Defensive Humor

One of the defense mechanisms of workers in healthcare is to make cynical jokes about some of the craziness.

I got into trouble with one of my columns for the local paper writing about a patient in the ICU who had subcutaneous emphysema from a punctured lung – which caused massive bloating and swelling of his skin, so his eyelids were swollen shut, his ears, his face, his neck, even his scrotum, were massively swollen and sort of crinkly. The nurses discreetly joked amongst themselves that he looked like the cartoon character, Mr. Magoo.

And he did. Of course that was not a justification for me putting my foot in my mouth, and writing about it – even though I explained it’s a defense mechanism to joke about critically sick patients to stop you losing your sanity.

In her book, The Cost of Hope: A Memoire, Amanda Bennett, comments on the same thing – in the course of railing against the madness of doing massive numbers of tests on patients who are at death’s door.

She questions the need for her husband, who was dying of cancer, to have had so much done that he had bills of $43,711 for one admission, $33,382 for another (after the doctors said he only needed comfort care) and $14,022 for the last three days of his life.

Outrageous though this may sound, Bennett recounts the hospital chaplain telling her (though admitting that he probably shouldn’t) a joke circulating among the staff about an orderly going to the morgue to retrieve a dead body.  The body is missing. Instead there is a note saying “Gone to X-ray.”

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