The Body Keeps Score, Part 5: Just Get Checked

Men of my generation were raised, in various ways, to regard medical help as a last resort. You went to the doctor when the thing was serious, meaning visible or limiting or producing a level of pain that the standard coping strategies — time, ibuprofen, ignoring it — had failed to address. You did not go to the doctor for things that might or might not be anything, because going with something that turned out to be nothing felt like wasting everyone's time, and possibly like weakness.

I am trying to unlearn this. The unlearning is slow but I am making progress.

The numbers worth knowing at 44

I want to give you the specific list, because I have looked at this properly and I had not, before Ellie was born, known all of it.

Blood pressure. The single most important number for cardiovascular health. Hypertension is symptomless until it isn't. It is checked in under a minute. Most pharmacies will do it for free.

Cholesterol and lipid profile. The ratio of HDL to LDL matters more than total cholesterol. NHS health checks, available to everyone between 40 and 74, cover this. Book one if you haven't.

Blood glucose / HbA1c. Type 2 diabetes develops slowly and asymptomatically. The NHS health check covers this too. Worth knowing if you are carrying extra weight around the abdomen.

Testosterone and related markers. As covered in the previous piece in this series. The GP will test this if you present with relevant symptoms. Or you can order a private kit.

Iron and B12. Deficiencies in both are common and both produce fatigue that is specifically not resolved by sleep. If you are tired in a way that sleep doesn't touch, test these before attributing it to parenting.

Skin. This one I mention specifically because I had a mole that changed and ignored it for about eight months before a GP appointment I had scheduled for something else. It turned out to be nothing. Eight months of a background hum that cost me nothing except the appointment I should have booked earlier.

PSA for prostate. Controversial as a screening tool because of false positive rates, but worth a conversation with your GP from your mid-forties, particularly if there is a family history.

The one that mattered

I had a routine blood test at 42 — the first one I had had in several years — and my iron came back low and my B12 borderline. I have written about this before in the context of tiredness, but I want to return to it here because the GP's response to these results was the thing that shifted my relationship with medical help.

He did not make me feel dramatic. He did not imply that these were trivial findings or that I was wasting his time. He treated them as useful information, gave me a specific protocol, and followed up three months later to confirm the protocol was working.

This is what GP appointments are for. They are for useful information obtained at a point when the information can change something.

The structural barrier

I am aware that all of the above is easier to say than to act on. The barrier to GP access in England is currently real. Appointment waits are long. The online triage systems are not universally user-friendly. The NHS health check requires booking, and booking requires finding the time and the motivation in the margins of a life that does not have generous margins.

What I have found useful is treating medical maintenance like the kettlebell sessions — something that is calendared rather than reactive. The NHS health check every five years, the blood test annually, the dental appointment, the optician. These go in the calendar at the start of the year and are treated as fixed commitments rather than optional tasks that can be displaced by the working day.

The reason it matters more now

I did not particularly care about preventive health in my mid-thirties in the way I care about it now. This is not because I valued myself less — I think I simply had a less concrete relationship with the consequences of neglecting it.

Now I have Ellie and Sam. Now the consequences are not abstract. The body that stays unmonitored, that accumulates an unaddressed back problem and a hormonal drift and a lipid profile nobody has checked since 2019, is not just my body. It is the body that needs to be functional for the maths to come out.

I am not anxious about this. I am motivated by it. The distinction matters.

Book the appointment. It is not weakness. It is maintenance. The machine is running; you are just checking the readings.