The Strong Black Woman Goes to the Doctor

"So you see, there's a pattern here," I said. "The women in my family wait until we're at the point of disability or death before we bring a problem to the doctor." My doctor buried his face in his hands as he laughed - at me and with me. We were finishing up a 45-minute diagnostic interview, which was laced with plenty of humor as we talked about parenthood, marriage, and my chronic failure to pay attention to health issues.

This visit should have happened a year earlier. But after a few rounds of calling the clinic to reschedule my follow-up visit last spring, I finally told the receptionist, "I'll just have to call you later." I was glad to have finally found a primary care physician who practiced holistic medicine (and accepted health insurance!). But the clinic hadn't seemed to catch on to that fact; they kept scheduling his patients for 15-minute slots. There was an inevitable backlog in his daily schedule. I'd wait an hour in the waiting room and then spend another hour with him.

Now add the commute, which was 30 minutes in one direction and 45 minutes in the other. In total, a visit to the doctor took over three hours of my day. And I just didn't have the time. It was the end of the spring semester, crunch time for students and faculty alike. I had too much to do. So I just kept putting off the visit. Before I knew it, it'd been a year and my doctor had left the group practice to start a new clinic, still pretty far away. Plus, I was now a mother and I didn't want to spend my precious baby-free moments at the doctor's office. I had too much to do.

In retrospect, this seems really obvious - I had fallen off the wagon in a major way. I was back in the throes of Strong Black Woman syndrome - taking care of everyone and everything but me. But until that doctor's visit, as I realized the similarity between myself and the other women in my family, I hadn't known that I'd relapsed.

To be honest, I'd probably only made - and kept - this doctor's appointment because of my mother's urging. My mother and her sisters were worried. In the past year, two more family members in their generation have been diagnosed with degenerative and debilitating neuromuscular or neurological conditions. This brings the grand total to five - out of fifteen. It's more than scary.

As my mother told me about the latest diagnoses, she also told me of the worries that she and my aunts had for my generation. She urged me to get back to my doctor soon and let him know that we needed to be on the lookout, especially because the most recent relatives were not diagnosed until they reached the point of disability. Most likely, they've had symptoms for years but didn't notice them, didn't take them seriously when they did notice them, and decided to worry anyone about it once they suspected it was serious. Now, I haven't asked whether this is the case; I'm simply speculating as to what might have happened. But I feel pretty secure in my speculation. After all, I am the women in my family. I am my mother's daughter and my aunts' niece.

That point became all too obvious just minutes after ending the telephone conversation with my mother. When I related the information to my husband, he immediately asked whether it might have anything to do with the muscular problems that I've had, and largely ignored, for at least six years now. Quite frankly, the thought that there might be a connection had never occurred to me.

So yesterday, I - a Strong Black Woman in recovery - went to the doctor. After that lengthy diagnostic interview, I thought I had given an exhaustive list of my ailments. But the physical revealed my tendency for minimizing my problems: "Your allergies are nowhere near 'under control.' You've got all kind of swelling up there." I guess that would explain the pressure that I'd been feeling in my head and face all morning. "Wait, do you have back pain? I feel tenderness here, and here, and here." Had I failed to mention that? Oops, my bad.

Curing Manhood?

A few months ago, I attended a continuing education seminar for psychologists on men and grief. At one point in the discussion, the instructor commented, "If you think of manhood as a sickness that needs to be cured, you need to work on that." With that one sentence, he gave voice to an uneasiness that I had been feeling in our discussions all day. Despite their biological sex or gender, those of us working as therapists tend to embody and value personality traits that are typically considered feminine. We like to listen, to process, and to talk about our feelings - about nearly everything. We place high esteem on intimacy, that is, feeling connected with others on a psychic level. And quite frankly, we think everyone should too.

Towards the midpoint of the seminar, I began to suspect that maybe we clinicians were on a mission to make men be more like us - to feel more, reflect more, relate more, and to talk more about all of it. More importantly, I recognized myself in the charge my by our instructor. In fact, I could easily imagine myself leading the campaign to have Hypermasculine Identity Syndrome (HIS) added to the Diagnostic and Statistical Manual of Mental Disorders, the bible of psychiatric disorders. Gender identity is what I read, write, teach, and talk about. Thus, with one statement, I found myself charged, found guilty, and sentenced. So for the rest of the afternoon, I began thinking that maybe we...maybe I needed to accept gender differences as another example of "apples and oranges" and to let men be men.

But (you saw that coming, didn't you?) there was just one problem with that: our traditional notions of masculinity in America (which, by the way, have only been traditional for about 200 years) aren't working. Not for men, not for women, not for children.

Case in point: life expectancies. While the gender gap is decreasing, there's been a stark gender disparity in life expectancies. On average, women in the United States live 81 years, men 76 years. The gender gap is even greater among African Americans, with African American women living an average of eight years longer than their male counterparts. The earlier deaths for men aren't attributed to sex chromosomes or sex hormones. Rather, they're more likely resultant from behaviors like the way men handle stress (bottling it up, not talking about it, not asking for help), take unnecessary risks, and behave violently and aggressively toward themselves and others. Okay, you won't really find any of those factors on a mortality chart. But they are factors related to the diseases that account for some of the gender disparity. Anyway, I'm trying to make a point here, not write a research paper. The point is this - the fact that men die so much sooner that women indicates that maybe there's something wrong with the way they live.

But perhaps more compelling are the data on how our ideas about masculinity impact relationships. In fact, this has convinced me, more than anything, of our need to rethink manhood. A major theme in that continuing education seminar was the father-son relationship, particularly the issues that many men (of all races) have with their fathers.

I see this in my undergraduate classes, especially among male students, who talk about fathers who have never told their sons that they love them. During his segment on the Tom Joyner Morning Show last week, D.L. Hughley talked about this very issue. He described once asking his father whether he loved him and getting the response, "You ate, didn't you?" It was a tongue-in-cheek response, one which Hughley found funny at the time and one at which I chuckled even as I shook my head in sympathy when he told it on the show.

But as Hughley noted in his commentary, he later realized that the whole exchange wasn't funny at all. He, like all children, needed to hear that his father loved him. He needed a father who did more than provide for his physical needs and comfort, a father who did more than provide rules, structure, and discipline. As he said:

I don't know one black men who isn't broken in some way. Broken either by the relationship he had with his father, or by the relationship he wished he had with his father...It's a shame that you're a casualty if you have a father, and you're a casualty if you don't. Finding the blend, the right way to be a father, the right groove, the right tempo to be a father, is an amazing thing...We can break a family with our presence as easily as we make them.

Our understanding of fatherhood is bound with our understanding of masculinity. And as I begin to hear more stories about men's issues with their fathers - the ones who stayed and provided - I realize that there is some serious work to be done.

So no, we can't just let men be men, any more than we can just let women be women. We are all deeply broken, our divine likeness obscured - hopefully not obliterated - by our conformity to societal norms and expectations about who we should be. This includes our gender identities.