Behind Closed Doors: The Funniest M&M Moments You Never Hear About

Morbidity and Mortality conference is secretly one of the funniest hours in the hospital. You just aren’t supposed to laugh.

Everyone sells M&M as this solemn, high-minded exercise in systems improvement and professional reflection. Sure. On paper. But if you’ve actually sat in enough of them—in surgery, medicine, OB, EM—you know the truth: behind the PowerPoint and the forced gravitas, M&M is a gold mine of absurdity, gallows humor, and “did we really do that?” moments that never leave the room.

Let me walk you through what really happens behind those doors. The stuff people only talk about at 1 a.m. in the call room.

Because yes, we learn from mistakes.
But we also try not to choke to death from holding in laughter.

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The Official Script vs. What Actually Happens

Here’s the sanitized brochure version: M&M is “a structured, blame-free forum for discussing errors, optimizing patient safety, and promoting continuous learning.”

Now here’s what actually goes down.

The room smells like bad coffee and anxiety. The chief resident is flipping through slides like an overcaffeinated lawyer prepping for trial. The junior on the hot seat has been rehearsing their “learning points” for three days and barely slept. The attendings straggle in, some clearly there for blood, some just for the show.

Everyone pretends this is purely about systems and not about who screwed up. Meanwhile, half the audience has already pulled up Epic on their laptops to see what really happened.

And in the middle of all the embarrassment, the 3 a.m. decisions, the bizarre near-misses—you get moments that are unintentionally (and sometimes intentionally) hilarious.

Not sitcom funny. Dark funny. “Life is insane and we’re hanging on by protocol and duct tape” funny.

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The Classic Categories of Unspoken M&M Comedy

Let me break down the main genres. You’ve seen all of these.

1. The Slide That Was… Too Honest

At some point, someone forgets to sanitize the slides.

The PGY-2 is presenting:

“At 02:14 the resident decided to attempt a manual disimpaction…”

Then they click next and the slide title—projected in 120-point font—is:

WHAT THE HELL WAS I THINKING

Dead silence. The program director blinks. The senior in the back snorts. The PGY-2 turns the color of an overripe tomato.

Someone coughs and mutters, “Let’s… rename that to ‘Opportunities for Improvement.’”

That slide gets screenshot (mentally) for years. Every time that resident talks in conference, someone whispers, “Is this a ‘what the hell was I thinking’ moment?”

The funniest part? Their original title was probably even worse. I saw one that the chief mercifully changed from:

I PANICKED: A CASE STUDY

to

Intraoperative Decision-Making Under Stress

Polished language over raw truth. Very on-brand for M&M.

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2. The Attendings vs. Reality Moment

There’s always that attending who lives in a parallel universe where texts are answered instantly, every note is detailed, and all decisions are made in a quiet conference room at 11 a.m. with complete data.

So in M&M, they say something like:

“I do not understand why you did not obtain a CT, MRI, echo, and consult cardiology before calling me.”

And the resident—who’s been up for 24 hours, three admissions deep, covering cross-cover on two floors—very carefully replies:

“At that time… I was simultaneously managing a code, two hypotensive patients, an ED transfer, and the CT scanner was down for maintenance.”

What they want to say is:
“Because this isn’t a simulation and the hospital is on fire, that’s why.”

The room knows. There’s that subtle head-bob of solidarity from the other residents. And occasionally, the attending across the aisle throws a lifeline:

“In fairness, that sounds like a realistic volume for nights. Maybe our expectations are a bit… aspirational.”

Translation: This question is dumb and we all know it.

That contrast between textbook expectation and real-world chaos is unintentionally hilarious. Like watching someone critique your CPR form while the room is literally flooding.

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3. “Communication Failure” as Code for “Total Circus”

Every. Single. M&M. has a “communication failure” section. It’s M&M’s favorite euphemism. But when you really unpack those cases, the comedy writes itself.

