Ha!

by Scott Weems

  I would like to end this chapter with a story from my first year in graduate school, back when I was a young scientist. I was attending a neuroanatomy class taught by Arnold Scheibel, one of the most respected neuroscientists in the country. When someone was needed to examine Einstein’s brain to identify the source of his genius, one of the people chosen was Arnold Scheibel. We used to joke that Scheibel invented the neuron, when really he was just among the first to discover how they communicate.

  Dr. Scheibel was known for being a rather direct, serious teacher, occasionally making jokes but mostly dispensing vast amounts of information and expecting his students to keep up. One morning, in a complete break of routine, Scheibel opened the class by announcing that at the end of his lecture he would share his recently discovered secret of life. Without a pause he proceeded with his lecture, and for the rest of the session we were left to wonder whether he was serious. Scheibel wasn’t one to exaggerate, so his claim seemed real. Finally, with only a few minutes before the class was scheduled to end, he returned to his promise.

  “So, now on to the meaning of life,” he said, sounding like a computer in a Douglas Adams story.

  “The secret is, simply, keeping salt out,” he said. Philosophers and religious scholars can question the purpose of our existence all they want, but life serves one main goal, and that’s keeping salt on the correct side of our cellular membranes. All neurons are inherently polarized, meaning that they hold a negative charge relative to their surroundings. That charge is maintained by keeping positively charged sodium ions outside the cell body, while potassium and other chemicals are given free passage. When neurons need to communicate, sodium ions are allowed briefly inside so that an electrical current is formed, thus triggering a chemical chain reaction and transfer of information to other cells. If the process breaks down and sodium travels freely through our cellular membranes, our neurons no longer function and we quickly die. That’s why without at least some sodium in our diet, we risk severe health consequences, because this transport of salt is essential. Too much sodium is dangerous too, because that threatens the heart, leading to hypertension and even cardiac arrest. Indeed, if there’s one thing that life couldn’t exist without—or, to put it another way, if there’s one thing life was designed to perpetuate—it’s the keeping of salt outside our cellular membranes.

  “And so, that is the secret of life,” Scheibel claimed. The lesson was over. What many neurophysiologists merely call the sodium pump had been elevated to the reason for our existence.

  I was fortunate to have the opportunity to share this story once with Margaret Boden, who has written about the sodium pump herself—and she was fascinated, but skeptical too. It seems the solution could just as easily have been ATP, she claimed. Otherwise known as adenosine triphosphate, ATP is an unstable chemical molecule used for energy storage. It’s responsible for everything from photosynthesis to biosynthesis and is found in every species regardless of type or complexity, providing a means for organisms to retain energy so that it can be used at future times. “Of course, it’s not the perfect example,” Boden added, with more than a hint of disappointment. “Because it turns out that very recently they found an organism with constant access to usable energy, I forget where. So, not every organism uses ATP, only 99.99% or something like that. That’s the problem with exceptions, because just when you think you have a general rule, some anomaly pops up.”

  Why did I share this story, especially in a chapter that started out as a discussion of computer-generated humor? Perhaps I wanted to show that the secret of life could just as easily have been a matter of keeping electrons in line, had computers evolved instead of humans. Or maybe I wanted you to question why Scheibel’s secret of life wasn’t about keeping potassium in.

  Actually, I wanted to point out how silly such hypothetical speculation is, in order to appease our computer overlords when they do eventually conquer the earth and enslave us in their sugar mines.

  As Ken Jennings said after his loss to Watson: “Karma is a bitch.”

  PART THREE

  “So What?”

  BECOMING A MORE JOVIAL PERSON

  6

  THE BILL COSBY EFFECT

  The witch doctor succeeds for the same reason all the rest of us [doctors] succeed. Each patient carries his own doctor inside him. . . . We are at best when we give the doctor who resides within each patient a chance to go to work.

  —DR. ALBERT SCHWEITZER, QUOTED IN NORMAN COUSINS’S ANATOMY OF AN ILLNESS

  NOW IT’S TIME FOR ANOTHER SHIFT IN TOPIC. THE FIRST THREE chapters addressed the What is? question of humor: What makes us laugh, and how do our brains turn conflict into pleasure? The two chapters after that addressed the What for? question: What purpose does humor serve, and what does it say about who we really are? Both of these sections provided important background for understanding why we laugh, but there’s an even more important question we haven’t addressed yet. I call it the So what? question: Why should we care what humor is, and how does it influence our physical, psychological, and social well-being?

  Studies show that humor improves our health, helps us get along better with others, and even makes us smarter. In the next three chapters we’ll see how. Along the way we’ll attend a comedy show, watch a corporate wrestling event, and see how listening to Bill Cosby raises our threshold for pain. And it all starts with a man named Norman Cousins, who was told by his doctors that he had a 1 in 500 chance of surviving a debilitating disease and ended up beating the odds through comedy. In fact, he laughed himself out of an illness.

