WRITINGS

HEALTH

My article appearing in South Bay Accent magazine:

Laughing Matters
By Matt Jones

"I hate it that my hair is falling out, but, hey, think of the money I'm saving on shampoo!"

A quip from a character on the latest FOX sitcom? A punch line from a stand-up comic? Try a comment from cancer patient Janet Rincon in her intensive care room.

"That's my patient, that's my audience," says Dr. Josh Sickel, a pathologist famous for his funny bone. "They can give back as good as they get." And that's a special treatment making news at Mountain View's El Camino Hospital.

Many patients once mum about their illness are ready to talk. Even laugh a little. And they positively rave about Dr. Sickel and how his "humor for healing" habits have changed their outlook. Not cured them, certainly. Maybe lowered their blood pressure a bit, or helped them sleep better, or gave their immune system a bounce back with a healthy dose of good cheer. Or just given them a break from the depressing patient thing every now and then. "He tells them in all his sincere and humorous ways that he is there for them," says Melissa Parker, a financial advisor who enjoys playing the jester in Dr. Sickel's troupe. "He sees the hard truth but chooses the easy laugh."

Once it was only the pill-piled pushcarts that made the rounds at El Camino Hospital. Now too it's Parker's jester cart jammed with puppets, wind-up toys, stuffed animals, and magic cards that makes wheelies from room to room. And a doctor or two has been known to offer a rubber chicken along with a thermometer to a giggling patient.

Some doctors have complained about the distraction to their work and their patients. "I worry about the waste of effort and lack of professional dignity that comes with the high jinks around here," says Dr. Mitchell, "but mostly I regret the insult that happens for some patients who feel the humor is forced on them."

"That's fair," says Dr. Sickel. "My volunteers and I have made a few stupid mistakes." There was the time early on when Dr. Sickel's gang was getting silly with a patient who just had to laugh--loud and long. "The problem," he winces, "was that we never accounted for the feelings of the other family sharing the room who were dealing with a serious illness. We apologized to them and backed out of the room."

That kind of gaffe nearly got Dr. Sickel's revue canned. Comedians can say that they bombed. Or died. Dr. Josh Sickel says he faced career suicide. Was he ignoring valuable clinical research time or eroding medical skills while bringing on the clowns? From pioneering author Norman Cousins to doc "Patch" Adams of movie fame, there was good precedent for injecting humor into the hospital ward. If not always good evidence that it made a bit of difference.

The doctors who criticized his method warned that Dr. Sickel's crew was interfering with patients' responsibility for self-managed care, or, worse, enabling patients in denial of their illness. Dr. Buckholtz, an El Camino Hospital oncologist and supporter of the humor as healing approach, says Dr. Sickel can help only to a point. "The body is its own mechanism," he says, "it's not always affected by one's state of mind, and there are clear limits to the power of laughter, whether we like to think so or not."

Today Dr. Sickel is ready with a funny face for everyone. He coaches other doctors to dispense mirth with medicine. He rallies nurses, staff, and outside volunteers to offer their own comedy cures. When he needs a financial backer for his plans, he pulls another funding magic rabbit out his hat. But the guy who now tells people to "leap first and wait for the net" not long ago was standing on the sidelines, idling away any notion of his future mission.

Coming to grips
About a year ago, Dr. Sickel was not having fun.

Strange, because everything in his role suggested otherwise. Some medical peers would say that as a lab guy, he had things easy. He didn't have to deal with their stress over patients and job burn out. But something wasn't right.

He was feeling sad. As a clinical pathologist, he could read patients' tissue samples under his microscope, gazing at slices of life that he would declare healthy or dangerous. Dr. Sickel had always enjoyed deciphering patterns. But now the lab of his psyche was showing confusing results.

Nothing about his background was helping him cope with a sudden set of personal problems. Not his MD. Not his professional awards. Not his Stanford teaching experience. Dr. Sickel was stymied and increasingly anxious. Bad things were happening to good people around him.

Now disease and despondency were hitting home. He could explain the clinical nature of his brother Robert's lung cancer, but not console him, offering solutions and not a shoulder to cry on. He could cite the causes of his cousin Catherine's breast cancer, but not lift her spirit. He tried to figure out why his marriage had cooled, but couldn't find the right words for his wife.

"I was lost in a world of diagnostic data," Dr. Sickel says. "Everything I understood about life had a objective answer. But suddenly my humanity, the bedside manner I had never needed in the lab, was calling out to me. I was feeling others' pain as if it were my own." Soon, however, he would learn that laughter is good medicine. And that would make all the difference.

A turn for the better came in an unlikely place. Delivering yet another cellular biology lecture at a medical conference in Los Angeles, Dr. Sickel found his mind wandering. "I began to free associate--to wing it, I guess," he recalls. "I remember talking about patterns in pathology scans and then wondering aloud about similar designs in art."

Dr. Sickel was evolving right before everyone's eyes. He was connecting his thoughts about technique and personal touch, medicine and mirth. The speech had the physicians scratching their heads. And not a few peers ready to write him off. Was Dr. Sickel losing it? Could there be any doubt when they heard him chuckling to himself?

The turnaround
For one doctor, however, Dr. Sickel had the right stuff. "He asked me if I had ever done any stand-up comedy," Dr. Sickel recalls being surprised. "He thought I was trying to be funny--like a Jerry Seinfeld bit." Was this a new calling? "I was ready for a change--my friends and family were too--anything to step out of my white coat for a while." But could Dr. Sickel's schtick play before a comedy house crowd? Only one way to find out: open mike night on Rooster T. Feathers stage in Sunnyvale. He killed.

"I'm not sure why I was a hit. Maybe it was the novelty of my background," Dr. Sickel says. Jessica Jenkins, the club owner, had seen a star. "I told the doc he should consider a career change," she cracks.

His next steps led him to a convention of the Association for Applied Therapeutic Humor (AATH) held in Anaheim, which was highlighting Humor Skills for the Health Professional. There he met Allen Klein, Clifford Kuhn, and Patty Wooten--doctors, humorists, and merry mentors who would rock his world.

His merry methods
Patients will tell you Dr. Sickel had a lot of convincing to do when he first tried humor in the halls of El Camino Hospital. Several thought the hilarity might hamper them. But the nurses got it right away. "We know patients' everyday ups and downs," nurse Allison Schmidt says. "We can see how humor lifts spirits immediately."

Now that Dr. Sickel had the spark of his own to share, he began calling on staff and local volunteers to join his band of merrymakers. Many donned red noses after hours. Others skipped a lunch hour or two to offer patients their humorous anecdotes.

Soon Dr. Sickel gained the hospital administration's support to create a closed-circuit TV channel showing classic comedy programs. Decidedly stress-free programs from I Love Lucy to Johnny Carson's old Tonight Show re-runs offer what Parker calls, coyly, "compassionate comedy for a captive audience."

Looking ahead
Laughter is not a cure-all in many cases. When humor won't help, Dr. Sickel also advocates and provides other affirmative activities, such as meditation, art, and music therapy programs at El Camino Hospital. He has paid for many components out of his own pocket, and recently raised more than $12,000 through the hospital Auxiliary's help.

And Dr. Sickel remains as vigilant as ever--in his lab diagnoses, his stand-up act, and in self-examination. "My office has my medical tools, but it's also filled with kooky stuff that helps me maintain a sense of humor." We'll just tell you that if you plan to visit Dr. Sickel's office for a casual chat, watch out for the "happy frogs." Nuff said? Oh, and you might keep an eye on Dr. Sickel: He's got lots of pranks planned that just might make you forget about that tennis elbow for a while.