Hank Green on his ‘Pissing Out Cancer’ comedy special, ulcerative colitis, and the jokes that got cut

There’s a website dedicated to asking how many days it’s been since Hank Green started a new project.

The counter resets often — the multi-hyphenate internet educator and science communicator rose to prominence with his 2007 YouTube project Vlogbrothers, which he founded with his brother, the novelist-turned-tuberculosis-fighter John Green. Free, educational YouTube channels Crash Course, SciShow, and Study Hall followed. Among other things, Green also founded the internet video conference VidCon, became a novelist himself, and became CEO of a socks and coffee subscription company that donates its proceeds to decreasing maternal mortality in Sierra Leone with Partners in Health.

But for a few weeks in 2023, the “how many days” ticker paused on “Chemotherapy.”

Last year, Green found out he had Hodgkin’s lymphoma. In his new comedy special “Pissing Out Cancer” on the streaming service Dropout, Green processes what it’s like to be diagnosed with cancer — albeit “the one you want, if you’re going to get it” — at 43 years old. (He’s now in remission.)

Before the special came out on Friday, STAT talked with Green, who is a member of the 2024 STATUS List, about what it’s like to be a science communicator with cancer, how we react to cancer differently than chronic diseases, and what jokes got cut from his show.

This interview has been edited for length and clarity.

You’ve been a science communicator for a really long time. What was it like to suddenly be the spokesperson for a health topic that you did not choose to be the spokesperson for?

At first, that’s obviously not what I was thinking about. At first I was thinking about the diagnosis and the treatment and existential anxiety, et cetera. And the way that I imagined it in the first moments when I was thinking about being public with it was only in that negative frame of illness.

I don’t think there was a moment, but there was a transition where I realized that science was happening to me, and that was my job. And when I realized that I could just keep doing a lot of what I do and be like, “Okay, so this is science. I know a fair bit about cancer already. I know a fair bit about cancer treatment already, but I can go a lot deeper.” And as I kept going deeper, just following my curiosity, I was like, “This is all interesting,” and I could just fall into a familiar frame, and that was great, because otherwise I was pretty depressed.

When you disclosed your diagnosis publicly, you were worried about everybody thinking about cancer every time they thought of you in the future. And now you have this special that’s about cancer. Has that idea changed for you over time?

It changed dramatically. If I was afraid of [talking about my diagnosis] and I just tried to hide it, all that would be in people’s heads is, “Hank got diagnosed with cancer.” And instead it was like, “Hank has used his cancer to educate people,” and that feels great. That feels like a positive thing that people are thinking about me, and it also feels like a positive thing that I’m thinking about myself.

The fact that chemo breaks tumor cells down and they exit through your urine — which became the name of the special — was one of the facts I most remember from you communicating about your treatment. Is there anything surprising or funny that you learned that didn’t end up making it into this special?

There’s lots of jokes that eventually didn’t feel fully appropriate. I had a joke about what it was like to have hairless genitals; it didn’t make it to the final one. It’s a funny joke, but it was just too much penis talk for me.

The stuff that didn’t make it into the show is mostly — it’s hard to make pain funny. It’s hard to make fatigue funny. I don’t remember what the joke is, but I had a joke about chronic pain that no one would laugh at. It was constructed as a joke; it had a twist that you didn’t expect, but no one ever laughed at it. So I just dropped it, which I kind of felt bad about because I feel like I’m not telling the full experience, but ultimately, it’s a comedy show.

I only have one joke in the show that people don’t laugh at that I kept in. Which is, “The worst part of getting cancer is that you have to call your mom. Unless your mom’s dead. In which case, the worst part is that you can’t call your mom.” It is constructed as a joke, but no one laughs at it. Which I think is fine, because to me, that’s not as much of a joke as it is an instruction to myself to be grateful for what I have.

Is there any dissonance for you of dealing with the heavy stuff while telling these jokes and people laughing at/with you?

Yeah. My biggest concern is that people who have had harder journeys than me will feel that I’m making light of it. I don’t think I am. And my experience has been, of the people I’ve talked to who are in a harder journey than me, that they love it.

One thing everybody should know about cancer is that no two cancers are the same. No two cancer journeys are the same. But there are these touch points that have a lot of resonance. Everybody knows about the ridiculous ways that they try to make the infusion center a nicer place for you, despite the fact that it’s definitely not going to be your favorite spot. That they’ll be like, “You can have yogurt!” Yeah … no … not really top of my list of concerns right now whether or not I have yogurt.

But I gained a lot from people who talked about their experience when I was first going into it. And so I’m grateful to people who talk about it, and I want to be one of those people.

I love your jokes about hitting your out-of-pocket maximum and how it’s alarming when the American health care system actually works really well. If you could change something about that system, what would you change?

There’s the obvious thing: Universal health care exists in other countries, and so clearly some form of Medicare for all could exist here, and that would be grand. And I think it would save a lot of lives.

I wish that our health care system had more focus on prevention, but I understand that it doesn’t, because also our brains don’t have as much focus on prevention. And it’s hard to get people to take preventive measures against anything.

I wish we treated more diseases like we treat cancer, honestly. The way that my whole community came up to support me … I feel if I had, like, trigeminal neuralgia, that would not be the case — I’d be just as debilitated, but I would not have people showing up for me in the same way.

I don’t know actually why [cancer is treated special]. When I got ulcerative colitis, nobody was like, “Here’s the number of a therapist.” Cancer? Immediately: “Here’s the number of a therapist.”

How was finding out that you had cancer different from finding out you had ulcerative colitis, and how did those two things intertwine with each other?

Oh, there was a lot of intertwining. The ulcerative colitis diagnosis … I didn’t know what UC was, I didn’t know how bad it could be; my doctor also didn’t want to tell me how bad it could be, I think. And that was a very slow thing where we tried this drug, and then two years later we’re on a different drug, and then we’re on that one for eight years, and then we’re on this next one for a year, and then the one after that for four years. UC control has been a very long part of my life and I’ve gotten a lot of colonoscopies and it’s sort of gradually happened, whereas cancer was like [pounds fist into his other hand]. It was very immediate; from “first worry” to “in the infusion center” was less than a month. Which is great.

And it’s f—ing cancer — I knew what cancer was. It’s interesting because ulcerative colitis can be just as dangerous as a cancer diagnosis, and it can be just as life-changing. Ulcerative colitis can be debilitating. It can completely ruin your social life. You’re afraid of leaving the house. You’re afraid of going into any space where you’re not going to have immediate access to a bathroom, afraid of traveling. And for a young person, that’s just like, “Oh, so I’m going to have a whole f—ing different life than I thought I had. Can I get a job? Can I work at my current job if I work on a warehouse floor and I have to go to the bathroom every seven minutes?”

But there [are] various interactions between my UC journey and my cancer journey, one of which is that it is possible that I wouldn’t have gotten cancer if I hadn’t taken mercaptopurine for so long. I was on mercaptopurine for maybe 10 years, which is a medicine with an increased lymphoma risk — says it right on the label. I read that and I was like, “It’s worth it.”