SPread Sheet IN THIS ISSUE

Standardized Patient Program Newsletter
educating, informing, entertaining, inspiring
Faculty of Medicine
SPread Sheet
IN THIS ISSUE
DIRECTOR’S
INDISPENSIBLE
2
RESPONSES
2
HUMERUS
3
PROSE
STAYING PROFESSIONAL
SPOTLIGHT ON . . .
Jacqueline Crowther
5
EVENT LISTINGS
5
SPIN AND AROUND
6
WHAT'S A
PICTURE WORTH? 6
HUMERUS
PROSE
8
HUMOUR’S HEALING
9
POTENTIAL
PICTURE THIS
14
HUMERUS
14
Contributors to this issue include:
Dr. H.S. Barrows, M.D.
Ron Clay
Eunice Friesen
Becky Klassen
Dr. Brian Seaward, Ph.D.
Tim Webster
Copyright © 2006
University of Manitoba
Permission to reproduce
and/or distribute any of
the material contained
herein must be obtained
from the Standardized
Patient Office.
ISSN 1715-5452
by SPP Director, Eunice Friesen
I am blessed to find myself within a special community in the
Standardized Patient Program. It is a community of individuals
whose love of drama, love for people and desire to make a difference have forged a common bond. It is amazing to see how individuals with such a wide diversity of backgrounds, ages and experiences work together in such great harmony.
3
The ABC’s of Emotional Vocabulary
Beevor’s Sign
PROSE
PONDERINGS
Volume 1, Issue 6, June 2006
When I “lurk” at training or testing sessions it gives me great
pleasure to hear the witty repartee and laughter that is shared
within the group. The selfless manner in which SP’s give of their
time and humanity is impressive.
Those of us who work in the SPP office are committed to nurturing community within our group and in communicating our special
skills to the larger University community. We communicate within
our group through the SPread Sheet, the e-mail distribution list, and
the great chats we have when you drop by to say “Hi!”
One of the ways we hope to communicate with the larger community is by our unique identification utilizing an SPP logo. I would
encourage you to take a moment to read the article WHAT'S A PICTURE WORTH? on page 6. Community is created by the individuals
who balance self-interest and shared interest within the group. I
hope that I have been able to provide a positive contribution to our
SPP family.
It is with regret that I inform you that after June 31, 2006 I will
no longer be a formal part of the SPP community. I have taken a
permanent position as Associate Director of University Teaching Services at the Pembina Campus effective July 1, 2006. Thank you for
your warm welcome and acceptance of me over the past year. I
wish you continued success in all your future ventures.
UPCOMING SESSIONS
There are no Upcoming Sessions scheduled for the rest of June or
for July and August, but Coordinators will be filling roles for the fall
sessions.
A prompt response to phone and e-mail messages from the SPP
Office is the best way to confirm your continuing involvement.
More details will follow in the September issue of the SPread
Sheet.
Questions or comments? Call 480-1307, extension 1.
Page 2
SPread Sheet Volume 1, Issue 6, June 2006
Contact the SPread Sheet:
T151—770 Bannatyne Ave.
Winnipeg, MB, Canada
R3E 0W3
Phone:
(204) 480-1307
Fax:
(204) 977-5682
E-mail:
[email protected]
Home Page:
http://www.umanitoba.ca/
faculties/medicine/
education/ed_dev/
spp.html
NEWSLETTER EDITOR
Tim Webster
SP PROGRAM STAFF
Eunice Friesen,
Program Director
Lezlie Brooks,
SP Coordinator
Holly Harris,
SP Coordinator
Tim Webster,
SP Coordinator
Jacqueline Crowther,
Office Assistant
INDISPENSIBLE
For the last year, SP Ron Clay has been struggling with respiratory ailments with no lasting success. It is with deep regret that he
resigned his duties as an SP on April 11 this year.
Ron started with the SP Program in April 2001, performing a
physiotherapy role with SP’s Robert Halstead and Brett Buckingham.
He went on to more roles with SMR, as well as CAPE, RCA, CCE, and
various OSCE’s. SP Coordinators were also able rely on Ron as a
motivated and dependable support staff person for many exams.
Ron’s enthusiasm for the program was undeniable. In one
memorable instance, Ron was portraying an “irritable” patient. A
young female student entered the room and he growled, “Whaddya
want?” so fiercely she almost fainted. Ron had to step out of role
momentarily to urge her to get over it!
For his colleagues who remain with the Program, Ron shares
this advice: “Be early for work, and be very well prepared.” He
notes that the training and evaluations that SP's provide help prepare upcoming medical professionals to deal with real people – a
critical role which should never be taken lightly.
Over the last five years, Ron has found working closely with a
group of people as diverse as the SP’s - some times with great intensity and urgency! - very energizing and rewarding. The decision
to leave the Program was difficult, but one he feels is best for all.
All the branches of the SP Program will feel the loss of Ron as
part of the SP Program, but wish him all the best in regaining his
health. In your own words, Ron: “Thanks for the good times!”
RESPONSES
We received a note from one of our readers about one of the DID YOU KNOW . . . ?
sections in the last issue regarding the number of muscles it takes to smile versus frown.
From: Attentive SP
Sent: Monday, March 20, 2006 7:11 PM
Subject: Re: The new issue of the SPread Sheet is
on the web!
