Gallows Humor

This week's NYTimes "The Ethicist" article was about medical students posting pictures of patients on facebook along with "gallows" humor comments. One of the most difficult things about being a medical student is relaying to friends and family who are not in medicine that when we make jokes about our patients, it usually starts out less as a statement about the individual patient, and more about our discomfort, fear, or sadness about a particular circumstance. However, Randy Cohen is absolutely correct that what initially begins as a defense mechanism to prevent burnout can quickly turn into a systematic way of dehumanizing patients. To avoid falling into that trap, it takes a lot of consistent and conscientious evaluation of how one laughs about patients. As someone who loves to laugh and appreciate the absurdities of life, it has been a line (even as a 4th year medical student) I have sometimes struggled with. Often, the way that I see I have crossed the line is to relay a joke to a non-medical friend (or often, my brother), who's reaction is as appalled as the writer into "The Ethicist." These reactions, while at the (hopefully temporary) expense of my image in that person's eyes, help me define and redefine and redefine where my own humanity is, so I can focus on the humanity of my patient.

I am currently reading "House of God" for the second time (the first was during first year of med school), and I am struck with how much more hilarious, relatable, and tragic it is after I have had so many similar experiences of my own over the past year and a half. I would definitely recommend it to get a sense of what it can be like to be in the world of medicine... minus the frequent in-house sex parties. The acting out I see with my friends and colleagues is much more of the inappropriate facebook behavior variety.