By Kathy LaTour

Cancer isn’t funny, but so much of what we endure lies beyond anything we have experienced in life that we have no store of coping mechanisms
from which to draw. But I recall clearly the day I chose humor to cope.

It was December 1986. Two months after beginning chemotherapy I was green from nausea, bald, gaining weight, and had a mouth full of ulcers when I called my insurance company about reimbursement for my wig.

I had confirmed that my plan covered some of the cost and was surprised to receive a denial of the claim. The insurance clerk (the newest high school dropout assigned to manage my healthcare) listened to my information and seemed baffled. She said to hold on, and when she returned to the phone she asked again what I had filed for. I spelled it. “W-I-G,” I said, adding, “It’s fake hair.”

“Oh,” she calmly replied. “That’s the problem; you filed for the wrong thing. You needed to file for a cranial prosthesis. You need to re-file and include a prescription from your doctor.”

I stared at the phone, overwhelmed by the absurdity of the situation. Then I started laughing. First, because it was so ridiculous, then because I realized there was nothing left to do but laugh.

Anger would have been one response, but the insurance clerk probably wouldn’t have understood, clearly too young and inexperienced to realize that in the past two months I had dealt with mortality, surgery, and major drugs, all while watching my 1-year-old begin to take her first steps. Besides, it felt better to laugh, a lot better. Up to that point, tears had been my constant companion and I was waterlogged.

After laughing uncontrollably for a few minutes, I was joined by the clerk, who had caught the infectious laughter bug (or was trying to keep me on the phone while she called 911 to come and find me, concerned that I had had a breakdown). We laughed together for a few minutes before I hung up, realizing as I did, that I felt better than I had in months.
In that instant I had regained my sense of humor.

Healing Laughter
Laugh at cancer? Yes. Cure cancer with laughter? No. But a growing body of evidence says that laughter and a lighter mood can make a difference in a number of physiological functions that can lead to better health. Indeed, a study from Indiana State University School of Nursing shows that in addition to its established psychological effects of reducing stress and pain, humor may affect immune function by increasing natural killer cells. This information has been added to a plethora of studies that link a pessimistic attitude to a weak immune system, which can lead to other ailments.

Indeed, laughter as medicine has been around a long time, promoted by researchers as a way to control the uncontrollable. Sigmund Freud talked about humor as a way to fool the superego and numerous researchers have explored humor as a way to control anxiety, anger, and depression. Recent studies show that the distraction humor provides can help reduce pain.

Paul E. McGhee, PhD, spent 20 years studying laughter before taking his show on the road as president of The Laughter Remedy (www.laughterremedy.com) to teach people how to use humor as a coping technique (see sidebar).

“I do some stand up, but it’s all with a substantive focus on what we really know and what we don’t know because there are many myths about what humor can and can’t do,” says Dr. McGhee.

For example, Dr. McGhee says it is often repeated that laughing releases endorphins, but there is not an actual study that supports this claim.

“We do know in the study of psychoneuroimmunology, or the study of how the mind influences the body, that anything you can do to sustain a positive, joyful state in a person supports the healing systems, and especially the immune system,” he says.

Dr. McGhee warns that the discussion of humor to cope does not mean humor to hide—the often maddening lament that we “keep a positive attitude no matter what,” which many cancer patients hear from family and friends.

“The real adaptive power of humor and a positive attitude comes from the experience of having gone through all the negative emotion issues, and coming out the other side with acceptance of the reality of your cancer. You face up to the issue and choose humor as a way of managing your mood.”

Dr. McGhee also addresses the physical aspects of a good laugh, pointing out that in normal, relaxed breathing there is a balance between air taken in and air expelled. Stress, on the other hand, causes shallow breathing.

“Frequent belly laughter empties the lungs,” Dr. McGhee says. “Each time you laugh, you get rid of excess carbon dioxide and water vapor that’s building up and replace it with oxygen-rich air.”

Finding Humor
It took three cancer diagnoses in 10 years for Dick Weismann to find his sense of humor. “I remember thinking, ‘Enough already,’” says the 71-year-old retired businessman of Carmel, California. “First it was breast cancer in my early 50s, then I got melanoma a few years later, and then, in 1995, I found out I had prostate cancer.”

Among other things, Weismann decided it was time to retire and move from the fast pace of Los Angeles to Carmel, closer to his family.

