Updated August 31, 2014.

Did you miss the first part of this article: Laughter At the End Of Life? You might want to check out that article for a bit of background and then come back here. The short summary? We're discussing how patients and family members/ caregivers use laughter at the end of life.

Laughter at the End of Life (LAEL) Function Number Three: Enable the helpee to exert more control over being helped. After a potracted battle with ovarian cancer in which my partner Heather MacAllister went off chemo and then back on chemo again numerous times, she wrote to her email list:

I am shaving my head this week.   I keep losing my hair from the chemo, so it's time again.   Please please don't tell me how good I look bald. I appreciate the compliment, and I agree :), But I am not making a fashion choice and when people say that I feel like people don't understand all the difficulty and illness that the hair loss represents. I know that everyone on lovetroopers [her support group]wants to (and has been!) very supportive of me so I know that you would want to know if something a person might say would be supportive or feel supportive or not. 

It's not easy to tell people who love you that you need them to love you in a different way. But humor can smooth over the blow a bit.

LAEL Function Number Four: Emphasize one's human to health care providers.

While my partner and I were waiting for the hospice nurse to do intake at our house, my partner was standing outside getting some fresh air while I attempted to shovel the snow off our sidewalk with a broom (we were living in Portland Oregon where a snowshovel seems like an un-needed luxury) and we began tossing around the wet snow at each other.

Just as she had made a series of snowballs to throw at me the hospice nurse, who had never met us, drove up. The following conversation ensued:

Hospice nurse: Are you all...were you...I mean...was this? Are you guys having a snowball fight? 
Heather:   A person has a little stage four ovarian cancer and all of sudden she's not supposed to be having snowball fights? 
Hospice nurse: Um. 
Heather: What's it gonna do, kill me? 
Hospice nurse: Um, good point.  

That initial interaction flavored our entire relationship with that nurse. She had to see us a real people, doing real things, because she had caught us in the act! We couldn't be just patients anymore. In an overwhelmed medical system, establishing a patient's humanity is an important key to getting the best care.

Laughter at the End of Life (LAEL) Function Number Five: Take an edge off high emotion to keep from veering into maudlin sentimentality.

Death and illness in popular culture are so overwrought with weird sentimentality that we've become almost anesthetized to the kind of real talk that needs to happen in intense caregiving and illness situations. Humor can provide a type of catharsis to lighten the intensity and, counterintuitively make the emotion more clear. As Heather wrote to her email list after surviving a nearly fatal hospital stay:

I love you all for all you've done and for being you. Words can't describe but please know how important your support has been to me these last two years. It's kind of like that footprints prayer where the person says ‘But Lord, in these hardest times of my life there is only one set of footprints. Where were you? Ah, my child, that is when I carried you.’ Corn fresh off the cob! But truly, the biggest support came when I was too out of it to even realize what was going on around me. Just know in your heart that I appreciate it deeply.