The Cruelest Joke: Laughing Through Tragedy

February 22, 2017 | 4 books mentioned 2 7 min read

There are certain conversations a doctor should have with a patient face-to-face. Telling a young man that his kidneys had failed and he’d need to start dialysis was an example of such a conversation. I’d seen him that morning, and both of us had anticipated that the bloodwork drawn just after his appointment would be bad. I’d patted him on the shoulder as he left my office and headed down to our hospital’s lab. “I’ll call you this afternoon with the results,” I’d promised, and now I was making good on that promise.

cover“Are you serious?” was all he could muster on his end. He asked me the question three or four more times. I answered yes each time. Then I listened to him cry for what seemed like an eternity but was actually just over one minute, because my office phone runs a timer for every call I make. I gave him instructions on where to go for placement of a dialysis catheter. I told him we’d start the treatments as soon as the catheter was in. At the end of the call, I said, “I’m sorry this has happened,” and he said, “Yeah, me too.” After hanging up, I reached into my shirt pocket for my earbuds, turned on my iPhone, opened the app for Spotify, and pulled up Mitch Hedberg’s Mitch All Together.

“I can’t tell you what hotel I’m staying at,” Hedberg says on the first track, “but there are two trees involved.”

I started to smile.

“They said, let’s call this hotel ‘Something Tree.’ So they had a meeting. It was quite short. How about ‘A Tree?’ No. ‘Double Tree?’ Hell yeah! Meeting adjourned!”

I started to laugh.

“I had my heart set on Quadruple Tree.  Well, we were almost there!”

I smiled and laughed and rubbed at my eyes.

I’m always listening to something on my iPhone. Late at night, after the kids have gone to bed, I pull up a sports-themed podcast while washing the dishes and making their lunches for the next day. In the morning, I soundtrack my walk to the train with a shuffle of the 200+ songs that currently populate my (creatively titled) “good songs” playlist. I like to listen to The Microphones when I’m walking in the rain, because I imagine every Microphones song was created during a storm. In the winter, I pass an hour shoveling snow with “WTF” or “This American Life” episodes.

A few weeks ago, I heard a comic on “WTF” complain to Marc Maron about some of his old albums that are available on Spotify. Until then, I was unaware that Spotify had comedy albums. Since then, I have almost exclusively listened to stand-up comedy on the app. And, to be more specific, I have used comedy albums on that app as my go-to listening for the commute home from work. For me, the listening choices I make for that commute home are prime-time programming. It’s the most important listening decision I make, because I’m exhausted and need to recharge before I get home. Some days I’m physically exhausted; on all days I’m emotionally exhausted. As a doctor who specializes in the rarest (read, most severe) forms of kidney disease, I’m often leaving the hospital and heading home just minutes after telling someone he can no longer rely on his kidneys. Forty minutes later, when I give my kids a good-evening hug and kiss, I need to feel completely removed from the diseases I’ve just left behind.

coverI’ve tried every kind of listening experience to block out the hospital and all its sickness during those commutes home: Frank Ocean is good, for example. Okkervil River’s Black Sheep Boy is a perfect antidote. On the other hand, The New Yorker’s fiction podcast is almost impossible to follow if you’re stressed, and I’d say the same for trying to get into any sort of new music unless it’s from Radiohead or Kanye West. But nothing, in my experience, has come close to the escapism of listening to Amy Schumer joke about catching her boyfriend masturbating (“Does it owe you money? What’s going on? He never chokes me like that!”) or John Mulaney tell the story of playing Tom Jones’s “What’s New Pussycat?” 21 consecutive times on a local diner’s jukebox.

cover“It’s weird because with humor, the equation is tragedy plus time equals comedy,” Tig Notaro says on “Hello, I Have Cancer,” the first track of her 2013 album, Live. “I am just at tragedy right now. That’s just where I am in the equation.” And that’s pretty much where I am in the equation, too, when I leave my office, head for the train, and open up that Tig Notaro album. I’m still in the realm of tragedy, but I need to escape as fast as I can via jokes.

I’ve never stopped to reflect on whether this behavior is appropriate until last month, when I read Emily Nussbaum’s New Yorker essay “How Jokes Won the Election,” and in particular her dissection of Donald Trump’s “locker room joke” about grabbing women by the pussy:

I saw the Access Hollywood tape, the one that was supposed to wreck Trump’s career, but which transformed, within days, on every side, into more fodder for jokes: a chance to say ‘pussy’ out loud at work; the ‘Pussy Grabs Back’ shirt I wore to the polls. In the tape, Billy Bush and Trump bond like the guys at McCann Erickson, but it’s when they step out of the bus to see the actress Arianne Zucker that the real drama happens. Their voices change, go silky and sly, and suddenly you could see the problem so clearly: when you’re the subject of the joke, you can’t be in on it.

Nussbaum appears to be making the case for sobriety over humor in the face of such awfulness. It’s not an easy case for her to make either, she admits. The essay opens with a proclamation of how much she loves jokes (“dirty jokes, bad jokes, rude jokes, jokes that cut through bullshit and explode pomposity”) and her discovery, as a Jewish child watching Mel Brooks movies “in a house full of Holocaust books,” of how well-told jokes could empower the oppressed. “But by 2016 the wheel had spun hard the other way,” she continues, pointing out all the jokes that Trump and the hateful “army of anonymous dirty-joke dispensers who helped put him in office” promulgated before and after November’s disastrous election.

