How a Little Laughter Went a Long Way

There may be no greater stress in life than being an intensive-care physician on the verge of a pandemic. Fear, uncertainty, frustration, anxiety—these were just a handful of the emotions we shared during our daily COVID-19 briefings as winter turned to spring. While at that time we had not yet had a single case in our hospital or area, the tension in that room often made it feel like otherwise.

It was a cool Sunday afternoon when my cell phone rang. “Its here.” I will remember those words for quite some time. “It” was COVID-19, and the first case had arrived through the emergency room. I was swarmed with fear and unease. Despite having known that the virus would eventually make its way through our doors, its arrival felt surreal.

Soon, the new cases began to pile up, and the plans we had meticulously made became a reality. During the height of the outbreak at my primary hospital site, all the active clinical sites surged beyond the capacity of our normal ICU. Thankfully, we were able to create additional space that functioned as critical care beds to care for the influx.

I started my week, during the peak of the pandemic, in a state of uncertainty, fear, and melancholy. Within hours of my first shift, it was clear that the veteran nurses and respiratory therapists would be the real heroes. They were heroes for the unbelievable care they consistently provided, but even more so, as the role models they became on how to handle the unwavering stress and fear of an invisible and deadly enemy.

The peak of the pandemic felt like any other day for these seasoned healthcare workers. While I could never see through their N95 masks, their smiles could be felt, and the positivity was contagious. During our daily patient rounds, which lasted considerably longer than usual, they made light of the cards we had all been dealt. They managed to make fun of themselves, our situation, and they taught me how to be a better leader and a better person. “Well at least my husband bought me a good life insurance plan,” one nurse joked, as for the first time in our careers we were risking our lives to care for patients. They made jokes about their homemade haircuts, poorly home-schooled children, online shopping bills and newfound obsession with washing their hands. That morning, as the sun peeked up over the horizon beyond that small rural hospital, we all took a minute to laugh.

Fear and anxiety slowly evaporated as we continued working through the morning. My coworkers managed to remain incredibly respectful and focused, constantly upbeat, using humor and levity to keep us all grounded. They eased me in a time when I needed it most, just as they had eased so many patients before me.

It is not surprising that laughter helped ease my mind in a time of uncertainty. It has been understood that laughter has the potential to decrease hormones often associated with stress such as cortisol and epinephrine. In addition, endorphins secreted by laughter can help when people are uncomfortable or perhaps in a depressed mood. [i] Depleted levels of the neurotransmitter serotonin is one potential cause of depression and there is evidence supporting increased levels after laughter therapy. [ii] Like eating well and exercise, laughing is just another weapon in the natural arsenal against “feeling down”. Beyond making us feel better, this simple act can potentially improve important relationships. A study out of the University of North Carolina showed the time spent laughing among romantic partners was positively associated with relationship quality, closeness and social support. [iii]

I consider myself a positive individual, and I use many of the tactics in this book to maintain this upbeat attitude. But the 2020 pandemic would forever bless me with a new and amazing tool. From the many healthcare workers I worked beside, I learned the power of laughter, a bit of self-depreciation, and the value in not taking life so seriously. There was no escaping reality. Once we all accepted this notion, we once again felt “normal.”

My outlook changed after that first day in what would be a long two months of pandemic critical care. I will always be thankful for the people I worked alongside, and I will carry with me the lessons they so effectively taught me. It was an education that no classroom, college degree, or science book could ever provide. The words of Coach Valvano and the courage and attitude of my coworkers will forever be engraved in my emotional makeup. There is little doubt that I am much better prepared for the next pandemic.

This Excerpt taken from the Book "How to Build a Smile: 14 Ways to a Better You"

[i] Yim, Jongeun. “Therapeutic Benefits of Laughter in Mental Health: A Theoretical Review.” The Tohoku Journal of Experimental Medicine 239, no. 3 (2016): 243–49. https://doi.org/10.1620/tjem.239.243. [ii] Cha, Mi Youn, and Hae Sook Hong. “Effect and Path Analysis of Laughter Therapy on Serotonin, Depression and Quality of Life in Middle-Aged Women.” Journal of Korean Academy of Nursing 45, no. 2 (2015): 221. https://doi.org/10.4040/jkan.2015.45.2.221. [iii] Kurtz, Laura E., and Sara B. Algoe. “Putting Laughter in Context: Shared Laughter as Behavioral Indicator of Relationship Well-Being.” Personal Relationships 22, no. 4 (2015): 573–90. https://doi.org/10.1111/pere.12095.