Understanding Different Brands of Humor

From Ambivalence to Disapproval

Posted Feb 14, 2018

"I saw a really good movie last week," Allison said. "You have to go see it. The title was…uh…"

Bonnie tried to help. "Was it…the one with…what's his name?"

Having been out of commission the last six weeks preparing for and recovering from brain surgery, I had no clue which movie they thought they were discussing, but I wanted to be part of the conversation, so I chimed in. "I watched a DVD last night. Well worth seeing. It's…uh…the one with that actor…you know, the one with the hair."

We looked at each other and dissolved into helpless laughter: Allison, who was going through chemotherapy; Bonnie, who was menopausal; and I, less than two weeks after my third brain surgery. We all had "broken brains" at that moment, and there was nothing to do but laugh.

More than a decade ago, I suffered bleeds from two of the several cavernous angiomas (clusters of malformed blood vessels) in my brain. Surgeries to remove the culprits left me with several cognitive issues, including a short attention span, poor organizational skills, lousy memory, and precarious balance.

The surgeries and my injured brain wreaked havoc on my life. My world devolved to endless doctor appointments, trips to the ER, stays in the hospital, physical therapy, occupational therapy, neuropsych exams, cognitive tests. Wherever I turned, concerned questions about my health bombarded me. Pitying looks dehumanized me. What little respite I found from the fear came from humor.

The most effective weapon I had to defend myself against unrelenting stress and frequent despair was to make fun of myself and my situation. I demonstrated my difficulty touching my index finger to the tip of my nose, one of the neurological tests doctors and nurses frequently had me perform. I referred to my difficulties with balance as swaying in a nonexistent breeze. I named my damaged brain the "Bloody Brain," a pun playing on my British phraseology.

Applying my sense of humor was especially effective when others joined in, but not everyone did. Some were too caught in their own distress to laugh; others reacted with a blank smile-and-nod that told me they weren't really listening. I definitely detected confusion in a few, and wondered if they simply didn't understand my particular brand of humor.

In one case, I sensed outright disapproval.

Every time I suffered an excruciating headache or a new symptom appeared, I was rushed to the ER. One such trip followed a string of seizures. As always, feeling the need to lighten the mood, I joked with everyone who showed concern, including nurses and doctors.

I was reclining in my hospital bed, joking and laughing with Cindy, a close friend who had arrived early that morning. It was the first time during my many hospital stays that anyone had stopped by for more than a brief visit. It was also the first time anyone other than a medical professional had accompanied me to the tests—CT scans, EEGs, MRIs, and more—I underwent while in the hospital.

For the first time, I wasn’t lonely and afraid—I was actually happy. When the attending neurologist walked in the door, I greeted her with a smile.

Instead of responding with the warmth and kindness I had begun to expect from other medical personnel, I felt a chill in the air. Everything about her radiated disapproval. Did she think my behavior, the relaxed camaraderie with my friend, was inappropriate? Did she think I wasn't taking my hospitalization seriously?

After a brief examination, during which it became clear that she hadn’t even glanced through my file, she left my room. When she returned, she was more knowledgeable about my case, stating, “You do indeed have angiomas, and two of them have bled.” She then proceeded to diagnose my seizures as psychogenic. “They are not true seizures, probably brought on by stress," she lectured. "Are you stressed?”

I was dumbfounded when she assured me that there was no need to be stressed since the angiomas were harmless.

“If they’re harmless, why do I have trouble with my balance?”

“You have balance problems?”

At her request, I demonstrated my inability to walk heel-to-toe. Her next pronouncement floored me: I had no balance problem (my flailing arms were "compensation"), I was faking my symptoms, I needed a therapist.

Her words and attitude plunged me into a state of self-doubt and depression. Though both my regular neurologist and physical therapist continued to assure me that my balance issues were real, I started wondering whether I was malingering. Was I not trying hard enough? If I tried harder, would my balance improve? Were my headaches as bad as they seemed? Perhaps they weren’t truly debilitating. Perhaps I could push myself to function through my ongoing fatigue.

Self-doubt crushed what little sense of humor I had for a very long time.

One good thing came out of my encounter with the evil neurologist, as I now refer to her. She jerked me out of denial. The time for sitting back and waiting for my doctors to determine my fate was over. Their wait-and-see strategy was no longer acceptable. There had to be a way for me to reclaim my life. It was time to become proactive and find that way.

I researched my options and discovered that the only known treatment for cavernous angiomas was resection surgery. With that knowledge came the ability to form a plan of action. I contacted a neurosurgeon who specialized in cavernous angiomas. After thoroughly reviewing my extensive medical records, he urged me to undergo surgery, because the risk of suffering additional bleeds was high and, given the nature and placement of the bleeders, such bleeds would be life threatening.

Taking action, including starting on the path towards surgery, brought back my ability to smile and then laugh. I started a list of things you wouldn’t want to hear from your brain surgeon, beginning with, “Oops!” Friends and relatives contributed to the list, from Cindy’s, “Where’s the uh…um…thingy?” to my brother’s, “It looked much easier on 'Grey’s Anatomy.'”

At first my laughter was forced, but it quickly became genuine and kept the terror of the impending surgeries at bay.

It's been ten years since that day with the evil—or at least humorless—neurologist, and my sense of humor continues to come to my rescue on bad brain days. Laughter isn't the only medicine, but it's definitely an important part of the mix.