On a recent episode of PeerPOV: The Pulse on Medicine, Andrea Austin, MD, and Bradley Block, MD, talked about the benefits and potential pitfalls of using humor in medicine.
Dr. Block: There are some rules to being funny. Even if being funny doesn’t come naturally to us, there are benefits to it. Andrea, what you said about gallows humor stuck with me.
Dr. Austin: Most of us can probably remember maybe feeling taken aback by hearing a joke that was mean-spirited. Over time, we’ve been hardened into believing that this is part of the culture of medicine. But gallows humor is a maladaptive coping mechanism. Gallows humor comes with cynicism, which is common in burnout. It is a form of distancing ourselves from patients and difficult situations. When we hear gallows humor, it may be an opportunity to check in on someone.
The number one rule of comedy is to not punch down. That essentially means that you’re making a joke at the expense of somebody who is less powerful than you. Gallows humor is punching down.
Dr. Block: Scott Dikkers says the role of comedy is to afflict the comfortable while comforting the afflicted. If we’re afflicting the comfortable, we must decide who “the comfortable” is. That’s punching up. You can make fun of the establishment, the hospital, or the EMR. You can make fun of yourself. I just leave the caveat that you don’t want to take a dig at your competency. You don’t want to say anything that makes patients lose faith in your abilities.
The expectation of how funny a doctor needs to be is so low. We’re not professional comedians, so any attempt that you make is going to be appreciated because, ultimately, you’re trying to break the ice. Laughter is a communal experience. If you’re upbeat and laughing, you’ll raise the mood. If you walk into the room and have positive energy, that’s going to feed into a positive experience.
Humor lowers cortisol levels. Patients will be more open and receptive to new information. It’ll certainly help your patient satisfaction scores. Plus, you’re going to enjoy medicine more because you’ll be having fun.
