What's So Funny?
Health care workers have long enjoyed a reputation for their dark senses of humor. They are amused by situations that other people would find appalling--situations that often involve death, disease, and even mental illness.
They do this, of course, as a defensive mechanism. Subjected constantly to images of suffering, they realize that they must either make light of a particular situation or become depressed by it. Think about the old TV series, M*A*S*H. Hawkeye, Trapper John, and B.J. found humor in just about everything. They had to, or else they couldn't have done their jobs. That's how it is in the world of medicine. To avoid becoming a casualty, you have to develop a thick skin. In the process, you learn to laugh about topics that make other people uncomfortable.
This behavior is not limited to those who work in hospitals, of course. Police officers do it, too. And firefighters. And EMTs and paramedics.
Last week, a man in China threatened to commit suicide. He stood at the edge of a bridge for several hours, tying up traffic as public safety authorities negotiated with him and readied an air bag below. Finally, a retired soldier decided to take matters into his own hands. He approached the would-be jumper, reached out to shake his hand--and shoved him over the edge. Asked in a newspaper interview why he did it, the man said that it had been selfish of the jumper to keep so many people waiting, especially when it was clear that he didn't have the courage to actually kill himself.
I found this story amusing, not because I have anything against people who contemplate suicide, but because the retired soldier actually did what others surely were thinking. There have been times, while negotiating with would-be jumpers, that I've thought to myself, "This is ridiculous. You're never going to jump. So why are we even up here?" I'd never say that out loud, of course, but I couldn't help thinking it. And here was this guy in China, actually carrying out those thoughts. The story would have been better only if it had been the rescuer, instead of a passerby, who had pushed the guy over the edge.
When finding certain things amusing, we sometimes forget that the experience of the public is not the same as our own. Outsiders will hear us laughing about the antics of a homeless person, for example, and they'll become incensed by our callousness. But there's generally nothing mean-spirited about any of this. It has more to do with familiarity. We deal with homeless people every night of the week, and at times, they do things that happen to be funny.
The same holds true of death. For the most part, resuscitation is a serious business. You're trying to bring someone back to life, after all, and nothing can be less funny than that.
But even during a cardiac arrest, with CPR in progress and all sorts of medical procedures being frantically performed, humorous things occasionally happen. It generally begins with an observation of some kind--Why did it take so long for that woman to call 911? Didn't she notice the dead body in the middle of her kitchen?--and then additional comments are made until finally we're laughing so hard that tears are streaming down our faces. To an ordinary person, this scenario is completely unacceptable. Death is a sacred topic, and besides, the rescuers on TV and in the movies always take everything so seriously. But you have to remember that this is our workplace. We've worked hundreds, or maybe thousands, of cardiac arrests, and we can do most of the necessary procedures in our sleep. Every so often, something funny is going to happen--just as it will in any workplace--and it's going to make us laugh.
Of course, some things are never funny, not even to us. If a patient goes into cardiac arrest, and his relatives are within earshot, then of course we're not going to laugh during the resuscitation effort. That would be callous. Likewise, you'll never find an EMT or paramedic laughing about a tragedy involving a child, or about certain kinds of terminal diseases.
Because while we may be thick-skinned, we're not heartless.
The story about the would-be suicide in China was reported in several places. Here is one link: http://news.bbc.co.uk/1/hi/world/asia-pacific/8064867.stm