The Ethics and Impacts of Sickle Cell Disease “Humor”

Sickle Cell Disease Comedy Can Form Bridges or Cross Boundaries

Comedy has walked a thin line between supplying appropriate and inappropriate content for as long as it has existed—likely as long as words have been spoken. At times, it has crossed boundaries to become offensive to certain audiences, sometimes the bulk of the public, but it can also build bridges between fellow sufferers and those around them. Disease humor—including sickle cell disease (SCD)—is a frequent culprit of boundary crossing that can have negative and positive impacts.

The Historical Purpose of Humor and its Connection to Suffering

Comedy has been around since we developed the capacity to laugh. Even great philosophers like Aristotle discussed ethical issues tied to the art of comedy. I was interested in the humanitarian purpose of humor, so I did some investigating through which I found a paper published in The Classical Quarterly by Malcolm Heath titled “Aristotelian Comedy.” 

Heath discusses Aristotle’s philosophy on comedy in the poetics. Yes, there is something about watching other people suffer that humans find humorous. Still, when you experience that same suffering in your day-to-day reality, it’s difficult to process, and you may even begin questioning people’s morality. How can one choose to find laughable moments in someone else’s pain? The answer lies in how comedy is used and the amount of ethical thought that goes into it. 

If one chooses to use any form of abuse in comedy, it should be laughable. Humor is universal and can enlighten humanity and bring comfort—but it can also bring pain and therefore comes with a certain level of responsibility.

SCD Jokes Can be Comforting or Cause Ethical Dilemmas

Disease humor can act as an extraordinary healer—providing a certain comfort to those suffering the challenges associated with various illnesses and assuring them they are not alone in their struggles. It can also offend those suffering from the disease through the spread of misinterpretations, incorrect assumptions, misinformation, stereotypes, and more. Further, it can confuse the general public about particular diseases, causing greater harm than good.

A few weeks ago, I discovered a lot of buzz erupting through the sickle cell community regarding a joke about SCD on the new HBOMAX series Velma. Although Velma was initially a white character, the creators decided to recreate Velma as an Indian American, played by Mindy Kaling. Ironically SCD affects nearly 1.4 million people in India, dramatically more than in the U.S.—only about 100,000 people.   

Most of what I read amounted to sickle cell disease warriors expressing their opinions, ranging from being extremely offended to feeling like it brought much-needed attention to SCD. Even outside of the sickle cell community, platforms, including Yahoo, have addressed the issue of ethical dilemmas arising from disease humor. 

Sickle Cell Disease: Humor Can Help or Hinder Victims

Whether disease humor is deemed acceptable and helpful or offensive goes back, in some ways, to who is telling the jokes and their specific content. For example, SCD warriors have published scores of videos on the internet jokingly discussing the sickle cell experience and how little healthcare providers know about the plight of disease sufferers. 

As someone living with sickle cell disease, I find these quite humorous because they are relatable. Although comedy can be funny, witty, and capable of raising our spirits, it’s a craft that requires a lot of discipline and ethical attention to ensure it serves its purpose humanely and without ostracizing or causing pain to certain groups.

Sickle Cell Sufferers Use Disease Comedy Themselves!

Keirra, a sickle cell advocate, creates TikTok videos of her sickle cell experience; one video, in particular, I find hilarious. In it, a nurse asks sickle cell warriors if they would like an ice pack as pain relief, without realizing that the cold temperature could induce sickling and prolong the pain she is trying to relieve. 

If you aren’t a sickle cell sufferer, you probably wouldn’t even understand the joke as it was written with a specific target audience—fellow SCD patients. There’s even an Instagram page @Sickle_cell_memes dedicated to memes featuring beautiful, relatable, and often comical content about the SCD experience. 

Sickle Cell is Notoriously Misunderstood

People on the outside rarely know the turmoil we face as we simply try to live our lives. Let me tell you, the pain that many of us feel can only be handled by the brave and the strong. While SCD has existed for centuries, it was first formally recorded in 1910. 

The illness primarily affects people of color, and this community has been fighting for attention, recognition, and to be seen and heard to this day. Sickle cell is an invisible disease. 

Many healthcare providers lack the knowledge to care for SCD patients, especially in the Emergency Department. Imagine going to the emergency room in excruciating pain, waiting countless hours, only to encounter a doctor that knows nothing about SCD and believes you’re a drug addict there for narcotics. Then, even worse, they take out a medical textbook, turn to the paragraph about sickle cell disease, and read about what they’re supposed to do as if the health care plan you and your PCP put in place is irrelevant. The experience is traumatizing.

Jokes Have Led to Further Misunderstanding of SCD

Many past jokes have impacted the public’s awareness and understanding of SCD—sometimes in problematic ways. Besides this type of introduction, most exposure to the disease revolves around a brief explanation after coming across sickle cells in a biology class during a lecture on genetics! That doesn’t mean you know what it’s like, though, living with the disease. 

In 2015, the film Ted 2 included a joke about sickle cell disease. The premise was, essentially, a scene in which Jonnie stumbled over a shelf of bottles filled with sperm, which spilled all over him. The clinician then walked in, telling him not to worry as it was rejected sickle cell sperm. Ted then announced, “You hear that, Jonnie? You’re covered in rejected black guy sperm…” 

Aside from being inappropriate in other ways—i.e., racist—it highlighted that individuals with SCD are not allowed to donate sperm. It was offensive and disrespectful on all levels. Isn’t it discriminatory that SCD individuals can’t donate sperm for money when other healthy individuals can? Please don’t misunderstand me. I entirely understand the ethical justification for this policy involving sperm donation. However, that rejection is still a force to be reckoned with, and it tends to hit differently when the root of your pain—and discrimination—is invisible. 

We live in an age where everyone wants a piece of the bag, but not everyone can make peace with obtaining that bag; it is no big deal. You must find a new way to hustle and make that bread, bringing in that income. 

At times, it feels as if only healthy people can achieve or advance in the world, and those who face an illness have no choice but to take the back seat. We have heard it time and time again… those four words: “Your health is more important.” Even then, we must watch people poke fun at the very malady they told us was so important. 

Even in Kevin Hart’s stand-up routine, the comedian stated, “Justin Bieber wants to be black so bad he went out and got sickle cell anemia.” His joke wasn’t that bad, necessarily. It was rather neutral, but he could have done better as it represented an annoying misconception of SCD. 

Before Making the Joke, Learn the History and Impacts of Sickle Cell Disease

The problem with joking about sickle cell disease is that those who do so are often painfully unaware of its history, how it arrived, and who it affects. 

The invisible malady primarily affects people of color, although it’s a genetic disease. Even to this day, not many people are even aware they carry the sickle cell trait. It wasn’t until the Sickle Cell Control Act was established in 1975 that even a few states—like New York and California—began screening for SCD. In 2006, newborn screenings for SCD became universal in all U.S. states, including Puerto Rico and the U.S. Virgin Islands.

There is absolutely no doubt that SCD sufferers represent an oppressed community, but who’s to blame but scientific racism? Before you joke about sickle cell disease or illness, please check your facts, learn your history, and consider the impact on those suffering from the ailment. 

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