Texas Tech faculty member explores laughter in medicine as part of collaboration.
It might seem out of the ordinary to look at the intersection of laughter and medicine, which is typically imagined as a serious, almost stoic, discipline.
Medical work requires its practitioners to walk a fine line between compassion and dispassion, to communicate with people in their most vulnerable moments and still project confidence.
Yet even with substantial training in emotional detachment, sometimes laughter slips in at the most unusual times. That is what Peter I. Barta, a professor of comparative literature and Russian in Texas Tech University's Department of Classical & Modern Languages & Literatures, has discovered in his research.
Barta has been studying the representation of health care provision in literature and cinema since 2015 with Dr. Michael Phy, J.T. and Margaret Talkington Professor and Chair of General Internal Medicine and Director of the Residency Program in Internal Medicine at the Texas Tech University Health Sciences Center.
“Dr. Phy is interested in the humanities, and that is what brought us together,” Barta said. “The idea then emerged that we would start a course for residents in internal medicine. We have been teaching jointly such a course since 2016. We talk about theories applicable to communication in the practice of medicine and put it into context through literature and film; our focus is on the impact of the practice of medicine on physicians.”
He said in most areas of medicine communication was vital for making a diagnosis, and without good communication between patient and doctor, the physician would be unsure of how to treat the patient.
“Medicine is therefore rooted in narrative; the patient is a story, but then so is the doctor,” Barta explained. “Our classes provide a structured setting and curriculum, giving participants a chance to work through material in the classroom environment among peers with whom they work in teams in the clinic and the ward on a daily basis, sharing professionally and emotionally challenging moments.
“The discipline of narrative medicine has primarily expressed an interest in illness and the implications of illness on the patient. However, as the current situation clearly reveals in the United States and elsewhere, physicians are under enormous pressure doing their job: unhappiness, fatigue and stress-related mental problems are unfortunately far too common, evidenced by incidence of alcohol and substance abuse and high rates of suicide.”
The classroom setting, Barta said, allows the residents to interact in a meaningful and beneficial way.
“What we do in the class is get residents to engage with questions arising in texts and films,” he said. “The emerging discussions have bearings on their own experiences. These highly educated, bright, young physicians find the sessions relaxing and produce very perceptive and original insights. They are a great pleasure to teach.”
As a result of their fascinating work, Barta and Phy created a network of international research collaborators at the University of Bari in Italy and the University of Surrey in the United Kingdom. The results included seminars, guest lectures, a conference in England and the publication of a collection of essays in the special issue of a professional journal in 2022, entitled “Read-Watch-Listen: Using Stories to Improve Medical Care.” It was edited by Barta and Phy in collaboration with Lucas Wood, associate professor of French at Texas Tech.
Their collaboration led to the idea of a transdisciplinary conference on Laughter and Medicine. Thanks to a grant from the British Academy and the Wellcome Trust, the international event will take place at the University of Birmingham on Nov. 4-5, 2024.
The conference is organized by Barta, Wood and Dr. Sabena Jameel, associate clinical professor in medical professionalism at Birmingham's medical school in England.
The conference is expected to attract physicians and academics from the humanities and the natural and social sciences. It will focus on laughter in literary, artistic and dramatic representations of physicians and their patients, the role of laughter in the training of medical professionals, laughter and mental illness, laughter and physiology, dermatology, dentistry and so on. Plans call for an edited volume to be published on the subject, and details of the upcoming conference will be publicized on the British Academy's website.
Barta said he found himself drawn to probing the connections between laughter and medicine in part because he was surrounded by doctors in his family: his parents, one grandfather, an uncle, cousins and a nephew.
“I am the only one who did not turn into a physician,” he said with a smile. “It is an environment that is close to my heart and in which I feel comfortable. I have never come across successful doctors who were not highly intelligent and blessed with an excellent sense of humor.”
Barta draws a distinction between laughter and humor.
“The former is an essential form of communication, specified by cultural conventions and regimes of politeness,” he said. “Humor – when we find something to be funny – elicits spontaneous laughter. This occurs much less often than forced laughter, which covers up, among others, embarrassment, confusion, fear and anxiety.”
In their classes, Barta and Phy regularly noticed that junior doctors laughed at the most inopportune times, at least as far as nonmedical people are concerned.
“That struck a chord in my thinking,” he recalled. “Without doubt, it was the residents of internal medicine at the Texas Tech University Health Sciences Center who provided the main impetus for the topic of our forthcoming conference, and we hope to see as many of them as possible in Birmingham next year.”