Is the "Stiff Upper Lip" Killing Us?

Mal Fletcher Posted 30 January 2013

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Medical research shows that UK lags behind other major developed countries in beating certain forms of cancer. Today, experts suggest that at least part of this may be explained by the famed British 'stiff upper lip' culture.

Some scholars question whether the British national psyche was ever, historically speaking, any more stoic than those of other Western cultures. Others argue that it became so only in the Victorian age. After all, they say, pre-Victorian England was rife with urban tales of degraded pleasure-seeking, self-centredness and a wilful ignorance of the plight of the poor and infirm.

Yet by the time Britain emerged from WWII, the 'stiff upper lip' attitude was widely celebrated as a contributing factor in its survival and victory. Churchill's promise of 'blood, sweat and tears' at the height of the war epitomises a national fortitude that has been respected, if not lionised, ever since.

In our time, a similar stoicism may be evident in the way we treat a much more personal sense of invasion - invasion by disease. There may be several reasons for this, aside from any cultural echoes carried over from the wars.

For people aged over fifty, there may be a reluctance to 'make a big deal' of personal challenges - even those as serious as cancer - because these seem insignificant compared to those our parents or grandparents faced during wartime.

There may also be, in this generation a reticence to admit to ageing - particularly because it has drawn so much of its identity from youthful escapades during the 60s and early 70s. In their youth, Baby Boomers' self-awareness was heavily shaped by their engagement with, or observation of, momentous events - such as the civil rights movement and Apollo missions - and by a growing global consciousness, which came on the back of satellite-linked mass media.

It was easy for Boomers (I'm on the young end of that cohort) to believe that they were a unique generation. They believed that the world they would leave behind would be a vast improvement on the one they'd inherited.

It may now be difficult for some of them (us) to accept the hard truth that 'make love not war' didn't carry anyone far past the summer of '68. The carefree generation of the party-hard early-70s is, predictably, having trouble facing old age with anything like its former joie de vive.

For some of those who do acknowledge impending eldership, there seems to be an attitude of 'let's go out on a youthful high'. A recent American study revealed that around 50 percent of Boomers have decided to spend their savings before they die, rather than passing them on to their children.

The British reticence to be open about cancer may also related to its high ranking in the table of most unpleasant diseases.

In some cases, cancer is not necessarily the certain death sentence it once was. Yet any cure is, it seems, still a way off. Meanwhile, popular culture speaks constantly to us of people who are 'battling cancer', or have 'lost their fight against cancer'.

Cancer is still the ultimate bogey man, lying in wait and threatening to reduce the most virile among us, if we let it, to the status of helpless victims. This seems to apply no matter who we are or how much money we have in the bank.

It's not surprising, then, that of all the diseases we could potentially face, we may least want to entertain the possibility of cancer.

There is also, perhaps, another more practical factor at play in our 'stiff upper lip' attitude toward this disease. It relates to the point-of-treatment experience within the NHS.

For all its strengths - which recent reports suggest other nations are hungry to adopt - the NHS suffers from an acute shortage of resources at the level of preliminary care, where people first speak with a doctor.

Many patients find themselves sitting in GPs' waiting rooms long after their due appointment times. When their doctor finally becomes available patients have around 10 minutes in which to share their symptoms and garner a diagnosis and treatment plan.

I say 'their doctor' knowing full well that the age of having one's own doctor - which allows for a sense of comfortable familiarity - is now well and truly past. If you visit your local clinic several times in a year, which is not uncommon for people in their 50s and 60s, you may find yourself dealing with a different practitioner each time.

There's little opportunity to develop the type of interaction and trust that might make full disclosure easier.

More than a few doctors are frustrated by this increasingly production-line approach. One intimated to me recently that he might soon be little more than a pill dispenser. Little wonder big pharma companies find it relatively easy to offload new products; medicos live within a culture that, against their better judgement, encourages them to employ quick fixes.

The British are well known for their reticence to wear their hearts on their sleeves (or even to take them out and give them a good airing once in a while). There are, of course, some benefits with this.

A willingness to soak up troubles, to demonstrate self-effacing fortitude, can produce great results in face of such national threats as outbreaks of disease or war. The last thing a community needs, when it is facing an existential threat, are complainers who talk up their troubles and spread timidity, fear or despair.

Arguably, our often narcissistic post-modern culture could do with a lot less self-absorption (or self-obsession) and more dutifulness and awareness of how our individual behaviour impacts the community.

However, the stiff upper lip attitude often associated with victory in WW2, may have been celebrated too much. It may have become so much a part of our national self-awareness that, on a personal level, we would rather hide from symptoms of sickness.

Stoicism - a quiet but steely determination to endure - may be needed after a diagnosis has been made, but one can't fight an enemy one won't acknowledge is at hand.

Some people prefer not to talk about 'fighting' a disease like cancer; they prefer to speak about 'managing' or 'living with' the condition. Yet even managing a disease requires an admission of its reality - and of one's emotions about it. After all, emotions play a huge role in any treatment regimen.