MiSPrint!!
Eleven is incorrect. It looks as though frowning
takes less effort in this statement: “ . . . it takes 11
muscles to frown and 12 to smile?”
Dear Attentive SP,
Actually, the information is correct. It apparently takes more muscles to smile than
frown – 12 versus 11 – but less effort, because the muscles for smiling tend to be in
better condition than the ones for frowning.
Thanks for taking the time to reSPond!
We apologize for any confusion this may
have caused any of our other readers.
More muscles,
less effort!
Questions or comments? Call 480-1307, extension 1.
Fewer muscles,
more effort!
Page 3
SPread Sheet Volume 1, Issue 6, June 2006
HUMERUS
PROSE
Two robins were sitting in a tree. “I'm really hungry,” said the first one.
“Me, too,” said the second. “Let's fly down and find some lunch.”
They flew to the ground and found a nice plot of plowed ground full of worms. They ate
and ate and ate ‘til they could eat no more.
“I'm so full, I don't think I can fly back up to the tree,” said the first robin.
“Me either,” replied the second. “Let's just lie here and enjoy the sun.”
“O.K.”, said the first. They plopped down, basking in the sun. No sooner had they fallen
asleep, than a big, fat tomcat sneaked up and gobbled them both! As he sat washing his
face after his meal, he thought:
“I love baskin' robins.”
Source: www.lighthousekeepers.com
STAYING PROFESSIONAL
The ABC’s of Emotional Vocabulary contributed by SP Becky Klassen
Those of us fortunate enough to grow up (or watch our kids grow up) watching “Sesame
Street” will have at least a passing familiarity with the seven (7) basic emotions. Thanks to
Kermit™ and the gang, we can generally tell if we feel happy, sad, mad, scared, surprised,
love, or even shame.
Verbalizing feelings in a feedback situation, though, typically demands more subtlety than
your average Muppet™ character can provide. The next time you need to describe an emotion, use one of the words from the handy alphabetized list below.
C is for . . .
A is for . . .
afraid
calm
caring
agitated
cautious
alarmed
cheerful
angry
antsy
comfortable
anxious
concerned
apprehensive
confident
ashamed
confused
awful
content
awkward
courageous
critical
B is for . . .
cross
bashful
curious
bewildered
cynical
bitter
D is for . . .
bored
brave
delighted
irritated
depressed
F is for . . .
hassled
disappointed
fatigued
hateful
J is for . . .
discouraged
fearful
helpless
jealous
disgusted
fidgety
hesitant
jittery
distressed
frightened
hopeful
joyous
disturbed
frustrated
horrible
down
funny
hostile
K is for . . .
furious
hurt
kind
E is for . . .
hysterical
eager
G is for . . .
L is for . . .
edgy
glad
I is for . . .
lazy
embarrassed
gloomy
impatient
leery
encouraged
greedy
indifferent
lonely
enraged
grouchy
inferior
loved
guilty
insecure
enthused
loving
intense
exasperated
H is for . . .
excited
irate
M is for . . .
happy
exhausted
irked
mad
(continued on page 4)
Questions or comments? Call 480-1307, extension 1.
Page 4
SPread Sheet Volume 1, Issue 6, June 2006
STAYING PROFESSIONAL
(cont’d)
The ABC’s of Emotional Vocabulary (continued from page 3)
mean
mischievous
miserable
moody
N is for . . .
nervous
nice
numb
O is for . . .
optimistic
Overwhelmed
P is for . . .
panicky
suspicious
sympathetic
patient
rushed
pessimistic
S is for . . .
pleased
sad
proud
safe
puzzled
scared
Q is for . . .
secure
queasy
sensitive
shaky
R is for . . .
shocked
rejected
shy
reluctant
silly
resentful
sleepy
restless
sorry
ridiculous
stressed
riled
surprised
T is for . . .
terrified
tired
troubled
W is for . . .
warm
wary
weary
wonderful
worried
Y is for . . .
U is for . . .
yucky
uncomfortable
unsafe
Z is for . . .
unsettled
zany
upset
This list is brought to
V is for . . .
you by the letters “S” and
“P” . . . and by the numvicious
ber 26.
victorious
Beevor’s Sign
Named after English neurologist Charles
Edward Beevor(1854–1908), Beevor’s sign
is the movement of the belly button towards
the head on flexing the neck. It is caused by
weakness of the lower abdominal muscles
(the muscles below the navel).
•
•
•
Normally, when you rise from a lying position to a sitting position, the navel stays in
the middle of the abdomen because the abdominal muscles above and below are con•
tracting equally. When the lower abdominal
muscles are weak, the navel is seen to rise as
the patient tries to sit up, but cannot sit up
•
because of weakness.
To reproduce this symptom, you must
cause your own belly button to rise when you
“try” to sit up – concentrate on pulling it up.
If you can’t do it naturally, you can learn it:
•
•
First, try to sit up from a supine (lying
down) position. It’s easier with your head
on a pillow.
With your hands on your abdomen - one
above and one below your navel – feel the
contraction of the muscles that are trying
to sit you up.
Lie back and relax.
Push on or wiggle your abdominal muscles
above the belly button: use only THESE
muscles when you try to sit up again.
