Mind if I Laugh?

Mind If I Laugh?
originally published  2007

Following the events of September 11, 2001 and the terrorism that ensued, I continued traveling around the country, addressing groups about the healing power of humor and laughter.  I heard a variety of comments:
“I really want to laugh, but I just can’t bring myself to do it.”
“I can’t bear to watch another news report—it’s sucking the life right out of me.”
“I feel like laughing, but I’m afraid other people will think I’m being inappropriate.  Is it really okay to laugh yet?”

Abraham Lincoln may have said it best: “With the fearful strain that is on me night and day, if I did not laugh I should die.”

Now more than ever, we, as individuals and as a country, need the healing power of humor and laughter to deal with the tragedies we experience.  Reports showed that the country is in poorer health overall than it was prior to September 11th.  Accompanying the levels of higher anxiety and stress are people suffering from a myriad of stress related illnesses and conditions: Headaches, stomachaches, general malaise, fatigue, difficulty sleeping, muscle aches, difficulty concentrating, depression, and the list goes on.

People find many ways to cope with their stress including unhealthy means, such as abuse of drugs, alcohol, food, sex and work among others.  A healthy person needs a variety of coping mechanisms at his disposal, as there is no single coping mechanism that will be right for every situation.  Humor should be one of the many tools one carries in his repertoire, as it is recognized as one of the healthy coping mechanisms we have available at our disposal.

Humor relieves anxiety and tension, serves as outlet for hostility and anger, and provides a healthy escape from reality.  It lightens heaviness related to critical illness, trauma, disfigurement, and death.  It comes as no surprise that many people are utilizing humor to deal with the trying times.  But is the humor timely?  Is it appropriate?

“When tragedy and death cloud our lives, they darken our humor as well.” (Karyn Buxman, This Won’t Hurt A Bit)

Much of the humor that saw after 9/11 is what has been referred to as gallows humor, dark humor or black humor.  In her book, Humor and the Health Professions, nurse researcher Vera Robinson explains, “(Black humor) is a humor that people have always used when they feel hopeless and helpless, when there is nothing we can do to change what has happened.  Black humor is a defense against the horror against whatever it is we fear and is a way to master it, and give us a sense of control by laughing at it.”

The truth is that we all experience tragedy on a variety of levels.  For some of us, it may be on a personal level.  At times, it may be on a community level.  And periodically we experience tragedy on a national or even global level.

On a personal scale
None of us will escape experiencing personal tragedy: Illness, accident, loss of job, divorce, or death in the family.  These painful ordeals can sometimes evoke humor that allows us to ventilate our frustrations about such unfair events in life.

Sometimes when we use humor to cope, others discourage us with comments about the inappropriate nature of the humor.  One patient told me that when making a joke about his cancer his daughter admonished him by saying, “Dad, you must not understand just how sick you are or you wouldn’t be cracking jokes about this.”

Author Allen Klein asked terminally ill patients about the use of humor and laughter during their illnesses.  Over three fourths of those surveyed said they wished their care providers and support persons would use more humor and not discourage them (the patients) from using humor.

On a community scale
Communities experience tragedies such as floods, earthquakes, fire, natural disasters, loss of industry or politicians caught in compromising situations.

1993 marked ‘The Flood of 500 Years’ on the Mississippi River. Communities along the entire river experienced flooding, destruction of property, loss of homes and jobs, and sometimes death.  Yet, humor marked the will of people to keep their spirits afloat, not to be oppressed and depressed by the Muddy Mississippi.  In Iowa the Des Moines Register held a contest, “I’m a Floody Mess,” where contestants tried to one-up one another with descriptions of their misery.  When the local water system failed as a result of the flood, and running water for drinking and bathing was no longer an option, one contestant wrote, “I smell so bad that my Sure deodorant is undecided.”

Following the 2007 fires in San Diego, in which almost half a million people were temporarily displaced and thousands lost their homes, healing and recovery once again were marked by signs of humor—sometimes literally. In front of one home which had been reduced to ashes, the owner posted a sign that said, “Fire Sale! Everything Must Go!”

On a national scale
Unfortunately we will witness events that have national ramifications, such as the Shuttle Challenger explosion, and even global ramifications, such as the loss of the World Trade Center in New York. With the technological advances in mass media, events that might once have been local tragedies now impact people near and far: The shootings at Columbine, the Oklahoma City bombing, Hurricane Katrina:  These events hit home through television, radio and print around an entire nation and beyond.

