Laughter as Medicine: The Origin of a Meme

Apr 03 2012 Published by under Uncategorized

There are no rules on the internet. But if there were, one of them would be “Thou shalt not contradict Zooey Deschanel.” That rule is about to be broken.

She is one of the internet’s beloved, a personification of free-thinking, blue-eyed, vintage-in-all-the-right-ways cuteness in a world where too many famous females are orange-tinted embodiments of everything your parents wished you wouldn’t become. Plus, she can sing and basically do everything and dammit, just look at those eyes how can you say no??

Knowing the weight of her influence, and due to my wife-sanctioned crush on her, I was a little disappointed when I saw this pop up on her HelloGiggles internet girlhub:

 

The supposed power of giggles. Yay, indeed.

 

As any good science skeptic/happiness buzzkiller can immediately discern, this is bullshit. But are we Dementors or are we teachers? No, we are not here solely to suck the happiness out of the internet. We are defenders of reason and illuminators of the obscure. At the core of every laughable cuteshare such as this lies a genesis, because platitudes do not spring wholly formed from the ether. Sadly, in the crowd-governed Old West that we call the social web, it is more often a nugget’s sheen that determines its value rather than it is its weight.

I wondered: Where the hell did it come from, and why should we care?

The origins of the offending mantra can be traced to 1979’s Anatomy Of An Illness As Perceived By The Patient, by Norman Cousins. Cousins was a lifelong editor and critic, most famously at the helm of Saturday Review, a weekly general interest magazine that died out in the early Eighties. A long-time liberal activist, he fought for nuclear disarmament and world peace, not only in the pages of his magazine but also as an unofficial ambassador between the United States, the Vatican and the Kremlin (a “position" which led to the signing of the Partial Nuclear Test Ban Treaty of 1963). He worked tirelessly to save mankind from destruction at the hands of its machines of war, even meeting with an aging Albert Einstein to discuss a path to nuclear peace. Perhaps his most notable editorial effort, “Modern Man Is Obsolete, was published only weeks after the bombing of Hiroshima and Nagasaki in August 1945. In it he offered that a post-nuclear world could not exist without a federated world government, and dedicated much of his later life toward that end.

It was perhaps on an unofficial diplomatic jaunt in 1964 that he contracted the illness that spawned the meme, his idea of laughter as true medicine. Upon returning home from the Soviet Union he reported a general “malaise” that within days manifested itself as a cascade of inflammation and debilitating stiffness of the joints. He cantankerously recounts being stuck with needle after needle by what seemed like every phlebotomist in the city, even at one point posting a sign on his door stating that he would allow blood to be taken no more frequently than once every three days. Cousins’ concerns were not without prescience, as his worries about hospital infection and X-ray exposure caused him to warn that “. . . a hospital is no place for a person who is seriously ill.” The food, too, was not up to his standards.

His clinician, a long-time friend, diagnosed him with ankylosing spondylitis, a degenerative disease of the cartilage that in its worst forms can lead to spinal fusion and debilitating physical distress. It was a diagnosis that he was not expected to overcome, since therapy at the time was limited to controlling the immense and overwhelming pain caused by the destruction of joint cartilage by one’s own immune system. At this point, Cousins’ memoir of disease begins to read like a case study in anecdotal medical observation, self-diagnosis, and placebo therapy, ultimately evolving into a watershed moment in the emergence of “natural” or “alternative” therapy in American culture.

Cousins, who possessed no formal medical training, meditated on his condition from a hospital bed. He had walked near a jet’s exhaust while crossing the  Moscow airport tarmac. Could that have been the cause? Perhaps it was the open window in his hotel room, feeding diesel fumes from nearby construction? No, his wife had failed to take ill, and she had been by his side the whole trip. He settled on “adrenal exhaustion”, a hodge-podge of misinterpreted and fuzzily defined symptoms not found in any medical textbook. Faced with a confusing array of diagnostic dots, Cousins began to randomly draw lines between them. He sampled from Hans Selye’s pioneering endocrinology work, strangely concluding that negative emotions and suppressed rage had modified the delicate balance of his endocrine system. Walter B. Cannon’s description of homeostasis provided Cousins with a scapegoat of imbalance, but devoid of any principles of chemical biology.