  NORMAN COUSINS

  Cousins’s story begins in July 1964 at a political conference in Moscow, where as chairman of the American Delegation he was charged with attending formal meetings on improving cultural exchange between the Soviet Republic and the United States. This involved many long evenings at social events and formal dinners—a stressful schedule considering that they were held in a country where he didn’t speak the language. He was also exposed to an unhealthy atmosphere—literally. Mid-twentieth-century Moscow was notorious for its dirty air and water, and Cousins’s hotel room was located in the center of town, right next to a housing construction site. Diesel trucks spewing fumes twenty-four hours a day left him feeling nauseated each morning. By the time he returned to America, his joints ached. Pretty soon he couldn’t move his neck, arms, or legs. His body had been overcome by a debilitating malaise.

  Growing concerned, Cousins finally saw a doctor and was told that he had contracted a severe collagen illness called ankylosing spondylitis. Collagen is the fibrous substance that binds our cells together, and Cousins’s was disintegrating. Without it, he would become unable to move.

  “In a sense, then,” recounts Cousins, “I was becoming unstuck.”

  His outlook was dire. Specialists told him that his only hope was to fight the pain using drugs, but Cousins knew that when drugs become the focus of a treatment, that’s a problem. “People tend to regard drugs as though they were automobiles,” he complained. “Each year has to have its new models, and the more powerful the better.”

  Another troubling aspect of his treatment was the disruptive way the medical staff addressed his illness. Once, four separate technicians took large vials of his blood in a single day. Taking so much blood—even from people who are well—usually isn’t a good idea, and Cousins wondered if maybe the treatment wasn’t doing more harm than good. He was fed mostly processed meals rather than a healthy balance of natural food. His sleep was frequently interrupted for tests that could easily have waited until the morning.

  It was about this time that Cousins decided that, instead of trusting the doctors, he would laugh.

  First, he left the depressing surroundings of the hospital and checked into a hotel, which was not only more cheerful but cost only a third as much. Then he got to thinking: What could he do to help himself? Since traditional medicine wasn’t going to cure him, what other approaches could he take? It was th
en that Cousins began to consider the effect of stress on medical recovery. Stress likely contributed to his illness, as well as hindered his treatment, so it seemed reasonable to question whether the effect worked in both directions. “If negative emotions produce negative chemical changes in the body, wouldn’t the positive emotions produce positive chemical changes?” he asked. “Is it possible that love, hope, faith, laughter, confidence, and the will to live have therapeutic value? Do chemical changes occur only on the downside?”

  One way to find out was to put himself in a good mood—and to do that, Cousins began a systematic plan for laughing. He started with films of the old practical-joke program Candid Camera (similar to Punk’d, but without Ashton Kutcher). This wasn’t easy, since DVDs and Blu-rays hadn’t yet been invented and the only way to watch these shows was to use a motion-picture projector. But he was able to borrow one from a friend, along with several Marx Brothers films, and anything that made him laugh became part of his treatment.

  Cousins watched the films regularly, every day, and despite being in pain he discovered that he was still able to laugh. Not only that, but the laughter was more effective in combating the pain than aspirin or any of his other analgesics. “Ten minutes of genuine belly laughter . . . would give me at least two hours of pain-free sleep,” he wrote.

  Amazingly, after a little over a week of rest and laughing, Cousins was able to move his thumbs again, something his doctors previously thought impossible. After several months, he could grab books from atop bookshelves, and as more time passed he even hit tennis balls and played some golf. His disease hadn’t disappeared—one shoulder and both knees were still causing him occasional trouble—but given his initial prognosis, his recovery was incredible. Cousins went on to live twenty-six more years.

  Cousins’s recovery was uplifting and positive, yet also rather troubling. His rejection of doctors, hospitals, and the newest drugs in favor of a more holistic approach probably saved his life. But if you were in the same situation, would you have had the strength to make the same choice?

  We’ve all seen medical “cures” that are far from scientific. However, while it’s easy to blame modern medicine for being impersonal, it’s wrong to think of doctors as closed-minded people. It’s the rare doctor who wouldn’t do anything humanly possible to help a patient. Alternative-medicine approaches, such as laughing, are alternative for a reason—they have yet to be proven as beneficial. They haven’t been ignored. Quite the opposite, as we’ll see in this chapter, laughter as a medical treatment has been studied quite extensively. Doctors just don’t prescribe it to their patients for the same reason they don’t recommend other alternative medicines, such as acupuncture or large doses of vitamin C. Research results have been mixed.

  This chapter takes a holistic view of humor and its effects on the human body. So far we’ve seen that our brains use conflict like our muscles use oxygen, or cars use gasoline. Humor empowers us to make decisions and take pleasure in a complex world. But the benefits don’t end there. Humor is also a form of exercise, keeping our minds healthy the same way that physical exertion helps our bodies. But like jogging in a smog-filled tunnel, humor used improperly can do more harm than good.

  THE DOCTOR INSIDE

  “Each patient carries his own doctor inside him.”