Push on or wiggle the lower abdominal
muscles below your belly button: THESE
muscles should not contract when you attempt to sit up – they should remain relaxed and soft.
Hold a mirror over your abdomen so you
can see your navel, and try to move it
“up” as you try to sit.
Practice, practice, practice!
This symptom, or finding, can be associated with spinal cord injury, ALS (Lou Gehrig’s Disease), and facioscapulohumeral
muscular dystrophy: face (facio), scapula
(scapulo) and upper arms (humeral).
Adapted from Training Standardized Patients to Have
Physical Findings, by Howard S. Barrows, M.D., Southern Illinois University, School of Medicine, Springfield
Illinois, 1999, p.5
With references from Wikipedia, the Free Encyclopedia, http://en.wikipedia.org/wiki/Beevor's_sign
Questions or comments? Call 480-1307, extension 1.
Page 5
SPread Sheet Volume 1, Issue 6, June 2006
SPOTLIGHT
ON
...
Jacqueline Crowther joined
the SP Program February 27th
this year as the Office Assistant. Her responsibilities primarily revolve around keeping
the office running smoothly.
“I’m still learning what that
means!” she says.
Edinburgh, although her number one vacation
spot is right here in Manitoba: Clear Lake in
Riding Mountain National Park.
The oldest of six (6) siblings, Jacqueline is
quite proud of her own three (3) children –
Christine, Colleen, and Lionel, who, in their
own turn, have made her a grandmother four
(4) times over. The slightest prompt will get
you a list of spouses, accomplishments, and
grandkids - complete with pictures!
An honours graduate from Red River College, she earned her Library and Information
Technology Diploma in June 2005 with the
Clearly her greatest joy is her family, but
first class ever to attend that particular proJacqueline also enjoys gardening, reading
gram at the new Princess Street Campus.
(fiction and non-fiction), walking where
She stills works occasionally at the Department of Education Library on Portage Avenue. there’s grass, trees and birds, swimming, and
watching sports – curling, hockey, CFL footJacqueline (pronounced: “jak-LEEN”) is a
ball, and baseball! . . . if it’s the Toronto Bluetraveler. She was born in Fernie, B.C., but
jays.
has since resided in Champion, Brooks, Olds,
Ask her how she’s doing around payroll
and Lethbridge, Alberta; Regina, Saskatchewan; Stonewall and Neepawa, Manitoba; and time and she might tell you: “Fair to middlin’!”
Ottawa, Ontario before finally settling here in but it’s always a fair treat when’s Jacqueline
Winnipeg. Her last vacation was to the British in the office, helping us work out the day-toIsles, where she visited London, Glasgow, and day mechanics of the SP Program.
EVENT LISTINGS
Baja Beach Club – nightly (weather permitting)
SP Jacqui Fox (pictured at right) sings popular tunes of all genres at
Brannigan’s Patio at the Forks. Shows run 8—11PM weeknights and
9—12PM on weekends. Visit www.singersparadise.ca for schedule details.
Barn Again – July 19—30
SP Steve Pennicook and Coordinator Tim Webster perform clean improvisational
comedy with the Crosseyed Rascals at the Winnipeg Fringe Theatre Festival. Advance
tickets available by calling 94-FRINGE. Show times posted at www.crosseyed.ca.
Cycle of Hope 2006 - July 4—15
SP Dan Savchuk cycles 1287km to raise money for Habitat for Humanity, finishing
three (3) days before his 65th birthday. Not bad!
To advertise your event in the next SPread Sheet, please forward the pertinent information by August 31 - contact information is provided in the sidebar on page 2. No phone
calls, please. We will accept information about any and all events that occur on or between
September 16 and December 15. Listings are free, but placement cannot be guaranteed.
Questions or comments? Call 480-1307, extension 1.
Page 6
SPread Sheet Volume 1, Issue 6, June 2006
SPIN
•
•
•
WHAT'S A
AND AROUND
We extend “Get well!” wishes to:
1) SP Ron Clay who is struggling with
respiratory ailments. See INDISPENSIBLE on page 2 in this issue of the
SPread Sheet for more details.
2) SPC Holly Harris, who suffered a
cycling injury on May 24th.
3) Program Director Eunice Friesen
who suffered carpal fractures in both of
her wrists on June 5.
Eunice Friesen is stepping down as SP
Program Director as of June 30 to take a
position as Associate Director of University Teaching Services. Eunice has been a
great motivator for change and innovation
since joining us in September of last year
and she will be missed. We wish her well
in all her future endeavours!
We are still compiling a catalogue of photos of all the SP’s and Recruits in the program; not all of the Coordinators know
what each and every SP and Recruit looks
like, and this will help us fill roles that
much more easily. So, if you haven’t sent
us one already, could you please forward
an 8” x 10” picture of yourself – preferably in black or white – to the SP office at
your earliest convenience? You can send
your pictures electronically to [email protected] or mail them by
regular post to:
PICTURE
WORTH?
A logo is an iconic symbol designed to
represent a company, product or service. It
also depicts an organization's personality. A
good logo is unique, and not subject to confusion with other logos.
A logo should be functional in many different contexts while retaining its integrity. It
should remain effective whether it’s reproduced small or large, in "full-color", or in
black and white. Last but not least, it should
represent the brand/company appropriately.1
That’s a lot of work for a logo to do! Why
is a logo so important? The uniqueness of a
logotype is of utmost importance to avoid
confusion among clients, suppliers, users, affiliates, and the general public.
