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Is Gallows Humor Ever Appropriate?

MMMM d, yyyy

One of the first medical phrases I ever learned was “gallows humor,” which defines as “humor that treats serious, frightening, or painful subject matter in a light or satirical way.” I was taught this when I was an undergraduate by a college senior who already had been accepted into medical school: “These are jokes that only people in health care would find funny.” I was also told, by him and others later on in my education, not to feel bad about these jokes, because they were a coping strategy for all of us who were in the health care professions. The implication of this is that this is the social norm – and therefore appropriate and, indeed, expected behavior.

But much of this humor should not be considered normative or appropriate. This week, being early released in Pediatrics, is an article by Dr. Robert Dudas, Dr. Michael Ryan, and Dr. Susan Bannister from Johns Hopkins All Children’s Hospital, Virginia Commonwealth University, and the University of Calgary, which discusses the role of humor, particularly when we are teaching and modeling the practice of medicine (10.1542/peds.2021-053044). This article is part of an ongoing series on medical teaching by the Council on Medical Student Education in Pediatrics (COMSEP) featured in Pediatrics. The title of the article is one that will catch your eye: “A Pediatrician, a Resident, and a Medical Student Walk Into a Clinic: The Role of Humor in Clinical Teaching.”

Drs. Dudas, Ryan, and Bannister discuss the different ways that humor can be helpful in medical teaching and team building. They also discuss the different ways in which humor can cross the line to being inappropriate, or even hurtful or harmful.

One also has to remember that, as with other things, humor is in the eye of the beholder. Whether something is humorous depends on the situation – and on the individual. What an attending may find to be humorous, a resident or student might find to be a microaggression or an insult. And this extends to our patients and other relationships as well.

I encourage everyone, whether you work with trainees or not, to read this article, as the descriptions of the different styles of humor and theories about humor will help everyone create a climate that is welcoming and nontoxic.

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