My husband won't see the doctor

He smokes, he coughs, he drinks ... but he refuses medical help!

Published January 31, 2013 1:00AM (EST)

                                                                                                                                                                                                                                                                                                                                                                                                                       (Zach Trenholm/Salon)
(Zach Trenholm/Salon)

Dear Cary,

My spouse refuses to see the doctor!

I am very worried and frustrated about my spouse's health. But every time I bring up seeing a doctor or getting help or anything he gets defensive and angry and tells me I'm bitching at him or patronizes me by saying it's not a big deal or he'll consider what I'm saying. But he never does. I have been with him for 13 years, we have two young children, ages 7 and 3, and I told him that I thought it was selfish and inconsiderate of him not to think about how we would feel if we lost him. This only upset him and he has shut down in speaking about it now.

Reason for my concern is legitimate. He smokes three to four packs a day, he has high blood pressure (he always has and the only reason I know this is I made him go to the E.R. twice in our relationship and both times, high blood pressure) and he is a heavy drinker. He's recently not as bad as he used to be; he was a raging alcoholic for about eight years and now is at about three to four glasses of vodka or mixed drinks a day. On weekends it's more. 

He was recently ill with influenza and I have never seen him that sick before, ever. He couldn't breathe or catch his breath, meanwhile still maintaining his smoking habits. He has gotten better -- he seems to be healing from the illness but so much is still lingering. He is coughing all the time ... he can never really have a conversation without coughing. And it's not a small cough, it's a hard, barky, loud, painful cough that makes you cringe. He has been having chest pains and pressure, pain in his left arm, shoulders and back. Last week there were these strange small red veins that just showed up on his left wrist and arm, I believe due to poor circulation, but again, I'm speculating. He has had diarrhea and stomach issues, his heart has been beating fast, even when he's just lying down.  He says he's super tired all the time, unbelievably tired and exhausted. He believes it's just the aftermath of being sick. I think it's something deeper than that. But since he won't get checked out it leaves me to do nothing but worry more and do research myself. Everything I look up says to seek medical attention right away. I email these findings to him, I have tried numerous tactics, kindness, being stern, telling him I am going to put him in the car, I have tried not engaging in conversations with him about his health, and just tell him to see someone, nothing works. 

A few weeks ago, I thought I really got through to him ... I broke down and cried and told him how hard it is to be with someone who blatantly refuses to seek help; that he doesn't listen when his partner is upset or worried about him; I told him I have had dreams of him dying, I have visions of what I would do if I one day come home to him lifeless. If I don't hear from him in the morning (as I get the children up and to school before he wakes up), I worry that he's dead. I know some of this is my worry, my issues, but it's hard not to feed into those fears with no answers and no hope that he will go willingly.  I also wonder if he does go in, if he would be honest with the kind of issues he's having. 

What do you do when you have someone in your life, the father of your children who acts like this?  Last week he stated to me that I should just love him today, make the most of these moments. I have been thinking about that ... deep down, though, I can't ignore his health, I can't ignore his issues and pain. I can't ignore that if he did die and I didn't try harder that I would live with that resentment inside of me. But most of all, our children, I cannot sit back and say nothing, when our boys are in need of their father.  Advice on how to handle this situation would be greatly appreciated.



Dear Hopeless,

If you have a doctor that you see regularly, make an appointment for yourself for a checkup, a visit. Before you go, print out a copy of your letter to me and my response. Also write down questions for your doctor. These questions might be: Is it permissible for you, as his wife, to make an appointment for your husband, and have the doctor's office call him to confirm it? Does your doctor's office have any suggestions for spouses to get reluctant patients to seek medical care?

If the doctor's office calls him to confirm an appointment that has been made, he may simply comply. He may think it is a follow-up, or he may understand that you have made it. Whatever he thinks, getting a routine reminder call from the doctor's office telling him that he has an appointment and reminding him to bring his insurance card may induce him to keep the appointment.

If household arrangements need to be made in order for him to attend the appointment, those arrangements may also remove obstacles to his compliance. For instance, if there are childcare issues, or transportation issues, or if he is concerned about getting time off work to go, if you take steps to remove those obstacles, the probability of his compliance may increase. Doctor's visits are routine and his workplace should not make that a problem, but he may be concerned about that anyway. Rational or not, it may be a concern that has stopped him from going. There are many things that might influence whether he will keep the appointment: Is it a good time? Is there parking? Is he concerned about the copay or the cost? Does he feel shame about his appearance? Does he feel shame about his cigarette addiction? Does he have buried memories of painful doctor visits? All these things are possible.

You can't control your husband. But you can be creative and thoughtful about the possible reasons he refuses to see the doctor, and you can experiment to see what works.

Give it a try: Just make the appointment for him.

If he breaks the appointment, make another one. Try again. Keep in mind that you are not trying to control him, but you are trying to manipulate his environment so that he is more likely to receive medical help. You are working with probability. Each time he goes or has any contact, that builds familiarity with the medical infrastructure. Familiarity lessens fear. Especially if he has a successful visit, it will make the next visit less objectionable.

Also in your appointment with your physician, ask what programs are available to help people reduce their smoking. If there is a program available, sign him up for it. Ask if the program will give him a reminder call or two. If it costs money, make it a gift to him.

There may also be research programs at a nearby hospital that require heavy smokers to participate, and that pay a small stipend, or offer the treatments they are testing for free. While he might balk at the idea of quitting smoking, he might be curious about participating in a study.

Also, if it is covered by medical insurance, I suggest you make an appointment to talk with a psychiatrist. Psychiatrists are trained medical doctors but they have the added advantage of training in how our emotional behavior affects our decisions. Insight into your husband's decision-making process may help you understand his reluctance and thereby help you help him to overcome that reluctance.

Face it: Nobody wants to be sick and die of lung cancer. But we're not all that rational. I think that sometimes we take the idea of free will and personal responsibility too far. Some of us are just screwed up and need help. Our bodies need to be taken care of. If we aren't smart enough to make the appointments, then it's great if somebody else makes them. The important thing is that our bodies get seen by physicians. Whatever it takes, get that body into the doctor's office.

There are limits, of course, to our influence over others. I also recommend that people in situations like yours attend 12-step groups such as Al-Anon. Because you have to take care of yourself. No matter what happens to your husband, you will still be there, a person with a whole life to lead and young children to take care of.

So take care of yourself, and see if you can set up opportunities for you husband to interact with the medical community. It may take some time, but this reluctance may diminish with repeated interactions.

By Cary Tennis

MORE FROM Cary Tennis