Those of us diametrically opposed to this man and his army were also playing with fire, misusing humor as a defense mechanism, a form of denial, a way of avoiding talking about important subjects. It’s probably not a coincidence that I jumped headfirst into comedy albums in November, after the locker room joker was elected president. It’s cathartic to hear David Cross rip Donald Trump to shreds on his most recent album. Just as it’s cathartic to listen to Louis C.K. make fun of himself for being so out of shape. Just as it’s cathartic to escape in Mitch Hedberg jokes instead of thinking about the sick person I just spoke to on the phone. But the laughter doesn’t change anything. Donald Trump is our president, Louis will always be fat, and that patient I just spoke to will probably die much younger than he should.

The question I need to ask — the question I think Nussbaum wants all of us to ask as we giggle away our sadness and fear — is who are the subjects of these jokes I’m enjoying. When I leave my office and all the illness contained within its walls to catch a train home, when I listen to Sarah Silverman or Patton Oswalt or Aziz Ansari, am I just laughing at some jokes? Or am I laughing, in a way, at my patients and their suffering? They’re clearly not in on the joke, and I so clearly want to be in on the joke. I want to be happy, instantaneously, and that desire may not be fair to the patients who need me.

In the age of the Internet, we have instant access to jokes. If I can’t find something funny on Spotify, I can find a great standup routine on YouTube. Or I can scroll through Twitter or Facebook, which offer up a daily round of humorous memes from both professional and extremely amateur comedians. Nussbaum sounds a note of caution about this access:

Online, jokes were powerful accelerants for lies — a tweet was the size of a one-liner, a “dank meme” carried farther than any op-ed, and the distinction between a Nazi and someone pretending to be a Nazi for ‘lulz’ had become a blur. Ads looked like news and so did propaganda and so did actual comedy, on both the right and the left — and every combination of the four was labelled “satire.”

The zeitgeist of 2017, at least in the circles I frequent, is impassioned resistance to the new regime on the one hand, balanced by an equally passionate search to laugh in the face of all this craziness. The Women’s March, as Alexandra Schwartz wrote online for The New Yorker, “in addition to being forceful, moving, and, yes, huge, was funny. Actually, it was hilarious, a vindication of the humor of women performed on a stage that stretched the whole world wide.” But we’re “just at tragedy right now,” as Tig Notaro said. There hasn’t been any time, and the immediacy of today’s media removes any possibility for time. In other words, as a citizen, I don’t have the luxury to wait and see how my country will survive the next four years, just like I don’t have the luxury, as a doctor, to wait and see how a very sick young man’s kidneys will fare. I need to act today. Should I be allowed to laugh at some point during these actions?

coverThis question isn’t just taken up by writers for The New Yorker, either. The title track of Father John Misty’s forthcoming album, Pure Comedy, was released the same week as Nussbaum’s essay, with an accompanying video that uses footage of Trump’s inauguration and Obama’s departure, alongside images of parents bathing their kids, a man snuggling with a lion, churchgoers swaying their arms in sync, protestors yelling at each other, and, of course, Pepe the frog (of White Nationalist meme fame), Kanye West, and wrestler John Cena. In an essay released at the time of the song and video, Josh Tillman (a.k.a. Father John Misty) issued a lengthy (nearly 2,000 words) discussion of his forthcoming album’s exploration of the “cruel joke” that is human existence. It’s hard to tell how serious he’s being in any of this — the song, the video, the essay — although I think he’s utterly sincere (and correct) when he ends that essay by saying, “The joke is that the best we can do is keep on keeping on, which we’ve proven ourselves pathologically adept at.” Or when he ends the album’s title track with a similar message, “I hate to say it, but each other’s all we got.”

And April brings us The Last Laugh, a documentary about Holocaust jokes that defends the role of laughing in the face of the worst situations. In the movie’s trailer, Mel Brooks says, “Comics have to tell us who we are, where we are, even if it’s in bad taste.” Unfortunately, I have to admit that Trump, for some portion of this country, fits Brooks’s description of a “comic.” But so, too, does Father John Misty, and all the women marching across this country with signs making fun of Trump’s tiny, pussy-grabbing hands. And, I think, so do I. It’s dark outside when I ride home, so the train’s windows reflect my image. I see a doctor clinging to his earbuds, biting his lip, then grinning, then laughing as Mitch Hedberg calms his nerves. I should be with my patients, trying to calm their nerves, but I need to get home. That’s who I am and where I am, even if it’s in bad taste.

Image Credit: LPW.

, a physician and writer, is the author of Doctor (Bloomsbury/Object Lessons).


  1. I will probably never know what it is like to tell a patient his or her kidneys are dying, and as a result, so are they. I know what it’s like to tell a student she has officially failed my class, but I take no pleasure in that, either. I am in no way comparing the two. But we learn to compartmentalize our lives lest we go completely insane. After my father died, I put my big girl pants on and started restoring an old car. It was a distraction, but a necessary one to help me deal with the pain resulting from the loss of the man who made me who I am today. These are coping mechanisms. They don’t always mean we are in denial (there are those who are), and it doesn’t mean we are weak (there are those who are, and there is no shame in that), but rather to try and understand who we are, and to try to grasp our minds around this fragile farce called reality. Your patients are afraid, afraid that they will slip away, another life unlived. But now we, collectively as a society are beginning to see the same reality as the forces behind Trump, especially Bannon, begin to reveal their plans for America, and now we as a society are terrified. We need to face the very real possibility that we are headed into a Dark Age, but if we take it all in at once, it will poison us. We need to compartmentalize, decompress at times, and there is no shame in that. My guilty pleasure is Creedence Clearwater Revival.

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