This podcast is intended for US health professionals only.
This transcript has been edited for clarity.
Eric J. Topol, MD: Hello. This is Eric Topol with my co-host Abraham Verghese. We have a real delight today. We're going to have a conversation with Dr Will Flanary, an ophthalmologist and comedian also known, in the medical community and beyond, as Dr. Glaucomflecken.
Will, you're really big on TikTok, YouTube, and Twitter — all the social media. Just last week, when the CDC came out with their 5-day COVID quarantine guidance, you had one of the most extraordinary videos on that. Can you tell us about it?
William E. Flanary, MD: I think those CDC guidelines came as a shock to a lot of people — a cognitive dissonance type of thing. As an ophthalmologist, I don't get into the hospital very often, as you can imagine. But seeing what my colleagues in medicine were talking about and experiencing with this new wave of the pandemic just didn't make sense with what the CDC was putting out there for their guidelines. That's a perfect setup for comedy — when you have something like this that just doesn't make sense. So many things in medicine are like that, things you can use to find a comedic angle. So I just went with it. I think I'm pretty good at dialogue and creating a scene, so I just took a look at the CDC and made the video. And people really liked it.
Topol: You remind me of Sarah Cooper and how she would mouth Trump's words. How do you do your videos? How do you include two or even three of you in one video? Do you have to script it ahead of time?
Flanary: I don't write anything down, for the most part. I have a process over a few days of thinking through what I want the jokes to be, what I want the lesson to be, or the subject of the humor and where I'm directing my ridicule. I do put a lot of thought into it, but I'm not the most organized person, so I don't write it down. I really should. It would probably make the recording process a little smoother. I'd probably be more efficient if I actually wrote it out, but it's all kind of in my head.
Topol: I don't think it could be any better, Will.
Flanary: It's a very low-tech operation. I just have my iPhone, a window that has good light, occasionally I use a tripod, and I just go.
Abraham Verghese, MD: Will, it's a great pleasure to meet you. Come to find out, we've crossed geographical paths before. We were both at Texas Tech, although I was at the El Paso campus, and then I was at Iowa, but probably not at the same time you were. And you made me feel ancient a little while ago by telling me that I spoke at your Dartmouth graduation.
Flanary: That's why I'm so excited to do this, because I still remember you giving that wonderful commencement address. It's great to have so much overlap with you.
Verghese: I want to begin by asking you about "Glaucomflecken," because I had to look it up. It's a valid ophthalmologic term. Does it mean something else?
Flanary: No, not at all. People actually think my name is Dr. Glaucomflecken. I've had patients call the office and ask for an appointment with Dr. Glaucomflecken. So, unfortunately, I feel like I may have made "glaucomflecken" more famous as a social media personality than an actual medical term. But it's an actual ophthalmology term.
Topol: I thought you picked it purposely because like with open-angle glaucoma, there's a new lens, so kind of a new lens on life. Is that what it is?
Flanary: No. The only reason I chose "Glaucomflecken" is because it's the most ridiculous word I could think of in ophthalmology. I was at a research conference. I'm in private practice now. Research is not my thing. Just thinking about Excel spreadsheets makes me want to throw up. So I was not in the research world, but I was at this research conference, bored to tears and I thought, Let me check out Twitter; I hear a lot about it, and I had a background in standup comedy, so I thought it seemed perfect. I could tell jokes to an audience of five ophthalmologists who were also on Twitter during this conference. And I thought, Well, this is going to be a comedy account, so what should I call myself? Ophthalmology is a field full of ridiculous words, and I thought, Let's go with Dr. Glaucomflecken. That's kind of silly. It was either that or Dr. Pseudophakodonesis, but that was a little much. Honestly, if I had known it would turn into this, I probably would have chosen an easier name to say.
Verghese: I like it. It has a good ring to it. Something about it makes you smile the moment you say it.
Our audience may not all be aware of this, but your humor comes with the backdrop of having gone through some serious medical crises. Would you care to talk about that and the relationship that has to the comedy?
Flanary: It's been a driving force for a lot that I've done in comedy and standup comedy, but also on social media. In my third year of medical school, I was diagnosed with testicular cancer. I had started doing standup in high school, and I continued that into college and even med school. But I had gotten away from comedy because life just got busy.
I always wanted to be a doctor. I realized very early on that a career in standup comedy is very difficult, so I took the much easier route of becoming a doctor. So I had gotten away from comedy, which is something I grew up with and loved doing. After I was diagnosed with cancer, I felt that urge to exercise those muscles again, to get back out there and tell jokes and really process what I was going through in this very difficult time in my life. In that way, comedy helped me to overcome this difficult situation I was in.
