“You can’t die yet — I don’t have your eu­logy done”

The Hamilton Spectator - - HEALTH - BRUCE HOROVITZ

Just weeks be­fore Christ­mas some years ago, Shirley Rapp and her fam­ily faced the dev­as­tat­ing news that she had what ap­peared to be a ter­mi­nal ill­ness.

But that didn’t stop Rapp from want­ing to do one last round of Christ­mas shop­ping for her kids. Her daugh­ter, Karyn Bux­man, a self-de­scribed neuro-hu­mourist and RN, went along. When the mother-daugh­ter duo stepped into a St. Louis-area sta­tionery store, Rapp picked up a day plan­ner that she ad­mired, turned to her daugh­ter and quipped: “If I make it past Jan. 1, will you buy this one for me?”

That’s when Mom and daugh­ter burst into laugh­ter that at­tracted ev­ery eye in the store.

For some folks, the process of dy­ing comes with less stress when it’s some­thing of a laugh­ing mat­ter. Not a yuk-yuk laugh­ing mat­ter. But, at its sim­plest, a will­ing­ness to oc­ca­sion­ally make light of the pe­cu­liar­i­ties — if not ab­sur­di­ties — that of­ten go hand-in-hand with end-of-life sit­u­a­tions.

An aging gen­er­a­tion of boomers, the old­est of whom are now 70, grew up to the back­ground sounds of TV laugh tracks and are ac­cus­tomed to laugh­ing at things that might not al­ways seem so funny. There’s even a non­profit or­ga­ni­za­tion funded by donors, con­fer­ence rev­enue and mem­ber­ship dues, whose mis­sion is sim­ply re­mind­ing peo­ple that laugh­ter is a core in­gre­di­ent of all facets of life — even end of life.

“Laugh­ter is the best medicine,” says Mary Kay Mor­ri­son, pres­i­dent of the As­so­ci­a­tion for Ap­plied and Ther­a­peu­tic Hu­mor, “un­less you have di­ar­rhea.”

Hu­mour is par­tic­u­larly im­por­tant when folks near end-of-life sit­u­a­tions, says Mor­ri­son.

Turn­ing 70 hasn’t stopped her from en­gag­ing in ac­tiv­i­ties specif­i­cally to make her laugh — like hop­ping on her pogo stick. “While death can­not be cured, your frame of mind is some­thing that you can change.”

Her group has some loose guidelines for the use of hu­mour among the dy­ing. Most crit­i­cally: make cer­tain that you know the ail­ing per­son very well be­fore us­ing hu­mour with them.

On its web­site, the Na­tional Can­cer In­sti­tute urges pa­tients to build hu­mour into their day-to-day lives, in ways as small as buy­ing a funny desk cal­en­dar and watch­ing comic films and TV shows.

Bux­man, who earned a life­time achieve­ment award from the AATH, gives speeches on the im­por­tance of life’s comic mo­ments. A former hospice nurse, she takes hu­mour very se­ri­ously. She has stud­ied the im­pact hu­mour has on the brain and on the stress lev­els of pa­tients in their fi­nal days. The right hu­mour at the right time, she says, can in­fuse the brain with plea­sur­able hits of the stim­u­lant dopamine, de­crease mus­cle tension and anx­i­ety in the body’s ner­vous sys­tem, and mo­men­tar­ily di­min­ish feel­ings of anger or sad­ness.

As it turns out, her mom sur­vived her ini­tial ill­ness — only to later de­velop a f atal form of Alzheimer’s. Near the end, Bux­man took her mom to the doc­tor’s of­fice — at a time her mom had stopped re­spond­ing to most ex­ter­nal stim­uli. While sit­ting in the wait­ing room, Bux­man could hardly be­lieve it when her mom ut­tered, “Make me laugh.”

Bux­man knew this was the time to share a funny, fam­ily mem­ory. She re­counted to her mom the story about the time the two of them vis­ited the kitchen sec­tion at a large de­part­ment store and saw a dis­play of fry­ing pans cook­ing what ap­peared to be ar­ti­fi­cial eggs.

“This food looks so real,” her mom said, pok­ing her fin­ger into the fake food. But the egg was real, and when the yolk popped, it oozed all over Rapp and the dis­play.

“As I re­counted this story, Mom’s face moved and her eye’s sparkled — and the two of us just dou­bled-over with laugh­ter,” says Bux­man. “Even near death, we can still com­mu­ni­cate to the most prim­i­tive part of the brain — with laugh­ter.”

But fam­ily-re­lated hu­mour isn’t only ac­cept­able in ter­mi­nal sit­u­a­tions — it’s of­ten help­ful.

Just ask Paula McCann, an el­der at­tor­ney from Rut­land, Vt., who writes the blog on­the­way­tody­ing.com. She re­calls when her then 83year-old fa­ther, John, who was di- ag­nosed with Alzheimer’s, re­quested to die at home. His chil­dren and wife took turns car­ing for him. One evening, McCann sat with her mother at her fa­ther’s side, shortly af­ter he had been ad­min­is­tered his last rites. Mother and daugh­ter started to dis­cuss where his soul was at that mo­ment. McCann sug­gested to her mom that per­haps it was in a hold­ing pat­tern, while God re­viewed the right and wrong he’d done, be­fore allowing him into heaven. That’s when her mother quipped, “He’ll be there for­ever.”

A sense of hu­mour about all of the drugs pa­tients deal with at life’s end helped Ron­ald Berk, former as­sis­tant dean at Johns Hop­kins Univer­sity, through a rough patch.

His wife, Mar­ion Smith-Wai­son, a former ob­ste­tri­cian-gy­ne­col­o­gist, was very ill be­fore her death 18 months ago. She had sched­uled a meet­ing at their home with folks of­fer­ing holis­tic medicines.

When Berk en­tered the room, a drug coun­sel­lor asked him, “Are you tak­ing any med­i­ca­tions?”

Berk shot back, “Yes, I was tak­ing crack — but I gave it up for Lent.”

Berk in­sists hu­mour at that stress­ful mo­ment of­fered a crit­i­cal “re­lease valve.”

Chip Lutz, a pro­fes­sional speaker who re­tired from the U.S. Navy years ago, re­calls the im­por­tance of shared hu­mour be­fore his fa­ther, Eu­gene, died last year. Try­ing to squeeze an ex­tra hug out of vis­it­ing fam­ily mem­bers, Eu­gene of­ten ca­joled them with, “Well, this might be the last time you see me.”

Chip had the per­fect re­sponse. “You can’t die yet — I don’t have your eu­logy done,” he shot back.

Few peo­ple hear more mor­bid jokes than hospice work­ers. Sev­eral years ago, Allen Klein, an author and mo­ti­va­tional speaker, vol­un­teered at a hospice in the San Francisco Bay area. An el­derly woman he was as­sist­ing told him that af­ter she died, she wanted her hus­band’s bed­room re­painted — with her cre­mated ashes mixed into the paint.

“Why would you want that?” in­quired a con­fused Klein.

“So I can look down at my hus­band and see if there’s any han­ky­panky go­ing on.”

THANASIS ZOVOILIS, GETTY IMAGES

On its web­site, the Na­tional Can­cer In­sti­tute urges pa­tients to build hu­mour into their day-to-day lives, in ways as small as buy­ing a funny desk cal­en­dar and watch­ing comic films and TV shows.

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