Humour can help cope with the most unfunny situation
September 25, 2008
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Robert Buckman
SPECIAL TO THE STAR
"Cancer" isn't funny. In fact it's probably the most frightening word in the English language.
Yet, my stand-up comedian friends tell me that 92.9 per cent of all jokes are about a relatively small number of topics – illness being one of them.
In my own experience, I have seen dozens of patients make a joke in order to cope with situations many of us would consider dire.
One example, which occurred more than 20 years ago, is unforgettable. My patient was a survivor of breast cancer. She had a mastectomy about 25 years prior to our first meeting and always wore an external prosthesis (which she referred to as a "falsie") inside her clothes.
When I met her, she was in her late 60s. The day before her visit to our clinic, she went swimming and the prosthesis fell out of her bathing suit, then started to make its way to the shallow end of the pool. Her friend was horrified and hissed, "Doris! Doris! Your THINGY has just fallen out."
What was my patient's reaction? Not horror, or utter embarrassment, as you might expect.
"Do you know what I said, Dr. Buckman?" she told me. "I just looked over my shoulder and I said, `Oh, there it goes, doing the breaststroke on its own.'"
A good one? Absolutely. And a wonderful approach to the predicament, as well.
What Doris, my patient, did was employ humour as an antidote to reduce the size and the stress associated with a threat or embarrassment (which is really a socialized form of threat or pain).
My theory (and it's only a theory) is that when any of us make, or laugh at a joke – no matter how threatening or frightening the subject – we basically put a frame around that fear.
We somehow establish a sense of perspective about the looming threat. When we are able to see some humour in a difficult situation, we reduce the stress and anxiety that we would normally feel. Humour is a mechanism that helps us cope with the things in our lives that hurt or threaten us.
By making that deviation from the "normal" reaction to the situation, a person such as Doris is basically saying to the onlooker, `Hey – you expected me to react that way, but look, I can exercise my own free will and I can respond in this way.'
As such, a humorous response acts as a valuable form of communication between the joker and the "jokee.'' (Assuming that there is such a word as "jokee". And if there isn't there should be.) The joker is sharing her or his ability to respond to the threat in her or his own way, stamping her or his own style on the event.
I think that this is why humour is useful and so common in threatening situations. But it has to come after the serious issues have been reflected upon and given sober consideration. Nobody can, or should, ever make a joke instead of discussing something important – but levity can be a very useful method of "decompressing" the emotions afterwards.
That is why, I believe, there is so much medical humour, usually generated by the patients. Although there is nothing intrinsically funny about cancers or their treatments, humour is a valuable coping strategy that can help everyone – patients, friends and health-care professionals – swim against the tide of disease and the depression it can cause.
Dr. Robert Buckman is a medical oncologist at the Princess Margaret Hospital and The Campbell Family Institute for Breast Cancer Research, University Health Network, and a professor at the University of Toronto
Toronto Star
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