That kickstarted my medical comedy career. I started doing more humor related to what I was going through in med school and what I was going through with cancer treatment, and I continued that for a while. Once residency started, I got away from comedy again, and then I was diagnosed with testicular cancer in the other testicle. I was very "lucky" — among the 1%-2% of people with testicular cancer who get it in the other testicle. And the same thing happened; I found my comedy again. Around that time was when I joined Twitter and got on social media, and the comedy snowballed from there. I just kept going, eventually creating this social media presence and these videos, all these characters, and a wonderful support network.
Topol: There was another chapter in the tragedy that you may want to mention.
Flanary: Oh, yeah, the cardiac arrest? That little thing?
Topol: The cardiac arrest. When was that?
Flanary: That was in May of 2020. I've been very open about this on social media. My wife saved me. I had a cardiac arrest in my sleep and my wife did 10 minutes of chest compressions and saved my life. By that point, I already had this Dr. Glaucomflecken thing going for several years, and I had just gotten into doing more videos about a month before that happened. I made a full recovery, by the way, which is just amazing. The statistics for recovering from an out-of-hospital cardiac arrest are dismal, but I recovered, and I pretty much documented my recovery through funny TikToks and telling jokes on Twitter. It helped me process what I was going through, which was by far the most difficult thing I've been through in my life. Not physically; the physical recovery is pretty straightforward. I was back to work a month later. But the more emotional, mental recovery with myself and my family was a big part of that.
Topol: It's remarkable what you've been through. Yet you may be one of the funniest comics in medicine. You're kind of like at a Stephen Colbert level of talent in the medical community. He also went through tragedy. He lost his father and brother in an airplane crash. It seems to be a common thing among great comedians. Have you noticed that trend?
Flanary: First of all, that's extremely high praise. But yeah, humor is a defense mechanism, in particular for comedians. When life presents these hurdles, these obstacles that you have no control over, that come out of the blue, completely unexpected, you feel like you have no control over your own life. I see comedy and telling jokes, using humor, as a way to gain some semblance of control over a situation over which you don't have any control. It's a way of reasserting your power and regaining some of the autonomy that has been taken from you. Comedy is such a powerful way to do that because you're able to do it on your terms. You're able to set the stage, you're able to not only laugh but have people share a laugh with you. It's a powerful coping mechanism in that way.
Verghese: I wonder if you know anything about the tradition of humor in medicine. I remember a landmark book by Norman Cousins who, to handle his illness [a life-threatening connective tissue disease], decided to go to a hotel room and watch funny movies and ignore traditional medical advice, and it seemed to work for him. You're part of a more recent tradition — I'm thinking of ZDogg and a few others out there who are doing what you do. What do you know about the tradition of humor and medicine?
Flanary: It's always been around, going back to Sam Shem and The House of God. Any time you have something as serious and with the amount of gravity as being a physician and the kinds of things physicians see and deal with in their day-to-day lives, you're going to have people coping through humor. But now with social media, it's easier to see it. We've all been doing this, we've all been cracking jokes in our physician lounges and on call with other doctors, in a hallway, in the hospital, at home with our families. But now that we have these platforms we can use to reach so many people, the humor is more out in the open. This is wonderful because it's starting to break down some of the long-held walls that have been placed between physicians and the public.
Topol: I certainly agree with that, and your rise in this field couldn't come at a better time for the mental health of the medical community. Humor and laughter and the medicine they provide are so important. This podcast is called Medicine and the Machine. What's different about humor is that there's no machine here. This is as human as you can get, and that's what's so special about your talent. It's something you don't see very often. Abraham mentioned ZDogg, who we've interviewed in the past. ZDogg is very different. He likes to do music videos. Yours is a different genre. He's very dramatic.
You've taken on almost every specialty in medicine, from family practice to anesthesiology to you name it. I want to encourage every listener who hasn't looked at your videos to take the time because they're incredible. Have you gotten pushback from these specialties when you go after them with comedy?
Flanary: There are always people who don't appreciate some of the things I make fun of. In my defense, I'm an equal-opportunity comedian. I go after every specialty I possibly can, including my own. It's so important not to take ourselves too seriously. We have an incredibly serious job that we do, but to be able to laugh at yourself is important. I've done certain things to try to keep myself from getting into too much trouble. I'm very careful about medical hierarchies because there are a lot of power dynamics at play in medicine.
Whenever medical students put on skits, they're lambasting their attendings, and it's always great. Second-year med students make fun of their attendings and everyone laughs. It's great and it works. It works well because the med students are punching up, right? They're punching up at their attendings who are perceived as having more power than them. It would be horrifying if it was the other way around, right? If it was attendings making fun of med students, that would not go over well. So I'm very careful about not upsetting those power dynamics too much. Whenever I'm making fun of a specialty, it's always another specialty making fun of that specialty, like cardiology vs nephrology, fighting with each other over fluid status.
