It’s not uncommon for doctors to make jokes when they’re about to do something unpleasant.
But why? Is it done out of cruelty or lack of caring? Could there be a humane reason behind what appears to be a misguided attempt at humor?
As a family physician, when someone asks me whether a procedure is going to hurt, I usually answer, “I won’t feel a thing.” But that’s not true. It always hurts me, at least a little. Occasionally it brings tears to my eyes.
Doctors don’t like to cause pain. “First do no harm” is taught from day one of medical school. Just as parents don’t like to hurt their children, physicians don’t like to cause discomfort, even when it’s in the best interest of the patient. Humor is a way physicians counter their own unwillingness to harm another person. It’s a method for doctors to reassure themselves that they are doing what is right.
But more importantly, humor helps put patients at ease. Patients who are nervous tend to experience more pain. Often the fear of pain, or fear of the unknown, causes more distress than the actual procedure. If a doctor can dispel fear, the discomfort will be much easier to manage. Humor helps people relax, but it also distracts them from what’s about to happen. The human brain can only focus on so much at a time. If the brain is involved in laughing, it’s less focused on worry or pain.
Humor is also a way of gauging a patient’s attitude toward their problem. Some patients can laugh over a heart attack or mastectomy. Others consider a minor blemish a serious threat to their self-image. Physicians can use a joke as a measure of a patient’s ego and stability. People who cannot see a lighter side to their situation often require more reassurance than a person who can laugh at themselves.
Sometimes doctors use humor as a way of getting to know their patients better. (What would you have them talk about anyway? How sharp the knife is? How deep the needle will plunge?) Just as humor creates a bond between friends, it can strengthen a doctor-patient relationship.
A mistake common to doctors and patients alike is taking medicine too seriously. True, some problems are life-threatening, but most physician encounters are not. Many problems physicians see would heal on their own if given sufficient time. Sharing a smile may speed your healing more quickly than an antibiotic.
Laughter is the best medicine, according to the good book. Physicians need jokes, too. Bring a good one to your next office visit and see if you don’t brighten your doctor’s day.
Copyright 2010 Cynthia J. Koelker, M.D.