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Getting in on the joke

Last month we brought you a short interview with Katie Holmes, about her article, Does It Matter If She Cried? Recording Emotion and the Australian Generations Oral History Project, asking how to read and make sense of emotion in oral history. Today we continue this conversation in an interview with Julian Simpson, one of the authors of another piece in OHR 44.1, Why We Should Try to Get the Joke: Humor, Laughter, and the History of Healthcare. Along with his co-author, Stephanie Snow, Simpson argued that making sense of humor is critical for understanding the history of healthcare and that oral historians need to do a better job of listening for and analyzing humor. In our conversation, we discussed the importance of paying to jokes, what they can reveal, and some of the particularities of humor in British culture.

How did this project begin? Did you go into it with the expectation of studying the use of humor, or did that emerge as you conducted your research?

The initial aim of the study was not at all to explore the role of humor in healthcare. My colleague at the University of Manchester, Stephanie Snow, was commissioned by a group of people connected to Guy’s and St Thomas’ hospitals to research the recent past of the hospitals and their associated institutions (medical schools, staff organizations etc.). We are both interested in the recent history of British healthcare and in how it can inform the present. The initial idea, both for us and those who initiated the project, was to look at the impact of recent change in British healthcare on those institutions, with a view to producing a history that would also speak to the present. The research was funded by the Guy’s and St Thomas’ Charity, and we are currently working on a book which is to published by Bloomsbury with the title At the frontline of British Healthcare: Guy’s, St Thomas’ and NHS reform since the 1970s.

It gradually became apparent however in the course of our research that the importance of humor as a part of medical culture had been underexplored by historians and that we had a wealth of evidence that it would make sense to share. Possibly because the interviews we were conducting touched upon issues that affected participants quite profoundly (for instance, the merger of Guy’s and St Thomas’ hospitals or neoliberal reform of the British healthcare system) and could be difficult to discuss, humor and laughter ended up featuring quite regularly in interviews. Humor seemed to be a key dimension of the materials we had gathered in archives as well. It was therefore more a case of humor suggesting itself to us as an important dimension of this research, both as a part of the history we were researching and as a key to understanding other aspects of it.

You argue that humor is an understudied aspect of both oral history and the medical field. What pointers can you give to people interested in addressing this lack of serious consideration?

When it comes to oral history interviews, reflecting on the use of humor has taught me that when people laugh in interviews or resort to humor it is often worthwhile spending some time reflecting on why they chose to do so. It can be enjoyable in itself to hear someone tell an amusing story but in the context of understanding the past through oral history, it is also important to go beyond our initial emotional response to what we have been told and reflect on what else is being communicated. Basically, we came to a slow realization that when a participant laughed or used humor in an interview, they were frequently signaling that the issue under discussion was a sensitive one or one that could be difficult to broach. Once you start thinking about humor in this way, it opens up new ways of analyzing materials. This applies as well to documents found in archives. So it is firstly a question of how we think about humor and laughter and the significance we attach to them.

In terms of exploring humor as a dimension of medical culture, I suspect that the fact we did joint interviews as part of the project contributed to bringing this to the fore. Humor in healthcare environments can involve transgressing some of our most fundamental taboos (in the article we quote a participant who spoke of laughing when dissecting corpses as a medical student) so it’s important to give participants the sense that they are ‘safe’ when sharing their memories. Being able to do this in the presence of others with an insider’s understanding of healthcare work can only help. If I were to focus exclusively on the subject of humor in medicine I’d be tempted to systematically make all interviews anonymous so that participants would not be concerned about how their anecdotes may be perceived. Transgressions that are understood in a particular profession may appear shocking to the general public – but then most members of the general public don’t have to deal with dying patients and dead bodies on a regular basis. It’s important as well to gain trust as in any oral history project. Especially with younger participants, there was at times the sense that they felt the need to be on their guard, in an age when any throwaway remark can be posted on the internet, resulting in the end of a medical career before it has properly started.

The article wonders how medical professionals might cope with stress if humor is becoming less tolerated in the medical field. Did your interviews give any indication of what medical professionals might be using in its place?

I think it would take a project exclusively focused on humor in medicine and its evolution to really get to the bottom of that question. The interviews that we did with medical students and some of the other materials we located lead me to believe that it still plays its part although people have become a lot more careful than they used to be about what they say and in what context they say it. That’s just an impression though. As I said, we didn’t set out to study humor specifically and therefore, our aim in this paper was more to point to the significance of a number of questions rather than necessarily seek to answer them. It would certainly be very interesting to explore the role of peer support and counselling to see if they are indeed in some ways substitutes for the sort of humor that would most probably result in staff being dismissed these days. One participant told me a story (interestingly in light of what I’ve just said about people being concerned about how anecdotes may be perceived, after we finished our interview) involving a serial male prankster who (successfully) impersonated a female member of staff on a ward and on another occasion caused a security incident when he gained access to the roof of the hospital. I’m not persuaded this sort of behavior would just be laughed off as a bit eccentric today. It is also possible though that humor like this has gone ‘underground’ and is simply less visible to the eyes of prying researchers…

In the second half of the article you connect particular humorous events (like the pantomime) to changes in UK healthcare happening simultaneously. Based on your findings, does it appear satire is more situation and distinct from the general coping usage of humor?

It’s hard to generalize in this respect – medical students also seemed to have a lot of fun satirizing their teachers and humanities students for instance. So, it can also be seen as a way of coping and dealing with pressure. It is maybe tempting to see medical students who for instance laugh at those studying other academic subjects as simply over-privileged and narrow-minded but maybe they are in fact looking for a way of justifying to themselves the sacrifices they are making as trainee professionals who take on a lot of responsibility at a young age? Whilst the satire that we describe that was directed at new management techniques in healthcare is clearly historically connected to the neoliberal reform of the NHS that gathered pace in the 1980s, it is also a coping mechanism. As we describe in the article, Betsy Morley, who initiated the Guys and St Thomas’ pantomime connected the satire it contained to the fact that she and her colleagues had been talking about how low staff morale was at the time. The thought of doing a pantomime and laughing at those shaping their professional experiences was described as cheering her and her colleagues up. Doctors who talked about the ‘mushroom’ technique of management (see our article for an explanation of what this involves!) were satirizing management culture but in so doing they probably also made themselves feel a bit better about the pressures they were under.

Is there anything you couldn’t address in the article that you’d like to share here?

Yes, on reflection, although we recognized that the importance of humor and laughter in our project may have been connected to the nature of the work that many of our participants were engaged in, we might have added that it is possibly also to do with the particular cultural place of humor in British life. It is telling for instance that the Chief Executive of Guy’s and St Thomas’ took on a leading role as a figure of fun in the pantomime that was set up after the institutions merged. And there are probably not too many countries in the world where a request from a conservative politician for the national broadcaster to play the country’s national anthem more often would lead to a major news program signing off with the Sex Pistols’ punk rock version of ‘God Save the Queen’ as BBC 2’s Newsnight did last year. Again, this points to the extent to which the global history of humor is in its infancy. The UK is certainly not unique in this respect but it would be interesting to know more about how the social role of humor has evolved across time and space. Oral historians can be at the heart of this project of writing the social history of humor– and we can enjoy the jokes while we work on it!

We hope you enjoyed this interview–and that you got a chuckle or two out of it. For more about oral history and emotion, check out the article in OHR 44.1, or our interview with Katie Holmes from May. Chime into the discussion in the comments below or on Twitter, Facebook, Tumblr, or Google+.

Featured image credit: “Laugh” by Thom Chandler, CC BY-SA 2.0 via Flickr.

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