Picture this:

• Nurse pages resident about the patient’s blood pressure.
• Resident is in a code, calls back 15 minutes later.
• Nurse just changed shifts, new nurse hasn’t been briefed.
• Cross-cover intern gets paged by the new nurse, thinks it’s a new problem.
• The primary team attending is at a conference in another state, checking emails sporadically at 3 a.m. in a hotel bar.

By the time you hear it at M&M, the story looks like a badly written farce.
People talking past each other. Orders misheard. “Oh, I thought you meant this patient.”

You sit there thinking:
Of course that went badly. The miracle is that anything ever goes right.

The funniest part is when the solution slide comes up:

“Solution: Improve communication.”

Right. That’ll do it.

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4. The Epic Documentation That Betrays You

The chart always has receipts. Always.

There’s a special kind of M&M humor where the story being told and the note that was written are not… aligned.

Resident:

“I immediately recognized the change in status and escalated care.”

Slide: Screenshot of note timestamped 03:17.
Nurse note showing page at 00:46.
ED note saying “spoke with resident, plan to observe.”

And then, the attending on the panel goes:

“Walk us through this gap here.”

Everyone in the room silently thinks: “Bro was probably trying to eat half a sandwich and pee for the first time in 9 hours.”

But the chart doesn’t care. It just sits there, glowing on the projector, destroying your narrative.

Occasionally someone will bravely confess:

“I wrote that note later and… I was trying to reconstruct the sequence.”

You can feel half the room thinking:
Same. Absolutely same.

The laughter is internal. But it’s there.

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The “We Are Ridiculous” Cases

You want the funniest M&M moments? It’s when we accidentally expose how absurd medicine is under stress.

Let me give you composite examples—details altered, but the spirit is accurate. Anyone who’s been around long enough will recognize the patterns.

The Case of the Wrong “Left”

Resident presenting:

“We then proceeded with a left thoracentesis.”

Chief quietly: “You mean right.”

Resident: “Right. Right thoracentesis of the left… I mean right side.”

One attending in the back mutters, “Strong work.” Half the room hears it and tries not to smile.

Then the radiology image pops up.

Arrow pointing to the correct side.
Report clearly says “moderate right pleural effusion.”
Procedure note says “left side,” but performed on the right.

You can almost hear the collective brain thinking:
They were tired. They were talking while charting. They meant right. They wrote left. We’ve all done this.

The conclusion?

• Standardize timeout language.
• Do a clear “point-and-say” laterality check.
• Don’t chart while talking.

But the funniest part is when someone adds, with a perfectly straight face:

“And… let us remember that right is on the right and left is on the left.”

Surgical humor is blunt.

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The “Epic Order Set of Doom”

This one happens a lot in medicine and EM.

Intern presents:

“We placed the sepsis order set.”

Slide comes up with the order set:
Blood cultures, broad-spectrum antibiotics, labs… and a generous 30 cc/kg fluid bolus.

Except the patient has a history of heart failure, EF 10 percent, already volume overloaded, breathing like they’re climbing Everest in a chair.

Attending:

“Why did you give the full 30 cc/kg?”

Intern:

“It’s… in the order set.”

Translation: I clicked the shiny big button. Because at 2 a.m., order sets are safety blankets.

Everyone in the room who has ever unleashed a nuclear order set and then realized their mistake feels a very specific, painful, funny-because-it-hurts recognition.

We pretend this is deeply complex. But half the time the fix is:

“Maybe do not autopilot the order set when the patient looks like they’ll drown from a glass of water.”

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The Pager That Wouldn’t Die

Emergency surgery M&M. Overnight case. PGY-3 on call.

They’re presenting a delay-to-OR case.
The patient sat in the ED longer than ideal. Decision-making dragged.

On questioning, it turns out the resident got:

• A page about the patient.
• A code stroke overhead.
• A trauma activation.
• Two simultaneous floor calls.
• A nurse physically tracking them down in the stairwell.

Someone asks, dead serious:

“Why was there a 25-minute delay in returning the page?”

And a senior resident in the back just starts laughing. Quietly. But cannot stop. Because that question only makes sense to people who don’t take in-house call anymore.