At times, the humor demonstrated after these events was a ‘hoping humor’, a “let’s hang in there together and we’ll get through this together” kind of humor.  The focus of the humor was more situational and unrelated to the tragedy; the humor was used as a relief mechanism from feelings of sadness and feeling overwhelmed.  One survivor of the Oklahoma City Bombing commented, “I laugh because I’m cried out.”

While we certainly see many examples of ‘hoping humor’ related to the tragedies of recent terrorism, we also see ‘coping humor’ or the humor that is used to express anger in a socially acceptable way.  By targeting humor at the ‘enemy’ or the oppressors, we are able to whittle them down in size and feel more powerful, more superior.

Some of the humor after 9/11 was grotesque, such as computer exercises allowing us to shoot Osama bin Laden in virtual games or blow up terrorists with a keystroke from the comfort of our own computer.  Some humor was less violent, yet still targeting our enemies.  An example is an e-mail forwarded to me:

“The nonviolent solution currently being circulated is to say to the Taliban:  Give us Osama bin Laden or we will take all of “your” women and send them to college.”

The Internet provides opportunities galore to express our frustration and disgust through games, cartoons, websites, jokes, discussion boards, chat rooms and e-mail targeting bin Laden, the Taliban and the like.

The challenge: What is stress relieving for some is stress producing for others.  While some find gallows humor to be a positive means of dealing with their stress, others find these expressions of humor to be salt rubbed into an already irritated wound.  What’s appropriate?  What’s not?  There is no clear-cut answer.  Gallows humor can be a positive means of coping with anxiety, but it helps if certain guidelines are followed:

Establish a bond: Gallows humor is less offensive when there is a bond between the initiator and receiver of the humor.  Often this is a type of ‘inside humor’ that is utilized within certain the boundaries of a certain group of people. There is an almost unspoken agreement: “I’ll not be offended by your sick humor if you agree not to be offended by mine.”

Be aware of the environment: The trick is to keep the humor within the confines of said group.  Once the dark humor escapes the confines of the group, it then may become hurtful.  Anyone who hears, sees or experiences the humor is part of the audience, whether you intended them to be or not.  Think twice before hitting the ‘forward’ key on an e-mail or blurting out a joke you just heard.  Will it be hurtful if unintended audience members intercept?

Be sensitive to the timing:  H. G. Wells once said, “The crisis of today is the joke of tomorrow.”  Generally it takes time for people to see any humor derived from pain or discomfort.  Some people never will.  Every person’s situation is unique and determined by their own set of circumstances and life experiences.

Despite its multiple benefits, humor is always risky business. Try as you may to be politically correct, there will almost always be someone waiting in the wings to be offended.  The humor or laughter provides an excuse for him to ventilate about an unspoken and deeper issue.  That being said, if you choose to use humor to cope with difficult times and are mindful of the feelings of others then, more than likely, most folks won’t mind if you laugh.  Indeed, they may welcome the respite.

Plato and a Platypus Walk into a Bar

They met as freshmen at Harvard 51 years ago! Thomas Cathcart and Daniel Klein have been longtime friends and colleagues. Not too long ago, they checked into a hotel with a pile of joke books and a pile of philosophy books and the result: Plato and a Platypus Walk into a Bar… Understanding Philosophy through Jokes. (Well, actually the original title was An Existentialist and A Horse Walk into a Bar—no joke, but I digress…)

Forty publishers rejected their book. Fortunately, the forty-first, Abrams Image, was savvy enough to spot a winner. A New York Times Best seller, as a matter of fact.

For those of you, like me, who managed to escape taking Philosophy in college (nurses aren’t encouraged to philosophize, especially while performing CPR), you would be pleasantly surprised at how the great insights of philosophers such as Kant, Aristotle, Descartes, Nietzsche, and Marx (Karl and Groucho) can be explained in such an understandable and hysterical way. The wit and charm of this book make it a must have for your library (even if your library is in your bathroom).

But as great as the book is, it cannot compare to seeing these two guys live and in person. I had the pleasure of laughing with them as they did a reading and signing at Warwick’s in San Diego. Fortunately for me, these guys are not aspiring to be full time speakers and entertainers (whew!). Fortunately for you, they are aspiring authors and have one sequel completed (Aristotle and an Aardvark Go to Washington… Understanding Political Doublespeak through Philosophy and Jokes) and another on the way.

Check out their humor and their website where you can buy their book and tell them I send laughs from San Diego!

Life in the Fast(food) Lane

A wise person once said, “Wherever you are, be there.”

