People often present their personal problems with associated fear and trepidation, and humour can acknowledge and normalise issues, as well as reassure patients they are not alone.
To quote Voltaire, the art of medicine is in amusing a patient while nature affects the cure.
Many funny moments in medicine are often associated with embarrassing or sensitive situations.
I can recall one very nervous young gentleman coming in one day, stammering to me that he thought something was wrong with his penis.
He was quite circumspect, and it was initially difficult to work out why he was concerned, so I proceeded to physical examination and after close inspection, I still had no idea what the problem was.
He finally confided that he was concerned that his appendage always hung to the left side.
Now, this is an awkward situation. You have a doctor, and a patient with his pants down, with completely normal anatomy.
I managed to think on my feet, and with all the thespian ability I could muster I assured him that I dearly wished I had one exactly like that.
It seemed to do the trick.
I really enjoy the sense of humour of my patients.
I remember fondly one octogenarian who could have your tummy muscles sore and your eyes weeping tears within the space of a consultation.
She had a twinkle in her eye and when complimented on her youthfulness for her chronological age, she replied "I've only got one wrinkle, and I'm sitting on it".
She was kind enough to participate in my training for the Fellowship of General Practice.
One of my assessments was to have consultations filmed with consent, and evaluated by a colleague.
The competence being assessed was more around communication and relationship skills rather than technical medical expertise.
I had some apprehension that she might tell one of her filthy jokes, so I was trying to direct the conversation around getting to know her more as a person.
I asked her about her spiritual beliefs, and with a perfectly straight face she replied that she was a "born-again virgin".
I managed to pass, and I hope the assessor enjoyed the show.
There are also times that you are so busy that you have conversations with patients that you forget, but the patient does not.
Sometimes this can be treacherous, and I have one story permanently etched in my memory.
I had a patient who was trying to conceive. She had been trying for some time, and we had got to the stage where we needed to refer for specialist help.
I have no recollection of this at all, but at the end of a long consultation, she asked me about how frequently she should have intercourse with her partner.
The idea here of course was to optimise the chance of conception.
Apparently, my advice, as I suffer from premature articulation, was to "Just hammer it".
She bounded back excitedly in a month's time, proclaiming her first pregnancy.
Accordingly, my professional recommendations reverberated around dinner parties for some time after that.
Please be advised that fertility expert I am not.
One day, in a time long ago, on the first day in April, one of my colleagues asked a staff member to make Mr "Jones" a cup of tea.
He had taken a turn for the worse and was in the car outside the back of our surgery.
The staff member dutifully made the tea and took it out the back to find a bemused undertaker who had brought Mr Jones along for identification prior to cremation certification.
He wasn't in good shape, of course.
Nowadays I am sure the eyebrows of concerned human resource personnel would be raised despite the mirth created by this practical joke.
Humans are complex creatures. This was admirably demonstrated on one occasion when a patient presented with a history of, shall we say having sat on an orange vegetable, and not being able to find said vegetable.
One of our caring and empathic doctors was able to rectify the situation, and the following week the grateful patient brought in some baking as a way of saying thank you.
Either the patient was oblivious to the irony, or had a devious sense of humour, but let's say eating carrot cake will never be the same again.
Tony Farrell has been a general practitioner for 30 years. He is a Mount Medical Centre director and a Fellow of the Royal New Zealand College of General Practitioners. Tony has a special interest in mental health and addiction and is a trustee of Hanmer Clinic and medical spokesperson for Alcohol Action NZ.
