Wednesday, May 4, 2011

Making fun of patients

Doctors make fun of patients.

It's a fact and it would certainly be kind of hypocritical of me to complain about it. There are probably some doctors who don't make jokes about their patients, but those doctors are humorless automatons.

But there are different ways that it can be done. Like during our team conference, I might say, "I sneezed while I was talking to Mrs. Katz and she tried to get out of her wheelchair and make me some chicken noodle soup." And everyone will laugh and say, "Aw!" Because of course, we all love Mrs. Katz and we tell anecdotes about her like we would tell everyone about a funny thing our child said.

Humor is a coping mechanism. I think as long as you care about your patients, it's okay to sometimes make jokes, as long as the jokes aren't cruel.

There was only one time in my medical training when I was truly bothered and disturbed by patients being ridiculed. When I was a med student rotating on Labor & Delivery, the first 10-15 minutes of signout each day was devoted to making fun of patients. And I really hated it. I thought the jokes were mean and directed at women who were already going through a pretty miserable time.

For example, there was a patient who had polycystic ovarian syndrome, and as such, she suffered from hirsutism (i.e. she was hairy). She went into early labor and we were giving her magnesium to keep her baby from being delivered prematurely. The woman was nice enough and I felt bad for her. And I didn't get why the residents had to spend several minutes making fun of how hairy she was during signout each day. It's not like she had time to get her body waxed while she was going into premature labor.

By the end of the rotation, the other female med students and I adamantly agreed that we were going to make sure we were immaculately groomed before giving birth. We couldn't stand the thought of being the object of one of these ridicule sessions.

I really think it wasn't right. But naturally, none of us said anything. Truthfully, the patients were much better treated than we were.


  1. "God, she's terrible at pushing. We should just cut her."

    "Well, that's what happens when you wait to have kids until you're OLD."

    "That woman ate her way to uterine cancer."

    I guess some of these comments weren't even intended to be humorous. They were just kind of mean.

  2. Wow, that's pretty awful- it's not really something that's funny- not like she can do anything about it.

  3. Agreed. I myself have definitely been guilty of making jokes about patients,but at the end of the day, I feel that as long as it doesn't compromise patient care and the patient isn't affected, then it is (exactly as you said) a good coping mechanism. Medicine can be a sick, twisted, messed up profession; if you can't step back and laugh at it, you'll never survive.

  4. Yikes. My mom is a Labor & Delivery nurse. I can't imagine her or her colleagues doing that.

  5. I had an emergency appendectomy a few weeks ago and, since it was an emergency and I went to the hospital in the middle of the night, I didn't really get a chance to *ahem* groom my what-nots in quite the way that I would had I known that a room full of people would be seeing me naked during surgery. I probably would've been more self conscious about it had I not been so doped up on morphine ;)

  6. We fatsos know we're getting made fun of, that's a big reason why so many of us avoid medical care. It's one reason my father went decades without a treatable disability (which contributed to his size) being even looked at. There's gotta be a better way, guys.

    I always try to be cheerful and a good sport with doctors, laughing at the situation myself when I can. I hope that makes me immune to this because it hurts a lot thinking about the doctors who I "bonded" with making snarky remarks about my body behind my back.

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  8. The doctor I dated once told me he'd had a rather large man for a patient that day. He was up for his annual physical which included a prostrate exam.

    One hand on the man's hip, the other with his finger appropriately in place, the patient laughed at the doc, "Thank God both of your hands are not on my hips..."

    (deleted other for clarity)

  9. OMDG: The comments weren't funny at all, but the residents would all laugh. I guess when you're completely exhausted, anything becomes funny. This is why I wouldn't want to be delivered by a resident.

    iamnothouse: Like I said, doctors do make jokes and I generally find it pretty benign.

    Haven: I can't imagine nurses acting that way. At least, I'd guess it's less common.

    Iris: That's awful to hear. I really doubt most doctors are making snarky remarks about you behind your back, especially ones you feel you bonded with. To be honest, there are so many overweight people these days, it stands out far less.

    ADoc2Be: I've heard some of the funniest patient quotes of all time from men having prostate exams :)

  10. Fizzy -- I thought EXACTLY the same thing after my Ob rotation. :-)

  11. I think any joke about someone based on their appearance or health is going to be cruel. The only people who will think it's funny are the ones telling the joke and their peers (and, as your post proves, even the peers aren't exactly 100% on board).

    This is another area where business seems to be ahead of medicine. The things I read on blogs or hear firsthand would never be acceptable in a corporate environment. And if an employee were blogging like the doctors and nurses do? They would be fired.

    I actually know someone who was fired this week for sexist jokes and racist comments. I fear that would never happen in a hospital.

    Medicine is extraordinarily tolerant of bullying in the name of coping.

    It is not okay. No matter how much the patients suck. How tired people are. It is not okay.

    Mean humor isn't coping with stress, it's letting the stress eat your soul.


  12. Honestly I could care less what doctors say about me, joking etc, I can comprehend the stresses that are laid on doctors and how they desperately need a way to cope, as long as they do their job to the fullest helping me get better...and as long as their comments are spoken out of the hearing of the patients.

  13. My first third year rotation was also OB. The first day we were all listening to morning report and the residents and attendings were dividing up who would assist on the OR cases. The first case was described as, "Who wants to help on the BURCH at 7:30 on the whale?" (the patient was very obese). One resident raised her hand and said "Sign me up for Moby, Captain Ahab!"
    Everyone (but we the med students who were too stunned) laughed.

  14. Humor is a coping mechanism.
    "The secret source of humour itself is not joy, but sorrow. There is no humour in heaven."
    - Mark Twain

  15. i really think its a matter of not growing up.. i say this in observation of how completely immature a lot of med students are. maybe they don't grow up because their lives have been about book smarts and thats it? not getting into the real world until you're a practicing doc, and by that time your ways are set. just a thought