Cancer? I barely know'er!

Strap in; the plane only hits the mountain even harder from here.

“With humor, the equation is tragedy plus time equals comedy. I am just at tragedy right now. That’s just where I am in the equation.” —Tig Notaro, at the first standup performance after her breast cancer diagnosis¹

Given this general formulation, cancer should be a comedy gold mine if you wait long enough—although “waiting long enough” is classically not a strong suit of cancer patients.

But if you listen to Tig Notaro’s set, you’ll see that she gets great laughs, despite being smack on the left side of the equation. Or listen to the musical “All Wigged Out,” where even the title is a puckish wink at chemotherapy’s most famous side effect.

Comedy, as an instrument, is not just about delivering an enjoyable performance to an audience. It’s for the comedian too.

“Laugh so you don’t cry” can be dialed all the way up when you’re on stage. Everyone can helpfully confront things they’d otherwise not. For Tig, that’s cancer; for her audience, it’s their fear of getting cancer. Comedy makes light of tragedy, and, done properly, can shatter its malignant consecration.

You know, good Hodgkins.²

Without comedy or very even-keeled people, cancer is witheringly difficult to confront. Besides the specter of grim death, the word itself is shocking in our culture. Collectively, we do not have good rules of etiquette to deliver and receive news about cancer diagnoses.³

Consider:

It’s like some lady’s husband getting eaten by a pack of feral hogs, and then you walk up to her and say: “I’m sorry your husband was eaten by a pack of feral hogs.”

But, of course, you wouldn’t do that. You’re already mortified at the very idea. Why? Because what do you say to someone whose husband was eaten by a pack of feral hogs? There’s no cultural script for that.

Cancer is, basically, homophagus⁴ feral hogs. People want to avoid addressing it directly. They don’t know what to say. They definitely don’t want to say the wrong thing (“At least the eating was quick?? Boy, they really pigged out, didn’t they??), but what even is the right thing? Panic!

This makes comedy a brilliant tool for addressing and processing cancer, because the technical setup of many jokes relies on an initial shock, or upsetting expectations.

You can be Tig Notaro and be just a little bit too casual about the whole thing. Or you could be Larry David earnestly, enthusiastically trying to argue that there’s good Hodgkin’s at a man’s funeral.

Cancer will play your improv games

“The second rule of improvisation is not only to say yes, but YES, AND. You are supposed to agree and then add something of your own. If I start a scene with ‘I can’t believe it’s so hot in here,’ and you just say, ‘Yeah…’ we’re kind of at a standstill. But if I say, ‘I can’t believe it’s so hot in here,’ and you say, ‘What did you expect? We’re in hell.’ Or if I say, ‘I can’t believe it’s so hot in here,’ and you say, ‘Yes, this can’t be good for the wax figures.’…now we’re getting somewhere.” —Tina Fey⁵

Unfortunately, cancer is a brilliant improv partner. It will always “YES, AND!” you:

You: Oh no, I have cancer! At least it's good Hodgkin's, and there's a probable cure.

Cancer: Yeah, isn't it crazy how the cure is poison?

You: What

Cancer (sotto voce): Bro, yes/and me

You: I mean...and the poison isn't that bad!

Cancer: Considering that the alternative is death, definitely. Definitely it is better than that. 

You: #%$K

You can be frustrated with this. I was.

And/or you can look at it as a reframe—a way to use the tools of comedy to effectively move forward in life. Because if you get cancer, many things will happen very quickly.

Diagnostic tests to determine which chemo regimen you can tolerate. Unending bloodwork. What stage is it? Surgeries. Administrivia. Health insurance. Whoops, now the side effects of your poison are kicking in, hope those aren’t permanent. Maybe take some more medicine to control those, but they have side effects too. Now you can’t poop. Your hair is falling out. All your hair is falling out. You need a bone marrow biopsy??

Even if you’re well prepared for cancer treatment, the speed and worry of it all can overwhelm you anyway.

But: instead of a relentless series of blows, you can experience these things as the worst/stupidest/funniest game of improv you’ve ever played in your life, at least in your better moments. You can “yes, and…” the cancer back.

Cancer: You had chemotherapy on Monday, and you feel terrible now!

Me: Now I don't have to help my roommates move to our new apartment! What a deal!

People have done more to get out of moving.

(Thank you, dear sweet Liam, for helping me pack my stuff, and for moving me.)

Make em laugh, make em laugh, make em laugh

My particular chemo cocktail was four drugs: doxorubicin, bleomycin, vinblastine and dacarbazine. This combination is usually referred to with the acronym “ABVD.”

But maybe that stands for “Always Be Very Dopy” too. Don’t groan at me!

Cancer cannot be processed entirely with humor. But don’t overlook it—I didn’t, and thankfully my friends didn’t either. It is salubrious. It is healing (not of the cancer, but you get what I mean).

“[A thing] didn’t go that well,” I said one evening this past November, with a good friend across the dining room table.

“Well,” he paused, “at least it’s not cancer or something.”

1. “Hello, I Have Cancer,” 1:16-1:37

2. From season 4, episode 5 of Curb Your Enthusiasm. H/t to Ben Ryan for flagging this.

3. This is partly because we conflate the worst cancers with all cancer. Not all cancer is a death sentence; mine wasn’t! It was good Hodgkins. The treatment was rocky, but I was, and am, reasonably sure that I will be cured.

4. From the ancient Greek “homophago,” which is used to refer to eating raw flesh, and can evoke cannibalism or the eating of people. (I am working on getting my hands on a 1977-or-later edition of Richard John Cunliffe’s A Lexicon of the Homeric Dialect so I can give you the proper citation.)

“Homophagus,” as a word, is hilarious. You know why. It’s just sitting there, saying both of those things, but laundering them through Greek so it’s unnervingly, technically “safe.” A joke in 30 Rock’s season 5, episode 17, “Queen of Jordan” relies on the same mechanism. Jenna tries to pull focus and get people on her side on a reality television show, so she makes a bunch of hats that say “Jennas-Side.com”.

5. Bossypants, p. 84, the breakout box entitled “The Rules of Improvisation That Will Change Your Life and Reduce Belly Fat*”