In our latest interview for NMP Live Meets... we caught up with Dr Phil Hammond - NHS doctor, campaigner, health writer, investigative journalist, broadcaster, speaker and comedian - to talk about mixing comedy with medicine, his thoughts on the NHS, and how he connects with audiences. Watch the full interview or read the transcript below.
In conversation with Dr Phil Hammond
When did you first discover your skill for comedy?
I started doing comedy at medical school, but you can imagine what that was like. Medical school reviews also have terrible pun names like, ‘Back Passage to India’, or ‘On Her Majesty’s Secret Cervix’, and they tend to be fairly scatological and actually not terribly funny but when you tell them in front of an in-house audience at medical school everyone roars with laughter and you think you’re the funniest thing in the world.
Then you go to the Edinburgh Fringe, and that’s where just about anyone who’s made it in comedy, it’s their stomping ground. You do a three-week run at the Edinburgh fringe, and then you find if you’re funny or not, because you’ve performed in front of the public and critics in some little black sweaty box somewhere. And that’s where you learn your trade, and I think that’s where I realised I could do it. But it’s a fairly tough apprenticeship.
Doctors often have a huge amount of confidence, but not necessarily the competence to go with it, and it’s a craft like anything else, you learn it, and I would say the Edinburgh Fringe was how I realised I could do comedy.
Are comedy and medicine a good combination?
I think actually there’s quite a strong history of comedy and medicine. If you look at people like Graeme Garden in the Goodies, Graham Chapman in Monty Python, Harry Hill and my former comedy partner, Tony Gardener. I formed this junior doctor double act called, ‘Stuck Off and Die’, with Tony back in 1990 when we were angry junior doctors, and then he gave up medicine and started ‘My Parents are Aliens’, and ‘Fresh Meat’, and ‘Last Tango in Halifax’. So, I think actually there’s a long history of doctors who have done comedy.
I would also say I think medicine is in-part a performing art; if a patient doesn’t feel better for coming to see you, then you’re probably in the wrong game. So I think there probably is an element of performance in medicine, and I think the two run side-by-side. I often say, I just communicate for a living... I listen and I speak, and if you can earn a living like that it’s not bad.
Is comedy a good way to deliver a serious message?
I think comedy is a very good way of delivering a message; I think satire in particular is a good way of crystallising an argument, but it doesn’t always offer a solution. You can be sarcastic, you can be ironic, you can try to hold people to account satirically, but ultimately if you want to make the health service better, you’ve got to try and offer some solutions as well.
So, I think comedy only goes so far, and people who think your comedy can be a medium for changing things, I think they’re probably a little bit inflated. I think occasionally it can. I would say, the American Comedienne Tina Fey doing a parody of Sarah Palin is one example of a political career being destroyed by comedy! Unfortunately, you can’t do the same for Donald Trump, who’s almost impossible to parody.
So I think, yes, comedy does get a message across; it highlights problems, but it doesn’t necessarily offer solutions. But I think it’s good. I’ve always done what I call comedy with a message, I like people to laugh, but I like people to think as well. But the trick is not to make it sound preachy; people don’t want to be preached to.
Ultimately, with a comedian your job is to make people laugh, but if they can think as well, then they go, oh yeah I got a bit more. Because comedy is a bit like a take-away meal, you go and have a take-away meal and you’ve forgotten what you’ve eaten ten minutes later. I like people to remember what they’ve heard.
Is humour appropriate in the consultation room?
I think humour is very useful and actually a very powerful way of communicating with people, but it’s interesting because the consultations are very intimate, it’s a one-on-one thing, but actually, after-dinner speaking is also quite intimate; you have to get to know your audience.
So when I do after-dinner speaking, I always sit with the audience first to get to know them. And likewise, in a medical consultation, you’ve got to get to know a patient and their relatives and carers, to see whether comedy is appropriate. And you judge the mood of the room, and usually I can make patients laugh.
I’m not there to tell jokes as a doctor, but generally you can cheer them up… and offer them hope, I think is the most important thing. With some comedy, people can be quite cruel and destructive, but some can be constructive and hopeful and that’s what I try to do in a consultation.
I’ve only once fallen on my face when I was a young doctor. I can’t remember what I said, I think it was a joke about somebody’s haemorrhoids looking like the Hanging Gardens of Babylon; and this chap said, “the consultation room is no place for a joke, sonny!”, and I realised I’d over-stepped the mark. But you learn from your mistakes, that’s important in any career.
