What do you call two orthopaedic surgeons reading an electrocardiogram? A double-blind study.
Poke your head in the right corners of the Internet and you will find plenty of doctors ribbing their peers in other specialties and publishing poker-faced pranks. In 1974, the British Medical Journal (BMJ) published a letter reporting a case of “guitar nipple,” whereby playing the instrument allegedly led to chaffing of the breast. A couple of weeks later, a J.M. Murphy, deciding the above had been a gag, escalated the whole thing in the very same pages with a short letter entitled “Cello Scrotum.” I leave the imaginary condition to your imagination. Decades later, the true author behind the cello scrotum letter revealed herself: it had been J.M. Murphy’s wife, Elaine Murphy, a psychiatrist and now member of the House of Lords in the United Kingdom. The two of them wrote, “Anyone who has ever watched a cello being played would realise the physical impossibility of our claim. Somewhat to our astonishment, the letter was published.”
Doctors do have a sense of humour, and despite the nerdy stereotype I was exposed to growing up, so do scientists. Biomedical research often appears dry and unappealing, thanks in no small part to the overly technical and objective language we are taught to use when reporting our findings. But come Christmas time, you will see doctors and scientists loosen their ties and crack a smile.
That is because every year, the BMJ publishes a Christmas edition filled with quirky research. Unlike the cello scrotum stunt, papers published in the Christmas edition still need rigorous methodology. They are serious papers about not-so-serious topics.
The BMJ began life in 1840 as the Provincial Medical and Surgical Journal. Its first dedicated Christmas issue was published in 1982, and this eccentric back catalogue now counts well over 1,000 articles. You will find, for example, that when research participants adopt the absurdly elongated strides of John Cleese in the “Ministry of Silly Walks” sketch from Monty Python, they use 2.5 times more energy than when walking normally. The researchers calculated that if we all walked like this for 12 to 19 minutes a day, we would burn an additional 100 calories. Silliness of movement can thus provide a cardiovascular advantage, which goes against our common sense. “Inefficient dancing,” they conclude, “has been around for generations but, too often, that lone innovator at your local nightclub or on your cruise ship has been the subject of derision rather than justifiable admiration.”
Silly movements also extend to what happens between the bed sheets, but getting a clear image of all this silliness can be hard. Enter a team of Dutch medical professionals who spent a decade trying to document how genitals look like in the middle of sexual intercourse by using a magnetic resonance imaging scanner. They called it an “observational study,” which actually led to a problem: the few brave men recruited for this had a tendency to show their soft side inside the scanner. What saved the study? The commercial release of Viagra! Softness was also an issue with regards to the image quality, but that was improved when the researchers switched to the, uh, Siemens Vision MRI machine. Ultimately, the study proved Da Vinci wrong, who had drawn the penis inside the woman as being straight; it is actually shaped like a boomerang during intercourse. Only one couple was able to “perform coitus adequately” in the machine without the use of a blue pill. How? They were amateur street acrobats, “trained and used to performing under stress.”
That boomerang shape reminds me of another BMJ Christmas classic which cautions men that what we throw out there may come back to hit us in the head and knock us out of the gene pool. The infamous Darwin Awards celebrate individuals who eliminate themselves in such an idiotic way that they improve humanity’s chances of long-term survival. Shooting yourself in the head to demonstrate that your gun is unloaded is not enough to qualify; you must shoot yourself in the head to demonstrate that your gun is loaded. It’s a high bar—or a low bar, depending on how you want to think about it. Who, do you think, is most likely to win a Darwin Award posthumously: men or women? A team of UK boffins crunched the numbers and it wasn’t even close. From 1995 to 2014, the winners have been men 89% of the time. In true scientific fashion, the authors conclude that this finding “supports the hypothesis that men are idiots and idiots do stupid things.” This hypothesis is parsimonious but may not fully explain the phenomenon. More studies, as always are needed. Until then, the authors write that hospital emergency departments will keep on picking up the pieces, “often literally.”
That is, of course, if the victims do visit their local hospital. Sword swallowers who injure themselves rarely do, according to a BMJ Christmas gem. The authors include the executive director of the Sword Swallowers’ Association International, based in Tennessee. They wanted to know what the side effects are of swallowing long, sharp objects for fun. Beginners tend to get “sword throat” (a play on sore throat), but they confessed to usually avoiding seeing a doctor. The risk of injuries over a career is actually quite high, with reports of perforations and intestinal bleeding. One belly dancer massively bled when a bystander pushed dollar bills into her belt, which caused “three blades in her oesophagus to scissor.” Sword swallowing is not for the faint of heart, but the BMJ reveals the tricks of the trade: it requires desensitizing your gag reflex, learning to align the sword with your throat sphincter, and reducing the pressure of that sphincter, which can feel like relaxing the muscles of your neck. A true medical marvel!
While many of these Christmas papers are quite comical in nature, others are more serious if somewhat unexpected. A transatlantic team of curious scientists compiled a list of how people died on Mount Everest (most die above 8,000 metres and it is usually while descending from the summit), while another team last year wondered if an artificial intelligence (Milvue’s Smarturgences) could pass the exam to be a radiologist. This might have been quirky a year ago but given the rapid evolution of AI in 2023 and a myriad of similar experiments, such as whether or not ChatGPT could pass the bar exam, the paper in retrospect doesn’t look funny so much as pioneering.
It may seem unconventional to use speed bumps as a test for an inflamed appendix, but according to a 2012 Christmas paper, it’s a useful tool for doctors to rule out appendicitis. When you’re in the throes of acute appendicitis and you are being driven to the hospital, going over a speed bump can be particularly painful. Thus, to figure out what’s wrong with the patient when appendicitis is suspected, asking them if their pain increased when going over speed bumps can help with the diagnosis.
This year, the BMJ’s Christmas edition includes a study on whether drinking cola can help clear food stuck in your throat (it doesn’t) and on the possible role karma may play in workload disparities between doctors (highly unlikely). It also features a study on nudging doctors to sit at the bedside of their patients. Doctors rarely do it, which can make them appear as uncaring or in a hurry. What if the chair commonly tucked away in the patient room’s closet was left near the bed? A randomized trial was conducted in a Texas hospital, and sure enough, the nudge worked: while doctors did not spend more time in the room, they were much more likely to sit down and their patients were more satisfied with their care.
None of these studies should be taken as the final say on these issues. The chair placement trial was done in only one county hospital. A single study is rarely enough. But these offbeat studies can shine a light on the quirks of human behaviour, and they certainly remind us that scientific research doesn’t have to be dull.
