Bad taste test

Here is a joke that has been circulating in the medical profession about Alzheimer's disease. What does the patient get if you prescribe Aricept [brand name of one of the drugs now used to stabilise the symptoms of the disease] and [the anti-impotence drug] Viagra? Answer: A night to remember.

More about that in a moment. Last Saturday we published the following on page 53 of Guardian Weekend, in a small celebrity spot called Tell us a joke: "Ronald Reagan goes to the doctor's. The doctor says to him. 'I've got two bits of news for you - one's very bad, and the other's not quite so bad: you've got cancer and Alzheimer's.' And Reagan replies, 'What was the first one again?'"

This is actually a version of a joke now so old that it has been held up as a classic. It was chosen as one of the "75 funniest jokes of all time" according to a poll conducted for American GQ, among comedians and comedy writers. We reprinted this in our supplement, the Editor, on May 28. "A man goes to the doctor. The doctor says, 'I have bad news, and I have worse news. The bad news is you have Alzheimer's. The worse news is you have inoperable cancer and you'll be dead in two months.' The man says, 'Well at least I don't have Alzheimer's.'"

A reader who has a spouse with Alzheimer's wrote to object to that joke. She said: "You should know that Alzheimer's disease is not a mildly amusing case of forgetfulness in old age but involves the loss of so much that defines us as people: the ability to make relationships, to read, even to speak; loss of control over basic self care and even over bodily functions..."

The repetition of the joke in the magazine prompted the reader to write directly to me asking me to explain, "where offending those whose brains are disintegrating and their carers comes in [my] hierarchy of concern". One other reader wrote to complain about the Reagan version.

I was curious to know what my colleagues thought so I circulated the Reagan joke in the Guardian office, with the following questions: Did you laugh at this? Were you offended? Would you have published it?

About 35 replied. A small majority did not find it funny, most because it was a hairy old (and some said tasteless) gag. Only three were personally offended, but when it came to the question of publication almost a third would not have used it because they felt that the offence to others was very easily anticipated and should have been avoided. However, a majority still thought it was all right to publish.

Several of those who were uncomfortable with it did not like the fact that it was directed at an individual. I did not like that either. A couple said, try it this way: "Iris Murdoch goes to the doctor's..."; or put in the name of a relative who has Alzheimer's. The humour, someone suggested, quickly evaporates.

The most interesting result from this random survey was the discovery among the 35 or so who responded, of seven colleagues who had all cared or were caring for a close relative with Alzheimer's. Every one in this group defended the publication of the joke and the therapeutic value of humour to patients and carers.

One colleague said, "I really think that faced with a loved one suffering from Alzheimer's or senile dementia, as I am with my mother, the best thing you can do is laugh... She now has maybe 2% of her old life left to her yet she still has moments of enjoyment and laughter." Another, who described the most taxing state of affairs, said, "If you make light of the situation, it doesn't mean you don't care or love them, or that they are no longer the person you remember."

The reader who complained to me suggested I spoke to Linda Grant, who has written about her mother's Alzheimer's and who, on Wednesday, wrote in G2 about another person with the disease. Grant told me, "I think the black humour that surrounds this disease is often the only way it is made bearable for family and even people who have it." She said the head of residential service at the home which looks after her mother had told her that he thought the most helpful book for relatives would be a joke book.

Before I forget, the joke that I began with. I had that from the chief executive of the Alzheimer's Disease Society. He said quite a lot of carers complained about Alzheimer's jokes, feeling that they trivialised things. He said he understood that. But jokes, he added, undoubtedly had a role in coping and caring.

I went back to the reader who had complained. She said she felt this one had been laughing at not with; then she added, jokes OK, but please don't print crap ones.

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