Panama City Beach, Fla. -- Alison Crane was back. So with countless hugs, and a few quips, the members of the group dedicated to "healthy humor" celebrated the return of the nurse who founded their organization in the spare bedroom of her Chicago-area townhouse.
During the group's first years, she did everything - editing its newsletter, organizing its conferences and giving the speeches. Now the Association of Applied and Therapeutic Humor was 20 years old, and they celebrated that, too, during their convention here on Florida's Gulf Coast.
"I'm its mommy," Crane said at an early session for newcomers to the group, a mix of nurses, physicians, psychologists, public speakers, clergy and "caring clowns," some of those wandering about in red and blue rubber noses. "Then I went into hiding for about 17 years."
And that would be one through-line of their weekend, the discovery of what had happened to their founder during those "lost years" or "dark years," as she alternately called them, and why she'd say, "I couldn't be around an organization that's so positive and optimistic."
It was an ironic truth that many of the group's members also know too well - that you can devote your career to caring for others in hospitals and nursing homes and hospices, and preach to them about the benefits of laughter and mirth, and yet sometimes, when illness and depression enter your own life, there's no way to laugh them off.
"Sometimes what's appropriate is to cry through your grief," Crane said, and during the next three days other professionals would speak of their own brushes with death and despair and their personal attempts to find solace in the lighter side of the bleakest moments.
The modern "therapeutic humor" movement got its start in the 1970s when magazine editor Norman Cousins wrote a book crediting doses of Marx Brothers movies - along with a new diet and vitamin C - with helping him come back from a potentially fatal illness.
Anatomy of an Illness as Perceived by the Patient helped spawn the use of clowns and "humor carts" in hospitals, studies attempting to document the physiological benefits of belly laughs and the formation of several national organizations, including the one that met here last month.
By the end of his life, Cousins worried that some people were taking his idea too far, attributing too much power to laughter, as if "ha-ha" might help cure all problems.
But you heard few such claims at the convention.
Indeed, at the Friday morning orientation for first-timers, Steven Sultanoff, an Irvine, Calif., clinical psychologist and former president of the group, cautioned that they would "learn some of the truth and fiction" in the field, and among the latter, he said, are claims that humor prompts the body to secrete more endorphins and that children laugh 400 times a day while adults enjoy that release a pitiful 15 times.
Though there were poster boards summarizing various studies, the claims here were far more modest. For example, humor might help in stress relief, or in communicating with patients or, most essentially, in coping with disease or other life crises, "just to improve the will to live," said the association's new president, Lenny Dave.
Dave, a Cincinnati-based humorist, lived through a heart attack a couple of years ago, at 48. He recalled being taken to the operating room, where a doctor in "a welder's mask" was going to perform an angioplasty. "I said, 'Doc, have you ever done one of these before?'"
"He said, 'I tried one yesterday on the dog.'"
Telling the tale, Dave shook his head at his missed opportunity. "I forgot to ask, 'How's the dog?'"
The Association of Applied and Therapeutic Humor now has nearly 600 members, and 200 showed up for the 20th anniversary convention, with an eclectic roster of speakers and performers - from a juggling divinity student to leaders of support groups for breast cancer survivors - offering the attendees broad philosophies and practical tips for improving the lives of their patients, and themselves.
The kickoff speaker was a classic icebreaker for both groups, David Coleman, known as the Dating Doctor. He's become a mainstay of the college circuit by dishing out such tidbits as: Don't look for someone to "complete" you because "what if they leave you tomorrow, are you then less complete?"
After his presentation, he held court from behind a table, signing his books and offering more personalized advice, as to a nurse who reported that a man in the audience just said to her: "Your husband must be one lucky man."
That was a line right from Coleman's talk - one supposedly that shows a man's interest, checking the woman's status. The problem, the nurse said, is that she told the fellow she did have a husband who thought he was so lucky "he left me a year ago." Coleman advised her to instead tell new suitors, like that one, "Thank you, that's very sweet. But I'm not healed yet."
And when the nurse walked off, he said, "Because these are some of the caregivers, sometimes they need help caring for themselves."
The next speaker was a Manhattan minister, the Rev. Susan Sparks, who mused on the lighter side of spirituality and even had an atheist joke: "I used to think I was an atheist - until I realized I was God."
'Gloom and doom'
But Sparks also mentioned her breast cancer diagnosis last spring and her dad's recent death. Later, she recalled the first weeks after her diagnosis as a lost time for her, amid "a million scenarios of gloom and doom," up to the scan to determine whether the disease had spread to her liver.
