A woman tells her doctor, ’I’ve got a bad back.’ The doctor says, ’It’s old age.’ The woman says, ’I want a second opinion.’ The doctor says: ’Okay - you’re ugly as well.’

In this gag, the setup mimics a familiar medical complaint-and-diagnosis exchange, then pivots on the phrase “second opinion.” Instead of revising the clinical judgment (“it’s old age”), the doctor supplies a different kind of “opinion”—a blunt insult about appearance. The humor relies on misdirection and on the double meaning of “opinion,” shifting from professional assessment to personal judgment. At the same time, it reflects a traditional strain of British music-hall/variety comedy associated with Tommy Cooper: quick, deadpan reversals and deliberately outrageous rudeness delivered as a punchline. The joke also illustrates how comedy can exploit social taboos (age and looks) for shock value.