Whenever Paul Engelman’s wife left the house to join friends at their monthly book club gathering, the Rockford resident found himself looking for something to do. With all their children grown and out of the house, he could watch a sporting event or knock out some items from his honey-do list. But what he really was looking for was a social outlet of his own.

Over the years, Engelman has had plenty of male friends. Guys he grew up with, attended school with or served with in the military. But now in his 60s, he has few friends he would consider close knit.

“There wasn't anybody I thought of if I needed to call somebody for some help,” says Engelman, who works as a defense contractor. “If I'm in a pinch, who would I call around here? The list was short. So, the No Book Book Club (NBBC) was born.” 

For the past four years, members of the NBBC meet on a regular basis, much like their wives do with their book club. Anywhere from five to 10 guys get together to simply hang out. It might be at Engelman’s house to watch a football game, or a visit to a neighborhood establishment for trivia night. Some of the members have even joined an indoor golf league. The only thing the group doesn’t do is read books.

“I put out the call to put together the No Book Book Club, and the response was energetic,” Engelman says. “There are guys who are in our age group, are late in their work life, or retired, have children out of the house, or who have a gap when it comes to male friends.”

Engelman isn’t alone in that sense. According to a survey by the Survey Center on American Life, fewer than half of the men responding are happy with their friendships. Only about one in five said they had received emotional support from a friend in the last week, compared with four in 10 women.

In 2021, 15% of U.S. men admitted to having no close friends, which was five times more than 1990. And men with six or more good friends dropped from 55% to 27% during that same period. 

Forming a bond

Male friendships are important for many reasons, according to experts. Friendships foster bonding, connection, support and even validation. Friendships give men not only social outlets, but opportunities to bond over things that consume our lives, such as family, health, work and financial issues.

Travis Swink, DO, is a primary care provider for OSF HealthCare. He talks about the need for relationships with many of his male patients.

“You have to have some outlet outside of your family that you connect with, because connection is very important,” says Dr. Swink. “Where I see the most depression and the most issues are with people who isolate. Finding some outside source of entertainment and activity is important.”

Victor Mendoza is a behavioral health provider with OSF HealthCare. He says friendships usually call for some emotional vulnerability which may make some men uncomfortable.

“I think one of the barriers that men have is that we have a hard time opening up, because that has been seen as a weakness,” says Mendoza. “That affects them from communicating with other men about their feelings, and what they have going on. That just creates more isolation, which leads to depression or anxiety.”

Mendoza says male friends often connect over real life situations. It could be marital problems or work-life balance issues. How much you want to unload on your male friends is up to you. Mendoza adds that you could save your problems for another day and simply decide to catch a baseball game and enjoy a hot dog and your favorite beverage.

“Not every single interaction that you have has to be deep,” Mendoza says. “It could also be spending time with other people and having a good time."

Where to start

Mendoza says there’s nothing wrong with hanging out with a male sibling or cousin. But if you’re seeking friendship outside of your family circle, he recommends connecting with community resources such as church, fitness centers or other social gathering places.

“Having a good support system can help with your self-esteem,” Mendoza says. “It could help with your productivity at work, at home. You know, being a better father, a better husband or a better partner. You feel happier and just enjoy life better, in general.”

Engelman says forming his men’s group has been extremely rewarding. He adds that the camaraderie he gets from his male friends provides the balance he was looking for in life.

While members have come and gone, including one who died from cancer, the men have become closer on an individual basis. Engelman is always looking for new members who he thinks might ‘vibe’ with the rest of the group.

“I've found in talking about the No Book Book Club that everyone I've talked to has said, ‘That's a great idea.’ So, we're going to continue and keep going.”
 

Paul Engelman interview clips 

Dr. Travis Swink, Victor Mendoza interview clips 

B-Roll 

When watching a basketball game on television, you may hear coaches and announcers say the star player is missing time with a hernia.

A sports hernia is different than a hernia suffered in everyday life, says Raman Kumar, MD, a colorectal surgeon and general surgeon at OSF HealthCare. But each should be taken seriously.

Hernia

Dr. Kumar says a hernia is when an internal organ or piece of fat goes through a hole in the abdominal wall. The most common type – around 80%  – is an inguinal hernia, when a part of the intestine pushes through the abdominal wall in the lower belly (also called the groin). Anyone can get a hernia, even newborns. But Dr. Kumar says they are seen more in older men. Symptoms include a bulge or swelling in the abdominal area and pain when moving.

“A lot of chronic heavy lifting,” can cause hernias, Dr. Kumar says. “Other things weaken the abdominal wall such as diabetes and smoking. Being obese causes a lot of weight hanging down on the abdominal wall. If you’ve had surgery in the past, that’s also a risk factor.”

So be mindful when lifting objects, Dr. Kumar advises. Lift with your knees, not your back, and don’t try to lift heavy items. Get a cart or a partner to help. Eat healthy and exercise to avoid obesity and diabetes. Avoid alcohol and cigarettes.

Dr. Kumar says an exterior wrap known as a hernia belt or abdominal binder can be a short-term solution. But surgery is often the endgame.

“If you have a hole or defect, it needs to be closed,” Dr. Kumar says. “The reason we fix hernias is because we don’t want a loop of intestine or bowel to get into the hernia, twist off and die.”

That would make a person very sick and possibly threaten their life, Dr. Kumar says.