I do the best I can as an ophthalmologist; I have to research some of these things because it's been so long since I've done any kind of body medicine. I do make a handful of people a bit upset, but on the whole, I get positive feedback even from people within the specialty. Whenever you gain a platform doing comedy, you're always going to upset somebody, and that's one thing I've had to learn. You can't please everyone, but as long as you're obeying certain rules within comedy, you'll be okay.
Verghese: As I was watching your videos again this morning, I found myself reflecting on the fact that we have this need not just to laugh but to vicariously poke fun at other people. It's as if the pandemic has brought out our need for humor, but also our need for a sort of harmless kind of justice. If you've been the butt of jokes in your specialty, then it's a nice opportunity to turn it around. You allow us to do this vicariously. Where do you think you're going to go with this? It seems that you have a limitless supply of topics. Have you been thinking about where you'll be a few years from now with this art form?
Flanary: I don't know. I haven't approached this with any particular goal in mind. I eventually kind of got bored with telling jokes on Twitter because I feel like I accomplished what there was to accomplish on Twitter. Then I moved to videos. When we started making TikToks, that opened up a whole new world creatively because I could put together these scenes and these skits. At this point, I'm still trying to push myself creatively. So in terms of a goal, I want to continue to get better at it — not only at the comedy, which I believe I have improved with, but also with dialogue and building in jokes and surprising audiences with different things, using physical gags as well, and just expanding my comedic repertoire.
I also want to improve the production, to start using more effects. Getting better at the whole process has been fun for me, and I continue to get better. One goal I have is to start making slightly longer videos that can still hold people's attention. In general, attention span is waning pretty much across the board. In terms of where to take it next, I don't know. If you guys have any connections in the TV world and you want me only to make a TV show...
Topol: I want you to do an hour-long Netflix special. Are you still doing standup now?
Flanary: I do standup in the context of certain events in medicine. I have such a niche that most of the performing I do is for medical audiences. I have an email address that I give out, and so I'm asked to perform at all kinds of different events. I will do some comedy. It's been a learning process, especially with the pandemic; I haven't been able to do much in person, obviously. That's now starting to come up, so I have some in-person events planned.
Telling jokes virtually is not that fun. For 2 years, I've been telling jokes in an empty room, to complete silence, with no feedback whatsoever, just looking into a camera. That's challenging as a comedian. So it's going to be nice to finally get back out in front of an actual audience and find out if the jokes I have been telling for 2 years are actually funny. I'll get to hear people laugh or boo or whatever they want. It's going to be great.
Topol: Back to that parallel with some of the well-known comedians. Colbert recently said he'll never go back to virtual. Trevor Noah, all of them, just as you said, they just have to have an audience to get the vibe and be able to truly relate. It seems to me, though, that your following now has to include a lot of nonmedical people. You have millions of followers out there and you're ready to branch out from the medical community. Everybody appreciates humor in medicine. So yeah, I'm looking for your Netflix special.
Flanary: One thing that surprised me in the past few months is how many people outside of medicine have reached out to me to say, "I don't get any of this, but it's still funny. I still laugh at it." I take that as a compliment to my acting skills because even if they don't really understand what's going on, if I can make someone laugh just by the way I'm acting, that's a real plus. I never thought of myself as an actor, so that's great.
Topol: You are an actor. There's no question. Your pauses during the videos, no less your expressions are just unbelievable. I wanted to ask you specifically about the video you did with Vivek Murthy.
Flanary: That was kind of a surprise to me. His office reached out to me. I thought it was a joke. I thought it was a fake email or some kind of spam at first. But then I noticed the HHS.gov address and I thought, Oh, this is real. His office reached out and said they were aware of the videos I've been doing. I had done a few things on burnout and they wanted to make a video with me addressing burnout and other potential topics as well. So we had this back-and-forth for a while. Of course, I'm not going to turn it down. It's the Surgeon General's office, right? I was thrilled. I was so happy to be able to collaborate on something.
I made up a script and sent it to them. I thought it was great. It was really funny. And they basically asked me to redo all of it because I think I took too many shots at the wrong people. The one thing I learned is that when you're dealing with an entity like the Surgeon General's office, there are different rules you have to play by, which I understand now because it's a whole different thing. We talked about it and refined where the humor was going to come from and what the message was going to be. And it turned out great. I'm really happy with what we did.
Topol: I would have liked to have seen the original version you sent to them. Abraham and I interviewed Vivek for this podcast, and we know him pretty well. In the video, he came across as quite dour. I thought maybe there was a good story there, so hearing the background is interesting.
