by Robert J. Lanz, LCSW
Mrs. B was in her late 70’s, a robust, jovial woman who weighed nearly 300 pounds. She enjoyed a close relationship with her sister, with whom she had spoken on Sunday, their usual day for a long distance chat to catch up on gossip and family business. Early Monday morning, so early that a phone ringing automatically brings to mind bad news and heartache, her sister’s husband called and told Mrs. B. that her sister had died during the night. She commented to him how strange it was to have just been talking to her a few hours before and all of a sudden she was dead.
“Yeah”, he answered not to be outdone, “it was strange. And I was sleeping with her!” Top that.
Mrs. B.’s daughter was the next person to learn about the death in the family. She so was upset by her mother’s very typical grief, that she suggested strongly that Mrs. B. not attend the funeral, which was to be held in just a few days in the Midwest town where the recently deceased sister had lived. The grieving Mrs. B. had come to the ER hoping to get a note from a doctor that would explain to her daughter it was okay for her to attend the funeral.
After the doctor had done a brief workup, Mrs. B was sent to see me. We talked about the loss of Mrs. B.’s sister and the natural course of grief—what to expect and how to handle it. Then we talked about the problem with her daughter, who obviously meant well, but who was just as obviously being overly protective. I felt that she might be projecting her own issues onto her mother’s situation and trying to control her own anxiety and grief by controlling her mother’s behavior. The discussion brought a burst of laughter from Mrs. B., and we both enjoyed the absurdity of asking a daughter’s permission to attend your dead sister’s funeral and having to get a note from a doctor in order to do so. The best part was the fact that Mrs. B.’s daughter was a nurse! Unable to resist, I wrote the doctor’s note myself on a prescription pad—all very official looking—so that the nurse wouldn’t have any excuses for preventing her mother’s trip. We laughed at the absurdity of that, too.
From there, things sort of got out of hand, and we started laughing at ourselves for laughing about the daughter, and then we got in trouble for laughing so loud, we were disturbing the other patients. One of the nurses finally had to come in our room to tell us we were being too loud and laughing too hard. As Mrs. B. was leaving, we laughed about the nurse, as well.
This poor woman had come to the hospital because she was experiencing intense grief, throwing her into emotional turmoil her body wracked with pain. And what treatment had she received? A $500 battery of tests including an EKG, blood draws and a chest x-ray. She was then handed over to a social worker, one who was ready for a good laugh. I guess she was, too. She laughed so hard, she finally started to cry, something she hadn’t been able to do since hearing of her sister’s death.
When she was through crying, she hugged me long and hard, and we both started laughing again. This time, when the nurse came back to the room, she told me she was going to report me to my supervisor. I had gotten totally out of control. I bit my tongue, I held my belly, and I blew air through my nose and still couldn’t stop laughing. The harder I tried, the worse it got. Mrs. B couldn’t stop either. The harder she tried, the harder she laughed, the harder she laughed the more the bed shook. The nurse watched in horror as this grieving old woman of three hundred pounds and 78 years shook and slobbered while my attempts to control myself only seemed to make it worse.
Finally, none of us could take it any more and I forced myself to keep a straight face. The nurse didn’t realize it, but under recent changes in the hospital staffing structure, she was my supervisor.
I maintained my composure just long enough to blurt out that information. Mrs. B. and I became so totally lost in convulsive laughter, that all the nurse could do was storm out and leave us. We were having too much fun. Can’t do THAT in the ER. This is a serious place.
That night, when the nurse went home, she probably dreamt of all the complaint letters I would get, and how they might reflect badly on her job performance. So did I. Even though I knew that our fits of laughter had been wonderfully restorative for the patient, I was aware that my behavior could be interpreted as unprofessional.
A few days passed, and I had all but forgotten about the incident but then I had a dream of my own. Letters from ER patients started coming in. Technically, they were complaint letters, and they differed in tone and makeup, but essentially, the other patients who’d been in the ER that day expressed the same sentiments. They had all written to complain that they hadn’t had as much fun in the course of their treatments as other patients seemed to be having, and that, next time, they wanted a social worker in their room, too.