Maybe it's the tumor streams that I work with (prostate, urology, skin), but I've met a few male patients recently who seem to be of the same mold.
The conversation tends to run along the lines of:
Me: "So, tell me where you're at right now in terms of your cancer."
Them: "Oh, it's going OK. It's a bit of a shock, but I'm coping."
Me: "Do you think you understand what the cancer is and the treatment options for you?"
Them: "Yep."
Me: "Have you spoken to your family about the cancer?"
Them: "Yep. They're fine with it."
Me: "So, you don't need any support or help at the moment?"
Them: "Nope."
However, their partners usually state otherwise:
He's a mess. He's refusing to talk about what's going on and I don't even think he understands what it means. He's not sleeping and he won't take his pain medication. I can't get him to eat and if he ate he'd be stronger and feel so much better. He just goes to work and buries his head in the sand about what's going on.
I find the male species a distinct challenge to engage, to talk to about what's bothering them. I'm finding myself learning more about fishing and football in order to have something in common just to get that toe in the door. I'm getting better at reading between the lines and seeing the body language cues for the questions that need to be asked.
Seven feet tall...
A middle-aged man who had been scheduled for a three-hour laparoscopic kidney operation ended up with a five-hour operation and three days in ICU. I was called in for emotional support. He seemed depressed and the nurses couldn't get on top of his pain, but the surgery had been successful and it looked like no further treatment would be needed.
When I met him he was sitting bolt-upright in a chair, scarcely moving. He told me about his history and operation very clinically. He scored his pain and described his response to analgesia. I asked him what he did for a job: He drives heavy vehicles. I asked him about his kids: They're all grown up, moved away, and they know a bit about what's happened. I asked him how his kids were taking it: Oh, they think dad is bulletproof.
And there it was: Dad is bulletproof -- nothing stops him or upsets him, he's always in control. Except that now he wasn't. His operation hadn't gone as planned, the pain was different than what he had expected, and he had planned to be home after three days and not still stuck in the hospital. Disappointment, loss of control, frustration, and being lost in a world that wasn't his.
Supporting Superman
From here we could talk about ways of getting back control and re-evaluating his experience to emphasize the positives. We talked about goal setting and moving on with the plan B that had been dealt to him. In the end, I apologized for not being able to offer more practical support to help him with his cancer journey, but I think he would have refused it anyway.
Do you find this to be true among your male cancer patients?
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