But what she recalled for her audience was how her mood turned around when she was told the liver scan had detected only "early signs of BLS - Bud Light Syndrome."
New president Dave mentioned to members the perception some outsiders may have of them as "these foolish people" with "this silly happy talk."
The odd looks from the sourpusses of the world come with the territory if you list yourself as a Professional Smart Aleck or Laughter's Chief Counsel, as one lawyer did in the convention roster - or if you identify your professional affiliation as Laughter on Wheels or the Jolly College. Or if your medical advice includes, "Start a Movement/Eat a Prune."
Or if you call yourself "Nurse Funshine," like Louisiana's Cheryl Fell, who bounds into a room like Mary Poppins, singing about how sugar helps the medicine go down.
Yet like most of the speakers, Fell was careful to point out where humor can be "heartless," as when it's sarcastic, or when it's inappropriate, like right after an ominous diagnosis or amid off-the-charts pain.
"You ever had a kidney stone?" asked another seminar leader, Indiana nurse Candy Waters. "Clowns don't work. Morphine works."
Saranne Rothberg arrived Saturday with her "Live Love Laugh" pins. She's the founder of the ComedyCures Foundation.
Her story: "I was just a stay-at-home mom who threw a chemo comedy party in 1999 when I was diagnosed with Stage 4 breast cancer while going through a divorce. Me and my daughter had a goal - 100 laughs a day. I went home that night and vomited my guts out and wrote down Comedy Cures."
In the hospital, she would see someone else pushing a chemo pole and ask, "Did you hear about the two satellite dishes that got married? The ceremony was terrible, but the reception was terrific."
Rothberg said her target patient would often retort: "That's horrible, let me tell you a better one" and off they'd go with the "tumor humor."
Among the merrymakers from the conference was Marie Bethke, a retired nurse from New Jersey who became a certified laughter leader after losing her son in the Sept. 11 terrorist attacks. Bethke works in nursing homes and with Alzheimer's patients and has gone through cancer care herself, as has her husband, Brud, who missed last year's convention because of his chemo treatments.
"You know, I think half the people at these things are cancer survivors," Brud said on the trip back to the hotel, where it soon would be time for Alison Crane to tell them about her past 17 years.
They gave her a plaque first, and a standing ovation, at the Saturday night banquet. Then she said, "Would you like to hear what happened to me?"
Some of it was classic post-traumatic stress, as she saw it, in her case from a close call while giving birth to her daughter, when they gave her a drug and "I coded." After that came her brother's AIDS.
"The day I was supposed to get my master's [in psychiatric nursing], I was at my brother's funeral." She spoke of a marriage that "blew apart" and the death of her mother, who had cancer "without my being told."
'The whole story'
She spoke of the illness of her second child, her son, and her own hysterectomy and pneumonia, and the thefts of her jewelry. And her panic attacks. Those were "not a fun thing," Crane said.
She no doubt sensed that the list was getting too long, but she had promised "the whole story," so on she went, telling about her bout with West Nile virus and even a date she had when she became single, with some guy whose first wife had killed herself after he criticized her.
"That's why I haven't been here for 17 years," Crane said when it had all come out.
The most interesting detail, though, was how she'd rescued herself from that emotional morass - by joining the Army. The Army Reserves, actually, working with soldiers back from Iraq.
Touchy-feely stuff would never work with these vets, who tested her time and again and groaned when they heard she was a psychiatric nurse. Yet humor, she said, once again bridged the gap. A lot of it is of the morbid, graveyard variety, not surprisingly. But sometimes the equivalent of a knock-knock joke did the trick.
"One said, 'This guy is so paranoid he thinks I'm stealing his pen.'
"So I said, 'Are you?'
Capt. Alison Crane found a new cause in these soldiers, who gave her some perspective on her past 17 years. "We're all on this big ball of dirt together," she said, and when the current leaders of the Association for Applied and Therapeutic Humor insisted that she be part of the 20th anniversary celebration, for the first time in a long time, she said, "Yes."
Sunday, it ended with Paul Huschilt, a Canadian humorist, offering a "comic summary" of the weekend. He parodied all the speakers, and Crane could not get a free ride, either.
After praising her courage, he said: "The point was she had been through hell. It was a profound story and everybody else at the conference had the same story. But they didn't tell it that night," he deadpanned, thus sending the humor therapists home on the necessary note, the transformation of pain into laughter.
Paul Lieberman writes for the Los Angeles Times.