Imagine Deputy Dean for Education Robert H. Gifford, M.D., HS ’67, (the real one) and dozens of his clones (second-year students in white coats and wigs) prancing around the stage in Harkness Auditorium and singing to the tune of the 1970s musical Fame:

Remember my name,
FAME.
I’ll be the dean forever,
Students will learn how to rhyme.
People at Yale Med will treasure
The Giff for a very long time.

That bit of surreal fantasy was the seed from which sprang Live and Let Diagnose, a James Bond-style spoof performed in February by the second-year Class of 2001. Gifford’s twice-delayed retirement, which has become a running gag over the last two years, was a recurrent theme throughout the show, as was this second-year class’s apparent reluctance to attend basic science lectures. Add song, dance, a ridiculous story line and large doses of irreverence and you have the latest installment in a stage tradition that has endured for 50 years.

The plot revolved around the scheme of an evil professor (Greta Galore) to remain head of her curriculum subcommittee. By cloning and controlling Dean Gifford, she plans to orchestrate her reappointment. Meanwhile, the diabolical Dr. No, a deadly lecturer in child psychology, has spiked the students’ food with Y-agra, a drug that compels them to attend class. To the rescue come James Bond and Ana Phylaxis, students in the M.D./Ph.D. program, which is universally regarded as a home for the “socially challenged” but is really a school for spies. Like its predecessors, the show poked fun at a variety of targets, including, but not limited to: deans of all ranks, faculty members with unintelligible accents, anatomy professors, the ignorance of first-year students and the arrogance of the third-year class.

After polling alumni and faculty in a highly unscientific survey, Yale Medicine has concluded that The Show is a tradition that dates to at least 1949, when the graduating class got the ball rolling with the Four Years for What Follies. The show remained a staple of the fourth year for the next two decades before evolving into a second-year tradition. Fifty years later, this exercise in sanctioned irreverence has become a fixture of student life almost as hallowed as the student thesis requirement — despite major lapses in taste, the occasional resentment of faculty and one dean’s threat to ban the show.

THE SHOW 101

To appreciate the show, there are things you must know. First, although a familiarity with medical terms is handy, it is not as essential as an intimate knowledge of the medical school personalities being lampooned. Keeping up with gossip also helps, as shows tend to draw their plots from current events and intrigues. It’s good to have seen last year’s show, since it will be the butt of at least a few snide cracks.

It’s also best to see the show on a Saturday night. Absent at Friday night’s performance are the hooting, cheering, catcalls and the inevitable attempt by first-year students to sabotage the production. The audience response — first- and third-years don’t take their skewerings lightly — is as much a part of the show as whatever nonsense is happening on stage.

The show also has its drawbacks — sophomoric humor, incomprehensible inside jokes and uneven singing, acting and dancing. And, at times, it seems the performance will go on forever, or until midnight, which is nearly as bad. What is it about this variety show that has made it last? What makes students drop other activities to write scripts and rehearse songs and dance numbers as early as October of the second year?

“It has a wonderful social function,” said Gifford. “Years later, as the students look back on medical school, they have long since forgotten what they learned in anatomy, but they will not forget a single line of the lyrics they sang in the second-year show. It brings the class, usually, very close together. It is a revelation to the students the amount of talent that exists in a group of 100 people.”

The producers of Live and Let Diagnose were similarly effusive in praise of their cast and crew. “Our choreographers have danced for years, our music directors studied music and our writers were born funny,” said Jennifer Wang, who co-produced the 1999 show with classmate Jordan Prutkin. Professors know better than to schedule important lectures the week of the show. “It is pretty all-consuming,” recalled Susan J. Baserga, M.D. ’88, Ph.D., now an assistant professor of therapeutic radiology and genetics, of her class show. Damn Yalies told the story of a medical student who sold his soul to the devil in exchange for a passing grade on the boards.

“If they worked as hard on their studies as they do on the show they would all be getting a Nobel Prize,” said Gifford. But he adds, “It plays such a valuable role in the socialization of medical students, it is probably worth the irritation it produces in the faculty when students don’t go to class.”

Brainstorming for this year’s show began in October, when students submitted ideas for skits and a team of four writers shaped them into a coherent format. By the end of December they had a rough draft. Editing and polishing continued, and the script was ready for rehearsal by the middle of January. A month later, rehearsals were daily events, starting at about 5 p.m. and continuing late into the night.

