A classic sketch featuring Dana Carvey as Tom Brokaw aired on Saturday Night Live in 1996. The comedic premise has Brokaw (Carvey) pre-taping former President Gerald Ford obituaries to “cover all contingencies,” while Brokaw prepares to spend the winter in Barbados, presumably then unavailable to cover breaking news. Brokaw is reporting the fictional/possible “Gerald Ford shot dead” story, when his producer prompts Brokaw to include the word “senseless” (marker 1:10 in the linked video). Brokaw reports, “Gerald Ford shot dead today at the senseless age of 83”; the crowd erupts in laughter.

Of course it’s not the age of former President Ford that is senseless, but his assassination. This post is not on the mechanics of humor, but there is something instructive about this joke, grounded in what we mean by “senseless.” President Ford’s age is easily accounted for, and not something arbitrarily assigned to the President. Indeed, we could verify the President’s age by examining evidence such as the year recorded on his birth certificate. What we could not account for are the motives, thoughts, and attitudes of the imagined assassin. Hence, it is appropriate to say, “shot dead, senselessly,” rather than, “senseless age of 83.” Brokaw’s inappropriate insertion of “senseless” upon the producer’s request plays as a joke about language and about the “thoughtless anchor” trope, who only reads the prompter but, in some sense, does not know what they are saying. (For another salient example, see Will Ferrell’s Ron Burgundy in Anchorman, “Go fuck yourself, San Diego,”)

Senselessness in the context of Carvey’s Brokaw cashes out as some feature of an event or thing that we cannot account for. It is inexplicable. It confounds us. It is senseless. Someone’s reported age is not senseless. The unlikely assassination of a former President is senseless. Let this be a stand-in definition for ‘senseless’: something for which an account cannot be given. Hopefully I have provided adequate motivation to pick up this concept and apply it. Regardless, nothing all that important turns on the definition we settle on for ‘senseless.’

My loved ones identify senselessness in my glioblastoma diagnosis. There is no known cause for glioblastoma. There is no known cure for glioblastoma. This characterizes the disease as a double whammy: no prevention and no cure; utterly senseless. Adam was diagnosed with glioblastoma at the senseless age of 34.

Fortunately, we are not doomed to senselessness. We can see our way out of it by appeal to a recurring theme on my blog: narrative medicine.

Read the following description of one responsibility of clinical practice from Arthur Kleinman, quoted in Dr. DasGupta and Dr. Charon’s article on personal illness narratives[1]: “Rather than technical adherence to any strict format of history taking, empathetic witnessing involves ‘the existential commitment to be with the sick person and to facilitate his or her building of an illness narrative that will make sense of and give value to the experience’” [emphasis added].

Kleinman’s claim, endorsed by Drs. DasGupta and Charon, prescribes that clinicians are assigned the task of helping persons under their care to construct their narratives, that is, to tell their stories, and in so doing, to find sense in the circumstances and by some measure render the experience valuable.

I floated an analysis of ‘senseless’ to be an event or thing that cannot be accounted for. If you get on board with that definition, then making sense, as Kleinman orders, of the senseless, involves giving an account for one’s circumstances. Easily done, maybe, when you pick out your own agency in a circumstance, but with so many cancers generally, and glioblastoma, particularly, there is no accounting for the disease and no role for personal agency. Personal agency features heavily in our acceptance and moving forward with the diagnosis, but causally, pre-diagnosis, there was nothing I could have done to prevent my brain cancer; this is what I mean by no role for agency. The circumstance seemingly remains senseless. Is there another interpretation on offer? I suggest an alternative.

Rather than seek meaning in the senseless, a Sisyphean task, as I have said, there is no accounting for glioblastoma, what if I were to recast the circumstances in a new way, not as Adam with brain cancer that has no cause and is thereby senseless, but let us examine the outcome, when I interpret the circumstances as Adam, the graduate-trained philosopher, nearly ten years of experience training, consulting, and facilitating organizational change management in professional settings, with a supportive family, a strong social network, and relatively unimpaired cognitive functioning relative to this stage of his disease, save for his neuro-fatigue, seizures, headaches, frequent breaks, etc. On this revised reading of my circumstances, I have done nothing to change the constants that are included in the story–I still have brain cancer; there still is no cure, but I recast the circumstances in such a way to mitigate the threat of those things for which we cannot account.

There is no accounting for glioblastoma, or my having the disease, that is all senseless, confounding, inexplicable, but there is a way to tell my story, to construct my narrative, that makes sense of things, or at least better sense of them than I possessed pre-reflectively. I repeat for emphasis: I recast the circumstances in a way that made sense, in such a manner to mitigate the threat of those constants that are senseless. We may infer from Kleinman’s direction that making sense aids the storyteller in finding value in the experience. What I have done here in a few short paragraphs that reflect my many months wrestling with my disease, is to set aside those things for which I cannot make sense. I allow the disease, and my having it, to be senseless, but as Kleinman orders, I can make sense of and find value in the experience. More accurately: I distinguished the particulars that make up the experience from the experience itself. Some facets of my experience, the cause of glioblastoma, for example, are senseless, but my illness experience is much, much greater than the diagnosis.

I penned an open letter to Senator John McCain last week, on the heels of his glioblastoma diagnosis. I received countless article comments, tweets, and emails. One email related the story of a person whose dad died from glioblastoma when this person was still a child, only 12 years old, too young to understand the complexities and difficulties of daily living with brain cancer. This person, then child, emailed to tell me that my letter of advice and support to the Senator helped this person to better understand what life was like for that person’s father. By constructing my narrative in new lights, lights seeking to shine brightly on the experience that can be made sense of, allowing the senseless particulars to remain as part of the experience, but their threat mitigated, I found value in my experience by sharing my story with others.

We find sage advice at the intersection of comedy and medicine. Unsurprisingly. These both are unique expressions of humanity. Comedy and medicine are experiences far greater than the particulars that make them up.

Clinicians and professionals aid a person in crafting their narrative with the purpose of distinguishing those things for which we cannot account from the experience itself, when performed successfully, sense can be made of the senseless, and value can be found in the experience, even an illness experience, but just like comedy, we get better with practice.

[1] DasGupta, Sayantani, and Rita Charon. “Personal illness narratives: using reflective writing to teach empathy.” Academic Medicine 79, no. 4 (2004): 351-356.