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The Arts and Medicine
November 8, 2016

Tig NotaroA Comedian Makes “Sick” Humor the Main Act

Author Affiliations
  • 1Senior Staff Writer, Medical News & Perspectives, JAMA, Chicago, Illinois
JAMA. 2016;316(18):1850-1851. doi:10.1001/jama.2016.16652

Within the first 5 minutes of her semiautobiographical television “traumedyOne Mississippi, we see Tig Notaro—last name Bavaro on the show—visit an airport restroom three times. When her character’s brother, Remy, arrives to pick her up, he blurts out that she also looks like shit. He’s right: She’s skeletal, but for good reason. She’s recently undergone a bilateral mastectomy for invasive breast cancer and now she’s dealing with a severe case of Clostridium difficile infection that’s causing those trips to the restroom. Heaping on the misfortune, she has flown in to be at her mother’s hospital bedside when she is taken off life support. An accident, we learn, has left Tig’s mother brain dead.

From One Mississippi. Photo credit: Amazon.

It reads, but doesn’t play—thankfully—like a medical melodrama. And it’s true, with a few minor tweaks. Over the course of four months in 2012, Notaro, a Los Angeles–based stand-up comedian, was hit with this trifecta, albeit in different chronology. A week after spending nine days in the hospital for the gut bug, she got the news that her mother—vibrant and youthful in her middle age—had tripped and hit her head in her Mississippi home and would never wake up from a coma. Then, Notaro’s cancer was diagnosed, and the surgery followed. The end of a relationship compounded the onslaught.

About a week after the diagnosis, steeped in fear and sadness, Notaro walked out on stage at LA’s Largo comedy club and greeted the audience: “Good evening, hello. I have cancer, how are you?” The crowd laughed, assuming she was joking. She assured them that she was, in fact, serious, but over the course of her set she reassured them: She might die, yes, but not tonight. That night they would laugh at the absurdity of it all—the cancer, the life-threatening infection, the sudden loss of her mother. The set, recorded on the concert album Live (verb, not adjective), went viral and brought her a Grammy nomination.

There’s magic in that set if you listen to it, a camaraderie and electricity that come through the recording. At one point Notaro wavers, wondering if she should switch to lighter fare, and a man in the audience shouts out, “This is fucking amazing!”

Humor lifted Tig, both the real and fictionalized versions. In her memoir, I’m Just a Person, published in June, she describes the natural high she felt leaving the stage that night, the complete opposite of her psychological state 30 minutes prior. In a scene in One Mississippi, Tig and a nurse share a big, hearty laugh after her mother has taken her last labored breath. It’s imagined, though—a fantasy version of events Tig conjures up in which all of this is not quite so horrible.

A later episode brings a shattering revelation about her mother’s life. In the wake of this exposure, Tig finally musters the courage to examine her own truth. She takes her shirt off and looks at her chest in a mirror for the first time after her mastectomy, revealing the scars where her breasts used to be. (Notaro, already small-chested, chose not to have reconstructive surgery. “I’d essentially be surgically attaching the equivalent of two kiwis, less hair, no stickers,” she writes in I’m Just a Person.) She also goes topless for a good portion of her new HBO special, Tig Notaro: Boyish Girl Interrupted. Her courage to bare all on camera took my breath away.

So yes, she’s incredibly brave. But is she funny?

Notaro’s jokes about her health crises and the death of her mother are arguably her best material. Before this, one of her well-known bits was about repeatedly running into late ’80s pop star Taylor Dayne around LA. She’s funnier when she’s wryly riffing on the hospital satisfaction questionnaire sent to her dead mother, or the possibility of a fecal transplant from her anal-retentive stepfather.

On Live, Notaro does a bit about her diagnostic mammogram. Looking down during the scan, the radiology tech remarks, “Oh my gosh, you have such a flat stomach. What is your secret?” “Oh, I’m dying,” Tig innocently responds. The joke—about what she calls her “C diff diet”—kills. “Don’t like exercising? Who does, girlfriend? This diet does all the work for you.”

Wisdom has it that comedy = tragedy + time. But, in a testament to her skill, Notaro didn’t wait until a “comfortable” amount of time had passed to joke about her cancer, and she still brought the house down.

She has been wise to let us, the audience, in on her secrets. “These aren’t topics we usually discuss except in small groups,” said Mitch Earlywine, PhD. Earlywine is a professor of psychology at SUNY Albany, an occasional stand-up comedian, and the author of the book Humor 101. “It’s extra funny because it’s such a forbidden, intimate domain,” he explained.

Notaro, of course, didn’t invent gallows humor, this particular brand of joke that pokes fun at illness and death. In the 1970s, comedian Totie Fields riffed on her recently amputated leg in an episode of an HBO comedy show titled, aptly, Standing Room Only. And in a slapstick home video filmed by Gene Wilder, Gilda Radner—in treatment for ovarian cancer—remarked to the camera, “Through the miracle of chemotherapy, I am able to play tennis as badly now as I did before I had cancer.”

Richard Pryor’s bit about his heart attack is considered one of his all-time funniest. On stage, he joked about his alcoholism and drug abuse and, finally, his multiple sclerosis. According to comedy historian Kliph Nesteroff, “After Richard Pryor, comedians felt OK to really expose their inner secrets, and that included serious health issues.” Because gallows humor has worked so well for comedians like Pryor and Notaro, we should expect to see more of it, Nesteroff said.

That’s probably a good thing, if the growing body of evidence around the psychological and physiological benefits of humor is any indication. Scott Weems, PhD, a cognitive neuroscientist and author of Ha! The Science of When We Laugh and Why, told me of one now-classic study, in which patients who watched comedies while they were in their hospital recovery phase required less pain medication.

Capitalizing on research like this, many hospitals now offer humor carts and rooms loaded up with things like silly games and funny movies. Some hospitals train their physicians to incorporate humor into their bedside manner or employ therapeutic clowns for pediatric and adult patients. Professional medical clowns from Big Apple Circus’s Vaudeville Visits program bring humor to elderly patients at Saint Barnabas Medical Center in Livingston, New Jersey, for example, and in the Bay Area the Medical Clown Project serves Alzheimer’s patients at facilities like California Pacific Medical Center. The University of Southern California Norris Comprehensive Cancer Center also uses medical clowns to enhance the adult patient experience. “This isn’t frivolous, but is beneficial for both patients and staff, since it means reduced use of drugs and inpatient services,” Weems said.

Gallows humor has its place in all of this, Weems added, pointing to research showing that people who are able to find humor in their medical conditions have the quickest psychological recoveries.

So to Notaro and other comedians: Keep the cancer and illness jokes coming. They’re good for our collective health.

Section Editor: Roxanne K. Young, Associate Senior Editor.
Submissions: The Arts and Medicine editors welcome proposals for features in the section. Submit yours at artsandmedicine@jamanetwork.com.
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Article Information

Corresponding Author: Jennifer Abbasi (jennifer.abbasi@jamanetwork.org).

Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for the Disclosure of Potential Conflicts of Interest and none were reported.