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The laughter prescription.


Many articles have appeared in the national press reporting scientific verification of the usefulness of laughter in combating illness and promoting health. Jane Brody, the highly regarded writer on health matters, has used her column in the New York Times to report on the "growing number of physicians, nurses, psychologists, and patients who have used the uniquely human expression of mirth to reduce stress, ease pain, foster recovery, and generally brighten one's outlook on life, regardless of how grim the reality."

Brody has called attention to the new practices of nursing homes and hospitals in using "laughter wagons: stocked with humorous materials and other gimmicks likely to amuse patients." She reported that a group at Oregon Health Sciences University calling themselves "Nurses for Laughter" wear buttons that read: "Warning: Humor may be hazardous to your illness."

Brody also quoted Dr. Marvin E. Herring of New Jersey's School of Osteopathic Medicine as saying, "The diaphragm, thorax, abdomen, heart, lungs, and even the liver are given a massage during a hearty laugh." The expression used in my book Anatomy of an Illness was "internal jogging."

Jane Brody made some practical suggestions:

Instead of sending flowers, consider sending the patient a funny novel, a book of jokes, a silly toy, a humorous audiotape and portable recorder, or if a video recorder is available, a funny movie. When my best friend contracted a life-threatening disease, I made her a loose-leaf "book of laughs" stuffed with New Yorker cartoons, classic witticisms, and personalized homemade jokes. Years after recovering, she continues to use the joke book whenever she thinks she is getting sick.

Brighten the sick room with mobiles, homemade silly sculptures, comical photos, and get-well cards. Place a poster of a scenic view on the window or wall, and change it often.

Keep on the lookout for humorous happenings and statements you can tell the patient about. Arrive at the bedside with a funny story instead of a complaint about the terrible traffic or parking problem.

Seek out caretakers with a sense of humor. ...

Consider organizing a local scout troop, school, or senior citizens group to prepare riddles or jokes that can be placed on patients' breakfast trays. Or challenge patients to come up with their own humorous captions for certain drawings. ...

Finally, when you hear a good joke, write it down or quickly relate it to someone to help you remember it.

In a similar vein the New Bulletin of the American Association of Retired Persons reported that Kaye Ann Herth, a nurse in Tulsa, Oklahoma, takes a "funny-bone history" of patients in an effort to ascertain their taste in humor. She uses this information to write "prescriptions" for laughter tailored to patient taste.

The New Bulletin also reported that volunteers for the Andrus Gerontology Center at the University of Southern California produced a handbook on the use of humor in long-term care facilities. The handbook gave these examples of humorous one-liners:

"A man's home is now his hassle."

"It's better to have loved a short girl than never to have loved a tall."

"Dieting--the triumph of mind over platter."

These one-liners, the article said, may or may not be funny, but they did have a good effect on the patients, many of whom were "coaxed out of their shells' to take an active part in the programs.

Earlier I spoke of the role of humor in creating a relaxed and responsive environment in audiences. I had an opportunity to see this effect in heightened form at the Sepulveda (California) Veterans' Administration Hospital.

I had gone to the hospital following a meeting with physicians assigned to the cancer unit. They were concerned because the mood of the cancer patients was so bleak that they feared the collective environment of treatment was being impaired.

At the suggestion of the doctors, I met with the veterans in the cancer unit. There were 50 or 60 of them. They sat in rows and were every bit as glum as I had anticipated.

I reported on my conversation with their doctors and said I doubted that they were helping them or themselves with the grim mood of the place. Certainly one could understand the reason for their feelings--and it was arrogant for anyone to lecture to them about it. But in coming to Sepulveda they were reaching out for help--and they were entitled to know what would optimize that prospect.

Any battle with serious illness, I said, involved two elements. One was represented by the ability of the physicians to make available to patients the best that medical science has to offer. The other element was represented by the ability of patients to summon all their physical and spiritual resources to aid in fighting illness.

