It seems like a good time to take a break from COVID writing and reading, and think about something beneficial instead of harmful. “Did you hear the one about … ?” A new article was published on a medical website highlighting laughter as good and perhaps the best medicine. It also indicates how doctors can utilize humor in their practice. This is not the first time laughter has been cited as good for you or the best medicine.
The idea of laughter helping your health goes back a bit, even to the Bible. Proverbs 17:22 reads, “A merry heart doeth good like a medicine; but a broken spirit drieth the bones.” One reference said the first documented time laughter was used medically was in the 1300s when Henri de Mondeville, a professor of surgery proposed post-operative therapy with humor. Back then surgery was pretty brutal with zero anesthetic or post op pain meds. But it must have been recognized that patients found some relief from laughing. Any relief is better than none!
Many studies and articles have outlined the beneficial effects of laughter. When you giggle, guffaw, cackle, chortle, chuckle or just plain laugh, you experience immediate physical changes, which result in heightened feelings of well-being. Laughter also yields long term benefits. When you have a good laugh, you take in more oxygen, which stimulates your heart, lungs and muscles, and prompts release of chemicals called endorphins. Laughter first increases, then lowers our blood pressure. It aids muscle relaxation, stimulates circulation and helps relieve stress.
Laughter decreases the level of cortisol, a hormone produced during stress response, which interferes with the area of brain that regulates emotions. According to Mayo Clinic medical oncologist Dr. Edward Creagan, “When this happens, the immune system deteriorates and becomes washed in a sea of inflammation, which is a factor in heart disease, cancer and dementia. Cortisol interferes with the body’s immune system, putting us at risk for these three groups of diseases.” Cortisol is necessary in stressful moments as our “fight or flight” response hormone and was defined decades ago. However, sustained chronic stimulation of cortisol is problematic.
Positive thoughts and funny experiences, on the other hand result in release of neuropeptides, which help counter stress. Endorphins are the principle neuropeptides here. They relieve pain and help produce a feeling of euphoria by binding to brain receptors called opioid, after narcotics or opioids, discovered in the 1980s. When morphine or other opioids are given, they bind to these pain receptors to produce relief. The word endorphin was coined from ENDOgenous, meaning born within, moRPHINe. Things that boost our own endorphins are exercise (runner’s high?), giving or volunteering (!), yoga and meditation, and consuming some spicy foods. Research from 2013 found even dark chocolate boosts endorphins (YES!). Of course, laughing does, too.
Laughter yoga, created by Madan Kataria, a family physician in Mumbai, India, began in 1995. It involves people meeting in groups who begin laughing for no reason until the entire group has joined in. We all have “caught” laughing from someone who is enjoying a big belly laugh. Norman Cousins, a famous writer wrote, “I made the discovery that 10 minutes of genuine belly laughter had an anesthetic effect and would give me 2 hours of pain-free sleep.” It might not work so well if you just had belly surgery, though!
A link is also alleged between laughing and greater longevity. Perhaps not quite like the guy who was told by his doc, “You have to quit smoking, drinking, and running around with wild women.” “Is that going to make me live longer, Doc?” “No, but it will seem like it.” Worth a chuckle, or at least an eye roll?
The article I referenced gives some tips of how a doc can employ humor in his or her practice. I try to insert some levity in patients’ visits when appropriate. I still bring my trademark screaming axe along on my couple days of practice. Over the years, I have had other items lurking in my drawers to break the stress of a visit. I tried my best to avoid bringing them out if I sensed someone’s stress was very high and humor titer low. I always told residents and students to make fun WITH the patients, not of them. Dr. Creagan recalls how people could be funny even when near death. He quoted one lady with terminal breast cancer who said she wanted to live long enough to max out her credit cards so there would be nothing left for the second wife.
Here’s today’s final stress reliever: the guy tells his doc, “Last night I dreamt I was a teepee. The night before I dreamt I was a wigwam. What’s wrong with me?” Doc: “I’m not sure yet, but I do think you are too tense.” (Too tents, get it?) Don’t you feel better now?
Dr. Bures, a semi-retired dermatologist, since 1978 has worked Winona, La Crosse, Viroqua, and Red Wing. He also plays clarinet in the Winona Municipal Band and a couple dixieland groups. And he does enjoy a good pun.