Editor’s note: This story is part of Meet a UChicagoan, a regular series focusing on the people who make UChicago a distinct intellectual community.
When University of Chicago Asst. Prof. of Medicine Nathaniel Glasser enters the clinic to begin his day of treating patients, he never does so without a tie.
Dressing well isn’t just a personal preference. Glasser’s background in sociology has taught him the importance of the tacit messages his appearance sends about him.
“I know this may seem outdated, but a lot of my patients are older. So I make the effort to look the part of a doctor for them,” he said. It’s not what he would choose on his own, “but it's not about me.”
Glasser is attentive to symbols. This helps in his studies on male health, specifically how social perceptions of masculinity influence health decisions and behaviors.
Both as a researcher and as a medical doctor, Glasser focuses on how health behaviors can serve as means of expression for patients—even if they go against the recommendations of physicians or risk bodily harm. This could range from getting involved in physical altercations to forgoing preventative care.
Men are more likely than women to die from certain types of cancer and are at a higher risk of heart disease—conditions that can be mitigated if caught and treated early. With more and more studies showing that men are less likely to receive or pursue preventative care, it is crucial for medical practitioners to understand the forces that influence these trends, Glasser said.
This keen eye for detail and strong observational skills serve him in his work with patients. But they also contribute to his hobby as an artist, painting portraits of male mentors and friends. For him, these paintings embody what he believes lies at the heart of his research: confidence in identity, both as an individual and as part of a community.
“For a lot of people, not fitting in is scarier than death, and it often leads to people preferring death to not fitting in,” Glasser said. “I take people's desire to fit in seriously.”
Sociology on the subway
Although he did not know it at the time, growing up in the Bronx in the 1990s immersed Glasser in the principles of sociology from a young age.
Starting in middle school, Glasser regularly took the New York City subway to school alone. In the enclosed space of a subway car, he noticed that a person’s appearance and behavior was often the only way to glean any information about their personality. What may be as simple as wearing headphones conveys messages like, ‘Don’t talk to me,’ or ‘Leave me alone.’
“When you're observing people like that,” Glasser said, “you start thinking about how you appear and how the other people perceive you.”
But it wasn’t until his second year of undergraduate studies at Yale, when Glasser took a class with Prof. Elijah Anderson, AM’75, on the methods and techniques for sociological fieldwork, that he could put a name for what he was seeing: symbolic interactionism.
Anderson introduced him to the Chicago School of Sociology, a method developed at UChicago more than a century ago that blended data analysis with real-world experience.
Glasser began putting those childhood experiences into an informed framework that would shape his future work and clinical practice. Drawing from the work of French sociologist Émile Durkheim, Glasser became interested in exploring the consequences for individuals unable to forge a sense of belonging with their community.
“For a lot of people, the specter of stigma or shame is much more proximate” than other issues, Glasser said. “Maybe that's why not feeling a sense of belonging is so scary: it certainly seems like it's much scarier than the more remote possibilities of illness, disease or death.”
Gaining hands-on experience
Glasser earned his MD at the Icahn School of Medicine at Mount Sinai in New York City through an early admissions program geared toward humanities-focused students. He then landed at Tulane University in New Orleans for his residency, eager to merge his sociological interests with clinical experience.
It quickly became clear, however, that Glasser had little control over his patients’ long-term health outcomes.
“What actually matters is not what happens in the twenty minutes that a patient is in your office or the two weeks that they're admitted to your hospital,” he said. “What matters is the years and decades that people spend living.”
Working with the Welcoming Project, a program dedicated to serving youth that were arrested or formerly incarcerated in the New Orleans parish, gave Glasser more insight into the kinds of forces that could also be at play.
“I'd spend a lot of time with the kids and their neighborhoods, and I would see a lot of the things that they would do. They would get into physical fights with each other, or they would take a joint and put themselves on Instagram Live,” Glasser said. “I would think to myself, ‘I know what these kids are doing: They're performing.’”
Despite the physical risks of fighting, such as sustaining injuries that might result in a trip to the emergency room, the risks of avoiding a fight in an environment where that behavior is expected could be more dangerous than fighting.
“There's symbolic meaning in fighting,” Glasser said. “If you fight with somebody, you're signaling something about yourself. And if you avoid fighting with another person, you also signal something about yourself, which may be more dangerous than getting in a fight.”
“But when you do fight, you may end up in the emergency room, and then the doctors are concerned.”
Research and UChicago
Motivated by his experiences from residency, Glasser joined UChicago Medicine’s PITCH fellowship to pursue more research training.
As a PITCH fellow, Glasser focused his research on masculinity and how a desire to uphold outward perceptions influenced men’s health-related decisions and behaviors.
By Glasser’s estimation, more than twice as many female than male patients visited the UChicago primary care clinic for outpatient care over a span of a year.
However, when it comes to inpatient care, which is usually more intensive, male patients by and large drastically outnumber female patients.
By forgoing or delaying preventative care—such as screenings—men are more likely to require more care for health issues that could have been caught and treated easier and earlier.
In one study, Glasser found that men who engage in more traditionally masculine behaviors have a higher risk of cardiovascular disease. His latest research shows that older men in states with more permissive firearm policies are the most vulnerable to suicide.
Looking to the future, Glasser has plans in the works to put what his research has uncovered into practice.
Through intervention implementation work that has yet to be published, Glasser said, he hopes to ramp up his studies in the areas around UChicago through initiatives focused on Hyde Park and the South Side of Chicago.
“I hypothesize that rejecting the recommendations of health institutions or another one of those ways people might reclaim masculinity, which is often associated with strength and independence,” Glasser said.
Art and patients
Glasser’s scholarly and professional focus on masculinity does not end when he leaves the office or clinic. In his free time, he turns to painting.
Using acrylic paint and mylar for a canvas, Glasser’s portraits often feature male friends or role models as their subjects.
“Since I came to Chicago,” he said, “all of my paintings have been of men who have influenced me in some way.”
Harkening back to his time at Yale, Glasser’s latest piece features Elijah Anderson, the professor who introduced him to sociological fieldwork. Another painting highlights friends from his childhood.
For Glasser, whether in the clinic, in the field or at the easel, the work is the same: to see how people make meaning in their lives.
“What matters is having a sense of belonging and self integrity—that other people see you and value you the way you see and value yourself. And that's the whole thing,” he said. “That's what I’m trying to study.”
