Hannah is a native of western Massachusetts (USA) and a graduate of Georgetown University (BA, Spanish) and Regent College (MCS, Pastoral Theology). She currently lives in downtown Charleston, South Carolina, where she works as a Palliative Care Chaplain at the Medical University of South Carolina. She is a proud aunt to five nieces and nephews and loves to keep in touch with fellow Regent alumni by good old-fashioned letter.
On a recent Sunday in church, the woman behind me in the choir collapsed. A doctor ran up from the congregation, the defibrillator was found, clothes were ripped off, and chest compressions began. The soprano section feebly tried to distract the congregation from the medical emergency behind us by standing in a row and singing “Guide Me O Thou Great Jehovah” (and yes, we longed for the “the crystal fountain whence the healing stream doth flow”). It didn’t work too well. In the end, the whole congregation filed out of the church and paramedics rushed in to assist our fellow choir member, who turned out to be okay, though pretty embarrassed. A while later, I heard a wry member of the bell choir say with a bit of a snicker, “For whom the bell tolls... am I right!?”
I laughed to myself, too (not out loud, I’m not a monster!), because it reminded me all too much of the dark humour I find in my everyday life as a Palliative Care Chaplain at a large trauma hospital. Palliative Medicine, the department where I am privileged to serve, is an interdisciplinary medical specialty that treats symptoms and distress (physical, social, spiritual) in patients who have life-limiting illnesses or are at the end of life. You know, the easy stuff. And it is full of some of the best—and perhaps funniest—people in medicine. I never laughed so hard at a going-away gift as when a palliative nurse practitioner friend at my former hospital gave me a girly travel mug from the gift shop that said in a perky font, “Killing It!” Yes, I truly was about to “kill it” as a minister with people who are dying, and I couldn’t wait. I proudly carry that thing around the hospital, my own little ironic joke amongst a sea of life-saving doctors.
I was introduced to gallows humour early on in my year as a chaplain resident doing Clinical Pastoral Education (CPE), and I was horrified by it. The Intensive Care Unit (ICU) nurses had a nifty and definitely dark expression: “Keep ‘em alive til 7:55!” Shift change happens at 8 am and 8 pm, so the 12-hour shift nurses desperately hope that their patient will make it through the shift without dropping dead. Death requires a lot of work in the hospital: there are a myriad of forms to fill out, the coroner and hospital supervisor have to be called, and then there is the emotional work of supporting grieving families. Sometimes the families are big and sometimes they are loud. Sometimes security has to be called in if things get out of hand and Uncle Joe starts beating up Uncle Phil about the patient’s last will and testament. Although initially averse to humour around death and dying, I’ve found it to be absolutely crucial as both a pressure valve release and as an acknowledgment that there is only so much playing at God that we can do in the hospital.
My favourite use of humour in the hospital has to do with funny patient names. Like the dying Mercutio in Romeo and Juliet, I too appreciate a good pun (“Ask for me tomorrow and you shall find me a grave man!”). No actual patient names are used in this article, but let’s say there’s a patient on the heart floor with the name “Queen, Esther J.” One of my fellow chaplains, who can be relied upon as a theologically astute and (strange combo though it is) pun-loving dark-humourist, might text me saying, “Do you think Room 824 is getting her heart transplant for such a time as this?” I look at the list of patients and start giggling. “You mean the patient formerly known as Vashti?” I reply. “Sounds likely. Nurse says she won’t do physical therapy because she puts lotion and makeup on all day.”
One palliative doc recently told me about a Siri fail when she was sending a text to the primary physician. “Patient appears to be rapidly declining,” read the text that she received. She thought she had written back, “Plan is for palliative extubation (breathing tube removal) tomorrow.” Except Siri transcribed this as “palliative execution.” Since the whole ethos of palliative care is to reduce suffering, the irony was just too much. We were laughing our guts out in the ICU about this one.
I remember the moment in my Clinical Pastoral Education training when I realized I wasn’t being funny. I walked purposefully from patient room to patient room with a serious look on my face. I charted gravely and competently in the medical record. I only talked to other staff about professional stuff. In other words, I wasn’t being me. I wasn’t offering all of who I was as an integrated person-in-relationship in the hospital. This is a big no-no in CPE. But I was worried that I wouldn’t be taken seriously if I was occasionally funny. I held a degree and provided care that was a mystery to most of my colleagues already—what would people think if I cracked a joke? But once I got over that fear, and got over (some of) my desire for recognition and acknowledgment of my own competency, I found that humour in the hospital is not just welcome, but actually necessary for survival.
My colleagues and I are surrounded by suffering, death, dying, and ambiguity on a daily and sometimes hourly basis. We truly “see through a glass darkly” (1 Cor. 13:12). The humour, often dark, is an acknowledgement that we, in fact, are not in control here, and a plethora of specialists, national rankings, and the best medicines that science can concoct doesn’t change that. Matters of life and death are, even with the most technically proficient care our institution can offer, outside of our “scope of practice,” as we say in the healthcare business. Only God knows. Not wanting to be like Job’s friends, I hesitate to do much more in the face of the radical suffering resulting from overdoses, addiction, trauma, incest, homelessness, and terminal illness than offer a ministry of the presence and compassion of Jesus.
But after a few hours or days of darkness and lament, and maybe a turn around the prayer labyrinth, you’d better believe I’ll be ready for a good dose of chocolate and humour (for both, the darker the better). One day we shall know fully, even as we are fully known. But in the meantime, isn’t the saying, “She who laughs, prays twice”?