But Seriously, Folks …
Laughter is the best medicine!

BY LORILYN RACKL
FROM DAILY HERALD

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Four-year-old Evan Petropoulos has a serious sinus infection. He’s in the hospital with an IV in his arm. The infection has swollen Evan’s right eye shut and put him in considerable pain. So why is the little guy giggling like a maniac?

The reason for the hilarity is Donna Mermel. Five years ago, Mermel helped get a “humour cart” rolling at Advocate Lutheran General Children’s Hospital in Park Ridge, Ill. The colourful cart overflows with neon-hued toys, rolls of smiley-face stickers and whimsical noisemakers. Armed with a crib sheet of jokes and goofy headwear, Mermel, a Lake Barrington, Ill., mother, and her small army of volunteers wend their way through the hospital’s halls about once a week, dropping in on kids who don’t have much to smile about.

Right now, Mermel has parked her cart outside Evan’s room. He perks up as soon as she enters. “Are you married yet, Evan?” Mermel asks the boy while volunteers dole out crayons and other goodies from the cart.

“Nooooooo,” Evan says in a tone of mock exasperation mixed with giggles. He becomes downright giddy as one volunteer uses “magic” to make a plastic lightbulb go on and off in her hand.

“How do you do that?” Evan asks with a big grin. From the corner of the room, Evan’s mother, Suzanne, starts to smile, too.

“He’s just eating this up,” she says quietly.

Using humour to ease pain and help healing is no laughing matter to a growing number of doctors, nurses and health-care workers. A small yet significant body of research suggests that the ability to see life from the lighter side may be medicinal. Studies have hinted that humour can alleviate allergy symptoms, increase pain tolerance, bolster the disease-fighting immune system, reduce the risk of stroke and heart attack—and even help diabetics control their blood sugar.

Paging Dr. Woody Allen
The idea that laughter can be therapeutic certainly isn’t a novel one. The Bible says, “A merry heart doeth good like a medicine.” Yet modern medicine’s interest in the link between humour and health can be largely traced back to a different book: Norman Cousins’s 1979 best-seller, Anatomy of an Illness. Cousins, a longtime editor of The Saturday Review, battled a painful and crippling arthritic disease called ankylosing spondylitis. Faced with a poor prognosis, Cousins decided to ditch his drug regimen in favour of large doses of vitamin C—and even larger doses of humour. He had a movie projector moved into his hospital room, where he’d watch Candid Camera episodes and Marx Brothers films. A nurse read him humour books.

“I made the joyous discovery that ten minutes of genuine belly laughter had an anesthetic effect and would give me at least two hours of pain-free sleep,” Cousins wrote in his book.

Gradually the pain went away, he became more mobile and he did what doctors didn’t expect: He got better.

There’s plenty of debate about whether Cousins’s humour and vitamin treatment was really responsible for his recovery. What’s undeniable is that his story unleashed a flurry of interest in humour therapy.

Research studies followed in the book’s wake and continue today. And many of them seem to support the notion that humour does a body good. Researchers at the University of Texas followed 2,478 people 65 and older for six years. They found that subjects who scored high on a happiness questionnaire had a much lower risk of stroke than their down-in-the-dumps counterparts. The happier folks were, the more protective the effect seemed to be.

In May 2003, Japanese researchers announced that a little laughter around the dinner table might help people with Type 2 diabetes, the most common form of the disease. Subjects in the small study, published in the journal Diabetes Care, had less of a spike in postmeal blood-sugar levels after watching a Japanese comedy show than when they listened to a monotonous lecture. Keeping blood-sugar levels in check is key to staving off diabetes-related complications such as kidney failure and blindness.

Another Japanese study suggests that comedy might give Claritin a run for its money. Patients allergic to dust mites and other common irritants saw their skin welts temporarily shrink after watching Charlie Chaplin’s comedy classic Modern Times. (A video of weather information had no effect whatsoever.)

Oh, Lighten Up!
Turns out that being able to laugh at yourself—or at least being able to see humour in difficult situations—may help your ticker, too. At an American Heart Association meeting in November 2000, University of Maryland Medical Centre cardiologists presented research suggesting laughter may be a buffer against heart attacks.

The researchers asked 300 people, half of whom had heart disease, a long list of “what if” questions. What if they arrived at a party wearing exactly the same outfit as someone else there? What if the waiter spilled a drink on them at a meal out with friends?

The investigators found that people with heart disease were 40 percent less likely to see the humour in life’s everyday absurdities than were people the same age with healthy hearts.

Of course, the findings could mean nothing more than that heart disease is hazardous to a sense of humour. But researchers theorized that laughter might protect against stress and the inflammatory changes that can injure the outer lining of our blood vessels.

“We know that exercising, not smoking and eating foods low in saturated fat will reduce the risk of heart disease,” says cardiologist Michael Miller, who led the study. “Perhaps regular, hearty laughter should be added to the list.”