A true logotype consists of either a name
or a name and a sign. A logotype may function as a trademark, to identify businesses,
organizations, events, products or services.2
U of M Logotype
The University of Manitoba logo, for example, consists of a picture and word mark. The
graphic symbol of the picture mark is represented by a simple and clean shield design.
picture mark
Attn: Tim Webster, SPC
Standardized Patient Program
T151B-770 Bannatyne Avenue
Winnipeg, MB R3E 0W3
word mark
DID YOU KNOW . . .
. . . that the small bumps on your tongue
are called papillae?
. . . that there are 60—80 cells in a taste
bud?
. . . that pound-for pound the tongue is the
strongest muscle in your body?
The shield contains four icons: 1) the
Manitoba bison (resting atop centre of the
shield bar), 2) the crown, 3) the maple leaf,
and 4) the open book. These four (4) icons
represent the provincial, historical, national
and institutional nature of the University.
Questions or comments? Call 480-1307, extension 1.
(continued on page 7)
Page 7
SPread Sheet Volume 1, Issue 6, June 2006
WHAT'S A
PICTURE
WORTH? (continued from page 6)
The bottom banner serves to showcase the
date the institution was established as well as
to enhance the optical depth of field. The
wordmark is in the Minion typeface.3
In order to achieve clarity and effectiveness in all print and electronic communications for both internal and external audiences, the University has even published a
twenty-two (22) page guide to using its distinct logo!
Faculty of Medicine Logotype
In the Faculty of Medicine's Coat of Arms,
the buffalo has been elevated to become the
crest and an open book lies on the Cross of
St. George. The green field below the cross
contains a golden snake-entwined torch, a
modification of the staff of Asklepios. Asklepios was the Greek god of medicine, while
the torch is a popular heraldic symbol for
learning or knowledge.
The Latin motto Fiat Lux (“Let there be
light”) was suggested by the torch and comes
from The Bible, the book of Genesis, chapter
1, verse 3. The sketch of the Arms was done
by R.G.M. Macpherson of Burlington, Ontario,
Canada's foremost heraldic artist at the
time.4
motto
elevated buffalo as
crest
open book on
Cross of St. George
modified torch on
green field
The coat of arms for the Faculty of Medicine, University of Manitoba began as a centennial project of the 1957 graduating class
who negotiated and paid for its acquisition
from the Lord Lyon of Scotland, Chief Officer
of Arms in Scotland. The Letters Patent were
not signed until March 18, 1983! Prior to this
date the Coat of Arms was unauthorized.5
The Coat of Arms may be displayed to represent the Faculty of Medicine, University of
Manitoba, or to signify association with that
institution. The use of these Arms by anyone
else is a violation of propriety, except in
Scotland where it is also a violation of law.6
Branding
Logo design is commonly believed to be
one of the most important areas in graphic
design, thus making it the most difficult to
perfect. The logo, or brand, is not just an
image, it is the embodiment of an organization.7 Just look at some of the world-famous
logotypes below:
Some of them don’t even have any words at
all, and still everyone knows what they represent!
Neuroscientists are just beginning to
measure the enormous impact logos can
have. In a recent experiment, Read Montague, a neuroscientist at Baylor College of
Medicine scanned volunteers’ brains as they
drank samples of Coke and Pepsi. When the
colas were not identified, the tasters showed
no particular preference for either, but when
they were shown the iconic red-and-white label, they expressed a huge preference for
Coke, irrespective of which cola they were
actually sampling.
Coke's logo, the scans showed, lit up areas
in the brain associated with pleasure expectation in a way that Pepsi's did not. Monta(continued on page 8)
Questions or comments? Call 480-1307, extension 1.
Page 8
SPread Sheet Volume 1, Issue 6, June 2006
WHAT'S A
PICTURE
WORTH? (continued from page 7)
gue's conclusion: Coke's more pervasive
brand marketing affected volunteers' preferences in ways they didn't realize--even if
they were normally Pepsi drinkers.8
SPP Logotype Contest
What a difference a powerful logo can
make! That’s why the SP Program Logo Contest is still accepting entries. Below are two
(2) samples of logos SP’s have sent in for our
logo contest.
The entry on the left uses a graduation
mortarboard as a background, signifying the
contribution the SP Program makes to medical education. It also features the caduceus,
or the staff of Asklepios, as a medical symbol
and the letters “SPP” in a blue that might remind SP’s of the gowns they frequently wear.
Please get back to us about which entry
you prefer, or send us a sample of your own
version! All SP’s will be able to vote on the
final choice. The winning entry will appear
on subsequent issues of the SPread Sheet
and be featured on our webpage; the designer will receive a “Night On The Town”
package, including accommodations at the
Fort Garry Hotel, brunch for two, and entertainment.
Deadline for submissions is August 31,
2006. Submissions may be e-mailed to
[email protected], but must have
a resolution of 300 d.p.i. or higher. Submissions may also be mailed to:
SP Logo Contest
T151B – 770 Bannatyne Avenue
Winnipeg, MB R3E 0W3
No faxes, please. We’re looking forward to
receiving those entries – good luck!
