How humor helped me with cancer

Let’s get something straight: dealing with cancer is serious. Whether you’re the one who’s gotten a diagnosis, or someone you care about has, there’s a lot to take in. Your emotions might be all over the place—and that’s okay. Your experience is your own; no one can tell you how to feel.

For blood cancer survivor Steve Buechler, his diagnosis opened up something he hadn’t expected: a chance at levity. A new way to get through each unpredictable moment. Making jokes became an important way for him to cope with the long, unpredictable treatment process—and a way to connect with the people in his life.

Here, Steve shares how humor found its way into his experience with blood cancer and how it’s shaped his outlook ever since.

When I say "cancer," do you think "humor"?
 

Table of Contents

• Humor during a "cancer odyssey"
• How humor and laughter can benefit us
• The philosophy of improvisation
• Find support
• Sources

Humor during a “cancer odyssey"

 

A common warm-up in improv is called “word ball.” It’s a word association game where an improvisor says a random word and someone else responds with another word that immediately comes to mind.

Here’s an example. If I said “cancer,” what is the first word that comes to mind? If not for the title of this essay, I doubt it would be “humor.” But for me, humor is near the top of the list. Here’s why—and it might make sense to you, too.

To be sure, cancer is no laughing matter. That is precisely why I found it essential to retain my sense of humor throughout a daunting medical crisis. Along with other coping strategies like mindfulness, physical activity, being proactive, and writing my story, humor was crucial to weathering my cancer treatment.

My sense of humor predates what I call my “cancer odyssey.” Many decades ago, during a dark period in my life, I saw the movie Hannah and Her Sisters. One of the main characters, Mickey, is a hypochondriac fearing that he is dying from a brain tumor. When he receives a clean bill of health, he is elated, but only momentarily.

He realizes that someday he will die of something. He ponders why life is even worth living if we are all going to die anyway. In this melancholy mood on a brisk, blustery day, he prowls the Upper West Side of Manhattan for hours with no apparent purpose. Eventually, he ends up at a movie theater and sits down in the middle of a Marx Brothers movie. After watching for a while, he has a revelation: even though we may never be able to answer the big existential questions about life, death, mortality, or evil, any world that includes the Marx Brothers is a world worth living in.

That’s always rung true to me. My sense of humor is wide-ranging, from the wacky antics of the Marx Brothers and Monty Python to the cerebral musings of George Carlin and Steven Wright. In all these iterations, humor makes this world one worth living in.

When I was diagnosed with acute myeloid leukemia (AML) in 2016, I vowed I would retain my sense of humor. It saw me through multiple rounds of chemotherapy, total body radiation, a double umbilical cord blood stem cell transplant, and a grueling recovery.

Facing my diagnosis, I consciously used humor as an antidote to the somber reality of what I was facing. It was a quiet form of resistance that kept the cancer at arm’s length. It was my way of saying, You may make me sick and even kill me, but I’m still going to enjoy a good (or bad) joke along the way.

The day after I began a 37-day hospital stay, my wife Sue arrived at my hospital with a fractured femur. She spent a week in a room two floors above me and then a month in a transitional care unit. This all happened so suddenly that people had no idea why our house seemed deserted and would remain so for over a month.

So, I sent an email to our neighbors to update them on our situation. I almost felt guilty conveying the dire news of my diagnosis and Sue’s operation. I wanted to counter the gravity of our situation with something more lighthearted, so I concluded the email with a “Joke of the Day.” It was a terrible joke—about three vampires walking into a bar and ordering a blood, a blood, and a plasma. The bartender responds, “Let me be sure I’ve got this right—that’s two bloods and blood lite, right?”

Over the next many months, I sent over sixty email updates to an ever-expanding group. Almost every one concluded with a joke, always set in a bar. Finding and composing them was a welcome diversion that kept me entertained and elevated my spirits even on the darkest days. I took perverse pride in finding the worst puns and dumbest jokes I could find, which somehow made them even funnier. Some said I favored quantity over quality, but I staunchly maintained my philosophy of humor: there are no bad jokes, only bad audiences.

By my third week into this odyssey, friends as well as doctors began providing me with fresh material. Here’s a sample of doctor humor:

A stranger walks into a neighborhood bar. Soon after, someone gets up and says “17” and the place explodes in laughter. A bit later, someone else gets up and says “42” and gets more laughter. So, the stranger asks the bartender what’s going on. The bartender explains that everyone there is a regular and they know all the jokes by heart, so they just tell them by number. So. the stranger jumps up and says “22” and is met with dead silence. He asks the bartender what’s wrong and the bartender says, “Well, some people just don’t know how to tell a joke.”

