so to speak since the mid sixties and it looks like
this sick entertainment will only get worse.


Anonymous said...


I am going to make a few more comments about this article and then I am done, I am so done. I thought the article was well written, crafted and composed of truths by Dr Sherman. It was such a good article I had trouble sleeping last night.

I'll say again this medical presentation is typical
of the female nursing agenda and commonly used
tactics in their arsenal.

I always refer to the black man required to sit at the
back of the bus. Why, because it is the best analogy you can find regarding discrimination. The black man
dosen't care about cultural structures that are ancient,
he dosen't care about socioeconomics, or any dynamics
that landed him in the back of the bus.

I hope these medical shows proliferate in their agenda driven desire to humiliate men and/or show
them as pathetic helpless creatures. I can but only
envision the kind of audience that enjoys watching
this kind of trash. Seas and Seas of obese female
nurses stopping on the way home for a big bucket
of Bon-Bons , a big bag of cheese crunch and a
six-pac of Dr. Pepper.

A Cardiologist I know once said, if something tastes
good then usually it's not good for you. Maybe the
producers of these medical shows have their own
secret agenda.


Anonymous said...

I think that during a physical adolesent males sgould be told exaxtly what girls are . Buck up and deal with it , it's part of life . If they are too embarassed over the fact that they may have an erection during sports exam then don't play sports . Having that happen doesn't come close to the humiliation girls and women go through for a complete exam . They may tell Doctors to be sensitive to feelings of girls and women during the exam . But that doesn't mean that happens . Unless you have the right body parts to have a pelvic exam done , and can experience the humiliation first hand , buck up and deal with the fact that there is no concern for your modesty or humiliation .

Joel Sherman MD said...

This anonymous commenter likely meant to post this on the adolescent thread.
We post this reluctantly just to show a sample of extreme views that don't help further any discourse.

We will not routinely post this kind of rant as it accomplishes little.

StayingFit said...

I agree with you, Dr. Sherman, regarding the comments made by Anonymous on 12/3/12. So, I won't say much in response. Besides, I think that her own words discredit her post far more than I ever could.

I would like to point out, however, that girls don't endure a full examination, as a condition of playing sports. Whether or not the examinations that girls do undergo are only performed when necessary, this I cannot say. But, there certainly are times when they ARE required, which is different than the situation with boys and sports. In the case of boys, there is no reason to perform such intimate examinations, and yet they are done routinely.

I'm saddened that the comments by Anon follow a familiar pattern, which I have observed on your blog, and on Doctor Bernstein's. That being, if one gender has been treated poorly, then the opposite gender should be treated poorly, as well, and they should not complain about it. I have seen this in posts by male and female commenters, and it serves no purpose, except to divide us. And that's a shame, because things will only get better if we work together to improve the treatment of everyone.

StayingFit said...

June 10th – 16th is International Men's Health Week, and the U.S. Government seems to have, finally, decided to participate in this event. Here is a link to the U.S. Department of Health and Human Services website's calendar for the month of June:

While I view this unusual level of attention to men's health with optimism, I can't help but notice that it contains many of the usual cliches that we have come to expect, when discussing this issue. The number one problem with men's health, we are told, is that men don't like to visit doctors.

The very first line, in bold letters, is “Man Up”. This is the usual attempt to shame men into seeking medical attention. We then see the word “manly” used to describe the steps that men can take to improve their health. Seriously, when was the last time that you heard any guy, or anyone, use the word “manly”? This reads like an attempt by college-aged women to “think like men”. I strongly suspect that this is exactly who created this page. At least, it seems apparent that no men were involved, because what man would have used this terminology?

Also, instead of employing the typical shaming techniques, maybe it would have been a better idea to ask men why they don't visit doctors, and to address those issues. They might also have spent a couple of dollars on a focus group, to determine what sort of appeal would work with men. Clearly, they did none of these things, since we have seen the “man up” campaigns fail time and again.

It may also be that they did ask these questions, but did not like the answers. Certainly, issues related to the blatant disregard to the modesty and privacy of men would have been raised, were the interviews designed and performed properly.

So, instead of a thoughtfully designed campaign, we get more of the same. As I said, I am pleased to see some attempt at this by HHS, since it is far more than I have seen in the past. However, it would be nice if they would actually exert some effort into doing it right next year.

Anonymous said...

Staying Fit's post regarding men's health and the fact that males visit doctors less often than females reminds of a post that I submitted to the bioethics blog some time agothat I believe is relevant to the issue:

The "Real Men Wear Gowns" campaign is similar to a radio campaign that has been running in my area for several months. Although these “public service announcements” avoid using the ill advised gown metaphor their central theme is that “real men” take responsibility for their health by seeing a doctor regularly for physical exams and making timely appointments for colonoscopies, prostate exams, etc.
This message would be reasonable if in fact it were not so hypocritical. As many of us are aware, while we are encouraged to be “real men” who use the health care system frequently, once we arrive at the physician’s office or hospital the last thing the medical profession wants us to do is act like men. Men are assertive, insist on maintaining some control over their own bodies, and demand to be treated with courtesy and respect, especially considering we are paying for these medical services through the hefty premiums charged by our health care plans.
However, once we access the medical system we are expected to act like obedient little boys who do what they are told no matter how humiliating, embarrassing, or even unnecessary compliance may be. If we refuse opposite gender intimate care we are likely to be patronized, insulted, bullied, and labeled as difficult patients.
Unfortunately, we will be continued to be treated like children by the medical establishment as long as we let them do so. It will only be when enough of us truly begin acting like real men who firmly insist on dignified treatment that the current system will be forced to change.

StayingFit said...

MG, I absolutely agree with your comment. If the medical profession were to address the issues that you raise, more men would see doctors, and no shaming tactics would be necessary.

Also, not to be too critical of the HHS site. But, there is a section in the lower right that lists resources related to men's health. When the page first went up, this contained links to a list of screenings for men, and another on prostate cancer. Unfortunately, both pointed to non-existent web pages! Thankfully, they seem to have corrected that.

However, it's a bit ironic that, while the whole campaign is about "being manly", the "Men's Health Topics" link points to WOMENSHEALTH.GOV! Ah yes, nothing more manly than looking up your medical advice on a site dedicated to women's health, right? What guy doesn't feel comfortable reading a site whose goal, stated at the top of the "Men's Health" page, is "Empowering Women to Live Healthier Lives".

I suppose that I shouldn't be too hard on them, though. As near as I can tell, this is the only other page that HHS has that is dedicated men's medical issues. It's just a shame that our government funds an entire site for women's health, but produces barely a page on men's.