A man’s most dreaded appointment: The prostate exam

ESSAY - Fear is no excuse for the high rates of preventable health-related fatalities among black men; nor is machismo and ego...

Luther Vandross was outed as gay after his death.

Turning forty is a momentous occasion. It seems to be the perfect intersection of wisdom and youth, aesthetically expressed as male pattern baldness without the wrinkles. Along with reaching that milestone in three years, I’ll also contact a Male Urologist to schedule a prostate exam.

In my younger, naïve days – oh to be 36 again – I had less trepidation. Upon learning that the exam was now digital – and why shouldn’t it be, after all it is 2012 – I was prepared to man-up and tough out the ice cold gel and ultrasound machine looking for prostate abnormalities. But when the doctor explained that the exam was digital as in fingers, not digital as in electronic, the anxiety was renewed.

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As it turns out, that was the least of my concerns. According to experts, my anxiety is not solely due to the invasiveness of the test, but from a mistrust of doctors that comes as a consequence of being black and male.

Though there are many reasons for this, one occurrence that came to light in 1972 stands out as emblematic of why black men have misgivings about doctors. The Tuskegee Study of Untreated Syphilis in the Negro Male, colloquially known as the Tuskegee Experiment, was forcibly concluded that year, which means, coincidentally, it just turned 40.

This human experiment studied 400 African-American men with syphilis and purposely did not treat them in order to watch the disease slowly eat away at their bodies and minds. The doctors did not tell the men they had syphilis, but instead told them they carried “bad blood.” The unwitting men were promised free meals and healthcare if they periodically saw the doctors.

This went on for – you guessed it – forty years. By the time the horrors of the experiment were reported in the national news, many of the men had died or gone insane, both results of untreated syphilis. But some public health scholars argue that the most damaging result was the perceived confirmation in African-American communities that doctors could not be trusted.

This is especially true for men. A 2010 study by Dr. Wizdom Powell, Masculinity, Medical Mistrust and Preventive Health Services Delays Among Community-Dwelling African-American Men, shows that African-American have a disproportionate mistrust of the healthcare system compared to men of other ethnicities. As a result, we are less likely to get routine preventive health checks on our blood pressure, cholesterol levels, and, of course, prostates.

This is especially important because the Centers for Disease Control and Prevention reports that heart disease is the number one killer of black men. It also states that black men have the highest rate of prostate cancer in the nation, nearly twice the incidence of white men.

This mistrust was not only experienced by the generations alive during the Tuskegee experiment; its residue was passed on culturally, thereby perpetuating it and worsening the problem. When Billie Holiday sang, “Papa may have / But God bless the child that’s got his own,” I’m certain this medical mistrust is not what she meant in terms of our descendants carrying forward a legacy.

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Ironically, a black male brought universal healthcare to the nation. Yet unfortunately, mistrust cannot be legislated out of the black male psyche. President Obama’s Obamacare makes access to healthcare a reality, but it does not make it more trustworthy. It can’t, and it shouldn’t. It is time for the black community to act and make the law’s utilization common practice.

We need to train our young men to eat better, exercise more, and learn that it takes more than a daily apple to stay out of the doctor’s office.

We owe it to all of our loved ones that have succumbed to cancers and heart disease — ailments that, if caught early, do not have to be fatal. Mistrust is no excuse for these fatalities among black men to persist; nor is machismo and ego.

Besides, prostate cancer is a whole lot scarier than facing down a family practioner’s digits. And I don’t mean his or her phone number.

Theodore R. Johnson is a military officer and 2011-2012 White House Fellow. A graduate of Hampton and Harvard Universities, he is an opinion writer on race, politics, and public service. He currently resides in Alexandria, VA. Follow Theodore R. Johnson on Twitter at @T_R_Johnson_III.