Wednesday, August 16, 2006

Dark Humor

The medical side of psych is given to dark humor about our clients. Social workers and some psychologists are much more likely to be offended by this, even if extreme care is taken to keep the offending comments away from patients and families. The neuropsychiatric team I once worked on was even more extreme, and I understand that neurosurgery is worst (or funniest) of all. There does seem to be a correlation: the more truly pathetic a patient’s situation is, and the less able we are to restore full functioning, the grimmer the humor.

It is often difficult for student nurses and new employees to absorb. To them, it seems shameful and insulting, as perhaps it should at first hearing – or tenth hearing.

Christine was refusing to let people in her room last night, waiting in the doorway…

Sounds like badger-like behavior

Or a weasel.

No, she’s much too sizable for a weasel. A boar, maybe.

My ethology is weak. I defer to your judgement in this doctor.

Badger-like behavior. BLB. Should we have our esteemed behavioral psychologist design a program to reduce BLB’s? John?

Are you going to ramp up on her meds some more?

No, she says they’re good where they are.

May I remind you doctor, that this is a badger who is telling you her meds are fine? A badger who greets you every morning with a joyful “Horsey!” and throws her stuffed animal at you?

What is that thing? It’s not a dog.

It’s a horse.

A fairly damaged horse, I’d say. Perhaps we need to run the two of them through the MRI together.

Maybe we can fix the horse.

If it were your family member we were talking about, you’d never let us treat her. Except that families, who are often in the same sad boat, have dark humor as well.

I wonder if the angels have dark humor about us, because the pain of watching us is too much not to.


bs king said...

I can say from personal experience that you all would also do well as ER staff. Example: After a particularly atrocious call over the radio about an industrial accident where a worker fell and landed on some equipment and got completely mangled, we were all looking at eachother in dismay that they were even bringing this case in. The first comment made?
"Why don't the medics just come right out and say it..."the head will be arriving in a seperate ambulance"".
We all thought that was the funniest thing.
For the record, the speaker was technically Harvard faculty.

Anonymous said...

I'm a former EMT. I didn't spend much time in the field, but my EMT instructors started on day one with the grim humor. By the end of the course, we were accustomed to it, so when I am in a situation with EMT's or medical personnel (my sister is a nurse), it doesn't really phase me. (I suppose that it would if it were me or a family member they were talking about.)
Some of the best lines:

About an embolism: "Something breaks off and goes kayaking through the blood stream..."

Head injuries: "Exposed gray matter generally means the patient is suffering from a terminal inconvenience." "When you see gray matter on the road, call the coroner, and take a break. No point in rushing."

Mechanism of injury: "Star patterns on the windshield are general signs of head trauma. Significant hematomas on the sternum and abdomen are general signs of internal trauma. Steering column poking out the back of a patient is a general sign of terminal inconvenience..."

Burns: "With a patient with significant burns, immediately call for ALS intercept (paramedics, etc.)" Student: "Is that because they can push fluids?" Instructor: "No, because they can push morphine. You don't want to listen to somebody burned badly. The screams will haunt your dreams."

"A patient is somebody you are sent to help. A victim is a helper who was injured in the attempt."

The funny thing is, some of the more morbid visuals they provided are still with me. I will never forget what an embolus (or thrombus) is, nor will I forget to fasten my seat-belt...


Anonymous said...

Those of us with handicapped kids sometimes shock people with the things we say. Our family's informal motto is "Let the Wookie Win". Our autistic, retarded, bi-polar, OCD, non-verbal (who sounds exactly like Chewbacca) daughter who outweighs me by 100 pounds often beat me when I tried to thwart her. (She's happy now in her own place where nobody yells at her or tries to take away anything she is cutting up)
Anyway, I was at a writer's conference when someone in our group said she was writing a book about post-polio syndrome and what one could do about it. I said, "I thought there wasn't anything you could do about it except grow weaker and weaker until you died." She said, "Well, no, there are a number of things..." and the conversation drifted elsewhere. Later a friend told me that the woman herself had post-polio syndrome.
So when I saw the woman at lunch, I sat beside her and said, "Now that you have your jerk quote for the front of the book, let's talk." I talked about my years in bed with lupus and the few hours a day I was up, people would ask me why I was yellow. When I mentioned lupus, every single person, every one, said, "I knew someone who had lupus, (Pause), and she died. Finally, one day while talking over the fence with the neighbor she asked the question, I answered, and she said, "I knew a dog with lupus, (Pause), and it died." I laughed for minutes while she stared at her crazy neighbor.
So the bookwriter and I discussed living with a chronic disease and became friends. I thanked God for her mercy and resolved to make sure I was surrounded by like minds before I said anything so calloused again.

LiquidLifeHacker said...

There should be a manual written!

Ha Ha bs King...I have been in the ER late at night (as a patient unfortunately) and heard some of the funniest things, like once I was watching a 25 something male patient get signed in and he kept whispering lightly and the poor girl signing him in kept saying could you speak up please, as she typed away and finally the guy said in a very very loud voice, "I haven't shit in over three weeks and so I need some help!" We had all seen the agony the poor chap was in but what was the funniest part was the timing of a group of nurses in the adjacent room started giggling as on cue and didn't stop, I don't think they heard the guy but, it got the rest of us going, which were sitting in the waiting area onto what I call the "church giggles" I felt so sorry for the guy but I couldn't stop laughing! It was such a hoot of laughter that even in his pain the guy held his gut and started to laugh too! I couldn't even imagine anyone going two weeks without getting help before then but we all had a good group laugh and for those moments we all forgot our troubles. I just remember that laughing really took me away from the pain I was in that night and decided right then and there laughter can be a blessing in disguise.

BTW AVI, when I read your, "I wonder if the angels have dark humor about us, because the pain of watching us is too much not to."

This really made me think, because I was with someone onetime that died and you know that feeling when relief jumps up front and rides shotgun with your grief? I tell ya, It was like I could hear an angel whispering to me like a party horn uncoiling with force into my ear, "Smile...they made it...the gruesome part is over...don't feel guilty because you can't come with's time to celebrate, hate to leave you right now, but a party is on!"

Its such a feeling of being left behind, but then, it comes tumbling down on ya, that a celebration awaits you one day too!