Intended for healthcare professionals

Editor's Choice

Welcome to our feast of fools

BMJ 2010; 341 doi: (Published 15 December 2010) Cite this as: BMJ 2010;341:c7228
  1. Tony Delamothe, deputy editor, BMJ
  1. tdelamothe{at}

Medieval Christianity understood the debt that goodness, faith, and sweetness owe to their opposites, explained Alain de Botton in an article in Harper’s Magazine earlier this year.

“For most of the year it preached solemnity, order, restraint, fellowship, earnestness, a love of God, and sexual decorum—and then, at New Year’s, it unleashed the festum fatuorum, the feast of fools, and for several days the world was upside down. Clergy played dice on the altar, brayed like donkeys instead of saying ‘Amen,’ had drinking competitions in the nave, farted to the Ave Maria, and delivered spoof sermons based on parodies of the Gospels.... After drinking tankards of ale, they held their holy books upside down, burned excrement instead of incense, and urinated out of bell towers. They tried to marry donkeys, tied giant woolen penises to their vestments, and held boozy orgies on the altar.”

This sacred parody wasn’t just a joke, argued de Botton, but to ensure that things would be the right way up for the rest of the year.

“If you really think that the Christmas issue is an example of festum fatuorum,” commented a colleague, “it’s a pretty tame one.” And yet.

Anon captures the feast’s anti-authoritarian tone by liberating the NHS’s abbreviations and acronyms (doi:10.1136/bmj.c6615). We don’t have priests urinating out of bell towers, but we have intensive care doctors micturating into wide mouthed plastic measuring jugs, unaided by the nursing staff (spoilsports) (doi:10.1136/bmj.c6761). “A modest proposal” (doi:10.1136/bmj.c6605) and “Pie sharing in complex clinical collaborations” (doi:10.1136/bmj.c6641) parody the modern day gospels on the primacy of primary care and the worthiness of multidisciplinary collaborations.

John McLachlan’s hoaxing of the scientific committee of an international conference on integrative medicine covers with wonderful economy spoof sermons, farting to the Ave Maria, and burning excrement instead of incense (doi:10.1136/bmj.c6979). Readers of the article in the print journal even get a moderately proportioned latex penis (rather than a giant woollen one) thrown in for good measure. And as happens in each year’s Christmas issue, booze is just about everywhere—if not in the nave or on the altar, then on the table (doi:10.1136/bmj.c6731) and underfoot (doi:10.1136/bmj.c6812).

By contrast there’s nothing remotely foolish about three entries from last year’s competition for the most interesting use of the journal’s online archive. Although they didn’t win, they seemed too good not to share. Learn about the teapot’s occasional, but fascinating, appearances in BMJs over the years (doi:10.1136/bmj.c6738), how BMJs of a hundred years ago were cannibalised for the plot of Casualty 1909 (doi:10.1136/bmj.c5168), and how the archives facilitated a meeting between Sherlock Holmes, Dr Watson, and their creator (doi:10.1136/bmj.c6898).

Given the wave of creativity that last year’s competition unleashed, we were tempted to run another one this year. The working title was “How to reorganise the NHS,” and the plan was for entrants to submit their answers on the back of an envelope. From our experience last year, however, it was clear that many entrants would have spent more time drawing up their plans than the coalition government has. It didn’t seem fair to waste their time.

With so much information crying out for our attention (doi:10.1136/bmj.c6815, doi:10.1136/bmj.c7126) we have to spend our time wisely. One timesaver is to stop speculating on the nature of the illnesses of the illustrious dead. The fatuity of these efforts is pointed up by Lucien Karhausen’s totting up of Mozart’s suggested causes of death (140) and psychiatric states (27). As he points out, Mozart died only once: “some causes are plausible, only few—maybe one, or maybe none of them—can be true, so most if not all of them are false” (doi:10.1136/bmj.c6789). His article allows us to draw a line, once and for all, under such speculative contributions.

Far better use of your time is to support our charity this year, Save the Children (, and to nominate worthy contenders (or even yourself) for next year’s BMJ Group Awards ( The deadline is 24 January—by which time the world should be the right way up again.


Cite this as: BMJ 2010;341:c7228


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