Humor in the medical literature - Editorial

Journal of Family Practice, April, 1995 by Howard J. Bennett

Humor has been published in the medical literature for well over a hundred years.(1) Although a number of authors have addressed the role of humor in medicine,(2)(3)(4)(5)(6) little has been written about the type of humor physicians write.(7)(8)

Medical humor has appeared in a wide range of journals, from those of international reputation, to specialty journals, to "throwaways." Those areas targeted for humor include medical school and residency training, medical language, academia, writing and publishing, research, and clinical practice. Although the authors have primarily been physicians, medical humor has also been written by nurses, PhDs, and occasionally even by lay people.

While some journals publish humor frequently, others do not. Cartoons, jokes, and anecdotes have appeared most commonly in journals such as Medical Economics. Poetry and the bulk of what I call "academic humor" have been published in the major journals. While some humor has appeared in columns such as JAMA's "A Piece of My Mind," in many cases, it turns up as mock research studies, in a journal's correspondence section, or even as white-space filler.

The Journal of Family Practice has published occasional humor pieces since 1992. Last year, the department Humor in Medicine was created, and I have recently become the editor of that section. I want to take the opportunity now to express my hopes for its future and to review the type of humor that has been published in our journals over the years.

ANECDOTES: According to Webster, an anecdote is a short narrative of an interesting, amusing, or biographical incident. The nice thing about anecdotes is that clinical practice is filled with amusing stories. They are also fairly easy to write. Here's one I published a few years ago in Pediatric Management:

I recently had a delightful time examining a 3-year-old boy. Although frightened at first, the boy giggled when I felt pancakes in his tummy and found birds in his ears.

When it came time to do the genital exam, I asked him to pull down his underpants so I could check his penis. He looked puzzled for a minute and then said, "But I don't have any peanuts."

JOKES: Although jokes only occasionally make it into print, they are the most common way people express their sense of humor. More than other forms, medical jokes reflect the "gallows humor" that results from the stress inherent in medicine. Here's a joke that was published in an article that explored humor as a coping strategy(9):

A surgeon, an internist, and a family physician go duck hunting.

The surgeon sees a duck, shouts "Duck!" and shoots it down.

The internist sees a duck, shouts "Duck! Rule out quail! Rule out pheasant!" and shoots it down.

The family physician sees a duck and blasts it out of the sky with a burst of machine-gun fire. As the tattered carcass falls to the ground, he remarks, "I don't know what the hell it was, but I sure got it!"

CARTOONS: Cartoons are more challenging than written humor because of the artistic talent they require. Consequently, most medical cartoons are published by nonphysicians. Some are created specifically for a medical audience, while others are reprinted for our enjoyment--see the Risus column in Medical World News. Nevertheless, if you can find an illustrator (a medical center is a good place to look), you might be able to collaborate on an idea and still get your nugget of humor published.

WITTY SAYINGS: Doctors have been coming up with funny sayings ever since they began handing out prescriptions. I recently had some fun with this topic in an article called, "A CAT Scan a Day Keeps the Lawyers Away."(10) Although most medical quips are anonymous, here are two whose authors are known:

A man is as old as his arteries.--Thomas Sydenham

Statistics will prove anything, even the truth.

--Lord Moynihan

Of course, doctors are not the only ones who have something amusing to say about medicine. Here are some famous quotes by non-MDs.

After two days in the hospital, I took a turn for the nurse.

--W.C. Fields

Either this man is dead or my watch has stopped.

--Groucho Marx

POETRY AND LIMERICKS: About 10% of the verse published in medical journals is funny. As the following example shows, a poem is an ideal form for the expression of one's medical wit.

To the Editor:

Last year, my husband, a pulmonary fellow, sent me a valentine; he thought that the cardiac system was receiving far too much attention on that day. I thought that your readers would enjoy the valentine.

A Pulmonologist's Valentine(*)

Roses are red

Violets are blue

Without your lungs

Your blood would be too.

CASE REPORTS: Amusing case reports have appeared in the literature both as full-length articles and as letters to the editor. One of the most famous of these reported the therapeutic effects of chicken soup.(11) Other examples include brief letters that describe strangely entertaining maladies of daily living.(12)(13) Although The New England Journal of Medicine is well known for publishing this type of material, it appears in other journals as well.(14)(15)