Life at the intersection of health and mental health: The importance of humor

I am a consumer of mental health services who has been serving in leadership roles in nationally facing organizations for many years. I currently work as the national VP of consumer and family affairs for a large managed care company (not named here because my remarks are not a reflection of that organization’s thinking, policies or programs). Many people in my family live with mental health issues.  My sister died by suicide. 

I struggled for years through the deep, bone-raking anguish of my mental health challenges, moving finally into a place of recovery. Now, however, I am faced with a recovery of a completely different kind because I was diagnosed with both uterine and breast cancer in early 2013. This blog offers my reflections on my latest journey to recovery, this time in the arena of physical health.  

No matter how you look at them, the surgeries I went through for my breast and ovarian cancers were difficult, painful, and undignified, with virtual strangers “all up in my business.” So throughout that period, humor was awfully important to me.

For example, in one of several surgeries, my surgeon inserted a long, needle-like wire into my breast as a means of locating the tumor. The process promised to be not only awkward and embarrassing, but also quite uncomfortable – akin to being skewered. Another process involved the use of radioactive injections that would help the surgeon locate various lymph nodes.

As I waited in pre-op, I went on a long riff with my brother and sister about whether or not the “skewer” might be used for roasting marshmallows. Given that I was also carrying a radioactive charge (from the injections), we together decided that no fire would be needed to complete the roasting process. The riff went on about whether, given the “antenna” I’d be carrying around, I might receive remote control signals or pick up “Radio Shanghai.”

In time, we were laughing so hard that I later thought, with some guilt, that our humor was probably not helpful to others nearby. But those nervous laughs sure helped me to forget about the pain and indignities I’d soon face. I found that I was less afraid as I was wheeled into surgery.  

Why is it, I wonder now, that we so often seem to forget about using humor to face the pain and indignity of mental health challenges? One person who does combine humor and mental health really well is David Grainier. If you have not yet experienced his “Stand up for mental health” program, you should definitely take a look. Then, think about how this great program might teach mental health consumers that you know how to translate their everyday experiences – and difficulties – into stand-up comedy.

One place that could have used a little comedy was the first of two post-surgical recovery rooms that I went to following that surgery. This is where medical staff dealt with us when we were still under anesthesia, just moving into consciousness. I stayed there longer than other patients, due to a weird reaction to the anesthesia, and was alert most of the time. As I watched, it seemed the culture of those nurses and techs toward patients was very clear – detached, disengaged, no eye contact, no warmth. For me, that was literally true, since I was so cold and had no luck getting more blankets. I wondered if that staff were so used people who were in a non-responsive state that they too had become non-responsive, unconsciously treating us as “things” rather than people?

While in that first post-surgical recovery area, I checked to see if my “wire” was still inserted (it was), and then started to joke with my nurse. She just looked at me very strangely and then walked away. My attempts to build a bridge through humor were not successful in that environment; compassion seemed distant while a bored cynicism seemed more the norm. 

In the second recovery room, where all the other patients were more alert, my nurse and techs laughed with me as I shared my feeble attempts at humor. These staff members called me by name, made sure I was warm enough. We shared stories about our dogs and their kids, connecting as real human beings, humor and all.

Much later, I looked back on those experiences and wondered if they might have some applicability to our mental health staff partners, who often seem disconnected and remote from consumers. This is something that I hear a lot from my peers and have experienced frequently in my life. While there are obvious exceptions – great people, great programs, and great systems – out there, it is not uncommon to hear about or experience disconnection, distance, and coldness as opposed to humor and warmth - a real human connection. Is this because these staff members see us when we are less than fully alert or engaged with others like the first post-surgical recovery room team? Is it hard for them to connect with us when we are so ill? Or, is it too hard for them – emotionally – to even risk the connection?

How do we bring more of that humor and connection into our behavioral health systems?