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Much Ado About Medicine

FUTURE PHYSICIANS SING, DANCE AND MAKE FUN OF MED SCHOOL.

The New Physician January-February 2004
In February 2003, despite blizzard conditions, hundreds of people packed the Roxbury Community College auditorium outside of Boston to enjoy more than two hours of dancing, singing and comedy. However, this wasn’t the local theater troupe putting on their version of “Music Man.” Instead, the performers were Harvard Medical School students, who continued a long-standing tradition of poking fun at what they know best: medical school.


Harvard’s future physicians are far from alone in their theatrical endeavors. Future physicians at many U.S. institutions—Albany Medical College, Baylor College of Medicine, Cornell University Weill Medical College, Duke University School of Medicine, Finch University of Health Sciences/The Chicago Medical School, the University of Pennsylvania School of Medicine and the University of Pittsburgh School of Medicine, to name a few—have similar traditions. And who can blame them for seeking creative distractions from their stressful lives? What medical student wouldn’t jump at the chance to take some good-natured shots at his faculty, administration and the world of medical education?


That ability to tease the sacred institution of medicine is one of the reasons the crowds come out to see Harvard’s Second Year Show. The 2003 production featured a rather intricate plot with the associate dean of student affairs losing the school’s notable endowment during a night of debauchery. The remaining money was enough to support only one department, so the battle to win over the student body began. Some departments instituted “no-fail” policies, and others formed pop music, boy bands. Eventually the pharmacology department resorted to drugging the entire student body into a group of pharmacology-loving zombies. Naturally, one future physician avoided the drugging and developed an antidote to snap classmates out of their trances. The antidote was also found to cure male-pattern baldness, and the miracle drug was then patented and sold, the profits used to refill the school’s empty coffers. Ah, everyone likes a happy ending.


They also enjoy being part of the joke, says Alejandra Casillas, who produced and performed in the 2003 show. “Although we poke fun at them, our dean of student affairs once said that it was more of an insult to not be mentioned in the show versus being made fun of.”


At the University of Pennsylvania School of Medicine (UPenn), faculty members are also performers, opening the annual show with a skit. Last year, they showcased their unique talents in “Penn Medicine Idol.”
“Our anatomy professor recited a poem about his mustache, members of the admissions office had a hula-hoop contest, and a trauma surgeon waxed eloquently about the joys of the surgery clerkship,” says fourth-year Kitty O’Hare, who has served as everything from a producer to a cast member to an usher in the productions. “It’s traditional, at the end of the skit, for the dean of the medical school to burst onstage and say, ‘Live from Dunlop Auditorium, it’s Spoof 2003!’ or whatever the year may be.”


Not everyone appreciates being parodied, though, says Alik Widge, a fifth-year M.D.-Ph.D. student who participated in the University of Pittsburgh School of Medicine’s 2003 Scope and Scalpel Society production. “Some faculty have, of course, not found their portrayals to be particularly funny, [but] the administration seems resigned to the fact that they’re going to be the butt of most of the jokes,” he says.


Mind you, Pittsburgh students don’t seem too concerned about negative feedback. After all, they’re about to graduate and with the Anus Equinus award are finally free to acknowledge the faculty or staff member who made their lives the most miserable. The infamous award is considered to be the antithesis of the Golden Apple award, which is also presented during the show. In the Anus Equinus ceremony, top nominees are “recognized” with dramatized testimonials. Not surprisingly, Widge says, the honoree is rarely present to accept the Anus Equinus. “Winners are the type of person who wouldn’t care what med students thought of them anyway,” he says.


Nevertheless, the majority of Pittsburgh’s faculty and staff is supportive of the production. “Students see [Scope and Scalpel] as a way of getting things off their chest—good, bad and indifferent,” Dr. Richard Moriarty, the society’s faculty adviser and a member of the 1966 “The Sordid Life of Wally Pimpstein” production, told Pittmed, the medical school’s magazine. “The students say pretty truthful things. What they wind up saying is important to say. That’s why the Golden Apple is a part of the show, and the Anus Equinus—it’s the yin and the yang.”


In fact, venting frustrations is at the heart of these shows. According to the Scope and Scalpel Society, the annual musical was born from a medical student’s and department chairman’s “gripe session” at a local bar in 1955. By the end of the evening, the two had concocted the idea to produce a class play about students’ grievances. Later that year, with the ardent support of the school’s dean, the society debuted to a packed house with a performance of “PMS IV.”


Since then, the show has become an annual parody of not just medical education but also of pop culture, featuring such performances as “Coldfinger” in 1965, “Scar Trek” in 1975, “Miami Slice” in 1986, “Thoracic Park” in 1994 and “Crouching Patient, Hidden Finger” in 2002. In 2003, a team of writers—who along with the director and producer are elected by the fourth-year class—created the medical-student version of HBO’s hit series about mob life. The result was “Sopranolols.”


Future physicians at UPenn achieve similar theatrical feats in their annual Spoof production, which is open to all students but tends to be staged by more first-years, fourth-years and mixed-degree students. “In designing the show, we try to maintain a balance of singing, dancing and nonmusical skits. It’s all comedy, or a reasonable attempt at it,” O’Hare says.


