In a past life, I was a columnist and assistant editor for my undergraduate campus newspaper. Prior to this, however, I had spent most of my life as an avid reader who dreaded writing. When the COVID-19 pandemic sent us home during the spring of my first year of college, I found myself with too much time to think and not enough structure. To my surprise, I turned to writing as a means of catharsis and clarity.
Over the following years, I published columns on healthcare, sports, culture, and personal reflection – often wrestling with questions I didn’t yet know how to answer but wanted to share with others. Later, as I took on an editorial role, I felt deeply privileged to be the first set of eyes on others’ personal and raw stories.
In medical school, I began to see similar parallels in patient care that reminded me ofmy prior experiences in journalism. Meeting patients at their most vulnerable often feels like being thrust into stories that require a new depth of empathy. As a third-year student, I continue to turn to writing to process experiences that have profoundly impacted me on rotations: witnessing my first patient death in a pediatric trauma, delivering my first baby and her parents asking my thoughts on her name, and sharing in grief with a patient grappling with a new terminal diagnosis.
Taking time to write about these encounters helps me find meaning on days that feel impossibly full of emotions, though carving out that time has grown increasingly difficult. And while I imagine it will only become more challenging as training continues, Dr. John D. Kelly, IV, MD, FAANA serves as an inspiration to those hoping to integrate narrative medicine into their daily lives, even as busy clinical professionals. Dr. Kelly is a Professor of Clinical Orthopaedic Surgery and Director of Shoulder Sports Medicine atPenn Medicine. He is a passionate shoulder preservation clinician and researcher, current president of the Arthroscopy Association of North America (AANA), and author of Your Best Life, a quarterly series in Clinical Orthopaedics and Related Research (CORR). He is also a stand-up comedian with a career spanning more than three decades. In the following conversation, he shares how the practices of writing and performance have enhanced his life and career.
Note: Interview responses have been edited for clarity.
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Annika: I would love to hear about when you first started writing.
Dr. Kelly: I played football in college, and my twin brother was also a player, and wewere having a hard time with the football travel, making classes, and doing well academically. So, my brother said, “Why don’t you become an English major?” I have to be honest, I did it for less than noble reasons. I missed a lot of classes, and it allowed me the ability to not have to go to every class and still do well “academically.” But, lo and behold, I started to learn how to write. I liked to write. Compared to the other courses I took, I was doing better in the English courses, and I said, “This says something here.” And I found that the better I wrote, the better I could think. Clear thinking correlated with clear writing, and vice versa. So, it was good for a guy with a little ADD here to just sit down and get my thoughts together.
In 1999, Dr. Kelly described experiencing burnout after having an eye illness and struggling to balance being a good father, husband, and physician. Returning to the fundamentals of self-care were lessons that were hard won as a part of his recovery. These experiences inspire the themes of his blog posts for Orthopedics Today and his quarterly column with CORR.
Dr. Kelly: I got to tell you, the whole narrative medicine thing has helped me becauseevery time I tackle a subject, it’s often something that I wrestle with, and I’ve learned to somewhat overcome. I’m just eager to share with other people because I learned this the hard way. You can’t go through the whole medical gig without strong relationships. They’re so important, and people forget about that. First things first, make sure your marriage, your family are good, your faith, your spirituality, your health. Then you can endure the other things.
Annika: When I was reading your columns, I was very struck by how you’ve spoken about some very personal and vulnerable topics. How do you find it being so vulnerable to such a large audience?
Dr. Kelly: Nothing gets an audience’s attention better than authenticity, right? I’m not going to mask this, and you have to be secure in your own skin. I’m a real big accomplishment/approval addict, and I realized I’m so much more than that. By being vulnerable and sharing, it immediately connects me to the reader. I don’t think you’re thinking less of me to tell you that I’ve been through therapy, and I grieve my brother’s loss every day, and I still have trouble sleeping with that. That’s who I am. I just want to humanize the medical experience, because the biggest problem I see in orthopedic surgeons is that they have this (even women), “I’m a bad dude, I’m not going to show my emotions” attitude. But when the gorilla in the room is burnout, you have to name it to tame it. So, you can’t just go on this delusion that everything’s fine when you’re struggling. I’m Catholic, and I believe in God Almighty, and I think that God has called me to do this and to share in some of the misgivings.