References:
1, 2. Wikipedia, the Free Encyclopedia
http://en.wikipedia.org/wiki/Logo
3. University of Manitoba, Public affairs
http://umanitoba.ca/publications/graphic_standards/
The entry on the right is on the background of a blue (for the familiar gowns!) ribbon – significant of excellence - and the
shape emulates the logos of both the U of M
and the Faculty of Medicine. The white lettering on black background is a nod to the
sign outside the door of T151. The four
golden (4) spheres within the three (3) letters “SPP” represent the concept of standardization, excellence again, and the four
(4) levels at which SP’s are paid.
HUMERUS
4. University of Manitoba Medical Journal, 53(3),
1983 (paraphrased)
5. Susan Bethune, Dean’s Office, Faculty of
Medicine, University of Manitoba
6. University of Manitoba Medical Journal, 53(3),
1983 (paraphrased)
7. Wikipedia, the Free Encyclopedia
http://en.wikipedia.org/wiki/Logo
8. Time Magazine, Sunday, Oct. 16, 2005,
“Getting Inside Your Head” by Terry McCarthy
PROSE
A doctor moonlighting as a theatre critic published a negative review of The Barber of
Seville. Cut to the quick, the director of the show charged him with opera rating without a
license. Source: All About Puns, http://www.workinghumor.com/puns/arresting_charges.shtml
Questions or comments? Call 480-1307, extension 1.
Page 9
SPread Sheet Volume 1, Issue 6, June 2006
HUMOUR’S HEALING
POTENTIAL
by Dr. Brian Luke Seaward, PhD
Laughter Provides Emotional and Physiological Benefits To Patients and Care Givers Alike
In the past three decades the medical
world has begun to take more serious notice
of the healing power of humour and the positive emotions associated with it. Humour
and laughter are currently being employed by
psychotherapists and other care givers as
tools to promote and maintain health, as well
as intervention and rehabilitation tools for a
host of maladies and illnesses related to
stress and life-style.
Although this empirical medical approach
is relatively new, the study of humour has revealed a complex psychological phenomenon.
Senses of humour have been categorized in
types associated with personality. Humour
has many styles and can be found in almost
any situation, on any occasion. Theories of
humour include the superiority theory, the
incongruity theory, the release/relief theory,
and the divinity theory.
Laughter has many clinical benefits, promoting beneficial physiological changes and
an overall sense of well-being. Humour even
has long-term effects that strengthen the effectiveness of the immune system.
In healthcare, humour therapy can help
relieve stress associated with disease and illness. It serves as a diversionary tactic, a
therapeutic tool for disorders such as depression, and a coping mechanism. It also is a
natural healing component for care givers
trying to cope with the stress and personal
demands of their occupations.
Feelings are chemical, they can kill or cure. -Bernie Siegel, MD1
For centuries people have said that laughter is the best medicine, but until recently
this fact remained scientifically unproven.
However, since 1964, when Norman Cousins
incorporated humour therapy in his treatment of ankylosing spondylitis,2 the medical
world has begun to take more serious notice
of the healing power of humour and the positive emotions associated with it.
The relationship between stress (negative
emotions) and disease and illness has proven
to be profound, with approximately 70 percent to 90 percent of disease and illness
strongly associated with stress.3 Cousins’s
premise and subsequent health philosophy
was this: "If negative thoughts can have
negative physiological repercussions, can
positive thoughts produce positive effects
throughout the body?"4 This hypothesis
planted seeds for the development of a new
medical discipline, psychoneuroimmunology,
the study of the mind-body relationship.
Humour and laughter are currently being
employed as tools to promote and maintain
health everywhere, from the classroom to the
boardroom.5 In addition to its use in preventive medicine, humour also has a role as an
intervention and rehabilitation tool in the
clinical setting for a host of maladies and illnesses related to stress and life-style. Although alone it is no replacement for clinical
medicine, humour’s supplementary use is
now recognized as a powerful aid for both
patients and healthcare professionals.
The History of Laughter
Many a truth be told in jest. -- Geoffrey Chaucer6
Even in the Biblical days, humour was
considered a tool of therapeutic medicine: "A
merry heart does good like medicine, but a
broken spirit drieth bones" (Proverbs 17:22).
Greeks included shades of humour in their
dramas, with comedy balancing the theatrical
scale with tragedy.
The Latin origin of the word "humour"
means fluid or moisture. According to medieval physiology, the body hosted four primary humours, each associated with a mood:
choler, anger; bile, melancholy; blood, confidence; and phlegm,
(continued on page 10)
Questions or comments? Call 480-1307, extension 1.
Page 10
SPread Sheet Volume 1, Issue 6, June 2006
HUMOUR’S HEALING
POTENTIAL
(continued from page 9)
apathy. An excess of any one of these humours brought on poor health and often ridicule, whereas a correct balance was indicative
of "good humour," or health.
example, Bernie Siegel writes that once, while
performing surgery for a cancerous tumor, he
heard Frank Sinatra’s voice on the radio
crooning, Why Not Take All of Me?9
Some cultures used humour and laughter
to lift spirits and promote health, employing
individuals like the European court jesters or
Native American shamans. However, humour
was not always thought of as good for one’s
health. Some cultures associated laughter
with the work of the devil. In Puritan times,
laughter was considered a moral sin, regardless of the occasion, and even smiling was
prohibited.