That’s fine by Lee Berk, associate professor of health promotion and education at Loma Linda University in California and a prominent humour researcher, who keeps jokes plastered all over the walls of his office and home. Berk has been investigating the health effects of humour since the early ’80s. In one study, he and other researchers followed two groups of heart-attack patients for one year in their cardiac rehabilitation programs.

While both groups continued their normal medications, the group that got to watch a half-hour sitcom daily boasted lower blood pressure, took lower dosages of beta blockers, had fewer episodes of abnormal heartbeats and, most significantly, had fewer subsequent heart attacks.

In 2001 Berk told members gathered at the annual meeting of the Society for Neuroscience that simply anticipating a funny event can be good for your health. He and his colleagues tested 16 healthy men at Loma Linda University. Only half of the men were told that in three days they would be treated to a video of Gallagher, the comic best known for his watermelon-smashing antics. Blood tests showed that only these men experienced a drop in stress hormones, and an increase in chemicals that benefit the immune system. The changes grew even more pronounced as it got closer to show time.

“This study shows that even knowing you will be involved in a positive humorous event, days in advance, reduces stress hormones in the blood and increases levels of chemicals known to aid relaxation,” says Berk.

A Spoonful of Cynicism
You might think that all of this would have us running to the comedy section of the nearest Blockbuster and swapping our antibiotics for Animal House. While watching humour can’t hurt, not all the research on its healing powers is sound, says Rod Martin, psychology professor at the University of Western Ontario in London.

“The evidence is really not as strong as people think,” Martin says. He questions the validity of many of the published studies, saying some are too small or poorly designed to draw any meaningful conclusions.

There’s also the problem of conflicting results. Some studies show significant increases in levels of disease-fighting “natural killer cells” in people exposed to humour, but other studies show no effect—or the opposite effect, Martin points out.

But he isn’t ready to write off humour’s health benefits just yet. Rather, he thinks much more research needs to be done, with special attention to different types of humour: A sar-
castic put-down may have a very different effect than harmless jocularity.

Martin is also quick to point out that some humour-health studies hold up surprisingly well. “The evidence is pretty strong that laughter increases pain tolerance,” he says. Few know that better than Lonnie Zeltzer, director of UCLA’s pediatric pain program. Zeltzer and another colleague are heading up an innovative study called Rx Laughter at UCLA’s Jonsson Cancer Centre. A major goal of their research is to see if laughter lessens the pain for kids sick with cancer and other chronic pain problems.

Unlike most studies, the idea for this one didn’t come from physicians—it came from the entertainment industry. While watching audiences laugh, television executive Sherry Dunay Hilber often wondered about the physical and emotional effects of all that chuckling and chortling. She took her questions to UCLA doctors. Together, they hammered out a plan for the study, which kicked off more than three years ago with the help of a $75,000 grant from cable TV network Comedy Central.

So far, the project has unearthed some interesting results. Zeltzer’s team found that healthy children were able to keep their arms in frigid ice water longer while watching funny videos. The kids also reported less pain and had lower levels of stress hormones. “I think humour is a way of helping the body’s natural pain-control system work better at the level of neurotransmitters, like endorphins and other chemicals,” Zeltzer said.

Critics point out that the funny movies may be doing nothing more than distracting kids and that a high-adrenaline video game might have the same result. But Zeltzer believes they’ll find the confirmation they’re searching for. And if their research goes on to show that laughter produces positive physiological responses, Zeltzer says they plan to work humour into treatments. Kids undergoing hemotherapy, for example, might watch SpongeBob SquarePants episodes daily to alleviate the stress and the fear that can inhibit the healing process.

“The implications are strong that laughter is good for us physically, psychologically, spiritually and, of course, in our personal relationships,” says Ed Dunkelblau, past president of the Association for Applied and Therapeutic Humour. “Unfortunately, because the whole subject of having fun is seen as a frivolous one, it’s very hard to get the research support we need.” Dunkelblau pauses for a beat: “People just don’t take humour seriously.”

The Last Laugh
While medical researchers try to get a better handle on humour’s medicinal prowess, clinicians who have seen comedy brighten the face of a sick child or lift the spirits of a cancer patient continue to believe.

Back at Advocate Lutheran General Children’s Hospital, Evan Petropoulos certainly looks like he feels better after his visit from the humour cart. He sits up in his bed and sets to work colouring pictures as Donna Mermel and her assistants gather their bag of tricks and prepare to move on. Mermel is still bantering with the little boy. “You be sure to call me if you need a girlfriend,” she says to the preschooler on her way out of his room.

“Yeah, right,” Evan says, rolling his eyes and hamming it up for the crowd. “You’re an old lady!” And with that, everyone has a good laugh.

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