Commentary

Humor: The Best Rx You Can Write

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I recently attended a fundraiser for a free clinic, at which a comedian was the main entertainment. I remember smirking a bit, anticipating a quick five- or 10-minute stand-up program with a few chuckles after dinner. I was amazed, however, when the comedian, Greg Schwem, spoke for almost an hour and had the 250 people in attendance in stitches. His premise is that every group needs to laugh at itself. The presentation was clean and motivational, and it was obvious he had done his homework for this particular medical group.

I have read all the articles, as you have, and know that laughter makes you feel good. Scientists believe it is the physical act of laughing (releasing endorphins and boosting T cells), rather than an intellectual pleasure, that makes laughing feel so right.1,2 The good feeling remains with you even after the laughter wanes. This was certainly true at this event.

One essential characteristic that helps us laugh, as Mr. Schwem suggested, is not taking ourselves too seriously. We all know the classic tight-jawed whiner who regards life with tomblike seriousness and never laughs at anything. You know whom I’m talking about?

This brings to mind the experiences of Ralph, a PA colleague who was excited to finally graduate and start work in a local family practice clinic. The more he worked, the less he enjoyed himself. Although his medical acumen noticeably improved in the subsequent six months, he got angry with himself when he didn’t know something or when he made any little mistake. The clinic atmosphere was filled with stress and negativity, which carried over to the patients. No one was having fun.

Ralph wisely realized that his coworkers were negatively affecting his attitude, so he decided it was time to move on. At his next job, he fortunately worked with colleagues who focused on positive issues and enjoying the moment; as a result, he was less critical of himself.

Work became as enjoyable as he’d hoped it would be. He enjoyed waking up in the morning and seeing patients. The day was filled with smiles and even (appropriate) laughter with staff and patients. He was amazed at how much better his professional relationships became, and this brighter outlook spread to other parts of his life.

Clearly, some events in life are sad and not circumstances for laughter. But most events in life don’t carry an overpowering sense of either sadness or delight. They fall into the gray zone of everyday life—giving you the choice to laugh or not.

That idea was borne out in a great book I read decades ago: Anatomy of an Illness: As Perceived by the Patient, by Norman Cousins.3 (Years later, this story became a movie with Mr. Cousins played by Ed Asner.) Cousins’ book was the first by a patient that spoke to taking charge of our own health. It started the transformation in patients working with their clinicians and using humor to boost their bodies’ capacity for healing.

When the author was diagnosed with ankylosing spondylitis, he forged an unusual alliance with his physician, and together they were able to beat the odds. Told that he had little chance of surviving, Cousins checked himself out of the hospital and into a hotel, where he developed a personal recuperation program incorporating mega-doses of vitamin C alongside a positive attitude, love, hope, and laughter induced by watching multiple Marx Brothers films. He made the jubilant discovery that 10 minutes of genuine belly laughing had a sedative effect and would give him at least two hours of pain-free sleep. He reported that when the painkilling effect of the laughter wore off, he would switch on the projector again—and not infrequently, it would lead to another pain-free interval.

His doctor’s talent was in helping Mr. Cousins use his personal powers of laughter, courage, and persistence. Cousins’ genius was in mobilizing his body’s natural resources, proving what an effective healing tool the mind can be. This remarkable story is truly motivating. Cousins died of heart failure in 1990, having survived years longer than predicted: 10 years after his first heart attack, 26 years after his collagen illness, and 36 years after his doctors first diagnosed his heart disease.

Incorporating more humor and play into our daily relationships can improve the quality of our patient care, as well as our connections with colleagues, family members, and friends. Humor gets us out of our heads and away from our troubles. It allows us to let go of defensiveness and to forget judgments, criticisms, and doubts. It even releases inhibitions and frees us to express our true feelings.

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