Hospital Humor
For anyone other than a nurse or doctor, this joke might seem crude and inappropriate, but you know that it is pretty typical of the humor you experience on the job every day. In the keynotes I do for nurses and doctors, I always ask them to describe their sense of humor in a single word. Ninety per cent of the time, the word that is shouted out from all over the room is "sick." ("Macabre" and "black" are also common descriptions.)
Most nurses and doctors have this sick sense of humor. You share humor that the average person would consider insensitive or inappropriate. (Policemen, firemen and EMS professionals also have this kind of sense of humor, as we will see later.) Why do hospital staff have such a crude and macabre sense of humor?
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Many of you confront life-threatening tragedy every day. So if humor does help cope with extreme emotional stress, as the basic research consistently suggests, you would expect it to show up in hospitals, where staff are exposed to serious illness and injury, death and dying every day. Working in a hospital is tremendously stressful, and staff have no choice but to develop effective tools to help them cope. Most doctors and nurses soon learn that humor is an especially powerful tool in letting go of the difficult emotions that accompany every day's work.
And where in the hospital would you guess that such humor is most common and most extreme? Answer this question from your own experience before you read further. Where should the greatest need for the benefits humor offers occur? In those areas where the illness or injury is the greatest, and where the threat and actual occurrence of death is most common: the emergency room, operating room and critical care units. Again, most nurses are very aware of this.
Every time I speak to a hospital group, I also ask them where in their hospital this black or sick humor is most extreme. The answer is always the same: ER, OR, CCU. The very same conditions that generated this kind of humor in the book and TV series "M.A.S.H." are operating in these areas of the hospital, and the black humor predictably emerges. Humor has also been found to be the most common coping mechanism of staff members in a psychiatric emergency room.71 Gallows or sick humor is also common among mental health clinicians who experience a lot of stress in t heir work.72 I've learned not to share this humor in my programs for non-hospital staff, since the reaction is invariably one of disbelief that healthcare professionals would laugh at such things.
New staff members, who are often initially put off by crude hospital humor, soon learn to enjoy it - or try to work elsewhere. Most realize that this kind of humor helps them live with the terrible things they must confront every day. It helps them fight off burnout and do their job effectively.
The following letter demonstrates doctors' and nurses' awareness of the importance that humor and laughter play in helping them cope with the constant stress of their jobs. It was written by the anesthetist present during the surgery on a man who died during the surgery.
"You saw me laugh after your father died. I was splashing water on my face at a sink midway between the emergency room lobby and the far green room where his body lay. Someone told a feeble joke and I brayed laughter like a jackass, decorum forgotten until I met your glance . . . your eyes streaming with tears . . .
My laugh was inappropriate, and for that I apologize. But it was a necessity. I laughed, nominally, at a corny joke. It's no secret that hospital people seem to enjoy warped humor . . . we're often too morbid: burned patients become crispy critters; Vietnam casualties were Jungle-Burgers. It's not pleasant. Neither is hospital work, at times . . .
While we may appear emotionless behind our various masks, please understand: Much of the stress that health care workers suffer comes about because we do care. We cared about your father . . .
That day you saw me laugh, I knew that another patient was waiting who needed my care and full attention in surgery. As I stood at that sink and washed sweat and vomitus from my face and arms, my laugh was no less cleansing for me than were your tears for you." 73
If you're the next patient to go under the knife with this surgery team after they've lost a patient, you want their full attention. You don't want them thinking about the last patient, whether there was something they missed, should have done, etc. So you want them to have a good belly laugh. The laughter helps them let go of any tension and upset that could prevent them from giving you their best effort during your own surgery.
Build Your Humor Skills 1. Gastroenterologists just have a _____ feeling about the decision. Clue: Another word for intestines. 2. Microsurgeons have no trouble agreeing because they're always thinking along the same _____. Clue: A blood vessel. 3. The proctologists considered the financial condition of the hospital and refused to go along with the decision, saying "We are currently in _________." Clue: They are behind in their payments for medical equipment. 4. The osteopathic doctors did not like the decision; felt they were being ________. Clue: Osteopaths sometimes do the same thing chiropractors are known for.
[Work on all four before checking the answers on the next page.]
If you're a doctor or nurse, you will always laugh at things others find cold, morbid and unfeeling. But this laughter is essential to fighting burnout and keeping yourself focused - prepared to deal with the next crisis situation that could come at any moment, possibly with someone's life on the line.
If you work in a hospital, you know that healthcare staff also laugh at more benign forms of humor, including things that patients say. For example, after completing his examination of a young woman, a male gynecologist told her that she had acute vaginitis. Her response was, "Why thank you." Another woman was concerned about the dangers of tampons. She asked her doctor if she was at risk for toxic waste syndrome.