For my readers, these jokes offset the impact of my serious news and let them know I was not losing hope. Many of my correspondents and even hospital visitors were uncomfortable discussing my status as a cancer patient. Humor assured them that I was the same person I’d always been, and that they could relate to me in the same way.

This became evident one day when I hastily sent out a report and forgot to include a joke. I caught hell for it. Many readers skimmed the medical details and playfully asked, “Hey, where’s the joke?” So, the absence of a joke became a meta-joke that triggered more banter. But I never forgot to include a joke again.

In my interactions with doctors, nurses, and staff, I routinely used humor to break the ice and lighten the mood. It was not a denial of my situation as much as a way of transcending it. My medical team seemed to appreciate the respite humor provided from the gravity of my condition and the details of my treatment.

I learned that many of my doctors and nurses could be quite funny if given permission by me to “go there.” Humor invited them to step outside their formal roles as medical practitioners. It connected us as people—not just as doctor and patient. Given that they had my life in their hands, sharing some laughs made our relationship all the more meaningful.

My use of humor brought multiple benefits. It maintained my identity and lifted my spirits while facing frightening medical realities. Humor also granted permission to others: It invited my medical team into a coping strategy that offset the gravity of my illness. It allowed friends, family members, and readers to feel more comfortable when they didn’t know what to say.

Humor sustained relationships and nurtured connections when I needed them most. Given everything that was beyond my control, humor became an essential means of living with my situation.

As I recovered (and somewhat to my surprise), I turned all this material into a memoir: How Steve Became Ralph: A Cancer/Stem Cell Odyssey (with Jokes).

How laughter and humor can benefit us  

 

Jokes are not the only form of humor, and my use of humor while facing cancer is hardly unique. There is ample evidence of the benefits of laughter and humor.
 

Physiological effects of laughter and humor

There are no medical studies to show how laughter and humor affect medical outcomes, but there is plenty of evidence about their positive impact on our bodies.

Researchers in the U.K. and Finland showed that laughter, especially when it’s shared with friends, leads to release of “feel- good” hormones in the brain and can reduce feelings of physical pain.¹ A good laugh has also been shown to decrease stress hormones and improve the immune system.²

There’s some evidence that the opposite is also true: negative moods can have negative effects on the body. In 2018, U.S. researchers drew blood at regular intervals to see the impact of negative and positive moods on certain chemicals in the body. When the blood draws happened soon after negative moods, researchers found elevations in substances in the body that cause inflammation.³ The elevations didn’t last long, but they seem to indicate that our moods have an impact on our bodies and maybe our health.

A survey among more than 20,000 men and women 65 and older in Japan showed that those who never or almost never laughed were 20 percent more likely to have heart disease and 60 percent more likely to have a stroke than those who laughed every day. The survey can’t tell us whether laughter causes the differences (it could be the opposite—those who are sicker simply don’t feel much like laughing), but the results are still striking.

Psychosocial benefits of laughter and humor 

We don’t need studies to tell us that laughter and humor can reduce stress, anxiety, and depression. If you’ve laughed, you know this. Plus, they can help the body relax and provide a sense of control/

In the context of a cancer diagnosis, humor can help us regulate negative feelings, create emotional distance from stressful situations, and foster hope in the face of illness—as it did for me. It can also help patients and nurses communicate better⁴, and cope with unpleasant procedures or embarrassing situations.

For instance, I learned that a joking reference or two went a long way in easing the embarrassment of asking my nurses about anal fissures from chronic diarrhea, or penile enlargement from IV fluids to flush the chemo out of my system. (The latter condition was particularly puzzling, since being in a hospital room with all kinds of side effects was the least erotic situation I could imagine!) Trading humor made it more comfortable for all of us.

Sharing laughter and humor can contribute to closeness, trust, bonding, and fellowship. It can connect people—because humor itself stands as an opposite to the gravity of cancer—and reduce feelings of isolation. As it did with me, humor helps us connect with others as a whole person, and not just a patient.

That said, there are individuals, situations, and circumstances where humor and laughter are not appropriate and can be hurtful. Patients are always entitled to their own feelings—especially when there is so little else we can control.

