Holding Space for Humor at the End of Life

If no one knows when a person is going to die, how can we say he died prematurely? —George Carlin


We so often find it difficult to find humor with end of life experiences, because it is such a sad and devastating time emotionally and we are struggling to grasp the enormity of the experience at hand. The quirky and sometimes absurd are either lost in the chaos and drama, or just simply passed by. People often feel that it is inappropriate or disrespectful and, more often than not, it very well may be. That is why the humorous moments usually go unnoticed, unrecognized and unacknowledged. To share a laugh with someone at the edge of death, however, is to share one of the most intimate moments that one can share with another human soul. It can also be so healing for both.

This usually does not happen until everyone gets to the point of acceptance in the process. I am specifically referring now to being with the terminally ill in a hospice environment. There is a certain feeling of freedom, released into the air that one can sense, not unlike experiencing the heady joy while inhaling negative ions released by the rushing waters of a river, lingering throughout a rocky, fern-lined forest.

I, myself, was unable to appreciate that these moments even existed, until I started volunteering at a Bay Area hospice, after my second partner passed away.

I was very familiar with the “Irish Wake,” being raised in that tradition. I remember as a young man being quite confused and maybe even a bit offended by the uproarious, alcohol-fueled laughter that took place following the funeral of a relative, held at the local restaurant or bar & grill. Victor Koenig’s in Floral Park, New York was the preferred choice. A requirement seemed to be that the meeting place had to be within a stone’s throw of the local Long Island Railroad trestle.

When my father passed away seven years ago and I returned to attend the wake in Long Island from the Bay Area where I now reside, I remember a gentleman from the funeral parlor coming in to tell us to “keep it down.” I think it was Billy Joel who sang “we might be laughing a bit too loud, but that never hurt no one.” It was a reunion of sorts, because I don’t get to see my siblings very much anymore. While the setting may have seemed odd, I know that my Dad was enjoying the sound of us all laughing together, as his now vacuous, white, marbled body clothed in one his favorite golfing cardigans lay before us—especially since he really struggled to hear anything as the years caught up with him. I used to watch his facial expressions from across the room at one of the last family get-togethers we had at my sister Moe’s house, before he died. I knew he couldn’t hear the conversation because I saw him conveniently slip both hearing aids into his polyester, cardigan pocket. But he enjoyed watching everyone howl. I in turn, enjoyed watching him.

I had first started volunteering at a local Bay Area hospice—the one that took care of my partner before he crossed over. I was assigned to a patient I will call Ruby. She was a “tough old Irish broad” full of “piss and vinegar.” I found out very early on that I needed to wear a shirt with a collar when I “came a callin.’ “ Otherwise, I would be met by her big, bulging, baby blues surveying me from top to bottom, followed by a look of disgust and through her cracked, thin lips, “you look like HELL!” This is the last person that I ever thought I would be sharing a laugh with before she died. She gave the staff a hard time and most who came into contact with her. I would learn later that she never had any visitors in spite of the stories she told me about how her ex-husband would occasionally pop in. She also spoke of her “damn son” who was still back east but never bothered coming to see his mom. I would later learn that her son had committed suicide years earlier. I happened to be there one day when one of our CNAs stopped by to bathe her. Ruby was now in an skilled nursing facility—SNF, or SNIFFs. A certain African-American male nurse friend of mine shared with me how the name came about. “When you first walk in,” he began and “sniff, sniff.” He would wrinkle his nose up and contort his face and then ever so quietly solicit a response to the question “What, what, what is that smell?”

The CNA—I will call her Torie—was a sweetheart, as are most CNAs (big shout out to Certified Nursing Assistants, as well as Hospice Nurses and Social Workers). She was also African-American. Now Ruby, who actually grew up in New York, like myself, was from a different era and actually from what she told me was raised in an upper class setting. One learns to take everything with a grain of salt when dealing with the aged and infirm. It is a quality that I find quite endearing. Torie asked me to step outside the room with her for a moment and she asked if I could hang around and help her out. She went on to tell me that my dear sweet Ruby would swing her fists at her trying her damnedest to strike her—all the while shouting obscenities, and of course the “N” word. I said I would be happy to help her out.

When we entered the room Ruby started the inquisition. “What did she tell you, what did she say...” etc., etc. Torie asked me to hold the sheets up while she bathed her. “Hey, turn your head.” Ruby shouted. It occurred to me that what I saw every week was basically from the waist up and buried under sheets. As I held the sheets up so that Torie could do a thorough job, I listened to the obscenities being hurled at BOTH of us now and reflected on the vision of her gnarled and twisted body that to me, resembled a pretzel. I knew she was in much pain and anguish. I didn’t even know that one could exist in a body in that state. When Torie was all done, she thanked me, said her goodbyes, and continued on with her day. As she exited the room, Ruby smiled, waved and said goodbye, then turned to me and in her best Grinch voice snarled, “I don’t like her, do you?” “Yes, I do.” I said honestly. “She is a sweetheart.” That was NOT the correct answer. Ruby said nothing, but twisted her flaky, wrinkled face and raised the right side of her upper lip, looking at me with disgust.

Once Ruby finished her commentary on what she thought of Torie she then said, annoyed “Well now I have to go to the bathroom.” “SHE made me have to go to the bathroom. Can you get my wheelchair and take me?” I knew that Ruby was bedridden and had a catheter. This was going to be a delicate conversation. “No Ruby, I am not allowed to take you since I am just a volunteer.” Quick thinking on my part. “They fixed things up so that you don’t have to get up and down and back and forth going to the restroom.” I was trying to be as vague as possible because I was just not sure “how this was gonna go down.” You can go, I will turn my head.” “IN THE BED!?” she asked with that maniacal, angry face that would periodically make an appearance. “Yes” I said. She looked at me with disdain, in disbelief, with her mouth hanging open and her baby blues on the edge of jumping out of their sockets. With her parched mouth agape and our eyes fixated on one another's, I suddenly started to “sniff, sniff. “ As I began to recognize that familiar rancid scent, Ruby’s snarl suddenly turned into one of the biggest smiles that I had ever seen her flash. She knew that I was aware of her latest accomplishment. I burst out laughing and so did Ruby. A nurse came in to check on us and see what all the “racket” was about. They were not used to laughter escaping from Room 231. “Everything is fine.” I assured her. As the nurse left Ruby’s room, we both burst out laughing again for a few more minutes. Tears were streaming down my face with joy, sadness, gratitude, heartache and amazement at this moment of human sharing, who I came to love dearly over the next six months or so, until she passed away. She taught me how to see through all the external distractions and bore right down to the soul of a person—their essence. I am forever grateful for our meeting and can still hear her cackle now and then as I continue on my own journey to my “forever home.”