Heard any good ones lately

I like jokes—hearing jokes, telling jokes, making funny turns of phrase. One of the ways I get through the joys, sorrows, pleasures, and frustrations of daily existence is with humor. I hear jokes almost every day, and sharing jokes with friends and acquaintances is something I like very much. As a hospice volunteer, I have learned that humor is often a good way for me to communicate with hospice patients.

I didn’t understand that role of humor when I first became a hospice volunteer nearly twenty five years ago. Like most new volunteers I was unsure about how to behave around patients and their families, especially what to talk about, what to say. The first patient to whom I was assigned introduced me to the idea that humor has a role in hospice work. W was an elderly man who had been a volunteer himself for many years with a service organization. Because of that experience he knew what volunteers did and how to relate to them. He was open and easy to talk to, and I soon learned that he liked jokes. Although he was dying of lung cancer and was having to deal with other family problems, he showed me by his good sense of humor and enjoyment of jokes that he was still alive and capable of laughing at life and its foibles. We traded jokes back and forth, and humor became sort of a currency between us. I still remember, and frequently tell, one of his jokes—one about an elderly couple going to the doctor with problems regarding sex.

That brings up an important point about jokes. Humor is a personal trait: a joke one person thinks is hilarious might be considered inane, NOT FUNNY, or offensive by another person. Humor doesn’t always work. Some people just don’t like jokes, and some patients are too sick or are too overwhelmed by their illness and pending death to find anything funny. That is the exception more than the rule, though. Usually, people want to laugh, even dying people and their families.

Humor is not an artificial, forced way to ignore what is happening to a patient. Instead, it is an acknowledgment that the patient is still alive and capable of appreciating life. Too often a dying person becomes his or her illness in the eyes of family and friends. It is easy for someone close to a dying person to be overwhelmed by the person’s condition and to forget that underneath the signs of mortality is someone still alive and part of the world. Often it is hard for close friends or relatives of a patient to make a joke—the humor comes out sounding forced and artificial. That certainly was the case for me, long before I was a hospice volunteer, when I visited my father as he was dying of cancer. I didn’t know what to say, and my attempts at humor or light-heartedness wilted as the words came out.

Humor works for me as a volunteer, though, in part because I am a stranger. I didn’t know my patients before they got sick, so I can more easily accept them as they are now when I see them as hospice patients. I don’t really think of them as dying either. Rather I think of them as if they were some neighbors on my street who might need some help or a visit. Consequently, I can talk to them as to any recent acquaintance, without any feelings of sadness or pity or bitterness. And in that aura of normalcy amid the circumstances of their dying we can make jokes and trade stories.

I have wonderful memories of sharing jokes with several patients. Of course, there was W, my first patient and the one who showed me the role of humor. Then there was R, whom I saw for several months as he was dying of prostate cancer. Originally the nurse/case manager thought that R was suicidal and felt that a volunteer would help distract him from those thoughts. I began to visit R and soon realized that he wasn’t so much suicidal as just lonely because he was by himself with his thoughts all day while his wife worked. I also realized that he liked jokes and seemed to recall every joke he had ever heard in his 70+ years. I would visit once or twice a week and we would spend an hour or more swapping jokes.

I also visited M, a woman in her 80’s originally from New York City. She had a grand New York accent, some splendid jokes, and the timing of a Borsch Belt comedienne. She had had a long marriage and particularly liked jokes that deal with husbands and wives. She told me the one about the couple in their 90s who were going before a judge to get a divorce after 72 years of marriage. The judge wanted to know why they wanted to get a divorce at this stage in their lives. The man replied, “Well, we haven’t gotten along at all for years, but we stayed together for the kids’ sake. Now they’re finally dead.”

Jokes have even worked when the patients couldn’t speak. I visited J, an elderly man who was aphasic from a stroke. Although he couldn’t speak, J was quite communicative with his gestures and facial expressions. I would visit him for an hour or so every week in the skilled nursing facility where he lived. I would tell him about my family and work and ask him about his health, the food, etc. I soon realized that he liked jokes and evidently hadn’t heard many in a long time. He was a splendid audience because he liked my jokes and because he showed his pleasure so obviously.

K was another patient who could not speak, not because of a stroke but because of Amyotrophic Lateral Sclerosis, Lou Gehrig’s Disease. I was visiting him at the time of the OJ Simpson murder case, and OJ jokes became a standard item on our agenda. I visited with K for several months as he declined. One evening I went to visit him, to say good-bye since the nurse/case manager did not expect him to live through the night. As I said good-bye I told him that I wanted to leave him with the latest joke I had heard. I related the joke as I squeezed his hand. He died that night, but I still remember K quietly chucking to that last joke.

Some people ask me how I can joke with a dying person. My reply is that hospice is not so much about dying as about living as fully and normally as possible until death comes. Dying persons are still humans, and most humans need and want to laugh. Moreover, humor sometimes offers a way to express real feelings about situations that are uncomfortable or difficult to talk about.

Heard any good ones lately?