Humor is not a likely panacea upon first hearing a diagnosis, or receiving bad news after a scan or blood test. But over the long grind of cancer treatment, when people have had time to recover from such initially shocking news, humor can play its part in getting some distance from the illness and the fear and anxiety it causes.

The philosophy of improvisation

 

After recovering from leukemia, I enrolled in a class at our local Gilda’s Club (a community organization for people with cancer and their loved ones) called Improv for Life™.  That experience emboldened me to take additional classes at a local comedy club.

In a typical class, we start with warm-up exercises and then move on to various games or scenes. These often begin with minimal prompts or suggestions of who, where, or why two or more people are in the scene. Then we just make it up as we go.

A key principle of improv is not planning ahead. Instead, we stay in the present moment and respond to whatever we are given. This requires active listening and close attention to people’s speech, affect, and body language. It also requires ongoing eye contact and the principle of “give and take” to make the scene work.

Another key principle of improv is “yes and.” This means we accept the “reality” of our partner’s contribution and then build on it. That also means we never reject any statements that come our way. Our role is to accept what we’re given, develop it further, and support our partner in moving the scene forward. This “yes and” principle applies internally to each actor as well. It reminds us to follow our instincts and ideas without judging them.

Improv differs from stand-up comedy in that the primary goal is actually not to be funny. Instead, improvisors are encouraged to be genuine and draw on their own life experiences. But if done properly, humor naturally emerges from the creative collaboration between partners and the unexpected turns that a scene may take.

Here's an example. In one scene, a half-dozen classmates and I were cast as items in a refrigerator. I was a jar of pickles. I introduced myself by saying my ancestors were immigrants from Poland via Ellis Island. (That was when our family name of Vlasikowski was shortened to Vlasic and the family built a pickle empire.) Then we heard from a woman who was a head of lettuce, unhappily crammed into the back of a dark, moldy produce drawer in the bottom of the refrigerator. At that point, the green foods noticed that the white foods like milk and eggs enjoyed spacious, well-lit locations on the upper shelves of the refrigerator in sharp contrast to the green foods. That led to an uprising of the green foods, seeking equal shelving space for all foods—and on it went.

I’m often struck by where the spontaneity of improv takes us. Starting from a few simple premises, scenes can go in an infinite variety of directions. These are aspects that give improv its creative power and organic humor.

Simply learning improv principles can activate our spontaneous, creative sides and help us break patterns. One of my favorite pastimes if I encounter a grumpy person is finding a way to make them laugh. If I can turn a transactional event with a stranger into a humorous moment with a fellow human being, it makes each of our days just a bit brighter.

Practicing improv has enriched my survivorship—and helped me weather the challenges that come with age, retirement, and the death of my longtime spouse. Improv has taught me how humor can arise through spontaneous group dynamics and foster supportive connections. Building collaborative relationships makes for good stage performances, but it also applies much more broadly to life.

There are specific benefits we can reap from improv—whether we are learning about it, watching it, performing it, or just consciously doing it in our daily lives. It enhances creativity, fosters team collaboration, and promotes adaptability in new environments. It enriches personal relationships by increasing empathy, trust, and better communication. People engaged in improv also report greater happiness, reduced stress, and improved well-being⁵.

A promotional flyer for my improv class/support group at my local Gilda’s Club identifies further benefits for cancer patients. In our classes, improv has restored broken social connections, reframed life events, and promoted healthy intimacy for people affected by cancer. It has given us practice for the tough stuff in life and allowed us to find bravery and resilience in confronting illness. In the face of all of cancer’s “no’s,” it has helped us find the “yes” again and enriched our capacity to experience the fun, play, and joy that are intrinsic to improv⁶.

Lest this sound daunting, consider that you have already been doing improv in every unscripted conversation, novel experience, and spontaneous moment of your life! The raw materials for humor and laughter are interwoven throughout our everyday lives. They are our birthright as human beings and one of the healthiest forms of expression and connection that we have.

Looking ahead, I’m confident that improv will continue to enrich my mental health. Alongside mindfulness and gratitude practices, improv helps me live in the moment, pay attention, be intentional in my thoughts and actions, value what I have in my life, and let go of anxiety and what’s beyond my control.

After reading this essay, my hope is that the next time you hear the word “cancer,” the value of “humor” will be among the word ball associations that come to mind.

Sources