“Other than that, I knew I needed to improve my immune system. I started researching and read Norman Cousins’ book. Humor makes me feel good, and I know from what I have read that a good belly laugh is good for you.”
Weismann’s research led him to the Carolina Health and Humor Association (Carolina Ha Ha) website (www.cahaha.com), where he was able to find funny films and videos. Then he took it one step further.

“I thought there were lots of resources out there that they hadn’t listed on their website, so I talked with Ruth [Hamilton, who created Carolina Ha Ha] and began researching. My mother was struggling physically at the time, but she still had a sharp mind, and I was getting her radio shows like Jack Benny that she identified with. Then I thought it would be neat if there was one place you could go for every bit of comedy that had ever been created, and that’s when I started putting together thehumorcollection.org.”

Weismann funds the website (www.thehumorcollection.org) as his personal mission. When he wants to laugh, he pulls out videos of stand-up comedians and Johnny Carson’s animal guests. Other than that, he likes to watch his 18-month-old granddaughter, who, he says, really cracks him up.

Living with a Laugh
Dallas artist Fran Di Giacomo also remembers very clearly the day she chose humor. Her surgery and chemotherapy for stage IIIC ovarian cancer had left her practically immobilized.

“I was sitting on the chair and my body had basically shut down. I was thinking to myself that I had to do something to get moving but didn’t have a clue what to do, so I started to look through the plethora of books friends had dropped off.”
Di Giacomo says she picked up one after another only to find that they made her feel worse until she picked up a humorous book.

“I flipped it open and read something and laughed. I felt great. I read more and then laughed some more. In 15 minutes, I realized I had enough energy to get up and go into the kitchen for something to eat. From that moment, I decided to find everything I could to laugh at.”

Di Giacomo added writing to her established artistic resume (numerous galleries carry her paintings) with a book that took an irreverent look at chemotherapy.

“I call it I’d Rather Do Chemo Than Clean Out the Garage: Choosing Laughter Over Tears,” Di Giacomo says. “My goal is to defeat depression.” Di Giacomo says that she attributes her five-year survival to deciding to live every day with joy and passion.

“Sure, I know the reality. I have been on chemotherapy for five years and remission isn’t even a word I use, but I get up every day and paint and keep my focus on living, not dying.”

What is Humor?
What makes us laugh or tickles our senses? Anyone who has walked out of the theater in the middle of a so-called “comedy of the year” understands that what is hysterical to one person may be completely incomprehensible to another. Some find their sense of humor runs toward rubber chickens and clowns, while for others it’s puns and sarcasm.

Dr. McGhee, who studied the evolution of play in children, says even those who study humor argue about a definition, knowing that it’s the individual who understands what is funny and what isn’t.

“What we do know is that as you go up the scale from lower to higher animals, a greater amount of time is spent playing while young—with its peak in humans. Humor is intellectual play; it reflects an unfolding of the intellectual skills as children progress into adulthood. We could find humor and a light side as children, but we lose it as we get older.”

Humor programs in hospitals often reflect this return to play, offering a range of humorous activities for patients. Hamilton created Carolina Ha Ha in 1986 after following the research of Norman Cousins, whose Anatomy of an Illness, published in 1964, is often referenced as the beginning of laughter therapy.

Hamilton, who has a master’s degree in education, began working with oncology patients and came to humor “on the job,” she says, creating the Duke University Medical Center Humor Project, which has been duplicated at a number of hospitals across the country.

“We created a Laugh Mobile that presents humorous material to both inpatient and outpatient cancer patients at Duke Medical Center,” Hamilton says. “Skilled volunteers engage in humor interventions and offer materials for patients to check out.”

Aside from physical release for the patient, Hamilton says humor is a distraction for the family and the patient who shift their focus from an uncontrollable situation.

“It’s a communication device, not only for the patient but also for the staff. We see the playful aspects of staff and patients all the time. In one instance we gave a nurse in the bone marrow unit a squirt gun. She used it with a patient on the treadmill every time he slowed down. They were both howling.”

In another instance a yo-yo from the Laugh Mobile reminded an elderly patient of his youth, and in short order he was performing complicated tricks for other patients. He was reminded of a playful talent from his youth that he could share with others.

Dr. McGhee says it best: “There is no evidence that humor is going to add years to your life, but there’s lots of evidence that it adds life to your years.”