The following is an excerpt taken from Chapter 3: Humor and Healing, or Why We're Building a Silly Hospital of Gesundheit!: Bringing Good Health To You, The Medical System, And Society Through Physician Service, Complementary Therapies, Humor And Joy.
The arrival of a good clown exercises more beneficial influence upon the health of a town than of twenty asses laden with drugs.Dr. Thomas Sydenham, seventeenth-century physician
Humor is an antidote to all ills. I believe that fun is as important as love. The bottom line, when you ask people what they like about life, is the fun they have, whether it’s racing cars, dancing, gardening, golf, or writing books. Philosophically speaking, I’m surprised that anyone is ever serious. Life is such a miracle and it’s so good to be alive that I wonder why anybody ever wastes a minute!
Anyone who has picked up a copy of Reader’s Digest in the last forty years knows that laughter is the best medicine. In spite of the empirical nature of this truth, the mainstream medical literature hasn’t refuted it, as far as I know. The late Norman Cousins wrote eloquently about having laughed himself back to health after suffering from a serious chronic disease. The experience had such an impact that he changed careers late in life to help bring this information to the health care profession. Jokes seemed so important to Sigmund Freud that he wrote a book on the subject. But we don’t need professionals to tell us about the magnetism of laughter. With great insight, we call a funny person “the life of the party.”
Humor has been strongly promoted as health-giving throughout medical history, from Hippocrates to Sir William Osler. As science became dominant in medicine, subjective therapies like love, faith, and humor took a backseat because of the difficult task of objectively investigating their value. I am astounded that anybody feels the need to prove something so obvious. When individuals and groups are asked what is most important for good health, humor invariably heads the list even over love and faith, which many people feel have failed them. Few people deny that a good sense of humor is essential for a successful marriage. All public speakers recognize that humor is essential in drawing attention to what they are saying.
People crave laughter as if it were an essential amino acid. When the woes of existence beset us, we urgently seek comic relief. The more emotions we invest in a subject, the greater its potential for guffaws. Sex, marriage, prejudice, and politics provide a bottomless well of ideas; yet, humor is often denied in the adult world. Almost universally in the business, religious, medical, and academic worlds, humor is denigrated and even condemned, except in speeches and anecdotes. The stress is on seriousness, with the implication that humor is inappropriate. Health education does little to develop the skills of levity. On the contrary, hospitals are notorious for their somber atmosphere. Although hospital staff members may enjoy camaraderie among themselves, with patients their goal seems to be to fight suffering with suffering. What little humor there is occurs during visiting hours.
The focus on humor in medicine at Gesundheit Institute has often been declared a major deterrent to our getting funds. Still, I insist that humor and fun (which is humor in action) are equal partners with love as key ingredients for a healthy life.
Although humor itself is difficult to evaluate, the response to humor-laughter-can be studied quite readily. Research has shown that laughter increases the secretion of the natural chemicals, catecholamines and endorphins, that make people feel so peppy and good. It also decreases cortisol secretion and lowers the sedimentation rate, which implies a stimulated immune response. Oxygenation of the blood increases, and residual air in the lungs decreases. Heart rate initially speeds up and blood pressure rises; then the arteries relax, causing heart rate and blood pressure to lower. Skin temperature rises as a result of increased peripheral circulation. Thus, laughter appears to have a positive effect on many cardiovascular and respiratory problems. In addition, laughter has superb muscle relaxant qualities. Muscle physiologists have shown that anxiety and muscle relaxation cannot occur at the same time and that the relaxation response after a hearty laugh can last up to forty-five minutes.
Psychologically, humor forms the foundation of good mental health. Certainly the lack of a good sense of humor indicates underlying problems like depression or alienation. Humor is an excellent antidote to stress and an effective social lubricant. Since loving human relationships are so mentally healthy, it behooves one to develop a humorous side.
I have reached the conclusion that humor is vital in healing the problems of individuals, communities, and societies. I have been a street clown for thirty years and have tried to make my own life silly, not as that word is currently used, but in terms of its original meaning. “Silly” originally meant good, happy, blessed, fortunate, kind, and cheerful in many different languages. No other attribute has been more important. Wearing a rubber nose wherever I go has changed my life. Dullness and boredom melt away. Humor has made my life joyous and fun. It can do the same for you. Wearing underwear on the outside of your clothes can turn a tedious trip to the store for a forgotten carton of milk into an amusement park romp. People so unabashedly thank you for entertaining them.