As we talked about burnout and ways to still show up for people in your life, Dr. Kelly turns his phone towards me, filled with reminders he has set for birthdays, deaths, marriage, and sobriety anniversaries.
Dr. Kelly: One of my patients, I told her my dad was in recovery and she told me her sobriety date. Just a 10 second text, “Hey, congratulations today,” meant the world to her.
Annika: That reminds me of something that I learned from a college Russian literature class. I don’t know if you’ve ever read The Brothers Karamazov, but one of the biggest things that I took away was the way in which you truly show love to people is small acts of intentional kindness every day. Just living your life that way, it truly does make a difference.
Dr. Kelly: I think Victor Hugo said to love another person is to see the face of God. That says it all, love another person to see God within them. And there was another one, Tolstoy, ‘Everyone thinks of changing the world, but no one thinks of changing himself.’ And that’s how I stay resilient because I decide to give uplifts to others and thus receive them in return. The presence or absence of uplifts in your day can determine who’s resilient and who’s not.
As noted, in addition to his writing practice, Dr. Kelly has been performing as a stand-up comedian for decades.
Annika: I discovered this while I was doing some research, but you’ve been a stand-up comedian for some time!
Dr. Kelly: That’s an easy thing, it’s genetics. My father was a comedian, my twin brother was a comedian. That was part of my identity as a young man. I wanted to be like my dad - he was so funny, made people laugh. And then I went from this phase where I had to be funny to now in my 60s, I just want to be funny to help others. Insecurity kicked in when I was younger. I had all the cardinal features of a child of an alcoholic – insecure, perfectionist, low self-esteem, all those things. My dad was a good guy, but the alcohol just permeated all of our family. I was spending my whole life trying to please him because I was never doing enough. Then, as I got older, this was a spirituality thing because I really believe that laughter is the best medicine, and I realized that God gave me this gift to make people laugh. Now I really try to be, first and foremost, a medium to make people happier.
I started a comedy show about 10 years ago with this club down in New Jersey, and one of my patients found out. She said she lost her husband, and I had a relationship with her in a special way because her husband was a twin. And then her husband’s twin brother died. So, she came to this show, and I came home that night, and I got this wonderful text. “Thanks, doc. You really made me feel better.” And I was like, woah, this stuff works. And that was a really powerful text. Just one little sentence. So now the reason I don’t get so nervous is that I focus on the audience. How can I make them feel better? How can I help their pain? And this is where the child of an alcoholic becomes the healer.
Annika: The way you’re talking about this reminds me of how wonderful art is, and in whatever form, be it comedy, music, writing, or visual art, I think it just brings the person who makes it so much joy. But I think part of the joy that you get in making is knowing that people will see it and it brings them something too.
Dr. Kelly: Absolutely! I hope, you’re at a young age now, that you’re cultivating some habits.
Annika: I’m trying! For those who have an interest in narrative medicine, policy, whatever, something that’s just a little different or a little outside of traditional medicine – what advice would you have for them in terms of keeping up with it and finding time for it, no matter where they are in their training?
Dr. Kelly: Aristotle said, you become what you do, right? So, it takes effort. One of the things I’ve learned in my 69 years now is that feelings mean nothing. You have to live your life on values and what’s important to you, and just because you don’t feel like doing it doesn’t mean that it’s not important to you. I would say to the students out there, just get started. That first step is the hardest. And you’ll find you get momentum, you build upon that, and then you get the feedback that you’re helping someone. I’ll be the first to say when my column is due for CORR, I may have writer’s cramp, but I just start writing and I do a little prayer, and all of a sudden things come together. One of the keys to a successful life is to learn how to prioritize and execute. We get lost in all the noise and what many people call the whirlwind. But if you can learn to quiet your mind and then learn how to prioritize and then execute. So, know thyself. First step is the hardest, you make the time and get started, and then you’ll see. I was intimidated by the whole comedy space. I started out with my dad’s bar and some medical gigs. I turned 50 and had a midlife crisis and said, let me see if I can take this show on the road. Then, at age 50 is when I started working nightclubs. It’s never too late.
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I hope you all enjoyed this interview with Dr. Kelly on narrative medicine, comedy, and burnout. At the end of this blog, you will find some work in the humanities by orthopedic surgeons and trainees, along with some opportunities to share your own. Stay tuned for more MSOS blog posts on paths in orthopedic surgery!
