Boston — ONE of the more promising new developments in the medical field is also one of the most unusual. It will cause no frenzied trading on Wall Street, has no adverse side effects, and involves no increases in medicare costs. It is called laughter. Alison Crane, who recently founded the American Association for Therapeutic Humor, in Skokie, Ill., is among its leading advocates.
When Ms. Crane was working as a nurse in a Chicago hospital, she recalled in a recent interview, she had an 83-year-old patient named Alice.
Like many older patients, Alice never wanted to be a burden to others. Unable to walk unaided, she would lie for hours in mounting discomfort, before calling a nurse to help her to the bathroom.
One day, while she was helping Alice get to that destination, Ms. Crane started snapping her fingers. Alice picked up the beat with a rendition of ``Shuffling Off to Buffalo,'' which blossomed into a gospel medley. From that day on, these excursions changed from a painful chore to something to look forward to.
``It's small things that get these people well,'' Crane says.
She was in Cambridge, Mass., recently to address more than 600 nurses, social workers, and others at a conference on ``The Power of Laughter and Play.'' Similar gatherings this year in San Francisco and Toronto drew as many as 1,000 people.
``It's really taking off,'' says Linden Skjeie of the Institute for the Advancement of Human Behavior in Portola Valley, Calif., organizer of the events. ``To get over something defined as terminal, you have to be very creative.''
For skeptics there was ample ammunition, as the the very latest in California pop therapy chic - from visualization to hugging - was on prominent display. In case anyone missed the point, volunteers dressed as gypsies and clowns greeted participants with feathers, balloons, and admonitions to smile. ``Trying too hard can become a parody of itself,'' observed Arlan Dean, a New York City comic and conference volunteer.
Yet mixed with the silliness was genuine wisdom, as well as evidence that the medical establishment is starting to give people credit for the role they play in their own healing.
Hospitals are setting up rooms where patients can watch old Marx Brothers and Woody Allen movies and listen to Bob and Ray tapes - the way Norman Cousins, former editor of the Saturday Review, did in his much-publicized conquest of a disease generally regarded as incurable.
Even the NFL is getting involved - Nurses For Laughter, that is. The organization produces a button that reads, ``Warning: Humor May Be Hazardous to Your Illness.''
In an opening presentation, Gerald Jampolsky and Diane Cirincione, his wife, explained the principles that guide their work with, among others, individuals diagnosed as having AIDS.
``We have to go beyond body,'' said Dr. Jampolsky, a former medical doctor and reformed alcoholic, who founded the Center for Attitudinal Healing in Tiburon, Calif. ``We have to heal our hearts, heal our thoughts.''
``It's never the situation [that's to blame]. It's never the other person. It's always our thoughts and attitudes about them.''
In an interview afterwards, Ms. Cirincione said, ``People come [to their center] to find ways to be of service,'' she said. ``People get so involved in helping other people, they lose awareness of their bodies.''
``That is what the experience of true healing is about.''
A star of the conference was Peter Alsop, a guitarist-songwriter from Topanga Canyon, Calif. The lanky Mr. Alsop has the wit of the class cut-up and a gift for dispelling anger and pain.
Alsop prefers not to talk about the sources of his inspiration. ``Words like `religion' and `Jesus' are sullied,'' he explained in an interview. ``They just give people reasons not to listen to me.''
``I'd rather talk about issues. For example, hurting inside. That's the problem.''
Joel Goodman, who edits a magazine called Laughing Matters, said his interest in humor and healing began with a hospital driver named Alvin, who helped lift the Goodman family's spirits when his father was undergoing heart surgery. ``Alvin did more than the heavy-duty professionals,'' Mr. Goodman says.
So Goodman started the Humor Project, in Saratoga, N.Y., the goal of which is to set off a ``contagion of inverse paranoids'' who think ``the world is out to do them good.''
The idea is catching on, Goodman says. Humana Hospitals has enlisted his assistance, and a major medical school has approached him regarding ways to inject humor into its curriculum.
All of which has pitfalls, as Goodman acknowledges. ``Let's organize it and kill it,'' he says, describing the danger of trying to plan humor in an academic or institutional setting.
Indeed, few things kill a good belly laugh faster than a discussion of its advantageous biochemical properties. And some conference participants saw other causes for concern, such as creeping expert-itis.
Alison Crane notes that humor is, by its very nature, irreverent toward conventional authority. Himmler wanted to make jokes about the Nazi government illegal, she says. And within the status structure of the hospital, the use of humor reflects the growing confidence of nurses, who traditionally have deferred to doctors as the ultimate authorities.
Yet attendees might miss this democratizing message, she worries.
All but three of the speakers plus Norman Cousins were doctors or Ph.D.s of some kind. A number were regulars from the corporate motivational circuit with finely honed stand-up routines - people who, a generation ago, might have been playing the Borscht Belt rather than the board rooms. Even Peter Alsop says he could not get included on programs like this one until he had completed his doctorate work at Columbia.
``I have a sinking feeling people will leave here thinking, `I'm never going to be as good as these folks,''' said Crane of the quick-tongued Ph.D.s. ``Humor is not necessarily joke-telling,'' she says. ``I'm not funny at all.''