Paralleling the four components of wellness
- mind, body, spirit, and emotions - are four
theories of humour, suggesting that humour
is an important factor in the integrity of the
wellness paradigm. The oldest theory of why
people laugh is the "superiority theory," an
emotion-based theory credited to Plato. It
suggests that laughter is a socially acceptable
outlet for aggression, where laughter at
someone else’s expense elevates one’s own
self-esteem (e.g., Dan Quayle jokes).
The Psychology of Humour
A smile is the shortest distance between
two people. -- Victor Borge7
A more recent theory is the incongruity
theory, a cognition-based theory that laughter
is triggered by the connection of two or more
Although this empirical medical approach is
concepts that seem absurd or incongruous-relatively new, the study of humour has refor example, years ago Charlie Chaplin envealed a complex psychological phenomenon.
tered a Charlie Chaplin look-alike contest and
Like love, humour has proven difficult to degot third place. Research indicates that
fine, with no consensus among scholars. Sufstroke victims with right-sided brain damage
fice it to say, humour is the quality of being
are unable to laugh at cognitive-based jokes,
funny or appreciating funny thoughts or acts,
supporting the theory that humour is a rightmanifesting in smiling or laughter.
brain cognitive function.10
With rare exceptions, everyone has and
Sigmund Freud, in his study of laughter,
demonstrates a sense of humour. In fact,
suggested the release/relief theory, explaining
senses of humour have been categorized into
that laughter is a physical manifestation of retypes associated with personality, including
pressed thoughts of taboos such as sex and
"good sport" (laughter at one’s own expense),
death.11 This theory may account for the conconventional (eye-to-eye humour, where two
tinued popularity of sexual jokes.
or more people laugh at the same thing),
creative (imaginative wit), and "life of the
Finally, the newest theory on humour is
party" (an extrovert who makes people
the so-called divinity theory. It suggests that
laugh).8
humour has the ability to make order out of
chaos, promote unity and connectedness
People have always been curious about
through shared laughter, uncover the naked
what causes laughter, from the incongruous
truth of a situation, and lift one’s spirit. In
to the ironic. Moreover, humour has many
essence, the theory goes, humour is a gift
styles, including slapstick, black (gallows) hufrom God.12
mour, parody, satire, and the lowest form of
humour, sarcasm (which literally means to
Although humour is classified as a perceptear flesh). Humour, it seems, can be found
tion rather than an emotion, it can produce
in almost any situation, on any occasion. For many positive emo(continued on page 11)
Questions or comments? Call 480-1307, extension 1.
Page 11
SPread Sheet Volume 1, Issue 6, June 2006
HUMOUR’S HEALING
POTENTIAL
(continued from page 10)
tions, including joy, mirth, hope, confidence,
and an overall sense of well-being. It is this
expression of emotions which has healing potential. Humour can serve as a positive coping strategy, often used to diffuse feelings of
anger or impatience by acknowledging the
absurdity of the threat to the ego. Likewise,
humour can be used to dispel fear, including
fear of the unknown, fear of death, and fear
of failure, by providing a wider perspective
and clearer focus on the situation. Humour is
often used to communicate these feelings to
oneself and others by diminishing the stress
in an acceptable way. In many ways, humour is a universal language.
The Physiology of Humour
Laughter, like a virus, is contagious.
-- Art Buchwald13
Physiological research in the field of humour and laughter has uncovered amazing
results, suggesting that, indeed, laughter has
many clinical benefits. In the short term,
laughter promotes many physiological
changes; most notably, it stabilizes blood
pressure, massages inner organs, stimulates
circulation, facilitates digestion, increases
oxygen supply to muscles, decreases muscle
tension, and promotes an overall sense of
well-being.14 In fact, laughter produces similar, if not identical, responses to those associated with progressive muscular relaxation,
a widely recognized relaxation technique
used to reduce muscle tension.
In addition, tears produced by laughter
differ from those produced by sadness and
depression in that they contain toxins the
body tries to release through the laughter response.15 The most remarkable effect laughter may produce is the release of neuropeptides, including the beta endorphine, which
act as pain reducers.16 Cousins, in his now
famous testimony, said that ten minutes of
laughter gave him two hours of pain-free
sleep during his recovery.17
Perhaps most interesting are the longterm effects of laughter and the positive
emotions that accompany it. Current evidence indicates that cells associated with the
immune system (the lymphatic system) are
activated through a complex mind-body feedback mechanism. Stress-produced emotions
trigger the release of cortisol and aldosterone, which in substantial amounts may actually decrease the T-lymphocyte cell count,
thereby impairing the immune response.
Conversely, positive thoughts and feelings
increase the effectiveness of the T-cells and,
hence, strengthen the ability of the immune
system to operate against illnesses from
common colds to cancer.18 Thus laughter
and positive emotions, including joy, love,
faith, hope, confidence, and will, contribute
to the strength and integrity of the immune
system. Although researchers have yet to
identify an intensity-frequency-duration formula for the exposure to laughter as with
physical exercise, conventional wisdom suggests that daily encounters with humour are
beneficial to total well-being.
Humour in Healthcare
Humour is mankind’s greatest blessing.
