Personal views: The show must go on
Authors: Robert Baker
Journal: BMJ (2001)

Declarations of conflict of interest usually come at the end of journal articles, but here's mine now. On 12 December 2000 the BMJ's editor broke new ground by combining the journal's annual Christmas party with a revue of sketches and songs in the style of the traditional medical student show. I performed, alongside 10 other acts that had submitted sketches after editor Richard Smith's published invitation.


Medical student reviews are, of course, not famous for the maturity of their material, and I was interested to see if the BMJ's version would be any more sophisticated. The answer was yes, and no. It was reassuring that not one performer made jokes at patients' expense. I think we all know now that House of God style sick jokes about ill people are deeply suspect. We are well shot of them. 


Despite tables at the back of the auditorium being stacked with food and drink, none of it was thrown



So rather than patients, the most popular target was health secretary Alan Milburn—shame he couldn't make it. So far, so grown up. But there was a solid dose of good old-fashioned immature smut in a number of the sketches. Some, rather satisfyingly, managed to combine the Milburn target and filthy humour. The biggest laugh in the evening probably went to the distressed psychiatrist who claimed his auditory hallucinations took the form of the voice of the health secretary permanently emanating from his own fundament. There are those who might disagree, but personally I see nothing wrong with risque material before an adult audience. You probably can't have a medical revue without it. Besides, off colour jokes in medicine have an honourable pedigree, as I will illustrate in due course.

The idea of having a revue followed James Owen Drife's claim that such things are healthy for our inflated sense of self importance (BMJ 2000;321:59). Is this true? My recollection from medical school is that caricaturing our seniors' eccentricity only made them worse. There is also that famous quote from Peter Cook answering the accusation that the 1960s satire boom was damaging to society. He replied by recalling the other golden age of satire, Berlin in the 1930s, “which did so much to prevent the rise of fascism.” Pigs' bladders make poor lances.

You might counter this by citing the example of the revue's compere, doctor-comedian Phil Hammond. It would be hard to deny his influence in reshaping the profession's self image and even future. But I don't think his most lethal accusations were made on stage at the Edinburgh Fringe's Gilded Balloon; they were made in his (rightly) rather less humorous column in Private Eye. Humour, on its own, changes nothing.

So, apart from making the audience better people, was the show any good? Well, the audience seemed to like it, not least because of the skilful management of Hammond himself. Dr Phil certainly knows how to handle an audience. And you can't help but warm to someone who reads out his own worst reviews on stage. Especially when they were published in the BMJ, and the author is in the audience. Thanks to Hammond, all of the acts, especially the earlier ones, had a tumultuous reception. My conflict of interest prevents me from saying whether we deserved it, but nobody was actually booed off the stage. And, despite tables at the back of the auditorium being generously stacked with food and drink, and it being a medical audience, none of it was thrown. A triumph, then.

So much a triumph that it should be repeated and perhaps become a regular fixture? I would hope so. One of the features that all the performers shared was that we all knew someone who'd thought of joining in but changed their minds. I don't know what made the final cast so determined to press ahead—self delusion, probably. But there is, as we all know, plenty of talent out there.

Smith willing, I'm game for next year and perhaps you will be too. A bit more warning and a few more acts and it could be something even better.

There had been a plan for the audience to vote for the best sketch and award a prize. This was quietly dropped, and a good thing too. Many of the performers had not seen the business end of a stage in at least 15 years. Getting up there at all was brave enough without risking a humiliating nul points.

And that illustrious pedigree of off-colour jokes in medicine? Some rather po-faced journals of psychosexual medicine still quote the experiences of a particular 19th century Canadian doctor. He specialised in publishing articles on penile entrapment syndrome—literally a man trapped in a woman's body. The author called himself Dr Egerton Yorick Davies. The anecdotes are cited in all seriousness, but in fact they were fabricated for his own amusement by a doctor with a mischievous sense of humour and a lewd frame of mind. Davies was a pseudonym. His real identity? The Great Victorian Eponym himself, Sir William Osler. If it was good enough for him . . .