Sometimes a funny situation occurs accidentally. Robinson (1975) described the mirth unintentionally created by a young nurse unfamiliar with the colloquial term vase for a bedpan: "When asked by a patient for a 'vase,' she looked around and finally asked, 'Well, how big is your bouquet?'" (p. 57)

Cousins' story is representative of much humor literature. Anecdotal and philosophical accounts abound. The health care professionals I interviewed are unanimous in the conviction that patients who maintain positive attitudes feel better and heal more quickly. Likewise, the patients I meet almost always describe their favorite caregivers as the ones who smile and joke around with them. But believing in humor is not the same as understanding it. After surveying a random sample of 204 nurses, Sumners (1990) reported that a majority were willing to incorporate humor in patient care, but felt uncertain how to go about it. Vera Robinson, a nurse with more than 30 years experience, asserted in the preface to her 1975 dissertation:

It [humor] is part of our lives even in times of stress, danger and death. Yet, despite our recognition of its value, we don't take humor seriously. Somehow, we are afraid to look at it, to analyze it and to make conscious, deliberate use of humor as a tool in communication, as a way of intervening in the stresses of living. We allow it to happen by chance. And, particularly in health professions, there's generally no attempt at a planned use of humor. (p. ix)

Goodman (1983 )-director of the HUMO R Project-proposed that "the human condition is inherently funny" (p. 15). Zijderveld (1983), a humor researcher, asserted "one should never underestimate the serious nature of play" (p. 6). And Robinson (1975) made a case that "humor is not just a laughing matter, it is serious business" (p. 3). All point to people's instinctive reliance on mirth as a coping mechanism. If these claims are valid, it seems artificial and perhaps destructive to exclude humor from the emotionally charged atmosphere of a health care setting.