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I used to be a very well mannered individual. Then two things happened:

  1. I went to nursing school.

  2. I got a job in a Level I trauma center OR.

Somehow, during the course of those two things, the filter that every “normal” individual has auto-installed in the brain began to disappear. It still worked, but sometimes the reaction was significantly delayed. I noticed an increased frequency of my mouth running ahead of my brain, and I was cracking jokes that I would have never cracked in my former life.

I also noticed that I wasn’t alone. Many of the surgeons and anesthesia staff I worked with also lacked this filter. I worked in various operating rooms in the United States and figured the humor would vary based on geographic location.

It didn’t.

Whether it is a small private surgical center or a large Level I trauma teaching institution, the operating room is a glorious melting pot of individuals who have been trained all over the world. Surgeons, anesthesia, residents, staff, students, and others come from a variety of institutions. Each has their own way of handling the stress that they deal with.

I have often heard nursing and medical students comment on the fact that what is said in the OR is irreverent and not funny. Some are turned off from working in the OR because of our odd sense of humor, lack of filter, and apparent inability to demonstrate humane levels of sensitivity.

Why do we do this? Are we just horrible people? It wasn’t just staff—I’d cared for cancer patients who joked about being bald, and a fresh amputee who laughed about being “down a limb.” What was wrong with these people?

To make sure I hadn’t entirely lost the sensitive side of myself, I did some research. Not only is this humor found in environments such as operating rooms, emergency rooms, and intensive care units, it has also been used by patients, and it has a name: gallows humor. Wikipedia defines it as “witticism in the face of—and in response to—a hopeless situation. It arises from stressful, traumatic, or life-threatening situations, often in circumstances such that death is perceived as impending and unavoidable.” It seems that someone at some point in history cracked a joke shortly before being hanged, and the term stuck. Why would this matter in the trauma operating room?

The next time you visit the OR, take a moment to think about the bigger picture and see how the above definition of gallows humor might fit in.

A group of individuals gathers in a room filled with intimidating technology, extreme temperatures, and multiple personal hazards. It may be the second or two-hundredth time that they have worked together—their experience ranges from ...

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