Thursday, November 21, 2013

Don’t prescribe laughter; you’ll only get stitches

Oh, hackneyed phrase! ‘Gad damnable cliché that demands the very least of us! Piss-weak shorthand! Lowest common denominator of meaningless adage!!

There is no statement so glib as “laughter is the best medicine”. A platitude such as this demeans us all, comparing comedians to surgeons, pranksters to pharmacists and clowns to biochemists.

Laughter is a reflex. Medicine is medicine.

Of course, laughter is lovely. A frothy burst of mirth that issues involuntarily from the subject is a joy to behold, experience and cause.  The snort laugh (with or without snot), the chuckle, the giggle, the guffaw, the belly laugh, the bladder-incontinence laugh, the laugh with accidental fart, the whinny and the Muttley are all expressions of merriment and humour which are up there with the best of the abstract nouns and certainly desirable from time to time in one’s life.

But is it all good news? Under the influence of laughter I have suffered painful muscle spasms. Laughter has also on occasion caused me to fall down (admittedly I may also have been drunk).  Laughter can make my eyes leak and my speech unintelligible. Laughter can make me dribble, choke, cry and wee (I’m sure it’s the same for you. Isn’t it? Please say it is so). These all seem to be symptoms of a terrible affliction. Is more laughter the cure for these bodily irregularities?

Nietsche, the philosopher, amoralist, atheist and paradox, identified the alternative purpose of laughter, that which we now identify as schadenfreude[i]. Laughter can be sarcastic, derisive, wry, mocking. A snicker, a crow, a howl and a titter reveal the dark side of laughter, the side “they” (the ones who spaketh the idiot utterance) don’t want you to know about. This is the seedy underbelly of wit, to wit: to laugh in one’s face or behind one’s back, to cackle wickedly (“I’ll get you my pretty”). A laugh can be scornful, jeering, villainous (think mwahahahaha!) and who can forget the laugh of The Joker? Laughter can be as sick as it gets – unsettling, disquieting, stress-inducing; presaging injury, even imminent death. And to cure this ill, we apparently need MORE laughter? Nuh-uh.

There are times when laughter is very necessarily contraindicated. In the case of abdominal or pelvic malady (or any kind of “down there” misadventure, one presumes), laughter is the very definition of pain. When a respirator enables breathing, chortling is not advisable - gags may very well lead to gagging, as it were. And I should imagine that if your chest had been cracked open to access your heart, lungs or any other vital equipment, a peal would have absolutely no appeal.

Based on language alone, laughter might as well itself be a disease, ravaging the body by splitting your sides and leaving you in stitches. People have been known to crack up or convulse with laughter. Contributing to this pandemic is the fact that laughter is contagious, and sadly, there is the suggestion that people actually die laughing. Where are all the public health warnings? Instead, we get a bunch of hippies banging on about mind-body connections, endorphin release and laugh therapy.

Medicine is a directed course of treatment for specific illness, disease, mishap or injury. It is not a joke. And a joke is not medicine.

Do you have a malignant tumour? Planning to just ‘laugh it off’? Not sure about that funny lesion on your back? Not finding it all that ‘funny’, really? Instead of tittering like a loon you may like to receive the BEST medicine, which happens to be medicine. Your medical professional (a term which excludes aromatherapists, colour therapists and clairvoyants, also sitcom writers, breakfast radio personalities and court jesters) will approach it in a manner indicated by scientific study, tested in rigorously controlled trials, and ratified by other members of her highly educated profession.

I won’t deny that when lying on a gurney in preparation for surgery, one might enjoy trading puns with the anaesthetist prior to going under. But a dirty joke is not what will bring you back.

Some argue that laughter has similar benefits to exercise, improving blood flow and strengthening the immune system. I can allow that laughter can lighten the mood, create a positive frame of mind and support mental health, but studies into laughter being an effective therapy do not demonstrate that the effects of laughter are any different to the effects of similar actions - screaming[ii], for instance, which can also be executed whilst lying on a gurney. Sure, we can intuit that sharing a joke can create a sense of connection, stave off depression, reduce the effects of stress and boost vitality, essentially making the pain of existence bearable. But it cannot fix a broken leg.

Laughter is NOT the best medicine, but you should do it anyway.

And consult a professional (during surgery or comedy club hours) if pain persists.


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