I said I hoped the veterans would agree that their part of the job was to create an environment in which the doctors could do their best. One thing they might do to replace the grim atmosphere was to put on performances. We could give them scripts of amusing one-act plays. Some of them might wish to produce or direct or act. If they wished, we could help them obtain videocassettes of amusing motion picture films. Ditto, audio cassettes of stand-up comics. One way or another, their part in the joint enterprise with their doctors was to create a mood conducive to the best medical treatment obtainable.

The veterans accepted the challenge. When I returned to the hospital several weeks later and spoke to the doctors, I was pleased to have them describe the change not just in the general environment but in the mood of the individual patients.

When I met with the veterans, they no longer sat in rows. They sat in a large circle. They were part of a unity; they could all see one another. When they began their meeting, each veteran was obligated to tell something good that had happened to him since the previous meeting.

The first veteran spoke of his success in reaching by telephone a buddy he had not seen since the Korean War. He had tracked his buddy to Chicago and finally made the connection. They spoke for a half-hour or more. And the good news was that his buddy was coming to visit him in California.


The next veteran read from a letter he had received from a nephew who had just been admitted to medical school. He quoted the final sentence of the letter:

"And, Uncle Ben, I want you to know that I'm going into cancer research, and I'm going to come up with the answer, so you and your buddies just hang in ther until I do."

More cheers.

And so it went, each person at the meeting taking his turn. The I discovered that everyone was looking at me and that I was expected to report on what it was that was good that had happened to me.

I searched my recent memory and realized that something quite good had in fact happened to me only a few days earlier.

"What I have to report is better than good," I said. "It's wonderful. Actually, it's better than wonderful. It's unbelievable. And as long as I live, I don't expect that anything as manificent as this can possibly happen to me again."

The veterans all leaned forward in their seats.

"What happened is that when I arrived at the Los Angeles airport last Wednesday my bag was the first off the carousel."

A burst of applause and acclaim greeted this announcement.

"I had never even met anyone whose bag was the first off the carousel," I continued.

Again, loud expressions of delight.

"Flushed with success, I went to the nearest telephone to report my arrival to my office. That was when I lost my coin. I pondered this melancholy event for a moment or two, then decided to report it to the operator.

"'Operator,' I said, 'I put in a quarter and didn't get my number. The machine collected my coin.'

"'Sir,' she said, 'if you give me your name and address, we'll mail the coin to you.'

"I was appalled.

"'Operator,' I said, 'I think I can understand the reason behind the difficulties of AT&T. You're going to take the time and trouble to write down my name on a card, and then you are probably going to give it to the person in charge of such matters. He will go to the cash register, puch it open, and take out a quarter, at the same time recording the reason for the cash withdrawal. Then he will take a cardboard with a recessed slot to hold the coin so it won't flop around in the envelope. Then he, or someone else, will fit the cardboard with the coin into an envelope, first taking the time to write out my address on the envelope. Then the envelope will be sealed. Someone will then affix a 20^ stamp on the envelope. All that time and expense just to return a quarter. Now, operator, why don't you just return my coin and let's be friends.'

"'Sir,' she repeated in a flat voice, 'if you give me your name and address, we will mail you the refund.'

"Then, almost by way of afterthought, she said, 'Sir, did you remember to press the coin-return plunger?'

"Truth to tell, I had overlooked this nicety. I pressed the plunger. To my great surprise, it worked. It was apparent that the machine had been badly constipated and I happened to have the plunger. All at once, the vitals of the machine opened up and and proceeded to spew out coins of almost every denomination. The profusion was so greast that I had to use my empty hand to contain the overflow.

"While all this was happening, the noise was registering in the telephone and was not lost on the operator.

"'Sir,' she said, 'just what is happening?'

"I reported that the machine had suddenly given up all its earnings for the past few months, at least. At a rough estimate, I said there had to be close to four dollars in quarters, dimes, and nicles that had just erupted from the box.

"'Sir,' she said, 'will you please put the coins back in the box.'

"'Operator,' I said, 'if you give me your name and address I will be glad to mail you the coins.'"