Each year, Spoof is given a different title or theme, yet there’s only a loose association among the sketches, she says. For example, “Spoof 2003: The Fragile X-Men” included a skit involving the inherited genetic abnormality but also featured: “Staphylococcus Hunter,” a parody of the “Crocodile Hunter”; “Pimping through the Ages” in such classic times as Homer’s Greece and Shakespearean England; “Pelvic Exam” put to the tune of John Mellencamp’s “Jack and Diane”; “Match Another Way,” a spin on the James Bond thriller “Die Another Day”; and “What Would Paul Dabrowski Do?” with students’ rewording a song from “South Park: the Movie” to pay tribute to the school’s beloved trauma surgeon and director of medical student education.


“My favorite memory was a skit in which ‘Staphylococcus Hunter’ was wrestling with the attending, explaining to the audience that the key is to ‘control the jaw’ in order to limit the number of pimping questions the attending can ask,” says second-year Brian Ash, the production’s band director.


Obviously, Spoof and most of these shows are littered with the language of medical school and inside jokes. Program notes usually provide enough explanation to let “outsiders” in on the gags, which has proved helpful to students’ loved ones. “My now-fiancé came to see the show, and though he didn’t get many of the jokes, he had a new-found understanding of my life and now revels in the use of such unique med school words as ‘gunner’ and ‘pimping,’” says fourth-year Stacey Garfield, who performed in Spoof 2003.


But the shows aren’t just fun and games. There are expenses to worry about. In many cases, the productions are financed by student governments, ticket revenue and advertising. Also, it helps if students and faculty do a lot of the work themselves.
“The show is very inexpensive to put on—we make our own props and put together our own costumes,” Garfield says. “We do two performances in one night, performed in one of the med school’s auditoriums. Advertising is all by e-mail and word of mouth. The biggest expenses are renting the spotlight and paying the sound guys.”


It’s a similar situation at Albany Medical College’s annual talent show. By limiting expenses to renting a 300-seat auditorium and audiovisual equipment, $5 tickets are usually enough to cover the production and then some.
In contrast, Harvard’s Second Year Show is supported primarily by donations. Through the school, support organizations, the student affairs office, alumni, staff and faculty, plus fund-raising projects, the production—which usually has a budget of around $20,000—is completely financed prior to the selling of tickets. As a result, the students are able to donate the show’s revenue to a charity of the class’ choice. In 2003, more than $7,000 went to Project Star, a Roxbury-based charity for children born HIV-positive.


Even when a show is barely able to cover its own costs, students still find ways to use it for a worthy cause. At UPenn, future physicians hold a bake sale to raise money for a local Ronald McDonald House, while Albany students keep their costs so low that there is always money left for charity.
“The ultimate goal of the show, in addition to having some fun, is to raise money for a local charity,” says fourth-year Anthony Plunkett, who has coordinated Albany’s show for the past three years. “So far, we have been able to raise about $1,000 per year from the show.”


Charity, however, is not the only reason performers get involved with and crowds come out to the Albany talent production, which usually includes about 18 acts, ranging from singing and dancing to martial arts, piano performances, comedy routines and slide shows. For performers, it’s the chance to exercise muscles not frequently used in the rigors of medicine. For the audience, it’s an opportunity to see the hidden talents of friends and colleagues. “I have found some of the most amazing qualities in my classmates that I never would have known had they not demonstrated them in the show,” Plunkett says.


Some participants have previous theater experience, but it’s certainly not required. “It’s a mix. The skit directors and writers tend to have some sort of theater or writing background,” O’Hare says. “I was the vice-chair and music director of a theater company as an undergrad. However, for the vast majority of the cast, this is their first time on stage. [It’s] a good opportunity for those whose only experience is singing in the shower.”


“I think most of us have acted in ‘something,’ but I’d certainly never sung on stage before,” Widge says.
And whether future physicians end up performing, moving props, selling tickets or working as ushers, there is always some way to get involved. “Show up. Be breathing. They’ll find something [for you] to do,” Widge says.


Once they’re participating in a show, many students say it’s a wonderful escape from the hardships of everyday medical education. “It’s also reassuring to make fun of the difficult parts of med students’ [lives]. In a lighthearted way, it helps us all feel like we’re not going through these times alone,” Garfield says.
The shows aren’t easy, though. There are lines to memorize, skits to rehearse, props to make, promotional fliers to distribute…. “It is really stressful, but it’s a good stress, and if I could, I would do it all over again,” Casillas says.


Yet, under these conditions, strong bonds can form. “It’s a wonderful way to bring people together...getting to know people you never really worked with before,” she says.
In fact, for some future physicians, their favorite memories of productions are offstage. “The best part was waiting backstage to go on, watching the other skits—we had video feed—with the other performers, laughing and excited, greeting the attendings who were performing and congratulating those who just finished their skits. It was an entirely different way of getting to know classmates and attendings,” Garfield says.


And the greatest moments may occur long before the curtains come up. “Last February, Philadelphia was battered with about 2 feet of snow in one day. We were supposed to rehearse all day, but while it was actively snowing, and the city was in a state of emergency, we hesitated,” O’Hare says. “By late afternoon it had stopped snowing, so we asked everyone in walking distance to come in. The cast slushed through waist-high deep snowdrifts in the middle of the road to get to rehearsal.”


Even in blizzard conditions, the show must go on.
Scott T. Shepherd is an associate editor with The New Physician. Direct comments and questions about this article to tnp@ amsa.org.