Finding Humour in Medicine

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Second year David Grosset Considers whether there is a place for humour in medicine, and finds himself pondering the strangely inspirational story of Hunter ‘Patch’ Adams, as well as America’s wackiest X-ray competition, and a smoking chimpanzee

“Our job,” the lecturer begins, “is to rigorously and ruthlessly train the humanity out of you, and make you into something better – doctors.”

The lecture theatre erupts with applause, the budding medical students eminently impressed by these words of wisdom. That is, except one man. Hunter ‘Patch’ Adams refrains from clapping because he believes there is more to medicine than memorising the branches of the thoracic aorta. He believes that through improving a patient’s quality of life via the medium of humour, he can significantly enhance their wellbeing. And that would make him a better doctor. And he was right. At least according to the 1998 film, Patch Adams, he was (if you have a spare 90 minutes it’s worth checking out, but let’s be honest, you probably don’t have that spare 90 minutes because ironically, you’re too busy memorizing the branches of the thoracic aorta).

After I dug a little deeper into the story of Patch Adams, I found there was more to his tale than a Robin Williams film with a meager 6.1 rating on IMDB. The real Patch joined the Medical College of Virginia in 1967, his ambitious aim to use the degree as a vehicle for social change, and to create a hospital that addressed every problem of healthcare delivery in a single model. After graduating in 1971, he and nineteen others, including two other physicians, moved into a six-bedroom house and called themselves a hospital. They were open every single day for twelve years, seeing patients with all manners of medical problems, taking 500-1000 people into their home each month. Care was infused with holistic elements, such as culture lessons, arts and crafts, nature, education and humour. Patch talked about using  a patient’s disease as a “gimmick to get them into a university of human culture…teaching love, joy, humour, passion, hope, wonder, curiosity, creativity and intimacy.”

What a load of rubbish! That’s what you’re thinking, right? Move into a house and calling yourself a hospital? There’s got to be a few laws against that! Fusing health with arts and crafts? Sounds more like kindergarten than hospital, right? The very mention of the word ‘holistic’ probably had you cringing in your seat. After all, you are here because you are good at science. Sure, you have some communication skills too, but ultimately we all realise we would rather have a socially redundant doctor who knows what they are talking about rather than an ignoramus who smiles and maintains eye contact.

But I think you may be forgetting a few things. Firstly, this all happened in the seventies, and if re-runs of Happy Days have taught me anything, it’s that in the seventies, people were more naïve and carefree. Secondly, I’m not the idealistic or trusting sort. I’m as cynical as they come. I recognise that if something was seriously wrong with me and I needed urgent care, I’d tell the driver to go to the hospital rather than Patch’s ‘university of human culture’. Yet I’m not writing to dismiss his ideals, I’m here to consider them. The reason is this: it would be easy to dismiss Patch if the extent of his dream was a Robin Williams film. But it’s not. This is real life. He has done these things. Patch has found a key role for humour in the care of human beings and in medicine. So I don’t think we can disregard his words. If you can look past the strange hospital house set-up and ‘university of human culture’ line, the basic idea of using humour to enhance quality of life to enhance health makes perfect sense.

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But are there any other roles for humour in medicine? It is a dangerous topic to discuss. The line between amusing and inappropriate is a tricky one to navigate. But there is humour to be found in the medical profession. I don’t think it’s inappropriate to say that, for example, foreign-accent syndrome, is a somewhat amusing prospect. Sufferers of this condition may say otherwise, but at least we finally know what was going on with Dick Van Dyke’s ‘cockney’ accent in Mary Poppins. If that doesn’t strike you as bizarre, then just wait till you find out about America’s Wackiest XRays competition. Don’t panic if you don’t recognise any of the anatomy, it’s a competition dedicated to x-rays of animals. The winner from last year was a dog that ate nine snooker balls (above). In the other x-ray (below), can you spot the false teeth? Don’t worry, I’m thinking it too – we should have become vets. It’s seemingly much more amusing, and I can’t imagine dogs and horses are too bothered about confidentiality.

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As a sidenote, next time you’re dishing out some smoking cessation advice you might want to avoid the story of Charlie the smoking chimpanzee. Described as an occasional smoker by the owners of the South-African zoo at which he lived, he actually exceeded the live span of a regular captive chimpanzee.

So what about medical care of human beings? Oddly enough, when you search for these things on the internet, some of the most amusing articles simply list humorous typos in medical notes. Some of my favourites include:

• The patient is tearful and crying constantly. She also appears to be depressed.

• The patient has no past history of suicides.

• The patient’s past medical history has been remarkably insignificant with only a 40 pound weight gain in the last 3 days.

• The patient has been depressed ever since she began seeing me in 1983.

• Whilst in Casualty, she was examined, X-rated and sent home.

• She is numb from her toes down.

• The patient is a 79 year old widow who no longer lives with her husband.

Of course it would be inappropriate and idiotic of me to insinuate that mistakes in medicine are funny. But you already know that, and you already know the duties of a (good) doctor, so I won’t lecture you on why mistakes are bad. Instead, I hope you can take these tidbits as a reminder to have a good chuckle once and a while, and to know that humour is present in medicine – you just need to know where to look.

I’d like to finish with our old friend Patch. When reading about his unorthodox approach to medicine, I found myself questioning whether anyone had ever tried to sue him. He did work in America, after all – the motherland of insurance claims and legal battles. As it turns out, though, Patch has “never seen an insurance form…never heard anyone say something nice about an insurance company…never held any malpractice insurance because we know we are imperfect…we can always promise care, we can never promise cure…we need the right to make a mistake.” I have to admit – I found this idea fresh, perhaps even inspirational. I think that sometimes our lectures make it seem that medicine is all about avoiding mistakes, navigating negligence claims and unhappy patients. So please, if you can, take this article as a reminder of why you are at medical school, that ultimately you have picked a great, diverse career with many components, and one of those is a tricky, but nonetheless special thing – the appropriate application (or, sometimes, injection) of a dose of humour.

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