TopRelevant Literature
Interactions between patients and physicians are a particularly rich communicative occurrence since “interaction is the fundamental instrument by which the doctor/patient relationship is shaped and through which medical care is directed” (Roter & Hall, 2011, p. 55). As a result, close attention to both the verbal and nonverbal exchanges that transpire between patients and physicians are not only important but necessary. Even though the current healthcare system has come a long way from the paternalistic communication practices of its past, we must still take care to understand and analyze best communication practices for both physicians and patients.
In the past doctors were simply trained to save lives, which emphasized, “protocol over emotion” (Davidson, 2016, p. 33). This approach to medical care neglected to focus on what is important in the patient-doctor interaction--the patient. As a result, doctors and healthcare practitioners often disregarded patient autonomy and desires. Eventually a paradigmatic shift emerged within the healthcare system which moved doctors toward a patient-centered ethic of care. Patient-centered care focuses on the person first. The model of patient-centered care considers the person or patient's whole illness experience by “knowing about the patients' life context (family, work, religion, culture, social support, etc.), as well as personal developmental stages (life history and personal and developmental issues)” (Hudon et al., 2012, p. 173).
To practice patient-centered care, healthcare practitioners are called upon to, “create languages which can bridge the gulf between physician and patient” (Bergum & Dossetor, 2005, p.13). Arguably, one such language that can bridge this gulf, is humor. Humor in the context of medical care can be viewed as “an important communication strategy of patients and providers” (Schopf et al., 2017, p. 374). In particular, humor generates positive effects as “humor can help to relax the patient…But, beyond being comforting and supportive, it can be empowering, and promote adjustment and learning” (Penson et al., 2005, p. 656). Humor’s ability to comfort and empower are only two of its many properties. Simply put, humor is productive.
Previous work on humor touches upon a variety of topics, but particularly salient to this case is a study on the use of humor in the context of families living with chronic illness and disability (Keller, 2017). Through interviews and immersive field work, data was collected about family communication on maternal Multiple Sclerosis. Through close analysis of interviews and fieldwork, it was established that humor was the most prominent mode of communication in the study’s family unit and was being used as a means of communicating the illness and disability experience with one another. This discovery led to an understanding of humor’s therapeutic benefits in the family unit, but most of all led to a greater appreciation of its ability to help individuals communicate about and through their experiences. The functions of humor were defined through the four “R’s” of humor: Reframing; Resistance; Relief; and Relational (Keller, 2017).
These four “R’s” acts as organizational tools to help understand the humor in families coping with disability and chronic illness. They also work as communicative tools to help describe humor’s function and explicate its uses. Humor as a form of reframing relies on the shared ability of two or more individuals to redefine a difficult or trying experience into something that brings levity and ease. For instance, in the original study (Keller, 2017) humor was used by family members to redirect conversations about Multiple Sclerosis (MS) that may have been too painful to talk about. It was used to make a difficult experience into something they could laugh about. Humor as a form of resistance is the productive means by which one or more can push back against stigma or stereotypes and empathize with a situation rather than sympathize. Again, humor as resistance manifested itself in the study through its ability to resist sadness and redefine the illness experience as more than a “tragedy.” Humor as relational means that humor can act as the stimulus for stronger relationships and help develop a greater relational sensitivity towards others. And last, humor as a form of relief helps to put individuals at ease or take a break from the emotional chaos that may occur due to their illness or a diagnosis. Humor acts as an outlet which can help all individuals process their experiences, and ultimately enabled the family to communicate more effectively about their lived experiences with MS.