Have you ever found yourself collapsing into bed at the end of an exhausting day wondering, “What did I do all day?”  Think about it for a second…  How many ‘hats’ do you wear in a 24-hour period?  For instance there’s the parent or grandparent hat, spouse hat, the hats of chauffeur, parishioner, volunteer, friend… just to name of few.  For some of you, the list may go on and on.  Think I’m exaggerating?  Perhaps your day goes more like this:

Waking up from a peaceful sleep, you begin the day sipping a piping hot cup of coffee in bed while scanning the morning newspaper.  Then you follow a tantalizing aroma to the kitchen where your significant other has prepared and serves a delicious but low-fat breakfast that you consume at your leisure.  Next, you slip on your sharpest outfit, stroll to your luxury car and breathe in the smell of fresh interior.  Noting your teenager left you with a full gas tank, you ease out of your driveway, cruise to work, and relax to your favorite music.

Seated at your immaculate desk, you dive into your work.  Then, after a productive morning, you take a well-deserved lunch ‘hour’ with a few favorite colleagues.  Returning to work, the company president pats you on the back, gives you a knowing wink, and says something about the bonus coming up in your next paycheck.

Once home, your family rushes to greet you, asking, “How was your day?”  You pick up the newspaper, settle into your overstuffed chair, kick off your shoes, and channel surf to your favorite television station, while the family prepares your favorite dinner.  After a mouth watering meal, you retreat to your spot in the den and enjoy three hours of television while the family cleans up the kitchen, straightens the house, completes homework, and puts laundry away. You complete your busy day with a leisurely hot bath, surrounded by scented candles while you sip a glass of wine in complete silence.  Feeling refreshed and energized, you slip into the bedroom for an hour of passion and romance, then after a restful night’s sleep, you leap from bed and enthusiastically greet another day.

Yeah, right… As for me, the average American*, reality looks more like this:

I toss and turn throughout the night, struggling to organize tomorrow’s schedule. After fumbling with the snooze alarm twice (the average American spends 24 years sleeping), I shuffle to the bathroom mirror, bleary eyed and grateful that America does not see me like this.  I then stumble to the kitchen where I microwave the remains of yesterday’s coffee (the average American spends $35 on sleeping pills and $3,342 on coffee). Kids scramble around sticking papers in my face that need to be signed… what’s this note from the teacher thanking me for packaging candy this afternoon?  The chaos continues as the family trips over one another in and out of the bathroom (the average American spends 7 years in the bathroom) and into the kitchen where they grab granola bars and cold cereal.  Snippets of conversation go something like this:
“Do I have any clean underwear?”
“No.  Just turn yours inside out.  It’ll last another day.”

“Can you iron this shirt for me?”
“No, we retired the iron years ago.  Throw it in the dryer on fluff.  If that doesn’t work, you’ll have to throw it in the wash and start over.”

“My t-shirt’s inside out.”
“That’s the way I found it in the laundry basket.  You have 2 choices: Start turning your clothes inside out before passing them on to me; or wear them inside out– then the next time you pull them off, they’ll be right side out again!”

After kissing everyone and scooting them out the door, I throw on an outfit and scramble for 2 matching shoes (the average American spends 1 year and 6 months getting dressed).  I look in the mirror, then the clock, and decide to settle for a bad hair day.  I race to the car and breathe in the essence of cold fries, spilled milk shakes, and an obscure dirty sock.  A quick check of the gas gauge confirms my fears.  Maybe if I coast down hill, I can make it to the nearest gas station.  Realizing breakfast is a figment of my imagination, I fly through the fast food lane, juggle a cup of scalding hot coffee between my knees (the average American drinks 56,044 cups of coffee), and stop at the first intersection where I finally apply my lipstick (the average American spends 4 years traveling in the car; of that time 6 months is waiting for the light to turn green). Thank God for traffic lights or I’d never finish putting on my makeup!

At my desk, I struggle to find where yesterday’s paperwork ends and today’s begins. The computer beeps constantly with reminders of tasks unfinished and projects yet to do.  I stay at my desk through lunch, savoring my healthy meal of stale leftover Halloween candy (the average American eats 1,483 lbs of candy, including 801 pounds of chocolate, 240 Hershey kisses and 11,113 M&Ms) and wash it down with a soda that has no calories, no caffeine, no sodium, and no taste.  Dashing to the restroom, I spy a memo from the boss tacked to the bulletin board, displaying a nebulous message about possible restructuring and right-sizing.  Great…

At the end of the workday, it’s time for the ‘second shift’ (i.e., duties performed after work, women usually putting in approximately 31 hours per week, about twice as many as their male counterparts**).  With my mom/chauffeur hat in place I begin the after-school shuffle: football/baseball/weight lifting practice, karate lessons, and religion classes, etc. (the average American makes 42, 481 automobile trips).  Finally back home, I attempt to serve a meal that doesn’t come in a bag or a box (the average American eats out at restaurants 14,411 times including 1,811 trips to McDonald’s).   While nibbling on an Oreo (the average American eats 35,138 cookies; of those, 10,532 are sandwich style), I snag various leftovers from the refrigerator, whisk them together, dump the contents into a greased pan and crumble onion rings over the top.  Voila! A casserole that defies all logic (move over, Julia Child).

