Good sense of humour: an essential job requirement for general practice?

Andrew Papanikitas is Deputy Editor of the BJGP.

The April issue of the BJGP hits the street this year at the confluence of Easter, April Fool’s Day, and the new UK ‘tax year’. Our articles reflect on death, trust, professional threats, and hope for the future. What meme could possibly unify all of these? A cheery song from the 1979 film Monty Python’s Life of Brian, perhaps?

Written by Eric Idle, Always Look on the Bright Side of Life lampoons Disney ‘happy’ songs — also parodied by the Happy Working Song in the 2007 film Enchanted. A group of people being crucified by the Romans sing it to the character Brian who, already crucified, is on the verge of death. According to his autobiography, Always Look on the Bright Side of Life, Idle wrote the song in one evening, using jazz chords he had learned through the ‘Micky Baker Jazz Guitar Course’ book.¹ I’ve previously railed against jolly songs when times are tough,² but this song does something entirely different.

When you’re chewing on life’s gristle

Saul Miller rages against the machine, an appointment system that pays lip service to continuity and simultaneously makes it almost impossible for a frail older patient to see her usual GP.³ Alex Burrell discusses articles in other journals that concern ethnic inequalities in breast cancer, denigration of general practice, knee braces, and health care on release from prison. Understanding these realities is a first step in meeting the challenges they bring.⁴

Sometimes it takes an entirely alien point of reference to see that something is not working. Anuj Sean Chathley finds that the unpalatable cost of takeaway fish and chips reflects economic realities far more accurately than the reimbursement of minor surgery services in general practice. This reflects not only a loss of income for GPs but a dramatic loss of amenity and relief for patients.⁵

Lest we focus purely on what use to be called ‘First World problems’, Ben Hoban paints a harrowing speculative portrait of UK general practice in the aftermath of nuclear war.⁶

For life is quite absurd … and death’s the final word

We need to talk about what is affecting us as humans. Giles Dawnay unpacks the polite but often insincere tendency to say ‘How are you?’ and the fact that it’s so hard to say anything other than, ‘Fine, Thanks.’⁷

John Goldie cautions that ‘Patients’ apologies for “wasting time” are not personal quirks but learned responses to a system that often treats unexplained symptoms as data rather than lived experience.’⁸

We need to talk about dying, argues Frances da Cunha. The NHS and the medical profession actually provides a miniscule amount of care to the dying person — only around 5%, a tiny part of their reality. Palliative care medicine, tacking a significant part of the 5% still derives around two-thirds of its funding from charitable donations.⁹

This’ll help things turn out for the best

Terry Kemple shares insights from Jimmy Wales, a co-founder of Wikipedia, on trust. Trust is not visible, but you miss it when you lose it. Trust develops from many inputs that include memories, beliefs, and emotions that help us predict how someone may act. GPs can start by reversing the loss in personal continuity of patient care by bringing back more family doctor style personal care.¹⁰

Clare Watson takes us from idealist principles into grounded practice: the Nottingham West Primary Care Network Equity Review 2025 was born out of a simple question: what would equity look like if it were treated as routine clinical business rather than a policy aspiration? Examples are provided!¹¹

Julia Knott and Tomasz Stefanski tell us how an Exeter GP surgery took the initiative and installed solar panels without a punitive deal or expensive capital investment (for the surgery). Could their arrangement be a more widespread one? Are there other ways of making greener practice less hard?¹²

So … always look on the bright side of life

Good sense of humour, often abbreviated to GSOH, is famously cited as a stipulation on lonely hearts’ profiles,¹³ but how essential is it as a professional requirement in primary health care? A sense of humour in times of adversity is not the same as toxic positivity — a sense of humour allows us to question and critique our life and times, occasionally reintroducing a sense of humility, and the release of laughter. You will find all of these vital qualities on https://www.bjgplife.com.

References

1. Idle E. Always Look on the Bright Side of Life: a Sortabiography. London: Weidenfeld & Nicolson, 2018.
2. Papanikitas A. Going the extra mile. Br J Gen Pract 2023; DOI: https://doi.org/10.3399/bjgp24X735957.
3. Miller S. 2050: the Larkins Lotto resolved. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X744693.
4. Burrell A. Yonder: Ethnic inequalities in breast cancer, denigration of general practice, knee braces, and health care on release from prison. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X744609.
5. Chathley AS. Undervalued and unsustainable: the economic reality of GP minor surgery services. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X744645.
6. Hoban B. Persisting, in spite of everything. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X744597.
7. Dawnay G. Fine. Thanks. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X744681.
8. Goldie J. Who decides what counts as illness? Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X744657.
9. Da Cunha F. We need to talk about dying. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X744585.
10. Kemple T. I’m a GP — do you still trust me? Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X744621.
11. Watson C. Primary Care Network Equity Review 2025: making equity real in everyday general practice. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X744633.
12. Knott J, Stefanski T. How to decarbonise general practice with zero capital. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X744669.
13. Collins Dictionary. Definition of ‘GSOH’. 2026.  https://www.collinsdictionary.com/dictionary/english/gsoh (accessed 16 Mar 2026).

Featured photo by Belinda Fewings on Unsplash.