Teaching, it seems to me,  is much the same as stand-up comedy. One is much scarier than the other, but which is the scariest depends on who you are. I was left thinking about the connection after a recent bad experience of teaching. I do a lot of teaching these days, most of it unpaid and most of it to medical students and doctors, and I enjoy it. William Butler Yeats famously said (although quite possibly he didn’t) that “Education is not the filling of a pail but the lighting of a fire,” and that’s very much my philosophy—from my own experience.

 Turned on by a teacher, I’ll do the work myself, scavenging for learning like a starving dog. In contrast, trying to teach anything to people who don’t want to learn is miserable, explaining why teaching can be draining.

In one of our madder moments when I was editor of the BMJ we banned the word “education”: instead we insisted on “learning.” Education, we thought, is top down, authoritarian, almost fascist—forcing information into people. Learning, in contrast, is bottom up, uncoerced, inspiring, a magical journey.

For me it thus follows that teaching is a branch of entertainment. Boredom in a classroom kills everything, like poison gas. But it’s a very hard thing to entertain for eight hours a day. Many comics do only 10 minutes at a time, using well honed material that they know will get laughs. 

Even so, my brother (a successful stand-up comedian for over 30 years) tells me, you’ll sometimes flop. All audiences, he has learnt, are different. One night the audience will laugh from start to finish. The next night, in response to the same material, the they will not utter even a titter. For a comic it’s a ghastly experience, and that’s the point when many quit.

Even though I’ve had no training, my teaching mostly seems to be acceptable. I try never to lecture for more than 10 minutes at a time, and I constantly ask the students to talk to each other and come up with ideas. My thinking is that they know most of what I have to teach them, and it’s a matter of coaxing the ideas out of them.

Because of the kinds of things I teach (leadership, getting published, publication ethics) I usually begin by saying “There are no right answers” and “There are no stupid questions.” I’m also an advocate of “All teach, all learn,” knowing that there will be much more knowledge in the room than is in my head.

So I’m very “right on,” and I try hard not to be boring. But sometimes it doesn’t work, and it hurts me. I feel I’ve let down my students. And medical students, I’ve discovered, are much harder to teach than doctors. Many doctors expect little. They are grateful for “a bit of peace” and a day away from seeing patients.

Whereas medical students are fed up with being talked at, sitting in rows, listening to some dope trying to teach them something that doesn’t interest them. They’d rather be putting up drips, riding around in ambulances, cutting up a corpse, or defibrillating somebody. They want action not talk.

With this writing I’m trying to console myself after my recent bad experience, and I think I’ve succeeded. Like a comic after a bad gig I’m determined to go on, but a few more bad experiences could finish my enthusiasm for teaching.

Richard Smith was the editor of the BMJ until 2004 and is director of the United Health Group’s chronic disease initiative.