Why did you continue with a career in medicine?
I think it’s quite seductive being on stage; if you’re successful you suddenly get loads of people laughing at you, and it can go to your head a bit, and some people enjoy that. But I find it a bit lovey, so if I do too much comedy, I find it’s almost artificial, and I like being grounded.
And actually, I like the day job as a doctor. I think it’s particularly important as a man, to sit down and try and be empathic and help people; because we’re very self-interested, we can go our own way and promote our own careers, but actually the beauty of medicine, and the beauty of the consultation, is actually that you’re using everything in your power to help someone and be empathic. And everyone needs to do that a bit, so if I wasn’t doing medicine, if I’d given up that and just done comedy, I’d hopefully do some charity work.
But I enjoy being a doctor, I find it an honour; but I would say I couldn’t do it full-time. I take my hat off to anyone who works full-time in the NHS, because it’s really, really hard at the moment. So, I do it, but I do it part-time.
What are your views on the NHS?
The NHS is, I think, our most important institution, in that it glues us together as a compassionate society. So if we go back to 1948 when it was founded, this idea of treating people according to need, the idea that we pool all our money, and then people are treated according to their need. So as Nye (Aneurin) Bevan said, the hallmark of a civilised society is that we look after those most in need, and I think that ethos still endures – that’s really important.
I think the NHS is under so much pressure now, partly because it’s a victim of its own success. When it was founded in 1948 half us died under the age of 65. Now one-in-three people live to 100. Some people reckon the person who will live to 150 has already been born. I don’t think it’s you by the way; don’t be too disappointed! But the point is, demand for services is growing about 4-6% year-on-year, because we’re living longer with diseases that previously would’ve killed us. And yet at the moment we would have had about ten-years of flat-line funding. And so, continuous growth in demand, with ten years of flat-line funding, if you think of that in terms of your industry, how would you cope with that?
Well, I think we’re struggling now with the notion of universal health care; the idea that the NHS can provide everything for everyone, for the money we’re putting in, I don’t think is sustainable. But I think the argument needs to be had with the public; the public who pay for the NHS need to decide how much money they want to put into the NHS; whether they want it to be entirely tax-funded; whether they want to pay private insurance or top-up fees; whether they’re happy for NHS providers to be state providers or private providers; all of these debates are happening now, and actually, I strongly believe it’s a public service, and the public should have a voice in that.
And I think the way it’s changed is that the centre has become more controlling and they’re making lots of big decisions now, and they promise, ‘no decision about me, without me’, but they just carry on doing this. And I think the public are left behind and haven’t really got a clue what’s going on.
How did you move into the media?
I never planned a career in the media; a lot of my comedy career has been winging-it, I guess.
When I first went to Edinburgh in 1990 I was a junior doctor activist, and although junior doctors always seem to be complaining about something, back then we were working 120 hours a week… I had friends who’d fallen asleep at the wheel, friends who’d fallen asleep in the wound… some people who got depressed and suicidal because of their working conditions. So, it was almost quite political comedy in the early days and very unusual; it was quite brave for junior doctors to have done that sort of thing.
So it got picked up by the BBC from Edinburgh, and then I was offered series on Radio 4. And I was at the BBC light-entertainment Christmas party, and I spotted Ian Hislop – who was the fairly recent editor of ‘Private Eye’, and I’d always been a reader of Private Eye – and I followed him into the toilet, and I said, “Ian, can I have a column in Private Eye?”, and he said, “would you mind not standing so close to me”! But in fact he gave me a column, which was then called, ‘Doing the Rounds’, and that’s when I started doing the whistle-blowing stuff in the media as well.
So I’ve worked for the NHS for over thirty years, but I’ve written for Private Eye for twenty-four years. And then presented, ‘Trust Me, I’m a Doctor’, on the back of that, which was a BBC series in the mid-90s, and I was the fist presenter of that. So I’ve been working for the BBC for pretty much twenty-odd years, but it’s all on health-related issues. So the material is similar, whether I’m doing comedy, or straight or broadcasting; I just change the timing slightly.
Has an audience member ever had a medical emergency?
There’s always a danger when you’re a doctor performing, because you are always a doctor, and the General Medical Council is quite strict about this. As you get older, your audience tends to get older, and it’s not unusual for people to collapse during my shows, and I then have to get down from on-stage, and attempt to resuscitate them or ask them what they’re doing.
