Right of Reply: Theodore Dalrymple

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The doctor and writer responds to a recent article on men's health

by Deborah Orr

WHILE I have every sympathy with Deborah Orr's depiction of the disgusting men she encountered in a pub recently, and am, like her, appalled that 90 per cent of young British males would not commit themselves to the mothers of their children, (though the question arises as to why the mothers consent to have their children in the first place), I doubt that the solution is for men to start worrying themselves sick over testicular and prostate cancer.

The health of the slobs she described was endangered much more by their revolting habits and way of life than by their ignorance of testicular cancer, which is still rare enough to be very unlikely to kill them, or of prostate cancer, which, if it kills them at all, will kill them slowly and in many years to come.

In this connection, it is worth pointing out that the comparison of breast and prostate cancer is somewhat misleading. Breast cancer strikes women earlier in life than prostate cancer strikes men, and therefore accounts for many more years of lost life. Women are, thus, quite right to be more worried about breast cancer than men are about prostate cancer.

It is very unlikely, moreover, that sheer ignorance of the dangers of smoking or drinking too much, of being grossly overweight and inactive, accounts much for the ill health of the kind of men Deborah Orr met in the pub. In 25 years of medical practice, I haven't met a single smoker who didn't know it was very bad for him.

Deborah Orr's comparison of herself and her friends with the male denizens of the pub is inappropriate. I can assure her that there are large numbers of female equivalents of these men in this country.

The fact is that people usually worry about their health in inverse proportion to the need to do so. The connection between good health and health consciousness is therefore much more complex and equivocal than Deborah Orr realises. For people who do not indulge in the most obviously self-destructive of habits, there is little need to worry about their health.