Mr. Bassetti, how often do you laugh as a doctor?

Actually, I laugh quite often. Although I would like to distinguish between different types of laughter. On the one hand, there is humor associated with hearty, spontaneous laughter. This is not the focus when it comes to patients because we are often dealing with diseases and fates that are no laughing matter. But there is a second form of laughter that is very important to me as a doctor.

Which form is that?

The smile – one of the most important forms of communication we humans have. I use a smile as a sign of friendliness and empathy toward my patients. As a doctor, I have to assess a person’s situation and medical history in just a few minutes. To do this, I rely on people opening up to me – and that includes them telling me their fears. A smile can often open that doorby creating an atmosphere of relaxation and trust.

Whereas humor is rarely appropriate?

Naturally, there are also funny and cheerful moments in medicine. For example, when I can celebrate the success of a therapy with a patient. But humor in medicine must always be associated with respect for the situation and the person. You have to use it carefully and purposefully. This is certainly possible, for example in the form of a hospital clown in a children’s hospital (see infobox on the Theodora Foundation). Another special situation for me as a doctor is when I can use humor to diagnose a disease.

When do you do that?

Laughter originates in the brain. Correspondingly, there are also neurological disorders that lead to an impairment of humor or laughter. For example, that someone laughs exaggeratedly or in situations where sadness would be more appropriate. For example, patients may well suffer from such a disorder after a stroke or craniocerebral trauma. Even in the case of patients with narcolepsy, i.e. sleeping sickness, laughter can have serious effects. It can lead to a sudden loss of muscle control, leading to falls. In other patients, laughing too hard can lead to what is known as a laughing fit – a circulatory arrest in the brain with loss of consciousness. Part of the diagnosis can therefore be to create a funny situation to test a patient’s reaction.

Generally speaking: What actually happens in our bodies when we laugh heartily?

When we laugh, we breathe deeper, which is why more oxygen enters the body, stimulating circulation. At the same time, endorphins, i.e. happiness hormones, are increasingly released in the brain and stress hormones are broken down. This makes us feel more relaxed and, for example, less sensitive to pain – because of the endorphin and also because laughter can distract us from pain. The heart and blood vessels as well as our mood benefit the most from laughter.

In other words, laughter is good for your health. Can it actually protect us from illnesses or speed up a healing process?

There is hardly any rigorous scientific evidence, especially with regard to individual diseases, otherwise laughter would be used more often in a targeted manner in medicine. But the effects mentioned above are certainly good for our health – both physically and mentally. Laughter and humor make us more relaxed and thus also help to release physical tension, for example. And smiles and laughter create empathy, closeness and thus facilitate social interaction – which strengthens our mental well-being.

Why do we laugh? Is it congenital?

Yes, animals such as monkeys, dogs and horses can also laugh or make laughing sounds. In humans, even newborns smile – first in their sleep. It’s something evolution has given us. Smiles and laughter are essential for babies’ survival, as they promote bonding with their parents. It has been proven that adults laugh far less often than children. This is a pity on the one hand, but also understandable on the other.

In what way?

Newborns and children have a more limited range of options when it comes to expressing themselves – this includes laughter and crying. As adults, we can interact in a much more differentiated way. For this reason, simpler forms of communication such as laughter become less important. What’s more, as we get older, we learn that humor can also hurt – there’s also malicious or sadistic laughter. This is why we generally use humor and laughter more consciously and also more cautiously than children do.

Among adults, there is a wide range between very humorous and less humorous people. Why is that?

How much I laugh has to do with my personality, my character, my experiences and also has a lot to do with the culture I live in. I used to work as a professor in Moscow. While I was there, it struck me that there was much less laughter in the former Soviet Union than in other countries. For example, if the Italians win a sports competition, they are overwhelmed with joy. In the same situation, the Soviets would hardly laugh or in fact show any emotions. It’s a question of socialization – in this case, for example, where self-control is seen to be important. The amount of humor and laughter used in medicine therefore also depends very much on a doctor’s personality.

But from a health point of view, would it do us all good to laugh more?

Yes, it would. It doesn’t have to be laughter yoga, but you can actually bring about the positive effects by laughing for no reason. I think smiling in everyday life is important. It does us good and connects us with our fellow human beings. Especially in times of great uncertainty and conflict, we should give it more space.