Laughter's still the best medicine

It's a form of comedic encephalopathy (acute on chronic), a clinical manifestation of humor as a defense mechanism.


There hasn't been much to laugh about in 2020.

Like you, I ask my friends and colleagues “How are you?” and mean it. Nowadays the first response I get is a laugh, one of defeated acceptance. We're six months into this pandemic and it seems like there's no end in sight. The Kübler-Ross model lists the five stages of grief as denial, anger, bargaining, depression, and acceptance. I propose a sixth: hilarity. It's when things get so bad, all you can do is laugh.

We've hit that point. It's a form of comedic encephalopathy (acute on chronic), a clinical manifestation of humor as a defense mechanism. You know it's been a long pandemic when you can have a healthy debate over the pros and cons of five different isolation gown types.

One mask I wear says EVERYTHING IS AWFUL. Every day, without fail, someone doubles over in laughter when they read it. That's a win!

I asked a friend at work, a wound care nurse, how she copes. Her response was deadpan yet serious: “Donuts.” For the next five minutes it was that scene in “Forrest Gump,” except instead of shrimp it was donuts.

A fellow hospitalist in our socially distanced office wanted to take off her mask but didn't know where to put it. She was frustrated. But eureka! She channeled her inner MacGyver, taped a spoon's handle to the top of the computer monitor with the bowl facing out, and voila, there she had it: an improvised mask holder! (I should mention this same colleague stumbled upon her new favorite bottle of wine recently, the appropriately named “Black Cloud.”)

Exercise comes up in conversation a lot, as a coping mechanism for stress and as a way to stay physically active. But one memorable conversation centered around the use of scales, or lack thereof. Another fellow hospitalist told me that the one time she'd used a scale during the pandemic was to weigh not herself but her burrito. (The burrito weighed 3 lb. if you were curious.)

But there was another moment at a patient's bedside. It was her 62nd birthday. Unfortunately, we delivered the news that she'd tested positive for COVID-19. Right then, a phlebotomist entered the room. The patient laughed. “A blood draw for my birthday, how sweet!” The phlebotomist jokingly offered to put a candle atop one of the blood collection tubes for the patient to blow out. “Don't do that,” the patient replied, eyes indicative of a smile. “I'm a good patient. I'd try to blow it out while keeping my mask on!” (We did get her a better birthday gift: a discharge home.)

Yes, wash your hands, wear a mask, keep your distance, and exercise. But it's OK to laugh. It's almost necessary. Even in a pandemic, laughter is the best medicine.