sick
Explanation
The Joke
The comic contrasts being sick "Before Having Kids" versus "After Kids." In the top panel (before kids), a man lounges comfortably on the couch and says "I sneezed today. I think I'm sick," and his partner lovingly responds "Let me get you some tea." The scene is peaceful, caring, and indulgent -- a single sneeze warrants bed rest and pampering.
In the bottom panel (after kids), the same couple is now haggard and surrounded by small children. The woman, looking exhausted, asks "I'm going to work, you okay?" The man, disheveled with a long unkempt beard and children climbing all over him, responds "Only puking out of my mouth so far, so thumbs up." The contrast is stark: what was once a minor inconvenience requiring tender care has become a situation where active vomiting is considered manageable as long as it is only coming from one orifice.
The Humor
The humor is rooted in the universally relatable experience of parenthood destroying any concept of self-care. Before kids, adults have the luxury of treating minor symptoms as serious events. After kids, there is simply no time or energy to be sick -- the children still need care regardless of how the parent feels. The punchline, "only puking out of my mouth so far," is darkly funny because it implies that things could be worse (and the parent has experienced worse), and that this level of illness barely registers on the post-parenthood scale of suffering. The visual deterioration of the characters -- particularly the man's wild beard and dead-eyed expression -- sells the joke perfectly.