FROM FORCEPS TO FOLLIES

Although shows are more elaborate these days, with more songs and dance numbers — and a new wrinkle, scenes on video — the basic formula harks back to what appears to have been the first show in modern memory, 1949’s Four Years for What Follies (A Tragedy in Four Years). That collection of skits lampooned faculty targets such as John Paul, M.D., who was portrayed singing “I Am the Very Model of a Modern Epidemiologist” to music from Gilbert and Sullivan’s H.M.S. Pinafore. Metabolism pioneer John P. Peters, M.D., was targeted for his tendency to conduct his rounds in such a low voice that students circled around him and leaned in to capture the great man’s every word. A skit had a gaggle of white-coated students moving around Peters as a single body. One of the songs asked, “How many liters, Dr. Peters?”

The man behind that show was William G. Anlyan, M.D. ’49, who wrote the script, provided piano accompaniment and directed the show on his way to becoming chancellor of Duke University Medical Center 15 years later. At Yale, Anlyan had led a vocal quartet called The Forceps, featuring singers Bi, Tri, Quadri and Contra. He decided to expand on the singing group and stage a class show. “It was great fun. It’s the thing that everyone remembers most,” he said. Classmate William D. Bevis, M.D. ’49, said the cast included nursing students. “The student nurses were just as inspired as the medical students,” he recalled. “They sang and they wrote lyrics for the songs.”

Although the tradition would last half a century, its early years were rocky. In the 1950s, then-Dean Vernon W. Lippard, M.D., threatened to ban the shows altogether unless students cleaned up their act. One production featured students with water bottles inside their costumes pretending to urinate onstage. “The shows got more and more obscene,” said Arthur Ebbert, M.D., professor emeritus of medicine and former deputy dean. Even the manner of collecting money was in questionable taste. “They didn’t sell tickets, but at intermission they would collect money by passing a bedpan around and you dropped your dollar in the bedpan.”

The show survived the dean’s warning, but interest waned and some classes chose not to do a show. When the Class of 1959 presented its own bawdy offering, it was the first in a few years. The 1959 production, which told the tale of an astronaut who is mistaken for a patient, roasted faculty, particularly in the departments of pediatrics and obstetrics and gynecology. “There were a lot of references to the posterior fornix,” recalled John Poglinco, M.D. ’59.

By the mid-1960s, a similar revue that celebrated the end of a second-year pathology course began to eclipse the fourth-year show as the main student production. “What happened,” recalled Thomas Lentz, M.D. ’64, now a professor of cell biology and assistant dean of admissions, “was the fourth-year show died out. Students didn’t want to get involved. They were applying for residencies and finishing their theses.”

A number of factors coincided in the late 1960s to drop the curtain on the fourth-year show. During the clinical years classes dispersed as students who had once traveled no farther than Yale-New Haven Hospital began rotations throughout the state. The social ferment of the times — the Vietnam War and the Civil Rights movement — led students away from the frivolity of a show. It also led them to reject authority, at times with unpleasant consequences. Once-good-humored jibes became personal and vicious. “The faculty stopped going,” Lentz said. “First they stopped taking their spouses, then they stopped going themselves.” Members of the Class of 1974 fought among themselves over nasty attacks that found their way into Proctalgia Fugax (loosely translated as Pain-in-the-Butt), a collection of sketches set to an operetta and centered on a clinical pathology conference. “The things that were in bad taste or caustic we didn’t want to put in,” said Richard A. Cazen, M.D. ’74, director of that second-year show and now a gastroenterologist in San Francisco.

Over the years the bitterness subsided, and in 1983 the graduating class demonstrated their school spirit by resuscitating two lost traditions, the yearbook and the abandoned fourth-year show. The class’s 1983 production, Still Crazy After All These Years, had alumni reminiscing about medical school, with each recollection segueing into a skit, said Peter Blier, M.D. ’83, Ph.D. ’87, a pediatrician and rheumatologist in Springfield, Mass. One skit had the cast singing “Rounds, rounds, go to rounds, I go to rounds,” to the tune of the Beach Boys’ “I Get Around.”

But the second-year show, which had weathered the stormy ’60s and ’70s, would ultimately prevail. It began to resemble a Broadway production, say faculty, and, as classes achieved a balance of men and women, it lost much of its vulgarity.

