As the Christmas holiday season approaches, many MJA readers may be feeling uncertain about the future. Will doctors be replaced by nurse practitioners, help lines and computers? Will we outlive our dwindling superannuation stashes? Will the Wallabies ever beat the All Blacks?

In such times of uncertainty, humour can be a blessed refuge, which might explain the deluge of entries for this year’s Christmas Competition. Never before have we been forced to be so selective.

Of course, the idea that you can clown around and still be a serious person is not new. If we all lived according to Nietzsche’s pronouncement that

we would probably have a lot more fun (as long as we ignored most of the other things he said). Some of this year’s entrants, such as Nair, who thinks the call for the medical profession to emulate the aviation industry might have gone too far (→ Flying and medicine: mutual lessons), and Young et al, who have put continuous positive airway pressure machines to a novel but thoroughly ridiculous use, obviously adhere to this philosophy (→ Blowin’ a blizzard in Brissie). Others, such as Kitzing and McCormack, remind us that too much frivolity where pressurised air is concerned can be dangerous (→ Pneumoperitoneum: a non-surgical cause), as can multi-tasking while tossing back festive fare (Buchholz and Rudan, “Foreign body inhalation: a nut in the tree”).

As a research journal, we always look forward to your quirky studies, and this year’s entries did not disappoint. Bolland et al have failed to demonstrate a selection advantage to male-pattern baldness (who says medical journals don’t publish negative studies?) (→ Does degree of baldness influence vitamin D status?), and Barnett et al have demonstrated, with the aid of a multicoloured six-legged “spider”, that the odds of being discharged alive from a London hospital’s intensive care unit on the weekend are not good. (→ Hospitals are dangerous places)

Uncertainty can also create opportunities for serious creative reflection. The devastation of the Boxing Day tsunami in his homeland caused Fernando to question whether he had fulfilled his true purpose in life (→ A sonnet to a doctor’s epiphany); Barr challenges the need for alarmist messages in doctors’ waiting rooms and suggests we replace them with carefully chosen artworks (→ The positive power of paintings); and Whitehall reflects on the extraordinary lengths he and his team went to in order to cushion the grief of a dead baby’s parents — and the miraculously unexpected outcome (→ No ticket for a corpse).

Of course, situational humour is the bread and butter of the Christmas Competition. We enjoyed conjuring a mental image of Miller’s paediatric patient being restrained by a “bear” (→ Occasional assistance needed for general practice) and Tuck’s painful tale of self-diagnostic uncertainty (→ Kid stone: a tale of valour and writhing agony). The yearly ritual of the secret ballot revealed, however, that our favourite story by far was that of Geoffrey Mullins’ experience with porcine anaesthesia in a teaching hospital, which wins the written part of the competition (→ Pigs, burns and curly tails). We learned a great deal from this story, and are proud to be the first journal in the world to publish the Mullins sign, the use of which we hope will spare many piglets from awareness under anaesthesia.

The winner in the image category is Neil Sharma, whose patient’s eye ultrasound demonstrated more than he bargained for (→ Baby in the eye?). It is Christmas after all and, Nietzsche aside, nobody can resist the appeal of a baby in a manger.

Each winner will receive an Australian-themed hamper to enliven their Christmas celebrations.

A final thought for troubled times:

Robert I Fitzhenry

If the pundits are correct, we can expect even more wonderful entries for next year’s competition. Now there’s something to look forward to!

Dr Ruth Armstrong, MJA