I prepare to sit down to eat with the family (the average American spends 17,307 hours eating meals at home) only to find everyone else wolfed down their meal and they’re already headed for homework and channel surfing (the average American, while watching TV, changes the channel 325,393 times).  Three hours later, after finishing dishes (the average American spends 16,961 hours preparing meals and cleaning up), laundry, and helping with homework, I discover it’s already time for bed.  There’s a vain attempt for a quick hot bath when I hear a quiet tapping on the door.  “Mom, I forgot, I’m supposed to bring 27 cupcakes in the morning to school ‘cause I’m the student of the week this week… okay?”

Easing out of the tub, I throw on my favorite flannel pajamas (the average American man has 166,148 sexual fantasies; the average American woman has 83,074 sexual fantasies), kiss everyone goodnight, and head back to the kitchen.

What did I do today? In its proper perspective, it was the best day yet, with many magic moments. However, with so many places to go, people to meet, and tasks to coordinate, it’s easy to lose touch with the miracle of now, to get sucked into life’s fast lane and miss the scenery along the way.  I don’t know how many hours the average American spends replaying mistakes from the past (I should’ve said… If only…), or how many hours the average American wastes worrying about what might go wrong tomorrow… or the next day.  But I do know that if I take a mindful step outside the fast lane and take a moment to be still, I become aware of all the gifts that surround me.  Life is an amazing journey. Live each day amazed and amused and take time to enjoy the trip.

Sources: * In An Average Lifetime, by Tom Heymann; ** ABC’s PrimeTime

What happened to The Journal of Nursing Jocularity?

Doug Fletcher, Publisher JNJ

Thanks for asking. I was Vice-President of the JNJ during its eight year stint and best friends with publisher, Doug Fletcher. Doug had a great vision when he created the JNJ and left a tremendous legacy. His untimely death, and the deaths of our friends and colleagues Bob Diskin (Too Live Nurse), Georgia Moss, and Diane Rumsey, left a huge void in the world of healthcare humor. In Doug’s honor, AATH has named its Lifetime Achievement Award after Doug (see www.aath.org)

Below is an announcement I created when we ceased publication of the JNJ. Barely a day goes by that I don’t think of Doug and smile.

The Journal of Nursing Jocularity was a quarterly publication for nurses and health professionals that was written, edited, illustrated and published by nurses and health professionals. The first issue was Spring, 1991; the last issue was the Spring, 1998. Filled with satire, true stories, cartoons, and all around funny stuff related to nursing and health care – it established its place in nursing history as the only humor magazine for nurses.
With the death of Doug Fletcher, Diane Rumsey, Georgia Moss, Bob Diskin, and Debra Woodbury on May 1, 1998 the Journal of Nursing Jocularity ultimately ceased publication.
Below is the news report from the Albany Times:

Tragic Accident Results in End of an Era

ELIZABETH BENJAMIN, MARK McGUIRE, and JOE PICCHI Staff writer

A fiery head-on collision between a tractor-trailer and a sport-utility vehicle left five people dead and three injured Friday morning on Route 20.  The dead were registered nurses scheduled to perform in a comedy show Friday night at the Theater Barn in New Lebanon. The show — “Who’s Got the Keys?” — was supposed to run three nights. A representative of the theater said Friday afternoon that the show had been canceled.All the victims, three women and two men, were in a 1994 Ford Explorer. One woman was thrown from the vehicle onto the road. The others remained in the Explorer, which caught fire after the tractor-trailer rolled over it, police said. A third car, a 1987 Chevrolet sedan, also was involved in the 10:24 a.m. accident.  The Explorer was registered to one of the victims, a Columbia County resident. The others were from Florida, Michigan, Pennsylvania and Arizona, State Police Capt. John Byrne said.The names of the dead were being withheld pending notification of their families, Byrne said. They were pronounced dead at the scene by Columbia County Coroner Angelo Nero.State Police Sgt. G.E. McGreevy said the Explorer pulled out of Jefferson Hill Road onto Route 20 and into the path of an eastbound tractor-trailer laden with about 1,300 used tires. The vehicles collided head-on.  The crash also involved a third vehicle that was heading west on Route 20 toward Nassau, which police surmise might have collided with the tractor-trailer before it rammed into the Explorer.  The condition of the wreckage and the death toll made it difficult for State Police to immediately determine the accident’s cause, Byrne said.

