When I was a second year medical student at the University of Kentucky, I went on neurology rounds with the residents and the chief. The patients had various devastating chronic neurologic illnesses, yet the neurology team joked and laughed with the patients. My first reaction was shock – how could my colleagues laugh when these people had such tragic illnesses? When I voiced my concerns, the chairman, a courtly gentleman with a white handlebar mustache, replied, “We don't have much else to offer. Laughter is the best we can do.”
Over the years I have accepted, in fact embraced, humor as a coping mechanism for physicians. I've gone from the dark humor present during the most stressful times, such as internships and residency, to lighter but still effective humor over later years. Some of the dark, bitter humor of residency could easily have been misinterpreted as cruel by outsiders, but for that peer group it became a survival mechanism – a choice for laughter rather than tears.
Humor has helped me to relieve tension, defuse difficult situations, counteract grim aspects of medicine, and alleviate pain. Recent clinical studies suggest laughter correlates with cardioprotection. Dr. Michael Miller, a researcher at the University of Maryland, used two questionnaires to study 300 subjects – one questionnaire evaluated anger and hostility, the other the propensity to laugh in various situations.1
Interestingly, patients with coronary heart disease were less likely to experience laughter than were controls. The researchers raise the possibility that the tendency to laugh can contribute to cardioprotection. As Canadian writer Rohinton Mistry wrote in his novel Family Matters, “There is only one way to defy the sorrow and sadness from life, it is with laughter and rejoicing.”
So maybe not just an apple but also a laugh a day may keep the doctor away.
So what's the punch line? Laugh – it could always be worse. We should all die laughing.
The author is Professor of Medicine and Section Chief of Gastroenterology, University of Washington School of Medicine, Seattle, and a member of Cortlandt Forum's Editorial Advisory Board.
Reference
1. Clark A, Seidler A, Miller M. Inverse association between sense of humor and coronary heart disease. Intl J Cardiol. 2001;80:87-88 (abstract only; subscription required).