The Necessary Lightness of Laughter

One can philosophize about the joys and benefits of four seasons, but in growing up sixty-some years ago on a Minnesota farm, winters were, frankly, a burden. As though the environment didn't pose enough challenges with prodigious amounts of snow up to one's eyeballs and long periods of unbelievable, unremitting Arctic coldness, there was also an internal burden, a kind of psychological or spiritual weight one felt when the intractable winter seemed to never want to end.

Easter was always a turning point for me. Even when Easter came early and there was a good chance it would still be "winter," it was nevertheless a passage from darkness and heaviness into light, warmth, and effervescence. A good part of this rite of passage took place when shopping with my mother for a new Easter outfit. What a relief it was to shed those cumbersome, thick, dark winter clothes and feel the ethereal kiss of completely impractical lightweight cotton. What a sense of freedom it was to put away those furry earmuffs and woolen scarves and don an utterly useless white straw hat. It felt necessary to do this every spring, necessary to breathe deeply, necessary to let in and become the lightness of being. More than anything, I think it was about balance in life, the yin/yang of dark/light, day/night, summer/winter, planting/reaping, joy/sorrow, living/dying.

As a nation, we have been preoccupied for months (and years) with the 9/11 tragedy, terrorism in general, our international wars, drought, the weather, global warming, the stock market, the economy, political scandals, election shenanigans, and all the other bad news that hits us every day. As individuals, these global and our own personal weighty and serious matters point up the need for lightness and balance in our lives.

At times, especially during periods of extraordinary stress, it seems as though all we do is work and worry. Work and worry could occupy our entire existence, and yet we instinctively know that working too much is not healthy or balanced and that when one works all the time (or does too much of any one thing), things feel out of kilter. Worry, in itself, is a killer.

One of the most therapeutic aspects about the work of medical transcription is that it contains an inherent opportunity for laughter. Not everything we see or hear is funny, but there are many moments when we cannot help but laugh, even if at ourselves. Laughter is thought to be a hard-wired physical and psychological reflex, so if things strike us funny and make us laugh, we can't help it. It's in our nature. Laughter modulates the immune system, attenuates stress-related hormones, increases the number of natural virus killer cells, and activates T and B cells. It gets stagnant air moving out of the lungs, which increases the blood oxygen. It raises the heart rate, and it increases the peripheral circulation. It is thought also to aid in digestion. Laughter makes our faces look nonthreatening.

Since human beings laugh about 30 times more often in social situations than when alone, it behooves us, as MTs working primarily in isolated conditions, to make ourselves aware of our need to be able to laugh alone and to practice it. If you can't find anything to laugh about, just fake it, like the woman who went to a serious sales convention and felt out of place because she was the only one without a beeper. The next day, she came back to the conference with her garage-door opener clipped to her belt. So there. Stand in front of a mirror, look yourself in the face, and say "ha ha ha ha ho ho ho ho he he he he ha ha ha ha." I promise you, you'll laugh (eventually).

Here are some recent bloopers seen in medical reports (for real):
"No history of tardy stools."
"Rectal exam defurred."
"Fan and steal incision."
"Low bile hypertension."
"The heart has no memories, scallops, or rubs."
"Status post blown knee amputation."
"Theological test for syphilis was positive."
"This Grandma Kipperus was given a sternovaginal examination."
"The patient is to return in 2 months for her Pabst beer (Pap smear)."
"Finger-in-the-nose testing was done well."
"X-rays of the vertebral column showed bunny fur formation (bony spur)." Just in time for Easter.

One of the funniest books ever written about medicine was called "House of God" by Samuel Shem. It's an old book now but still a good one. He was the first one to describe a GOMER (Get Out Of My Emergency Room). A GOMER is a patient who defies all medical reason. Shem's criteria for a GOMER are:
1. Medical chart weighs more than 5 pounds.
2. Ties Foley catheter into pajama strings.
3. Has seizure and never drops cigarette.
4. Asks for cigarette during pulmonary function testing.
5. BUN higher than IQ.
6. PO2 less than respiratory rate.

May your transition to spring bring you the necessary lightness of laughter and other gifts of the spirit.