Sports hernia

Dr. Kumar says a sports hernia is a muscle tear in the groin area. They’re seen in athletes due to all the twisting, turning and bending that comes with competition.

“Stretch before you do any type of activity. Work and develop your core muscles, including your abdominal and hip muscles.” Dr. Kumar says. “If the muscles are strong, they are less likely to tear.”

Athletes who complain of groin pain should immediately leave the competition and get checked out by a trainer or doctor. Resting and icing the groin will help, but a combination of medication, physical therapy or surgery will likely be needed to fully heal.

Be proactive

If you have symptoms of a hernia or sports hernia, see a health care provider right away.

“Nine times out of 10, we can determine you have a hernia just based on a physical exam,” Dr. Kumar says.

But for more complicated cases, your doctor may order an ultrasound or CT scan. Then, the provider will develop a treatment plan.

Interview clips

Previous coverage

Hernias: More common than you think

Pro wrestler and actor John Cena admits to never wearing sunscreen growing up in Massachusetts. When he later moved to Florida, he still failed to protect his skin from the dangerous rays of the sun. 

But a routine visit to a dermatologist quickly changed Cena's attitude. His doctor found a cancerous spot on his chest. A year later, another spot was found near his right shoulder. It was a wake-up call for Cena, who not only applies sunscreen daily now, he's become a spokesperson for a sunscreen brand. 

Cena said in an interview with PEOPLE that he now feels a responsibility to share the lessons he's learned about skin cancer with others - especially men. 

“Men especially are becoming more conscious of self-care,” he said. “I just think we need to make it more commonplace.” 

It’s that time of the year when people are outdoors for several reasons – sporting activities, vacations, and working outside jobs.

But under the brilliant sun rays lurks a potential danger especially to men – skin cancer, more specifically melanoma.

More than 97,000 new melanomas will be diagnosed this year (58,120 in men and 39,490 in women), according to the American Cancer Society. Nearly 8,000 people will die from melanoma, the majority – nearly 5,500 of them – will be men.

“Men are more likely to develop skin cancer, in fact twice as likely, to develop melanoma over time because of several different reasons, whether that's related to the type of job that they do because men tend to work outdoors more often," says Ben Guth, a nurse practitioner for OSF HealthCare.  "It can be education related where they aren't taught what to look for when it comes to signs and symptoms of skin cancer. And finally, they just don't use sunscreen when they go outside, which is very protective when it comes to sunburns and developing skin cancer in the future.”

There are other factors. Some research suggests that women’s sun-damaged skin seems to heal better than men. And men tend to have thicker skin, which makes it more susceptible to UV damage which can lead to melanoma.

The good news is that if caught early, melanoma and most skin cancers are highly curable. The problem, however, is most skin cancers don’t have symptoms until it reaches the later stages. So that makes it even more important to take care of our skin and know what to look for.

It starts with education.

“I think you need to have a well-rounded approach when it comes to protecting yourself from the sun and that education comes, one, from primary care providers and dermatologists," says Guth. "We educate on the importance of sunscreen, applying it every two hours, especially when outside. The American Academy of Dermatologists recommend using at least an SPF of 30 and that being a broad spectrum and even water-resistant, depending on the type of work or activity you’re doing outside.”

When applying sunscreen, don’t forget to lotion up around the ears, behind the neck and on top of the scalp, especially men who are balding. Ask your partner for a hand to get to those hard-to-reach spots.

While not everyone is a fan of using sunscreen lotion, don’t despair. There are other ways to help keep your skin protected this summer.

“There several other options if you don't like sunscreen or the greasy feel on your skin – wearing long sleeve shirts and pants, especially those that block sun, wearing a big hat, whether that's a baseball cap or a wide-brimmed hat with sunglasses," says Guth. "And you can also find areas of shade or protection from the sun especially during those high times where the sun is most strong, especially between 10 a.m. and 2 p.m.”

Guth strongly recommends men make a standing appointment for a skin checkup.

“If you have a dermatologist, it's good to have annual skin checks especially if you've had lesions in the past or had skin cancer in the past and had them removed," says Guth. "Outside of that men should just be talking with their provider about their concerns.”

Guth adds that if something doesn’t look or feel right, talk to your primary care provider or dermatologist. Don’t wait. And remember to always pack your sunscreen, even on those cloudy days.

Like smoking, it’s never too late to stop ignoring the dangers to our skin. Just ask John Cena. 

Interview Clips 

B-Roll 

Others may not be so fortunate. 

They may notice muscles getting thinner and weaker and a loss of body hair over time. 

Or the shift can be subtle like mood changes, less energy, a lack of concentration or a lack of sex drive. 

Shitladas Pamnani, MD, a primary care physician with OSF HealthCare says men, like women, experience major hormonal changes, especially in their testosterone levels as they age. 

Some call it “male menopause.”

“Our energy goes down, sex drive goes down, it’s a natural cycle,” says Dr. Pamnani. “Our skin is not the same as we age, and other body organs, including hormone producing glands, are not functioning as well either as testosterone levels naturally decline.” 

Recently, a study published in the Journal Annals of Internal Medicine revealed that low testosterone in men can also lead to an increased risk of dying. 

While age is a major factor in testosterone levels, illnesses can play a role, too. 

Type 2 diabetes and obesity can affect all levels, as can treatments such as radiation therapy, chemotherapy and steroid medicines.

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