Flanary: It was amazing just to get to meet him. He's such a nice, nice man and very thoughtful. He had read up about me and heard about my medical history and all that, so we talked about that, which I wasn't expecting. I felt fortunate to be able to work with him on that.
Topol: It was creative. It's a way to reach the medical community that you wouldn't think our government or our surgeon general would be thinking about, so that's good.
Verghese: I met Surgeon General Murthy at a formal event and he was in his full uniform. And I had the privilege of shaking his hand. And he said, "Hey, Dr Verghese, you spoke to us when I was a medical student." And that made me feel ancient again.
Flanary: So you've spoken at every single medical school out there, Dr Verghese.
Verghese: I wanted to say that I don't think your listeners realize how much ophthalmology education you provide. When I trained, we were given a 2-month ophthalmology rotation at a big eye care hospital. I felt like I got a good grounding as an internist and I can tell iridocyclitis from conjunctivitis. But your videos and some of the material on your website are extremely helpful. Talking about the future, I'd love to see you mix humor with education to bring ophthalmology out of this black hole.
Flanary: General ophthalmology knowledge is pretty lacking. When most people finish medical school, they haven't learned much ophthalmology, and then certainly not after that. I've tried to educate in my videos; I've done a lot more in my public speaking. I've found that when I'm invited to speak at a conference or a grand rounds, they're expecting me to be funny. But medical audiences are unique in that when you go to a medical event, people are also expecting to learn. They're there to learn. And early on I figured out that just telling jokes confuses people. They're like, Wait, what is going on? What is happening? Why is this random internet comedian ophthalmologist just telling jokes and trying to get me to laugh when I'm supposed to be learning? I figured out that the way to reach an audience at a medical conference is to build in some kind of education along with the humor. That's where you can really make an impact at a medical conference.
So I started talking about consulting ophthalmology and eye exams, eye drops, and things like that, while also incorporating humor, trying to keep people from wanting to leave. I think that's the key to getting people outside of ophthalmology interested in learning about ophthalmology — infusing humor into it. That is something I enjoy doing. I get sidetracked by all the other stuff going on, such as the CDC. I should get back and do more education along with the comedy.
Topol: How do you balance everything? You have a practice in ophthalmology and your work in comedy, and you could make either one of those full time, plus your wonderful family with your kids and a wife who saved your life. How do you balance it all?
Flanary: I'm fortunate to be a private-practice ophthalmologist. I work 4 days a week, so I have flexibility in my job. I wouldn't be able to do the comedy to the extent that I'm doing it if I wasn't in the job that I'm in.
Basically, I find 1- to 2-hour blocks of time here and there, sometimes late at night, sometimes over lunch. And I'll have an idea. I've been thinking about this idea for a few hours. I think, Let me just knock this out. Let me just put on a costume — sometimes I bring costumes to the office and occasionally my partners will walk in on me wearing some kind of headgear. I just find periods of time that allow me to do all the things I need to do in life. It does get challenging and I get tired. I haven't done a video in about 3 days, just because I haven't had the time. It's hard to find it sometimes. But as long as it's still fun to do, I'm going to keep finding the time to do it.
Topol: That's terrific. I'd love to see you do a standup routine.
Flanary: The thing is, I've been doing this niche medical comedy thing for so long that if I just went to a random comedy club and did a 5-minute set with my medical jokes, I probably wouldn't do very well. It's just such a niche for the most part, but maybe I'm wrong.
Topol: I don't know. As you mentioned at the outset, you started a career in comedy long before you went into medicine. You are an astute observer. That seems like the essence of comedy; you pick up on things that make people laugh. So it's a combination, it seems.
You could draw on things from being a parent, doing all the different things you do in your daily life. I think it's unlimited. It's exciting to be watching your career going forward. You're just getting started, in some respects. We're thankful for the way you brighten up the medical world with your talent.
Verghese: Someone told me long ago that as long as you have a doctor and a dog in your novel, people are going to be endlessly fascinated. Look at all the procedural medical shows people watch. I agree with Eric. I think you're underestimating the general appeal of your kind of humor. People don't have to be in the profession to get it. I compliment you on the great service you're doing for all of us, giving us some relief from what has been a very stressful time. I look forward to more brilliant work on your part.
Flanary: Thank you. That's what keeps me going the most in making this content — when I hear from people who are working in the ICUs and who tell me it was great to have a laugh at the end of the day. I love hearing that. Some of them are just stupid skits, but they have a real effect, and it's nice that I can help in some way.
Topol: Well, Dr. Glaucomflecken, you are a gem. Thanks for taking the time to be with us. We'll follow you with keen interest and look forward to all your future videos.
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