  This is the claim that best describes Cousins’s philosophy, one taken directly from his book, Anatomy of an Illness. In his recounting, Cousins describes both his laughing treatment and the responses he received from doctors, relatives, and friends after they heard news of his recovery. Everybody seemed to have an opinion about what had caused his ankylosing spondylitis to remit. Some thought Cousins had simply willed the disease away through positive thinking. Others argued that his recovery was an anomaly—one that randomly occurs in only one in a million patients and shouldn’t be interpreted as a blueprint for future success. Still others simply congratulated Cousins for having the courage to control his own medical destiny.

  At one point in his book Cousins equates laughter with internal jogging—a great analogy. We know that laughter benefits the body because it’s an aerobic exercise. Highly controlled measurements have shown that laughter expends between 40 and 170 kilocalories per hour. Lots of work had equated that to other forms of exercise, with the most common being that a hundred laughs are roughly equivalent to ten to fifteen minutes on an exercise bike. How you measure number of laughs I have no idea, but it still sounds like a good time to me.

  One way jogging improves our health is by pushing our hearts to work harder, and laughter relies on the same mechanism. As researchers have shown, both systolic and diastolic blood pressure rise during exercise. The same thing happens during laughter. Sometimes these changes last no longer than a single heart beat, and sometimes they last much longer, but that elevation is critical because the more we work our heart, the lower our resting blood pressure—and the less our hearts have to work the rest of the time.

  This benefit can be long lasting, too. Two measures of blood flow—carotid arterial compliance and brachial artery flow mediated dilation—can remain elevated for up to twenty-four hours after viewing a laughter-inducing comedy.

  One scientist who knows a lot about the benefits of laughter is Michael Miller from the University of Maryland. His specialty is vasodilation, which refers to the widening of blood vessels. The reason elevated blood pressure during exercise is healthy is that it helps our blood vessels stay flexible. Healthy vessels relax or constrict depending on our level of activity, but unhealthy ones remain stiff and tight, restricting blood flow at the times when we most need it.

  Two of the greatest threats to our health are vasoconstriction and reduced vasoreactivity. Often caused by stress, these conditions lead to narrower blood vessels, reduced blood flow, and a decreased ability to vary the amount of blood delivered throughout the body. In many people they also lead to coronary disease and stroke. Doctors recommend frequent exercise because aerobic activity loosens up the blood vessels, making them more pliable. And so does laughter, according to Michael Miller, who presented his findings on vasoreactivity to the American College of Cardiology in 2005. Specifically, laughter decreases stiffness and increases vascular reactivity, thereby increasing blood flow to the areas of the body that need it.

  Miller’s study examined twenty men and women, all with roughly the same level of heart health when the study began. Subjects watched the opening scene of either a stressful movie such as Saving Private Ryan or a comedy such as Kingpin. Before and after each movie, measures of vasodilation were taken, assessed by tightening and then releasing a blood pressure cuff on the arm. By aiming ultrasound devices at subjects’ arteries, Miller also measured how well the arteries “rebounded” after the cuff’s constriction, thereby letting him know how flexible or unresponsive they were. He expected the stressful movie to lead to less responsive blood flow, as had been seen in numerous previous studies. The question was whether humor would have the opposite effect, and low long it might last.

  Miller found that fourteen of the twenty subjects experienced reduced artery size following the stressful viewing, leading to reduced blood flow. Even more impressive, however, was the change seen in the humor-watching group. Among those subjects, all but one showed increased artery size, with an improvement in blood flow of more than 20 percent. This change lasted long after the movies concluded.

  It has always fascinated me that our bodies don’t get stronger through rest but by exertion. Muscles increase in mass first by breaking down, then rebuilding. Blood flow is improved when blood pressure is first increased through exercise, then allowed to return to a lower state, the blood vessels more relaxed than if they hadn’t been worked. Laughter has the same effect, and that makes us stronger and more capable of dealing with challenges later on.

  Our hearts aren’t the only things benefited by laughter, either. Research shows that laughter suppresses glucose levels in diabetics, helping to prevent diabetic neuropathy. It also im
proves immune system function, reduces chemicals associated with joint swelling in arthritis patients, and even helps allergy sufferers combat dermatitis. In short, the mirth associated with laughter leads to positive physiological changes throughout the body.

  A big challenge for psychologists and doctors is identifying how cognitive states, like mirth, lead to physical changes in the body. We know, for instance, that exercise puts us in a good mood because it leads to the release of dopamine, which gives us pleasure. That’s a physical act leading to psychological change. But does cause and effect work in both directions? Can improved state of mind lead to physiological change?

  Fortunately, it can. Consider, for example, immunoglobulin A. This antibody is one of our immune system’s first lines of defense against invading organisms such as bacteria, viruses, and even cancer cells. Though our bodies produce several different kinds of such antibodies, they all work the same way—first, by identifying and targeting the foreign body and, then, by either neutralizing it or tagging it for attack by other defense mechanisms. Studies show that watching funny movies and listening to stand-up comedy significantly increase immunoglobulatory response—and so does being in a humorous mood. A similar effect has also been associated with natural killer cells, which, in addition to having a very impressive name, help stave off diseases like cancer and HIV. Watching movies like Bill Cosby: Himself or Robin Williams, Live at the Met has been shown to increase killer cell counts by up to 60 percent.