Rijksmuseum Amsterdam
Rembrandt: Self-Portrait in a Cap: Laughing, 1630

The physician must have at his command a certain ready wit, as dourness is repulsive both to the healthy and the sick.

Medicine is a serious business; when clinical conversations are scrutinized doctors can be seen to laugh less often than patients. But they do laugh—linguistic analysis suggests that physician laughter performs important interpersonal and therapeutic work. When patients laugh, it’s to make a show of alignment or affiliation with the doctor, signal a problem, or demonstrate superiority to their complaint. Anatole Broyard, in a 1990 essay written while he was being treated for prostate cancer (“Good Books about Being Sick”), wrote of one cheerful doctor:

Bernie Siegel, a doctor who says “call me Bernie,” is a sort of Donald Trump of critical illness. He sounds like a proprietor or landlord of mortality…. Yet, for better or worse, he introduces an element of camaraderie into the medical process.

For Broyard, camaraderie can be overdone: Bernie reminds him of a doctor he once knew who wore such outlandish-looking suits that “I couldn’t help wondering about his medical judgment.” I work in family and emergency medicine; this year I conducted an anonymous survey asking all of my primary care patients, over the course of a week, what they thought of my medical care. One of the responses read, “Dr. Francis can be good for a laugh”—I’m still puzzling over what that patient meant.

In Studies of Laughter in Interaction the linguists Phillip Glenn and Elizabeth Holt have brought together twelve scholarly articles, each illuminating an aspect of the work laughter accomplishes across a range of human interactions. Two of its chapters are related to laughter in the clinical consultation. Others explore a comprehensive range of situations: between teachers and students in class, joking between friends, by job interviewees, between a mother and her autistic son, high-stakes political interviews, and so on.

Laughter is pervasive in human life, across cultures. There is more variety in the laughs generated by one individual in different situations than there is between separate individuals in similar situations. It has

physical, psychological, spiritual, and relational benefits. It is the cost-free medicine that can release endorphins helping us feel good, exercise our muscles and breathing like yoga, help us lighten moods and cope with problems more readily, and strengthen social bonds.

This book could be read as a manual for those who find complex nonverbal communication bewildering, illuminating the startling complexity of everyday social interactions.

The distinction between laughing with and being laughed at is an ancient one: of around thirty references in the Bible to laughter, most involve derision or scorn and only a handful refer to laughter that is in any way connected to joy (do a digital search for “laugh” in the Bible, and you’ll find it far more often as part…

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