Dark Humor in the ICU (“Celestial Transfer”)

Informant Context:

Stella is a traveling ICU (intensive care unit) nurse who currently work in Atlanta, Georgia.


STELLA: I feel like people in the ICU especially have like, really dark humor. Um… like, dark kind of like—twisted humor? And I think like, you kind of like, have to be that way. Like, it’s like, it’s kind of the saying of like, “If you’re not laughing you’re crying?” Like, the things that we see are so tragic that like, we kind of just have to like, make light of them? And it’s not ’cause like, we’re like, making fun of people is just like… “Wow, the situation is like, so bad… like, this is just ridiculous that I’m watching this” kind of thing. Um…

INTERVIEWER: Can you give an example of… maybe a joke that you’ve heard or something people frequently make fun of in the ICU?

STELLA: Um… like, I don’t… like [laughs]… if a… like, it’s like—this is like, so bad. I don’t—like, I kinda don’t, like, feel super comfortable like, saying… like, like—so I’ve heard people say like, um… you know, like—oh, like, so-and-so made like, a “celestial transfer”. And so, it’s kind of like—kind of like a jokey way of saying like… if the patient died… and it’s like, instead of transferring them to the floor or like, discharging them from the hospital they were like, transferred to the sky. You know what I mean?

INTERVIEWER: Right, right. 

STELLA: Like, to heaven. And so it’s like, “Oh… like, you know, so-and-so… you know, had a ‘celestial transfer’”, and everyone’s like, “Oh, yeah”. Um… but yeah… I mean, I don’t know. I feel like it’s… it’s not something that anyone outside of that profession would understand nor think is funny [laughs]. 

Informant Commentary

Stella displayed some apprehension, even guilt, when sharing this particular joke. She feared that those outside her folk group would characterize the humor of medical professionals in the ICU as “heartless”, in her words. For her, the meaning of the humor lies in replacing pain with levity. She went on to describe this folk practice as an absolute necessity to cope with the constant displays of suffering which surround this folk group.


Certain experiences and responsibilities breed jokes which are not considered humorous or even relevant to people without the same experiences and responsibilities. In the case of this specific joke, the experiences and responsibilities shared by those within the folk group are ones closely associated with death, particularly death within a hospital setting. This is why the joke directly references hospital terminology (“transfer”). In addition, references to the word “celestial”, or the movement of a patient from the “terrestrial” to the “celestial” suggests that even within this example of so-called dark humor, there is an implicit hope of peace for their shared patient.