Pre-joy and Type 2 Fun for the Dermatologist

Two hours before I left the office I received a text from a patient of mine informing me of a screening that evening; the film was about a team that had ascended a previously unclimbed mountain in Antarctica. The patient knew that I had been to Antarctica the previous winter and thought I might be interested. After a series of texts with my wife, we settled into our seats as the show started.

During the next 90 minutes, Mike Libecki (www.MikeLibecki.com) talked about his team’s adventures in Antarctica’s Queen Maud Land in 2012, where they scaled a mountain while battling horrendous weather, frostbite, and otherwise unthinkable conditions. His description of mountain climbing included the terms “joy” and “pre-joy.”

We all know what joy is. Pre-joy was his way of describing the opposite of joy (ostensibly “misery”), as he knew that eventually the awful period where he was cold, hungry, and otherwise unhappy would pass and he would be happy again. I loved this description, as it is something that can be brought into so many lives and practices in order to make the bad times seem like a fleeting situation rather than the ongoing disaster they seem to be at the moment.

Pre-joy could conceivably occur in so many moments during medical school or training that have subsequently been amalgamated into our past memories, some of which now are considered “fun times” or, as described below, “Type 2 fun.”

Type 2 fun also relates to Antarctica in my mind because a fellow passenger referred to many aspects of the trip as such: Things that don’t seem to be fun at the time are later considered fun when looking back on them.

During our trip to Antarctica there were many harrowing situations (storms at sea, kayak trips in icy and rough waters, sea sickness, etc.) but in retrospect, I guess they could easily be considered Type 2 fun. Again, the goal in these classifications is to rephrase and restate the experience in a way that turns the experience into an adventure rather than a miserable episode.

This can easily be translated into our practices as we go from day to day and patient room to patient room. Whatever is happening in the clinic, I try to be positive and laugh about it with my staff, rather than absorb it and become negative. I don’t always do this perfectly, but I do try and usually succeed.

We also see evidence of it in our patients who will either be positive about a condition or therapy—such as isotretinoin, when thanking us for their clear complexions—or negative about the side effects when they encounter dryness or other issues. We need to reflect on the way that our patients absorb and react to difficult situations and try to do the same in order to make our lives better.

Having said this, it may be a while before I willingly go on a boat for any stretch of time. But I can say that 15 months out from my 22-day trip to Antarctica, the experience does seem to be remembered as more “fun” than the “Type 2 fun” I initially categorized it as. And luckily, my life contains significantly more joy than pre-joy. I hope the same can be said for you, my colleagues and readers. n

—Joel Schlessinger, MD
Chief Cosmetic Surgery Editor