-- Mark Twain19
Comic relief, now widely viewed as a viable preventive technique for coping with
stress, is also being used in many clinical settings as a supplemental tool in the healing
and recovery process for everyone from alcoholics to cancer patients.20
The difference between clinical medicine
and humour therapy is most notably found in
their application. Whereas clinical medicine
is prescribed by a physician and administered
by healthcare givers, the use of humour therapy is often more subtle and much less formal. Comic relief arises from the ironies and
incongruities acknowledged in everyday life,
experiences in which inhibitions are suppressed, allowing a natural flow of emotions.
(continued on page 12)
Questions or comments? Call 480-1307, extension 1.
Page 12
SPread Sheet Volume 1, Issue 6, June 2006
HUMOUR’S HEALING
POTENTIAL
(continued from page 11)
Healthcare givers must be extremely sensitive to the patient’s needs and moods and
not force this mode of therapy. Instead, they
should take advantage of opportunities initiated by patients to help relieve stress associated with disease and illness.
to discuss, and as a therapeutic tool, to help
dissolve psychological defenses inhibiting recovery.23
Humour as a Coping Mechanism
Several hospitals across the country, particularly those with oncology wards, are developing humour programs for their patients.
These offer rooms with videocassette recorders and compact disc players, in-house humour cable channels, library shelves filled
with humourous books, and movable humour
carts with a host of resources to promote
laughter.22
Clinical staff note that the primary benefit of
humour therapy is it serves as a diversionary
tactic, taking patients’ minds off their illness
and related moods of depression, thus promoting a balanced expression of emotions.
Both anger and fear surface in the fight
against life-threatening illnesses such as cancer, and care givers can use humour to help
patients control these emotions rather than
becoming the victim of them, as described by
comedian Gilda Radner during her visits to
the wellness community.24 Similarly, in the
rehabilitation of persons recovering from substance addictions, humour can help them express negative emotions in a positive light,
thus relieving feelings of despair and helplessness. Many addictions are related to low
self-esteem. Although humour does not necessarily build self-esteem, the ability to laugh
at oneself can be a crucial transition in the
basic stages of recovery.
Humour therapy in this context is generated by the patient, not the therapist. It is
important to distinguish between laughing
with a patient and laughing at a patient.
Care givers also need to be cautious about-or even refrain from--using sarcasm, since it
may be a direct reflection of latent anger.
Sarcasm is an inappropriate form of humour
in healthcare because it may promote stress
rather than reduce it. On the other hand,
positive humour can provide ammunition to
deal with stress and the emotions surrounding it: anger and fear.
Humour as a Therapeutic Tool
Healing for the Care Giver
Psychotherapists have discovered humour
as an aid in the treatment of several clinical
disorders, most notably depression. Although opinions are divided on this issue, humour has been reported to strengthen the
bond between client and therapist in the
treatment process, increasing the progress
toward recovery. Currently, humour is used
as both an assessment tool, to help the
therapist learn what topics the client wishes
Comic relief is a natural healing component not only for patients, but also for care
givers. In her book Humor and the Health
Professional, Vera Robinson cites the need
for healthcare professionals to incorporate
humour into their lives to cope with the
stress and personal demands of their occupations.25 Humour helps balance the scale of
emotions in a hospital setting where morbidity and mortality often cast a dark shadow.
Humour provides several ways in which it
can help patients in healthcare facilities or
clinical therapy.
Humour as a Diversionary Tactic
In many ways the hospital setting is the
antithesis of the home environment. Illness
and death often cast a shadow of intense seriousness, interfering with the expression of
the full range of emotions. Experts suggest
that on average a person laughs approximately 15 times a day.21 In the hospital,
however, this number can drop to zero.
Questions or comments? Call 480-1307, extension 1.
(continued on page 13)
Page 13
SPread Sheet Volume 1, Issue 6, June 2006
HUMOUR’S HEALING
POTENTIAL
(continued from page 12)
Although professionalism is expected in the
healthcare industry, an absence of humour is
now viewed as unprofessional, supporting the
trend to take one’s job seriously, but oneself
lightly.
The use of humour therapy on the oncology ward of Shady Grove Adventist Hospital,
Rockville, MD, resulted in a significant decrease in employee burnout and attrition for
nurses in that ward over a two-year period.26
Professionals can integrate humour into
their life-style by making a point to find one
humourous thing a day, laughing at themselves, recognizing moments of fallibility, exaggerating events to the point of ridiculousness, looking for life’s ironies, and starting a
"tickler notebook"--a collection of cartoons
and jokes.27 This is particularly important for
the healthcare professional working with
AIDS patients or others facing death, as physicians and nurses often transfer their somber emotions to their patients. It is important to balance the workday with supplemental activities that add joy to life.
Good Medicine
It’s never too late to have a happy childhood.
-- Tom Robbins28
Science is beginning to prove what many
people have known all along: that, indeed,
laughter is good medicine. Humour and
laughter enhance positive feelings and emotions to balance the preponderance of negative emotions that surface during stressful
times. Humour and laughter appear to have
many healing qualities. The introduction of
humour therapy and comic relief programs in
many clinical settings as a rehabilitation tool,
and in work settings as a prevention tool, reveals the strong mind-body connection associated with humour, which can promote wellbeing for patients and care givers alike.
