Laughter and Medicine

She asked me, “Is it okay to laugh?” My patient Linda, who was only 12 weeks pregnant, had just had a chorionic villus sampling, or CVS. During this procedure, a small piece of placenta (chorionic villi) is removed via a long, thin needle inserted into the woman’s uterus, and then the sample is sent to a laboratory for genetic analysis. My patient fell into the category of advanced maternal age, and she desired invasive prenatal testing because her age put her at a higher risk for having a baby with a chromosome defect. Clearly she was nervous prior to the procedure, and was relieved when it was completed.

Chorionic Villus Sampling
This procedure carries about a one in 500 risk of a miscarriage. Her risk of having a baby with a chromosome defect was about one in 100. We discussed different options, and she chose the invasive CVS test instead of amniocentesis because CVS is done at the end of the first trimester, whereas amniocentesis is done after 16 weeks’ gestation.

She entered the procedure room and asked if her husband could stay in the room.

Many doctors do not allow the partners into the procedure room to observe, but we feel the partner often comforts the patient. So Linda and her husband watched the entire procedure, which took a few minutes, on the flat-screen TV, and then listened to the list of postprocedure instructions. We tell patients to try to relax for 24 to 48 hours after the procedure, and that certain symptoms are normal. And that’s when Linda asked if it was okay to laugh.

I was struck by her question. Many might think, why is a woman who has just completed a serious medical procedure asking about laughing? I thought about Linda’s question and I responded, “Of course it’s okay to laugh. Why do you ask?” Linda then told me her husband is very funny and makes her laugh all the time. She didn’t know how she would handle it if she were not allowed to laugh after the procedure.

Does Laughter Heal?
Many of us have heard the saying “Laughter is the best medicine.” Is it true? Cancer treatment centers have humor therapy sessions. And pediatric units often have clown therapy. There are those who believe the source for this saying is the Bible (Proverbs 17:22), which has the following: “A joyful heart makes for good health. But a broken spirit dries up the bones.” Laughter is said to reduce stress, lower blood pressure and promote relaxation. It is likely because of the release of endorphins, proteins that are produced in the brain and when released give an “opiate-like” feeling of well-being.

I know Linda was smiling 10 days later when she learned that the chromosome analysis on her fetus was normal. I have been doing procedures for more than 25 years and this was the first time I have been asked about laughing after a procedure. Linda and her husband seem to have a great marriage and I am sure they will be great parents; I hope they will keep laughing!