Leong GWK, Looi JK (2008), A case study on laughter - The best medicine? Or a potential cause of death? Annals of MED3062, 1:1-2
Abstract
Laugther has long been considered as an activity to stimulate the release of endorphins (endogenous morphine) in our body, which brings about a sense of happiness. In our case study, the effects of laugther were examined as it is unusual that an intense bout of laughing will cause syncope. Syncope can be considered as a natural protective mechanism which kicks in when cerebral perfusion is reduced. By falling onto the floor, the effects of gravity is eliminated and hence more blood can be channeled to our brain. Our evolution has not caught up with the current living environment, where the presence of many sharp objects might pose hazards when fainting occurs.
Aims
The study was devised when the 2 researchers had nothing better to do after returning home from a dinner cum talk on asthma, and felt inspired to conduct an experiment on the respiratory and neurological system.
Method
A 20 year old female patient was stimulated via MSN with a statement that she likes lalas. This was followed up by another statement that she has old taste, since the researchers were told that she was excited to meet up with a distinguished guest of our university from Australia (who happens to be an elderly gentlemen), so much so it was rumoured that she wanted to hug him if possible. The researchers waited for the subject to respond.
Results
True enough, the subject called up one of the researchers and started laughing and hyperventilating non-stop. The duration of the incident was recorded to have lasted 2 minutes before the subject hung up. The incident was witnessed by the subject's housemate, who was at hand to provide assistance when the subject experienced syncope as a result of hyperventilation, laughter and suspected vertigo attack preceding the syncope. The researcher's consider themselves fortunate that the subject did not refer the incident to an ethics committee, which would have barred the researchers from conducting such nonsensical experiments in the future.
Discussion and conclusion
A literature review conducted reviewed that the only related study so far was performed on a man. Findings from this case study may prompt the need to find out more about the effects of laughter (good or bad) in females via a larger study, since it was shown that women handle stress better than men. Also, there is also a need to exclude the diagnosis of hysterical attack in this case which fits the above description.
No doubt the benefits of humour cannot be denied. However, the risks of inducing intense laughter in a patient with a medical history of vertigo cannot be ignored. More studies will need to be conducted before laughter is being labelled harmful to health in these and other related groups of patients. All in all, we hope that this case study will not discourage people from laughing more.
Also, the researchers will bear in mind to take a proper history and perform a thorough physical examination, to ensure that the subject does not have any risk factors if recruited for future studies, which may include pregnancy, allergies, chronic alcoholism or altered mental function. The researchers may also consider some form of mass stimulation with rescue medication back up to improve the power of such studies if ever conducted in the future. No confidence intervals / statistical methods were employed because the researchers did not fully understand the principles of evidence-based clinical practice as classes on it were conducted too early in the morning.
References:
1. http://yougotanna.blogspot.com/2008/07/1.html
2. http://en.wikipedia.org/wiki/Lala_%28disambiguation%29
3. Bloomfield D, Jazrawi S, 1995, Shear Hilarity Leading to Syncope in a Healthy Man, JAMA, 293:2863-2864
4. Taylor, S, 2000, Biobehavioral responses to stress in females: tend-and-befriend, not fight-or-flight, Psychological Review, 107(3):411-427
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