Dr. Seaward is assistant professor, Department
of Health and Fitness, American University,
Washington, DC.
For more information about humour therapy,
contact the Humor Project, 110 Spring St., Sarasota Springs, NY 12866, 518-587-8770.
NOTES
1. Bernie Siegel, Peace, Love and Healing, Walker & Co., New
York City, 1990, p. 17.
2. Norman Cousins, Anatomy of an Illness, W. W. Norton, New
York City, 1976.
3. Roger Allen, Human Stress: Its Nature and Control, 2d ed.,
Burgess Press, Minneapolis, 1992.
4. Cousins, Anatomy of an Illness.
5. Barbara Mackoff, "The Business of Laughter," New Woman,
October 1991, pp. 74-75.
16. Geoffrey Chaucer, Prologue to The Monk’s Tale, 1386.
17. Victor Borge, "International Humor Treasure," Humor Matters,
vol. 7, no. 4, 1991, pp. 127-139.
8. Ramond Moody, Laugh after Laugh, Headquarters Press, Jacksonville, FL, 1987.
9. Bernie Siegel, Love, Medicine and Miracles, Perennial Library,
New York City, 1986.
10. Vera Robinson, "Humor and Health," in P. McGhee and J.
Goldstein, eds., Handbook of Humor Research Vol. II, SpringerVerlag, New York City, 1983.
11. Sigmund Freud, "Humor," International Journal of Psychoanalysis, vol. 9, 1928, pp. 1-16.
12. Tal Bonham, Humor: God’s Gift, Broadman Press, Nashville,
TN, 1988.
13. Art Buchwald, "The Healing Power of Humor," keynote address for "Humor and Health," American University, Washington,
DC, November 27, 1990.
14. William Fry and Waleed Salameh, Handbook of Humor and
Psychotherapy: Advances in the Clinical Use of Humor, Professional Resource Exchange, Sarasota, FL, 1987.
15. Allen Klien, The Healing Power of Humor, Tarcher Press, Los
Angeles, 1989.
16. Siegel, Peace, Love and Healing.
17. Cousins, Anatomy of an Illness.
18. Siegel, Peace, Love and Healing.
19. Alex Ayres, The Wit and Wisdom of Mark Twain, Harper &
Row, New York City, 1987, p. 109.
20. Erma Bombeck, I Want to Grow Hair, I Want to Grow Up, I
Want to Go to Boise: Children Surviving Cancer, Harper Paperback Books, New York City, 1989.
21. James Hassett and John Houlihan, "Different Jokes for Different Folks," Psychology Today, January 1979, pp. 64-71.
22. Norman Cousins, Head First: The Biology of Hope and the
Healing Power of the Human Spirit, Penguin, New York City,
1990.
23. Fry and Salameh.
24. Gilda Radner, It’s Always Something, Simon & Schuster, New
York City, 1989.
25. Vera Robinson, Humor and the Health Care Professional,
Charles B. Slack, Thorofare, NJ, 1977.
26. Christine Flannigan, "Humor as a Coping Strategy for Cancer
Patients at Shady Grove Adventist Hospital, Rockville, MD," keynote address for "Humor and Health," American University, Washington, DC, November 13, 1990.
27. Joel Goodman, "How to Get More Smilage Out of Your Life:
Making Sense of Humor and Then Serving It," in McGhee and
Goldstein.
28. Tom Robbins, Still Life with Woodpecker, Bantam, New York
City, 1980, p. 277.
Copyright© 1992 by the Catholic Health Association.
Reproduced from Health Progress with permission.
Questions or comments? Call 480-1307, extension 1.
Page 14
SPread Sheet Volume 1, Issue 6, June 2006
PICTURE THIS
SUBMISSIONS
The SPread Sheet is
your newsletter; if you’d
like to contribute any articles, opinions, thoughts,
trivia, anecdotes, pictures,
or jokes for the next issue,
please do so by August
31. Contact information is
provided in the sidebar on
page 2. We do, however,
reserve the right to edit
any and all submissions for
length and content in collaboration with the contributor. Submissions that
are not included in one issue may be included in
subsequent issues.
Source: MediClicks, http://www.mediclicks.net/nexium/cartoonarchive.asp?i=76
Used with permission
HUMERUS
PROSE contributed by SPP Program Director, Eunice Friesen
A couple goes on vacation to a fishing resort. One morning the husband returns after several hours of fishing and decides to take a nap. Although not familiar with the lake, the wife
decides to take the boat out.
She motors out a short distance, anchors, and continues to read her book. Along comes a
game warden in his boat. He pulls up alongside the woman and says,
“Good morning Ma'am. What are you doing?”
“Reading a book,” she replies - thinking, “Isn't that obvious?”
“You're in a restricted fishing area,” he informs her.
“I'm sorry officer, but I'm not fishing, I'm reading.”
“Yes, but you have all the necessary equipment. For all I know you could start at any moment. I'll have to take you in and write you up.”
“If you do that, I'll have to charge you with sexual assault,” says the woman.
“But I haven't even touched you!” protests the game warden.
“That's true, but you have all the necessary equipment. For all I know you could start at
any moment.”
The game warden tipped his hat, said “Have a nice day, ma’am,” and left.
Questions or comments? Call 480-1307, extension 1.