" . . . People see or read about persons -- not just yogis -- whose minds can cope with pain or can control bleeding, and there is a gee-whiz reaction akin to what happens when people see bears ride bicycles or when they see a woman sawed in half at the circus. Yet nothing in the field of vended magic is as arresting as new knowledge about the regulatory possibilities of mind. A new frontier in the understanding of life is being opened up. It represents one of the main challenges confronting medical science today." -- Norman Cousins in JAMA, the Journal of the American Medical Association, Aug. 3, 1979

Norman Cousins is teaching laughter at UCLA Medical School

Sure, you say, Guffaw 101.

Actually, that's not too wrong.

Bellylaughs made him what he is today, and he'll be the first to tell you.

Up until a few years ago he was just your everyday American literary giant, 40 or so years editor of the Saturday Review of Literature, critic, philosopher, spokesman for international cooperation.

And, oh yes, perpetrator of spoofs (that's the word he likes) in the pages of SRL on (but not limited to) April Fool's Day. Unobtrusive ones, of course, like the Ninas in the Hershfelds: If you didn't know to look for them you'd likely never notice.

Then he got sick. So sick that the doctors all but gave up. All they knew was that he had a degenerative collagen illness. Collagen is the body's glue that holds the cells together. Cousins was, as he puts it, literally "coming unstuck."

Medical science was not helping and he was getting worse. On the basis of his own vast reading and some urgent on-the-spot research, he concluded he should dump the medicine he was on (including aspirin) and try Vitamin C for his illness and laughter for his pain.

Allen Funt ("Candid Camera") with an assist from some old Marx Brothers films, took care of the laughter and a cooperative and sympathetic physician got him fixed up with intravenous ascorbic acid.

Now, the most surprising thing about it all is this: Only the occasional nay-sayer suggests that he would have gotten well anyway.

Cousins, in town this week to attend a holistic health conference at Walter Reed Hospital, doesn't admit to surprise at all. He's "gratified," he says that the prestigious New England Journal of Medicine printed his article about his experience, that this summer he has had published two articles in the similarly prestigious Journal of the American Medical Association, that 14 publishers vied for book rights (Anatomy of an Illness As Perceived By The Patient, W. W. Norton) just out. That he speaks at medical conventions, including those of the AMA. That he is a professor at a medical school.

He believes he's on to something big, and evidently at least a suspicion that indeed he is, is being shared more and more by the medical establishment.

"Any medical student," says Cousins, "can give you a horrendous catalogue of all the terrible things that happen to the body under the impact of negative emotions: fear, hate, rage, exasperation, frustration. You learn about constriction of the blood vessels, increase in blood pressure, excess flow of hydrochloride acid, adrenel depletion, indigestion, headaches.

"But we haven't yet sufficiently recognized that the body does not operate only on one wave length. It just doesn't respond to negative emotions, it responds to the positive emotions. It's impossible to have one without having the other. But the salutary effect is not as well understood."

Cousins knows it has to come from within and it is this concept he is trying to impart to the medical students he lectures.

"I'm teaching most of those things that bear on good medical practice that you generally don't learn in medical school: the concept of patient responsibility, the art of listening to people, respect for life, the importance of compassion, the need to engage to the fullest the patient's own healing mechanism, the need to give a patient the understanding to use his or her own healing mechanism.

"The doctor," says Cousins, "does a better job when the patient takes his or her own end. This is not just a matter of being obedient . . . For a long time the center of gravity of health care was outside the individual, represented symbolically by the doctor saying, in effect, 'Come to me and I'll heal you,' or the prescription saying in effect, "Take me and you'll get better.'

"You have to recognize that when people are sick, it's not just that they're attacked by a bug, but because their lives are out of bounds. And if you want to help them cope with tension, you've got to give them a side of life they enjoy.

"So medicine is incomplete when it attempts to deal only with the effects . . . the trend in medicine, fortunately, is toward increased respect for immunology. And when you talk about fortifying the body's immunological mechanisms, you're not talking about just physical factors, you have to talk about emotional and spiritual factors."

At UCLA, Cousins is called an Emotional Support Resource. As such, he was sent a patient, a young woman deeply depressed because she was losing the sight in one of her eyes, a fact confirmed by the eye clinic. Cousins describes what happened:

"She came to me because she wanted to find some way of breaking out of the depression. Well, you don't make a person like that feel guilty because she's depressed. I told her if I were losing my eye I'd be depressed too. But after we accept that, what are the consequences and how do we deal with them?

"One of the consequences had to do with other people. Others are going to be depressed, not just because of her eye, but because she's depressed. So she had to take some responsibility for that fact.

"She hadn't thought of it that way. And if she felt it was important to keep her parents and her husband and child from being affected, then she might have the motivation to go on and do something about it. Which she did.

"We decided she had to be cheerful, but it couldn't be contrived. The others would know it. It had to come from within. She might need some props, so I suggested the books to her that I used -- Perelman, Thurber, Nash, Wodehouse, also Woody Allen. I told her to go at this thing as though it were a prescription.

"She called up a few days later to tell me how her parents had come to dinner and were amazed at how cheerful she was and they all laughed together at the stories -- 'rolling on the floor,' she said, and 'for two days I felt marvelous.'

"Then I went away for a few weeks to China. When I returned she called to tell me that a wonderful thing had happened. "They don't understand it in the eye clinic but there's a 30 percent improvement in my eye. No surgery. It's been saved.'"

'Now," says Cousins, "Laughter is very easily disparaged, just because it seems to be easy. But it tends to be something of a symbol for the plus things in life. It is related to joy, related to optimism, to the will to live. It tends to crystalize an awful lot of things, at least as the most visible expression of good things that happen inside you or to you.

"So while illness is not a laughing matter, perhaps it ought to be . . . "