Ultimately, Cousins somehow convinced his doctor to allow him to undertake an experimental therapy. It consisted of high doses of vitamin C, abstinence from painkillers, funny movies and pleasant surroundings. It’s as if he thought, “I feel bad, so I will heal if I force happiness.” Where biologists had noted that vitamin C could aid in building cartilage, Cousins applied brute force, injecting as much ascorbic acid as his veins could stand. He checked into a hotel and stockpiled Marx Brothers films, and it was this experience that planted the seed of what grew into a psalm of pseudoscience. He wrote:

“I made the joyous discovery that ten minutes of genuine belly laughter had an anesthetic effect and would give me at least two hours of pain-free sleep.”

Cousins made a full recovery within months, returning to work with no sign of the ankylosing spondylitis that had ravaged his body.

We can easily imagine how a cultural game of telephone translated hours of sleep to added longevity, and replaced minutes of deep laughter with seconds of light-hearted giggling. Details like these are inconsequential when the claim itself holds no water. What’s more interesting is how Cousins filled the remaining pages of Anatomy Of An Illness.

I believe history would have given Cousins a pass if his tale were limited to a personal account of the supposed Power of Positive Thinking™. Instead he devotes page after page to selling the placebo as medical therapy over clinically tested modern tools. The placebo effect is well-accepted as real, and even Cousins’ accounts of its myriad mysteries are pulled from medical literature, including the groundbreaking studies by Henry K. Beecher and Louis Lasagna (stop laughing, that’s his real name.) Volumes have been written about its very real and very strange manifestations. My favorite collection comes in video form:

Where Cousins remains tarnished with guilt is in his refusal to separate biology from the ethereal mind. Not the mind of neuroscience and endocrinology, but the detached spiritual mind sullied by “inner congestion”, and Dr. Zhivago’s “soul” as it “exists in space”. Cousins played a fair card when he insisted that a patient’s will to live could manifest tangible, if misunderstood, outcomes. But he stacked the deck in dismissing the nervous system’s very real connection to biofeedback systems, and by insisting that magic could ensure longevity where medicine had failed. Where he had an opportunity to honestly dissect the placebo’s effect in his own life, he instead became a witch doctor surgeon general for later generations enamored with vitamin therapy and spiritual healing. It was fear of technology and fear of chemistry.  It was fear of medicine leaving the realm of the country doctor and entering the laboratory. He even assaulted aspirin as Placebic Enemy #1. I can't help but wonder, did his fear of modern medicine have roots in his fears about modern warfare?

“The placebo is the doctor who resides within,” he wrote. Of course, this is irresponsible without science residing alongside it. Emotional states, stress response, and inflammation have all now been medically linked via biochemical pathways and careful scientific scrutiny. But the pseudoscience spawned by Cousins’ back-porch wisdom has proven only one thing well: That anecdotes can lead to longevity, but the effect is confined to pseudoscientific legend rather than medical reality. Zooey Deschanel’s cuteshare is living proof. We can trace an entire realm of pseudoscience back to this moment, and there's ample proof that it lives on strongly today.

I’ll offer my own anecdote for Norman Cousins, a magazine editor who tarnished an otherwise fairly admirable life by surrendering to medical paranoia and pastoral folklore. Let’s pretend for just a moment that laughter and happiness are the powerful medical tools that he claimed them to be, that positive thinking alone could heal incurable diseases where medicine and science had failed. In that world, Chris Farley and John Belushi are older than Noah, and Rush Limbaugh never made it through childhood.

But in this world, we can’t accept that as true. Instead we accept the placebo effect as mysterious and complicated, and we grapple with the ethics of its application alongside science-based medicine. The mind is now known to exist in concert with the body’s biology, and not in isolation. And in this world, ankylosing spondylitis has an onset of eight to ten years and stems primarily from an autoimmune response brought on by a particular genotype. There is a way for science to explain Norman Cousin’s illness and recovery, though. It involves reactive arthritis, an extreme bout of inflammation brought on by a bacterial infection in the body of a weary and exhausted traveler. It requires that a patient be uncooperative with hospital staff and not submit to regular blood tests that could aid in diagnosis. It requires a distrust of modern medicine and industrial technology that aligns well with the ideology of a anti-nuclear and peace activist of the mid-Sixties. Most of all, it involves a patient who gets better, by no stranger forces than the ones that heal any infection.

Norman Cousins owes Zooey Deschanel an apology, but since he’s no longer with us, mine will have to suffice. Please don’t be mad at me, Ms. Deschanel. Feel free to keep on giggling, though. It works for you.

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