We dissect the “communication delay” as if this is a NASA control room with strict page-return SLAs, not a barely staffed hospital at 3 a.m. powered by Taco Bell and adrenaline.

The comedy is systemic. The expectations and the reality belong in different universes.

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The Jokes That Never Make the Minutes

You want the real M&M culture? Listen to what’s said right before and right after the meeting.

Pre-M&M, in the hallway:

“You up?”
“I’m about to be.”

“If they ask you why you did that, just say ‘systems issue.’”

“You presenting today?”
“Yeah.”
“I’m so sorry for your loss.”

Or my favorite, from a cruel but honest senior to a trembling intern:

“Hey. Worst case, you bomb and nobody ever trusts you again. You’ll be fine.”

Inside the room, the gallows humor is more subtle. It’s in the tiny asides:

• “At that time of night, the thoracic surgery fellow is a theoretical construct.”
• “The consult note was… aspirational.”
• “That’s not how I remember that, but sure.”

The program directors pretend not to hear. Unless they’re the kind who’ve been around long enough to smirk.

After M&M, in the workroom, it’s open season:

“You really said ‘in retrospect, that was suboptimal?’”

“I love how you called your panic ‘anchoring bias.’ Very academic.”

“Did you just cite yourself as a limitation?”

Residents turn near-catastrophes into folklore. Not because they do not care, but because if they do not laugh at the sheer insanity, it will eat them alive.

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What Actually Happens During a 60-Minute M&M

Category	Value
Serious learning	25
Quiet anxiety	25
Blame-dodging	20
[Unspoken dark humor](https://residencyadvisor.com/resources/medical-humor/how-chiefs-use-dark-humor-to-gauge-burnout-on-the-team)	20
Actual actionable change	10

The “Educational Pearls” That Are Actually Roasts

On the surface, every M&M ends with “teaching points.”

Behind the scenes, half of them are weaponized subtweets.

You’ll see a slide that says:

Learning Point: Always review imaging personally when making critical decisions.

Translation:
Stop blindly trusting that one-line read you glanced at between admits, you clown.

Or:

Learning Point: Early attending involvement in unstable patients is crucial.

Translation:
If things are going sideways, do not try to be a hero. Call the adult.

Sometimes the roast gets very specific:

Learning Point: If you’re placing a central line and are not confident with the anatomy, obtain assistance.

Everyone immediately knows which intern this is about. They’re sitting in the fourth row, staring very hard at their shoes.

The best programs—this matters—use humor carefully. They let the room recognize the absurdity and the pain at the same time, without shredding the person in the spotlight.

The worst programs weaponize the mic. I’ve watched attendings turn M&M into a public flogging, then act surprised when no one speaks up about near-misses anymore. That’s not funny. That’s just toxic.

But you asked about the funny stuff. So let’s keep going.

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The “Future of M&M” You’ll Pretend to Believe In

Every few years someone decides to “fix” M&M.

They announce:
“We’re going to make this safer. More systems-focused. Maybe even… anonymous.”

Here’s how that plays out behind the scenes.

Anonymized Cases: The Worst-Like-Us Game

People try anonymous formats. No names on the slides. Just “Resident A” and “Attending B.”

By slide 3, half the room has figured out exactly who “Resident A” is:

• The call schedule is public.
• The chart style is unmistakable.
• The attending who’s suddenly very quiet? Dead giveaway.

It turns into a weird, half-whispered game of “Guess Who.”
You’re not supposed to say it, but you know.

The intention—protect people so they feel safe disclosing errors—is good. The execution crashes into the reality that hospitals are gossip ecosystems with shared trauma and very long memories.

AI-Augmented M&M: The Coming Circus

You’re in the “future of medicine” category, so let’s be honest about where this is going.

In a few years, someone will roll out software that automatically pulls all adverse events, near-misses, overnight rapid responses, time-to-antibiotics delays, and suggests “cases for M&M” with natural-language summaries.