Three people were pulled alive from the crash scene and taken to Albany Medical Center Hospital, one of them by helicopter. The accident closed Route 20, a two- to four-lane road that twists through Rensselaer County en route to Massachusetts.

Truck driver Byron Chacon, 30, of West Haven, Conn., is in fair condition, authorities said. He underwent surgery for injuries to his right arm and suffered multiple abrasions, according to hospital officials.  His co-worker, Jose Ardon, 38, also of West Haven, was in fair condition with a head injury, facial cuts and burns to his hands, officials said. He was taken to the hospital by helicopter.  Donna Brightman, 36, 921 Saratoga Ave., Ballston Spa, the driver of the third vehicle, was released from the hospital after being treated for a head cut and a knee injury.

Police said the tractor-trailer began its trip from the West Haven offices of Inter-East Tires, which collects used tires and brings them back to Connecticut. The truck had made several stops in Albany and Troy, and was en route to Pittsfield when the accident occurred. “I feel terrible,” said Inter-East Vice President Steve Briley. “This fellow (Chacon) has been an excellent employee. We’ve never had a problem.”

Brightman’s westbound sedan, which was damaged on the driver’s side, careered off the road into the woods about 100 yards from Jefferson Hill Road. Broken glass and parts of her car were strewn along the road, uphill from the crash site.

Byrne said it was too early to determine what happened, but police have developed a working theory: that the tractor-trailer was heading down a moderately steep hill on Route 20 while the Chevrolet was headed uphill toward the village of Nassau. The Ford Explorer was on Jefferson Hill Road, which is about in the middle of the hill. Police think the blue car might have hit the tractor-trailer first, causing the truck to plow into the Explorer as it pulled out of Jefferson Hill Road heading toward Nassau.

The Ford Explorer was reduced to a twisted, blackened hunk of metal. The vehicle appeared to be squashed, as though the tractor-trailer had driven directly over it — which Byrne called “one possible scenario.”

The impact of the trailer hitting the Explorer was so great that the vehicle’s license plate was found deep in the woods. The Explorer caught fire and was fully engulfed when the members of seven volunteer fire departments arrived.

The tractor-trailer plowed over the north side guardrail on Route 20 and flipped, scattering the used tires onto the road and into the woods. The trailer stretched halfway across Route 20, blocking the road.  Two hours after the accident, fire and police were still extracting the dead from the Explorer.  “You get pretty messed up when you see people burning and can’t do anything about it,” said Tsatsawassa Fire Chief Jay Kreutziger, who arrived at the scene moments after the crash and saw the Explorer engulfed in flames.

Kreutziger said a nearby resident, who was unidentified and could not be found, hurried to the road with a fire extinguisher in an unsuccessful effort to douse the flames.  Both truckers were able to get out of the vehicle on their own despite the fact that the truck’s cab was upside-down.  Traffic was diverted to side roads off Route 20, which remained closed as of 11 p.m. Friday but was expected to reopen by midnight.

At a news conference Friday night at Troop G headquarters in Loudonville, Byrne said he confirmed that several of the victims were nurses who were supposed to perform the night of the accident in a production called “Who’s Got the Keys?”  The show was part of a Nurses Week celebration, following a demonstration at the state Capitol by a grass-roots nurses organization called the Florence Project that publicizes problems related to health care.

Bright yellow fliers advertising the show were strewn about the accident scene at the intersection of Jefferson Hill Road and Route 20.  The fliers described “Who’s Got the Keys?” as a musical comedy put on by a cast of 20 singing and dancing health care professionals. The show was to be about an exhausted nurse who “discovers the real meaning of being a nurse” by battling an evil, four-headed HMO monster with help from a wacky cast of characters.

Katherine Smeland Pebler, the New York state coordinator of the Florence Project, said the five nurses who died in Friday’s accident had just rehearsed “Who’s Got the Keys?” at the Theater Barn and were heading to Albany to attend the rally at the Capitol steps.  A nurse who had been at the rehearsal but declined to join the group heading to the rally and instead went home to her 4-year-old son assisted the police in identifying the victims, Smeland Pebler said.

“Our profession has experienced a great loss,” said Smeland Pebler, reached by phone at her home Friday night. ”The fact that these RNs, who have been working so hard on this play to bring to light the demise of health care in our nation, died, is tragic. Further, it disturbs us with the Florence Project that they were on their way to our rally.” Oster
contributed to this report.

First published on Saturday, May 2, 1998
Copyright 1998, Capital Newspapers Division of The Hearst Corporation, Albany, N.Y.