Daily Editors' Notes

The gift of gallows humor

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Mary Gustafson, McKnight's Staff Writer
Mary Gustafson, McKnight's Staff Writer
Comedienne Tig Notaro — from what I've been able to glean in my relatively brief history as a fan of her comedy — does not appear to have any connection with the long-term care industry. But in listening to her now famous standup act that announced her diagnosis of breast cancer, I had a feeling many in the LTC field would welcome her as one of their own.

Even by LTC standards, Notaro has had an excruciatingly rough year. Within a span of roughly four months, the petite 41-year-old performer developed pneumonia, which was quickly followed by a weeklong hospitalization for Clostridium difficile, which caused her to lose an additional 20 to 30 pounds.

Shortly after she was released from the hospital, her 65-year-old mother had a fall, hit her head and then quickly died. Then, while grieving the loss of her mother, Notaro broke up with her girlfriend.

Then, Notaro learned that she had stage 2 breast cancer.

Within days of her diagnosis, she was scheduled to perform a standup act in a Los Angeles theater. Rather than cancel the gig, she decided to perform. And instead of pretending everything was OK she decided to get onstage and tell the audience the nitty-gritty details of all of it.

A recording of her set that night is available for download from comedian Louis C.K.'s website for $5 (and I promise it's the best $5 you'll ever spend). Or, you can read, listen or watch a plethora of interviews Notaro has given in the wake of her performance's success. She eventually underwent a double mastectomy and says her prognosis is excellent.

To me, the most incredible part of her story is how unsurprised I've been of her willingness to joke about such a tragic chain of events. OF COURSE she can joke about it — what else could a sane person do? If I've learned one thing from people who work in long-term care, it's that when the going gets tough, the tough save their stories until happy hour — or the dinner table.

As McKnight's own Nurse Jackie a.k.a. Jacqueline Vance, R.N., B.S.N., told me, her medical-savvy family and friends made irreverent shop talk into an art form: “We face such tragic situations on a daily basis that you have to develop a ‘gallows' sense of humor to survive it. Callousness doesn't work, because it changes who you are.”

Or as another friend of mine, who has a Ph.D. in physiology, explained the other day, “Humans are hard-wired for resiliency.”

And it's true, isn't it? If you really think about the real “survivors” you know, don't they all share kind of a dark sense of humor?

Vance said she learned early on in her career about the healing power of laughter. Nowhere was this clearer than the day she admitted an elderly woman to a post-acute hospital floor. When she was admitted, the patient seemed very sweet, very prim and proper and looked “well put-together for her age,” according to Vance.

When Vance answered the woman's call light the next day, however, the woman was resting in her bed, with her wig off, her dentures in a glass, without a shred of clothing on. She said to Vance “Sweetie, I've been just about freezing waiting for someone to come in and give them a startle. I just wanted to show you young things what old looks like. Now grab me my robe and my wig and my teeth and put me together!”

If that's not a recipe for making lemonade from lemons, then I've got a lot of learning to do.

Now I won't be so naïve as to suggest that laughter is the best medicine for everything. Even when Notaro jokes about the patient satisfaction survey the hospital sent her mother after she died there, she can't mask the pain completely. But having the courage to share it with others is a gift.

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Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.

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