Dose of Comic Relief

There may not be much humor in medicine but there is some medicine in humor. Doctors are acknowledging the therapeutic benefits of having a good laugh

When Payal Khemani was hospitalized two years ago, she realized the cure wasn’t going to be less painful than the disease. But a few weeks into treatment, she found an unlikely solace, “A nurse walked in wearing a radiant smile and kicked off our conversation with a joke,” recalls the 46-year old Mumbai banker. “Before I knew, she’d become essential to my existence.” What was endearing about the nurse was her ability to enliven an otherwise despondent setting the humor. This took Khemani’s mind off her agony for a while. “To me and my family, laughter was inconvincible in my situation,” says Khemani. “But my responding to humor seemed to suggest I was finally beginning to accept my diagnosis, which doctors said was the first step to recovery.”

Relentless work and travel left Karthik Ramaswamy, 32, with chronic fatigue last year. The pain relief he was prescribed provided succour, but no motivation to slow down. For the Bangalore based IT- Professional, popping painkillers soon become an everyday way to keep going. “Coping with exhaustion and irritability was a constant battle,” he says. When his father chanced upon his stash of analgesics, he forced Karthik to seek help. “I couldn’t believe it when the doctor said when the doctors said I was addicted to painkillers.” On his Doctors advice, Karthik tried out something that he can’t raving about: “Whenever I feel the urge, I watch comedies on TV, DVD or the internet, depending on where I am. It is an amazing distraction and helps keep my withdrawal symptons at bay.”

Humor, it turns out, is not just an antonym of distress, but also its antidote. It is now also known to aid healing, especially in conditions exacerbated by stress, humour hold promise as a complimentary therapy too. In the west, clowns, humor carts, and special rooms devoted to funny movies and books are gradually gaining ground across hospitals. A new beginning has been made in India with brightly dressed and bulbous –nosed clowns prancing and playing through pediatric wards in certain hospitals in Bangalore and Chandigarh. “In Bangalore, we have worked across four hospitals,” says Mili Jalan, a therapeutic clown who, along with Sanjay Balsavar, heads Doctor Clown India. “The real challenge is to draw and retain volunteers.”

Therapeutic humor, says the Association for Applied and Therapeutic Humour, is any intervention that promotes health and healing-physical, emotional, cognitive, social or spiritual- by stimulating a playful discovery, expression or appreciation of the absurdity or incongruity of life’s situations.

By releasing mood-enhancing hormones such as serotonin and noradrenaline, humour contributes to feelings of well-being and happiness. It enables greater sense of control over life’s situations, helps release fears and anger, and encourages relaxation. That can be immensely therapeutic even in life threatening conditions such as cancer. “Where cancer patients who do well differ from those who don’t is their ability to put cancer in the background,” says oncologist Dr Navin Manjesh.

A recent Australian study of older people with dementia shows that humour has the effect of anti-psychotic medication in enhancing positive behaviours and reducing agitation. Researchers at the University of Maryland Medical Centre say that watching a funny movie improves the functioning of blood vessels, much like aerobic exercise or satin does. As American humorist Henry Wheeler Shaw (aka Josh Billings) said, “There ain’t much fun in medicine, but there is a lot of medicine in fun.”

“In therapy,” says Dr Adarsh Tripathi, assistant professor and consulting psychiatrist at King George’s Medical University, Lucknow, and “Humor narrows interpersonal gaps, communicates a carrying attitude, and relieves anxiety associated with medical care, allowing clients to open up. “Senior consultant psychiatrist, Dr Sanjay Chugh seconds that: “A statement with a ring of humor can sometimes force the client to look at the situation from an alternative perspective, reducing the psychological weight of the situation,” he says.

At the Mumbai clinic of the veteran dentist Dr Suchetan Pradhan, comedy shows on TVs, coupled with this self-directed humor, helps patient get in a happy frame of mind. “Pain is often heightened by the anticipation of its arrival and having concentrates elsewhere lowers their pain perception,” he says. “Employing humors is about evoking and transferring empathy to make the medical process easier and effective.

Tripathi cites the example of 13-yr-old Ananya   brought to him by her mother for being cripplingly shy. She had nearly no friends and shunned school. The mother was worried that if Ananya once felt uncomfortable in clinic, she wouldn’t come again. Tripathi chose to meet her at an outside location and begin her by befriending her with humours stories. To everyones surprise, Ananya not only attended all subsequent sessions, but is also making steady progress today. “She couldn’t have been helped by conventional ways of dealing with clients,” Tripathi says.

Bangalore-based Nazneen Tonse also wears a hat of therapeutic clown. She works independently with senior citizens today, but was earlier associated with Docteur Clown India- an offshoot of the French NGO Docteur Clown- and regularly visited sick children in paediatric wards. “One of the benefits of humour is that children co-operate better in medical procedures,” she says. When a 3-yr-old boy suffering from chest infection was too scared to use a nebulizer, his first time with a device meant for inhaling mist-like medication into the lungs, Tonse went up to him and joked, “Look at this, such a small boy and he’s already smoking!” the trick worked: the boy smiled and began imitating Tonse’s deep inhalation and exhalation. Tonse avers that it is adults more than children who need clowns. “Children can use their imagination and play, but as adults we have forgotten to use our imagination.”

When it comes to using humor in medical situations, caution and sensivity are the buzzwords. Humor must be timed correctly and must not be personal or offensive,” warns Chugh. “The application of humor is more of an art than science,” avers Tripathi. “Humor cannot be somebody’s expense,” says Pradhan. “Not all patients appreciate humor. Humor should not be forced to point where it becomes counterproductive,” says S Menaka, a Chennai-based counselor.

While formal humor therapy has yet to come in its own in India, it doesn’t help either that doctors often have trouble lightening up. “Most doctors equate a serious disposition with a sense of power. Besides, we, as a people, have a rather plastic sense of humor,” says Pradhan. Adds Chugh, “it must be remembered that using humor does not mean being less serious about work.” Indeed, for humor in itself is serious work.

Source –  Times of India – The Crest Mumbai; Jan 5, 2013