One of my most embarrassing ones, I did something for Radio 4 actually, and for some reason they decided to give people a drink on the way in, and I think someone had a few too many, and this was half-way through a Radio 4 recording, and somebody collapses and I had to stop the recording and get down from the stage.
Foolishly, when I did, ‘Doctor Phil’s Rude Health Tour’, I invited people to bring their ailments along and this person brought a urine specimen along – she thought she had an infection, it was stinging a bit, but she didn’t have time to see her G.P – and I actually had my black bag with me, I had some sticks in there and I managed to test it and it was highly likely she had a urine infection. And then there was a G.P in the audience who’d brought his prescription pad, so I passed it on to him, he prescribed some anti-biotics and she left the show with some anti-biotics.
It’s very rare you go for a night of comedy and you leave with anti-biotics, but it has happened – I might be struck off for that but who cares, it’s a good story!
How do you connect with an audience?
Well here’s an interesting thing, this is how I connect with people (takes out a small mauve Clangers soft toy)… this is the most important prop that I have. Most people of a certain age who grew up in this country will remember the clangers; it was the first ever children’s colour TV programme.
Oliver Postgate, who gave us Bagpuss and other things; he was an old-style pacifist, socialist, green who was asked to come up with a colour TV programme. He came up with the Clangers, who were a population of mauve mice who lived on a planet; they had free soup for all; it was like socialist propaganda; there was no need for politics or money because everyone got the soup they needed, there was blue string pudding.
But ‘Clangers’ is actually what I use as an acronym for all things you need to be healthy and happy: and the ‘c’ of clangers, is ‘connect’. So Clangers, rather spookily stands for: Connect, Learn, be Active, Notice, Give back, Eat well, Relax, Sleep.
But connection is by far the most important of those things, because human beings are social animals, we exist to feel that we are leaves on a tree, that we belong to something bigger, and you have to connect with the audience. And probably the best way of connecting is to be self-deprecating; to tell jokes about yourself; to tell about mistakes that you’ve made; your problems as a junior doctor; problems in your own family; that generally is universal, because once people see that you’re laughing at yourself, then that invites them to make those connections, rather than just taking the mickey out of other people.
The secret if you take the mickey out of other people is to do them higher up the tree than you are. There’s no point in me making jokes about patients in particular, because they’re lower down the pecking order. So, I think provided you’re self-deprecating and your targets are higher up the tree than you are, then I think that generally connects with an audience.
And what’s also relevant, is that I think that most of the problems that we face are universal; work-life balance, how to ‘be’ as well as to do; we’re obsessed with achieving in our lives, but we never sit down and enjoy the world around us.
So I think that when you do comedy with a message you give people space to reflect on what you’re saying as well, and that usually connects.
Do you also give serious presentations?
I often get asked to do serious stuff as well, so I’ve chaired a lot of health conferences as you’d imagine, but some non-health conferences, and often they will book you in the combination of serious interactive facilitation during the day, and then they’ll get you to do a comedy speech in the evening. And that often works quite well, because the audience has got to know you, and then cleverly you can bring in themes from the day and make them funny in the evening.
I think it’s important when you’re doing conference facilitation that you’re not a Jeremy Paxman; you’re not there to interrogate people; you’re there to get the best out of them. And I really enjoy facilitating conferences, I really enjoy audience interaction and getting the audience involved.
One of the strengths of using a stand-up comedian who’s used to handling an audience, is that they can get audience engagement, which people often struggle with. We often use all sorts of electronic devices and pressing things, but actually face-to-face questioning is important. So I think you have to be sincere and you mustn’t undermine the motives of the conference. But then when the conference is over you switch into comedy mode and you can lightly subvert one or two of the things you’ve seen during the day.
What is your typical audience?
I’ve spoken to thousands of audiences, I’ve done this first since 1990, so I’ve been doing it for twenty-six years and I’ve spoken to just about every audience you can imagine, from funeral directors, to Women’s Institutes, to banking executives, to politicians, to patients.
I think health is universal: ‘what keeps you happy?’... ‘how can you get the most out of your one wild and precious life?’ are pretty universal themes that everyone is interested in. I think people are interested in their health even if they neglect it.
So I haven’t yet found an audience where health, mental health, depression, death… you think they sound like dark themes, but I can assure you there are ways of making them funny and engaging, because we’re all leaves on that tree and those universal themes apply to everyone. And it’s interesting how similar we are; you would think that Women’s Institute and banking executives would be a different audience, but they often laugh at pretty much the same things.
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