I congratulated myself, briefly, on my restraint. Surely there are times when humor simply isn’t appropriate? But later I got to thinking about how jokes work. One person reveals information bit by bit, and then springs a surprise on the listener. Freud wrote of how a joke teller wields control, creating tension, and then choosing the precise moment when the tension will be released.
Maybe what my patient needed at that moment — uncertain about her fate, tucked too tightly into her hospital bed, tethered to various tubes and wires — was to be in control.
Maybe the most healing thing I could have done for her right then was to let her hit me with the punch line.
Dr. Suzanne Koven is a primary care internist at Massachusetts General Hospital. Read her blog on Boston.com/Health. She can be reached at inpracticemd@gmail .com.