That means:

• Every time you typo an order and correct it, some algorithm may flag: “Near-miss: wrong dose ordered, canceled before administration.”
• The AI will spit out “contributing factors” like “provider fatigue” and “high patient-to-provider ratio” in beautifully color-coded dashboards.
• Admin will drool over the metrics.

And then we’ll sit in M&M watching a machine list our sins, while a human panel pretends this is all an impartial process.

You know what the residents will do? Exactly what they do now.
Turn it into dark humor.

“Did the AI just roast me for my fluid choice?”

“Cool cool cool, Skynet thinks I’m ‘pattern-prone to late antibiotics.’”

“Do we get to submit a rebuttal to the algorithm?”

It will not fix the core problem: medicine is messy, understaffed, overstretched, and deeply human. And humans cope with pain—especially preventable pain—with humor.

The “future of M&M” probably looks like:

• More data.
• More automation.
• The same hushed laughter after someone accidentally leaves “WTF” in a slide note that gets projected.

Some things are timeless.

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Aspect	Official Story	Real Experience
Purpose	Systems improvement	Systems + subtle blame + culture theatre
Tone	Solemn, academic	70% serious, 30% suppressed dark comedy
Cases Selected	High-yield learning	High-drama, politically safe, sometimes random
Learning Points	Objective, evidence-based	Half teaching, half passive-aggressive subtweets
Emotional Outcome	Enlightened and reflective	Mildly traumatized but weirdly bonded

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Why This Humor Matters More Than You Think

Let me be very clear: nobody is laughing at bad outcomes. The room goes quiet when there’s real harm. You feel it in your gut.

The humor circles everything around it:

• The impossible expectations.
• The absurd workflows.
• The way three different services can all think the other one is responsible.
• The fact that you’re being judged on decisions made when you hadn’t eaten in 10 hours and were wearing a pager that sounded like a fire alarm.

Residents use comedy as armor. Faculty do it too, though they hide it better. M&M is where medicine admits, briefly, that we are not robots.

And that’s the unspoken secret: the funniest M&M moments are also how the culture metabolizes shame and fear without losing its mind.

You cannot write that into the official objectives. But you’d feel its absence if you ever took it away.

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FAQ

1. Is it actually okay to laugh during M&M? Or is that career suicide?
You do not belly-laugh at the front of the room. That’s how you get a reputation for being flippant about harm. But a quiet smile at a ridiculous systems failure, a small chuckle when someone makes a light self-deprecating comment—that’s normal. Watch the seniors and attendings you respect. Match their level. If the program culture is hyper-formal and dead silent, you keep the humor for the hallway afterward.

2. Do cases really get chosen for drama instead of learning?
Sometimes, yes. Publicly, it’s about “learning opportunities.” Privately, people also weigh politics: which attending can handle being scrutinized, which resident can take the heat, which service needs a “reminder” about something. It’s not pure pedagogy. I’ve seen truly educational cases skipped because the fallout would be too ugly, while a more superficial but safer case made the cut.

3. How do I survive presenting a disaster case without getting destroyed?
Own what you did wrong. Don’t get defensive. Frame your choices in the context of what you knew at the time. Explicitly name the real-world pressures: volume, competing priorities, unclear handoffs. Good attendings respect honesty more than rehearsed perfection. And for your sanity, debrief with co-residents after. Turn it into story, not just shame. That’s where the healthy humor lives.

4. Is M&M actually effective at improving patient care, or is it mostly theater?
It’s both. Theatrical? Absolutely. Sometimes performative as hell. But I’ve also watched real changes—new protocols, clearer paging hierarchies, better backup systems—come directly from repeated M&M themes. The comedy is a side effect of humans trying to systematize chaos. Under the sarcasm and the awkward jokes, people do care, and M&M is one of the few places the system is forced to look at itself, even briefly.

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Key points to walk away with:

1. M&M is officially solemn, but under the surface it’s powered by dark, necessary humor.
2. The funniest moments usually expose the gap between ideal medicine and 3 a.m. reality.
3. If you understand that culture, you won’t just survive M&M—you’ll actually learn from it without losing your mind.