Faculty and alumni, however, lament the loss of the fourth-year show. Clinical professors, with whom students spend their last two years, are now spared the withering ridicule accorded their colleagues in the basic sciences. “When you work in the wards with faculty, you learn a lot about their personalities and peccadilloes,” said Sherwin B. Nuland, M.D. ’55, HS ’61, who played a leading role in his class show as a hapless patient. “There’s nothing like being in an operating room with a professor of surgery at three in the morning when crucial decisions are being made.” To say that the show is irreverent, said Nuland, “is like saying the flag is red, white and blue.” But that very irreverence is a sign of affection and comfort, he added. “When you’re comfortable with the faculty you feel free to lampoon them,” he said. His show had a patient going from service to service at the medical school and finding himself in worse shape after each visit. At show’s end he is struck by a car. The diagnosis? “The patient’s a little run down,” Nuland said.

To be lampooned in the show is the highest honor. “We’re told that faculty come to the show because they know they’re going to be made fun of,” said 1999 co-producer Wang. “The ones with the accents, the ones who are heads of certain courses, the ones that are very much characters always end up in it.” One scene in the 1999 show paired associate deans Ruth Katz, J.D., M.P.H., and Nancy Angoff, M.P.H. ’81, M.D. ’90, HS ’90-93, (who accommodated the second-year class by playing themselves) in a sweetly sung duet to the tune of Paul McCartney and Stevie Wonder’s “Ebony and Ivory.” The two deans turned in a respectable performance of “Empathy, Not Rivalry” and made fun of themselves in the process: “She’s uptight and I am touchy-feely,” sang Angoff. To which Katz replied: “I balance the budget while she runs group therapy.” The audience loved it.

PROFESSORS, PRANKS AND PARTING SHOTS

According to Gifford, faculty participation started in the early 1990s when faculty members pulled a prank on the students. Then-Dean Leon E. Rosenberg, M.D., HS ’63, Gifford and others jumped up from their seats in the audience, feigned anger at being ridiculed and began singing their outrage to the tune of the Beatles’ “Let It Be” with lyrics written by Alvan Feinstein, M.D., HS ’54. “We each had a verse, then we all sang the chorus,” Gifford recalled. “It brought the house down.” It was faculty’s first and only appearance in the show until Gifford and then-Dean Gerard Burrow, M.D. ’58, made another appearance a few years later as a pair of gamblers taking their chances at Foxwoods Casino in hopes of erasing the school’s deficit. Students also began offering roles for sale in the annual Hunger and Homelessness Auction, and faculty bid for the privilege of appearing in the show.

This year Dean David A. Kessler, M.D., joined Katz, Angoff and Gifford in the cast. On the night of their rehearsal the deans bought pizzas for the cast and joined them for dinner. Then, Jennifer Lucero directed a dance number involving all four deans. Gifford recited a spoonerized version of Cinderella while Katz danced the title role. Angoff was the fairy godmother and Kessler played the “prandsome hince.” “I can’t believe I paid $300 for this,” said Katz, who shared the bid with Angoff at the homelessness auction last November. Students Tara Lagu and Aaron Covey pranced around the stage as the “sticked wepsisters.”

Rehearsals intensified, becoming longer and more frequent as opening night approached. On Saturday night, the show’s final performance, producers were on the lookout for the first-year prank, a traditional effort to sabotage the show. This year, however, a prank came from an unusual source — the third-year class. During the first act a hissing sound emanated from the audience, then a balloon carrying a banner that read “Diagnose This” wafted up to the ceiling.

The second-year performers also played a trick on Gifford. The script called for him to announce that, unlike past years when the administration had asked him to delay his retirement in order to take on one more task, he was really leaving at the end of the academic year. On Saturday night his wife, Karlee, emerged from the wings, and asked, “Do you promise?” Her unexpected appearance startled Gifford, and in the next scene he flubbed his lines, turned away from the audience, and started over.

The show ended with the entire Class of 2001 joining in a medley of songs — among them, one to the tune of the Sinatra classic “New York, New York.”

Start washing your hands and wearing your
gloves, Learn how to use that stethoscope and draw
some blood.
With clinical pearls that we learned in school,
Now we can find the optic disk and culture
stool.
I got accepted here, but off the wait list, dear,
My heart’s with you, Yale Med, Yale Med.

With the medical boards offered on a flexible schedule at designated computer sites this summer, the second-year show represents the class’s last shared effort before students move on to clinical studies and two years of rotating clerkships. “It takes on more importance as the last class activity,” Prutkin said. “This is the last time that we are all working together, all doing something together.”

“It’s nice to have an activity that is fun and that people can bond over,” said Wang. “It’s good to see your classmates when they’re not under tension, when they’re having fun.”