Considerable literature has emerged concerning the impact of the extended COVID-19 pandemic on the ability to handle stress and sustain mental health. Healthcare professionals are among the most vulnerable segments of the population to these consequences of the pandemic. There are numerous studies and reports of stress, sleep disturbances, and increased mood and anxiety symptoms among health workers. This is not surprising considering the exposure to an increased risk of infection, fear of infecting other people, working extraordinarily long hours with isolation from family, challenges of working conditions with the early inadequacy of personal protective equipment and overcrowded hospitals, and the experience of the suffering and death of patients.
The ability to cope with prolonged stress and avoid or minimize mental health problems is referred to as “resilience.” The consequences of prolonged stress can be seen in episodes of depression and anxiety leading to negative effects on family and social relationships and work performance. A variety of interventions to support the mental health of healthcare professionals have been proposed and studied. These include various forms of coaching with groups or through telehealth.
An article in the June 3, 2023 issue of The Lancet highlights another tool. It also illustrates how something old can be new. In the midst of the war with Russia, a video depicting a female Ukrainian soldier in full camouflage gear doing a Pikachu dance on a snowy bank with the sound of gunfire in the background went viral on the internet. Noting that medicine is not an actual war, and that doctors and nurses are not soldiers, the physician authors nonetheless emphasized the common need for an emotional outlet during all the trauma, tragedy, and death. They commented that searching for levity in the midst of a crisis serves to confirm our shared humanity and the universal need to laugh. The short article has a particularly powerful paragraph:
The aphorism “laughter is the best medicine” has been attributed to the Book of Proverbs in the Old Testament: “A merry heart doeth good like a medicine: but a broken spirit drieth the bones”. This ancient wisdom might also hold true for some medical conditions. Research suggests that laughter might raise the pain threshold and improve glucose tolerance, have positive effects on the immune system, and lower blood pressure. Indeed, laughter seems to be associated with certain healing properties among some patients.
Indeed, the healing effect of laughter has been the subject of study and commentary from such institutions as the Mayo Clinic and the Geisinger Health System. The health benefits include release of endorphins, reduction in stress, boosting the immune system, and increasing blood flow to internal organs. From a psychiatric perspective, one author has written that “[l]aughing at oneself also encourages healing” and adds a quote from a widely published psychoanalyst that “there is a need to learn to laugh at oneself as an individual and also as a professional.” Studies have shown that humor contributes to personal resiliency.
The closing line of the Lancet article regarding laughter sums things up well: “And in a job as stressful and demanding as health care, [laughter] can often be the medicine that physicians themselves desperately need.”
Considering the report submitted by the New Jersey State Bar Association concerning the prevalence of depression, burnout, suicidal ideation, problem drinking, and isolation among members of the legal profession and the New Jersey Supreme Court’s recent formation of a Committee on Wellness in the Law, there are many transferrable lessons to be learned. While this is a serious topic meriting serious thought and discussion, let’s instead end with Jerry Seinfeld’s memorable observations about a doctor’s waiting room.
The waiting room. I hate when they make you wait in the room. There’s no chance of not waiting. ‘Cause they call it the waiting room, they’re gonna use it. They’ve got it. It’s all set up for you to wait. And you sit there, you know, and you’ve got your little magazine. You pretend you’re reading it, but you’re really looking at the other people. You know, you’re thinking about them. Things like, “I wonder what he’s got. As soon as she goes, I’m getting her magazine.” And then, they finally call you and it’s a very exciting moment. They finally call you, and you stand up and you kinda look around at the other people in the room. “Well, I guess I’ve been chosen. I’ll see you all later.” You know, so you think you’re going to see the doctor, but you’re not, are you? No. You’re going into the next waiting room.