The veterans exploded with cheers. David triumphs over Goliath. At the bottom of the ninth inning, with the home team behind by three runs, the weakest hiter in the lineup hits the ball out of the park. A mammoth business corporation is brought to its knees. Every person who had been exasperated by the loss of a coin in a public telephone booth could identify with my experience and share both in the triumph of justice and the humiliation of the mammoth and impersonal oppressor.

The veterans not only were having a good time, but they were showing it in their relaxed expressions and in the way they moved.

One of the doctors stood up.

"Tell me," he said, "how many of you, when you came into this room a half-hour or so ago, were experiencing, more or less, your normal chronic pains?"

More than half the veterans in the room raised their hands. "Now," said the doctor, "how many of you, in the past five or ten minutes, discovered that these chronic pains receded or disappeared?"

Why should simple laughter have produced this effect? Some brain researchers with whom I have spoken have speculated that the laughter activated the release of endorphins, the body's own pain-reducing substance. The veterans were experiencing the same effects that had occurred to me in my own bout with inflammatory joints many years earlier. The body's own morphine was a work.

In view of what is now known about the role of endorphins not only as a painkiller but as a stimulant to the immune system, the biological value of laughter takes on scientific validity.

"If you wish to glimpse inside a human soul and get to know a man," Dostoevksy writes in his novel The Adolescent, "don't bother analyzing his ways of being silent, of talking, of weeping, or seeing how much he is moved by noble ideas; you'll get better results if you just watch him laugh. If he laughs well, he's a good man. ...

"I consider it one of the most important conclusions derived from your life experience," Dostoevsky continues. "I especially recommend it to the attention of young would-be brides who are prepared to marry the man of their choice but are still watching him with misgivings and distrust and cannot take the decisive step. All I claim to know is that laughter is the most reliable gauge of human nature. Look at children, for instance. Children are the only human creatures to produce perfect laughter, and that's just what makes them so enchanting. I find a crying child repulsive whereas a laughing and gay child is a sunbeam from paradise to me, a revelation of future bliss when man will finally become as pure and simple-hearted as a babe."

One of the most frequent questions put to me by patients is "Where do you find things to laugh at?"

My favorite sources are books--the very substantial humor collections by Isaac Asimov and Leo Rosten and, especially, E. B. White's Subtreasury of American Humor. (In the sidebar at left is an excellent list of books, audio cassettes, and videocassettes compiled by the Comprehensive Cancer Center of Duke University.)

While I was a hospital patient, I had a good time viewing old motion pictures and TV programs. I found some of the old Marx Brothers comedies and "Candid Camera" reruns highly useful for this purpose. But I also had access to other materials, including classified notices from the "Personals" columns of the Saturday Review.

It is a serious error to suppose that laughter is the only emotional antidote to stress or illness. Some people tend to be humor resistant and derive benefits in other ways. An appreciation of life can be a prime tonic for mind and body. Being able to respond to the majesty of the way nature fashions its art--the mysterious designs in the barks of trees, suggesting cave paintings or verdant meadows interrupted by silvery streams; the rich and luminous coloring of carp fish with blues and yellows and crimsons seemingly lit up from within; the bird of paradise flower, an explosion of colors ascending to a triumph and a jaunty crest of orange and purple; the skin of an apple, so thin it defies measurement but supremely protective of its precious substance; the way the climbing trunk of a tree will steer its growth around solid objects coming between itself and the sun; the curling white foam of an ocean wave advancing on the shore, and the way the sand repairs and smooths itself by the receding water; the purring of a kitten perched on your shoulder, or the head of a dog snuggling under your hand; the measured power of Beethoven's Emperor Concerto, the joyous quality of a Chopin nocturne, the serene and stately progression of a Bach fugue, the lyrical designs in a Mozart composition for clarinet and strings; the sound of delight in a young boy's voice on catching his first baseball; and most of all, the expression in the face of someone who loves you--all these are but a small part of a list of wondrous satisfactions that come with the gift of awareness and that nourish even as they heal.
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Title Annotation:part 2; humor and wellness
Author:Cousins, Norman
Publication:Saturday Evening Post
Date:Oct 1, 1990
Previous Article:China's blockbuster diet study.
Next Article:Kid Brother.

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