I’m the Doctor and the Doctor Gets to Tell the Jokes

Using Humor in Patient Encounters

When my nurse of 18 years decided to take another job, I was crushed and asked her why she was leaving.  She said, “Eighteen years of the same stupid jokes.  I just can’t take it anymore.”   I think that was her humor because she was taking a job with a shorter commute, but she was right.  I have used the same, close-to-stupid jokes forever.  I do it because I want to be down-to-earth and approachable with patients, and maybe even have them enjoy the visit.  So, here are some of my oft-used phrases[MS1] . 

·      When I look at a patient’s eyes to look for corneal arcus, a sign of hyperlipidemia, I say, “Look at my nose, and try not to laugh.” 

·      I run a lipid clinic so I often have to look at the palms of patients with hypertriglyceridemia to make sure they do not have the palmar crease xanthoma typical of Type III hyperlipidemia.  When I look at their palms, I pause and say, “This says you are going to meet a short, balding cardiologist.”

·      When patients make a humorous remark, I always reply, “Hey, remember, I ‘m the doctor here and only I get to make the jokes.”

·      Instead of asking someone how old they are I generally ask them how young they are.  Some laugh.  Some ask, “Do you mean how old am I?” at which point I often say, “You have a bad attitude about aging.”

·      Patients often ask   “How long do I have to take this cholesterol-lowering medication?”  I used to say, “Until Willard Scott reads your name on the Today Show” because Willard read the names of viewers who were 100 years old.  Willard died on September 13, 2021.  So now I say, “Until your picture appears on a Smucker’s jar” because Smucker’s now pictures folks 100 and up on their jars.  Sometimes I have to explain that because some folks don’t know what that means.  Then I say, “After you’re 100 , you can stop your meds because you’ll be too old to worry about it.”

·      Sometimes people, especially anxious people, ask me if they are going to die or some such very threatening scenario.  Obviously, I reassure them since reassurance is usually appropriate.  I sometimes say, “I think you are going to do very well, but as Yogi Berra said, “It’s hard to predict the future, especially in advance.”  In other instances, people will ask if something ominous will happen.  Again, I reassure them, and sometimes say, “You can’t die (or whatever).  Think of what that would do to my reputation.  You've got to do well to protect my reputation, enough about you already.”   Most patients find that very entertaining, and in a jocular way, it emphasizes that I have a vested interest in their doing well. 

·      When I talk about patients going home from the hospital, I often tell them I am going to “evict them”, and sometimes I add that they haven’t paid any rent since they’ve been here.  Alternatively, I talk about their leaving as an escape as in “You are doing so well that I think it’s time for me to help you escape.”  The implication is that I also know that being in a hospital is not fun.

·      I always look at women’s fingernail polish.  If it’s red, I say, “Great, it’s obvious you’re getting enough blood to your fingernails.”  It they are blue, I say, “Gee, it looks like you’re not getting enough blood to your fingernails."

·      Whenever I have a cold or the sniffles, I wear a mask.  I usually walk in and say to the patient, “I’m going to wear this mask because I have a cold.  It’s not a holdup, but you haven’t seen the bill yet.” 

But, be careful with humor.  It can only be used if it fits your personality and with the right patient.  If you are at all uncomfortable, avoid it, but I use humor whenever appropriate to appear more accessible to patients.  

Feel free to plagiarize any of these, but I understand if you don’t want to. 

#medicine #medicalhumor #medicalpractice #humor #patientcare

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 [MS1]The plagiarized line is fine, but it’s also at the end and seems better there.