Peter Brindley: Life and death—definitely a laughing matter

Today is Mum’s birthday. There will be much laughter and the stories will be brought out and passed around like treasures. It will be hilarious, ludicrous and wistful: much like life itself. Our family will guffaw, we will feel lighter, and more connected. There will be me, my Dad, my brother, and four grandkids. Unfortunately, Mum won’t be there: she died a decade ago. We will still laugh though. It’s what she would want. It’s also what we need. Life and death are far too serious not to laugh.

While we should give penicillin its due, laughter really can be the best medicine. This is why I insist on getting my five-a-day. This is why I am seriously perturbed about the growing chuckle-free state of the world. Let’s be frank, some of our workforce has joined the humor police. This has left otherwise lovely people scared to laugh, and others’ just a little too empowered when it comes to taking offense.

When a colleague believed his lab had isolated the genes associated with elite performance the military was the first group to knock on his door. “But what trait do you want to isolate?” my friend asked: “visual acuity?” “ability to follow orders?” Nope, it was sense of humour, and because it meant an ability to cope and to endure. This is why- and with all due respect- I believe that we have to elevate the sides of our collective mouth and laugh out loud. It is good for our brain chemistry, good for our team and ultimately good for patients. Let’s stop deluding ourselves that being serious makes us look clever: it actually just makes us look sad.

Just as we cry when happy, we often need to laugh when sad, or exasperated, or angry, or numb. Humor might be the finest tool when there is emotion that needs discharging: be it delight or consternation. Sure, sometimes it is frivolous, but it is rarely the sign of a fool. Laughter is a safety-valve and a chimney-stack for enduring the “slings and arrows of outrageous fortune.” 

Humour research has only recently been “taken seriously,” but the academic champions-of-chuckle suggest it distinguishes us from other great apes. It is presumed to be evolutionarily important, and probably emerged from panting during play-fighting. The assertion is that early hominids that could make laughter sounds or jokes created stronger bonds. Laughter also signaled to the tribe that it was safe to stop hitting each other and time to start building a resilient team or tribe.

“Non-funny” primates didn’t pick up on the signals, and went quiet, got angry, or left in a strop. A decade ago, these were the people we “forgot” to invite to the pub. Nowadays they are the ones preventing us from enjoying a harmless giggle and a necessary pint. Those with genetic mutations that allowed them to make better jokes, or better understand the meaning of sounds, were more likely to thrive and pass on their funny bones. Humor is how we detect and confront incongruities, and laughter may be the evolutionary reward for such dangerous work.

In more everyday parlance, humor is a nonsense detector and deflector. It is how we catch and release tension, deal with the unknown, and keep the group feeling safe and free. This is probably why “the man” doesn’t care for it. It is why I take my giggles so seriously and will fight for my chance to be silly. Many a great ICU rotation even used to end with a water fight. As a junior doctor, the day that I left drenched in water and with my legs shaven and painted blue I knew I had “made it” and this is how they say thanks. Now trainees are lucky to get herbal tea, and even less likely to get honest feedback.

Satire is a fist-free weapon against nonsense. It is the use of irony, exaggeration, or ridicule to make serious points and speak up for the powerless. When one of my favourite childhood comedians, Rik Mayall died, the equally fabulous Caitlin Moran said that humor is “intelligence left to burn”. Another Brit, Douglas Adams argued that we should never take life seriously given that “we live at the bottom of a deep gravity well, on a gas covered planet, and orbiting a nuclear fireball.” We should laugh because it’s a wonderful surreal miracle that we are alive. One day we will lose that gift. This is why you should laugh while you still can.

Obviously, laughter is a tool and, like a hammer, has the power to help or hurt. Clearly, I am not condoning being mean. And if I give a joke, then I need to take a joke. After all, there are times when I am quite literally “laughable.” But I am sure that we all need to laugh like our lives depend on it. If not for me, then do it for dear old Mum. I miss laughing with her every day.

Peter Brindley, professor in the department of critical care medicine, Department of Anesthesiology and Pain Medicine, and the Dosseter Ethics Centre, University of Alberta, Edmonton, Canada. He is on Twitter @docpgb

Competing interests: None declared.