Being funny is a powerful magnet for friendship, life’s most important treasure. Nothing attracts or maintains friendship like being a jolly soul. I know that humor has been at the core of preventing burnout in my life. Finally, as a nonviolent person, I feel that humor has often protected me by deflecting potentially violent situations.
In the twelve years we saw patients during the pilot phase of Gesundheit Institute, we had many opportunities to explore the relationship between humor and medicine. Although we greatly appreciated casual humor, it seemed imperative that we deliberately incorporate it into our day-to-day lives to prevent an atmosphere of agony and despair. Some of this humor came from a stream of jokes that patients and staff brought with them. However, jokes die quickly, and we found that for an atmosphere of humor to thrive, we had to live funny.
We learned to first develop an air of trust and love, because spontaneous humor can be offensive, and we wanted it to be taken in the spirit of trying. (Cautious people are rarely funny.) It soon became clear that silliness was a potent force in keeping the staff together as friends. And I, as a physician, began to see the potent medicinal effect of humor on diseases of all kinds.
Humor is important, too, for the health of a community, whether a neighborhood, church, club, or circle of friends. It has helped me live communally for more than twenty years. The first twelve years we used our home as a free hospital, surrounded by patients who had great mental and physical suffering. The staff stayed many years without pay or privacy because it was so much fun. As physicians, we also discovered that humor was a major medicine. Humor, maybe even more than love, made our pioneering project work; it would have been impossible without this great social glue.
We live in a troubled world. Many aspects of society are unhealthy or even deadly, and large segments of the population live on the edge. If we are to doctor society we must rely heavily on humor. Often in public a parent and child are at odds, and the frustrated parent is ready to strike out at the child. If I put on my rubber nose and act goofy, most of the time the situation is defused and neither parent nor child has a win/lose feeling.
How can one inject more humor into a medical setting? First, it must be a joint decision by administration and staff. The most important elements of bedside manner are not medical knowledge or skill but the qualities inherent in fun and love. Once the medical establishment has agreed to accept more humor, people at all levels of employment will be willing to take steps in this direction. It is easiest to be funny when people are familiar with one another. Spend time together learning your limits and practicing being funny. Invite patients and visitors to participate. Be open to experimentation and escalate slowly. Expect many experiments to fail and even to cause some pain. Avoid racist and sexist humor. Strive for goofiness and fun, not an infinite string of jokes.
Some hospitals have begun the process already. At Duke University Hospital, humor carts deliver videos, cartoon and humor books, juggling equipment, toys, and games. DeKalb Hospital, near Atlanta, has created a Lively Room for romping. The clowns of the Big Apple Circus in New York City have created Clown Care Units, which visit children’s hospitals on a regular basis to bring joy and assist with patient care. The Association of Therapeutic Humor is creating a clearinghouse with information about humor and about people who practice it as therapy. Finally, we at Gesundheit Institute are building the first silly hospital, where the entire context will be geared to fun and play.
There are many avenues to explore. I think hospitals need to give patients a choice between a goofy ward or a “straight,” solemn ward. In lectures all over the United States, I ask medical groups which ward they would choose, and more than 90 percent always choose the goofy ward. In any hospital, “fun” rooms could be designated as playful environments for all to enjoy. This could attract many of the community’s creative people, forge closer bonds between hospital and community, and diminish the hierarchical nature of current medical practice.
For all levels of staff, I suggest classes, intimate gatherings, picnics, and even slumber parties to cultivate the closeness needed to ensure more humor and joy in the workplace. I suggest creating humor support groups and maybe a place where people come just to laugh. Many hospitals have realized the importance of faith and have included ministers and priests on the staff. The same could be done with humor: hire clowns and playful people. Many large communities have performers and artists who could be invited to bring their specialties to the hospital. Some hospitals might even consider creating space for them, including a well-stocked costume and prop room.
The practice of medicine is hurting at many levels. Patient discontent is so great that many are resorting to lawsuits. Many health care professionals are so dissatisfied that they are quitting or even killing themselves. Few if any happy hospitals exist. Most people hate going to a hospital and have traumatic experiences when they do. Yet, it doesn’t have to be this way if we make great efforts to change it. Service to people in times of pain and suffering should - and can - bring rich fulfillment. Let us call on humor to lend a hand and make medicine fun.
Adams P with Mylander M (1998) Gesundheit!: Bringing Good Health To You, The Medical System, And Society Through Physician Service, Complementary Therapies, Humor And Joy Rochester: Healing Arts Press
B.C. is a professional speaker who teaches Humor Therapy. He may be contacted at:
www.worldwidebc.com
