Sometimes the best way to diffuse anxiety and fear, for both physicians and patients, is humor.
Last month, a close family member became a patient for a serious medical condition at one of Boston's premier teaching hospitals. The medical care the patient received was second to none; without a doubt the very best any hospital could give. That said the experience of any patient in such a situation is not without its frustrations and confusion.
As we're sure many of you can relate to, as medical and administrative professionals, we were often the go-to translator to convert what the hospital staff and physicians said and did into something that the patient, our family, and friends could understand. These conversations can present a number of challenges. First, and foremost, we were emotional and scared about the patient's diagnosis ourselves. Then again, we became somewhat defensive when a layperson dared question or criticize a nurse or administrative staff member. It was a tough situation.
At one particularly tense and emotional moment, as the patient was being taken by a nurse to be prepped for surgery, our family managed to share a laugh. It's a bit of a story, but another relative, a real manly man, was carrying a computer bag many would describe as feminine. The nurse, as sweet as could be, asked the man if he was carrying a purse. The man replied, "It's a men's European carryall." We all laughed out loud and then proceeded to tell and retell that story throughout the day. (From "Seinfeld," "The Reverse Peephole," Season 12, Episode 9.)
Ah, Seinfeld! For our family, there is no greater universal language and it comes with built-in laughter. For the rest of that intense day and the days that followed we called upon many "Seinfeld" references to explain tough situations and provide a bit of stress relief.
One particular episode, "The Chinese Restaurant" (Season 2, Episode 11), provided a wealth of material. For example, the patient needed surgery, but because he was relatively stable, his surgery was postponed to make room for patients with more pressing needs. When one anxious family member started to complain, we quoted Elaine, "It's not fair that people are seated first-come, first-serve. It should be based on who's hungriest." In that one quote there is both understanding and humor - it's a winning ticket!
Once we started to talk about it, we realized that "The Chinese Restaurant" is really a great tool for arguing for single-payer healthcare. From the dog-eat-dog politics around George arguing he was waiting the longest for a payphone to Mr. Cohen getting a table even though he didn't wait at all, the American healthcare system uses market forces to distribute what is a public good. It doesn't work. We're not sure how successful we were, but we did try to wear our single-payer advocate hat as much as possible throughout this experience.
Once we got going, the "Seinfeld" references were easy to name. A friend with a cold was prevented from visiting: "Sorry the 'Bubble Boy' can't be exposed to your germs." (Season 4, Episode 7). A relative was overwhelmed by the swarms of medical students in the teaching hospital, "You don't want them doing anything to you that makes other doctors go, 'I have to see this!'" (Season 2, Episode 1). Every conversation with pharmacy and administrative staff seemed to end with, "yada, yada, yada," so that they could avoid stating: "You're going to get a huge bill." (Season 8, Episode 19). And we were acutely aware that we had to a walk a thin line between advocating for the patient and being labeled a "difficult" patient. (Season 8, Episode 5).
Nearly two decades after the final episode aired, "Seinfeld" proved to be a useful tool for our family member's health crisis. It's not that serious medical conditions are a laughing matter, of course they aren't. But comedy gives us perspective and understanding, especially when our own anxiety can make a bad situation worse. Just don't tell Fulton the "Pachyderm" story and that Phil "took it out." It just might kill the patient with laughter. (Season 5, Episode 16).