‘Even if the patient is about to die, You mustn’t fret and you mustn’t cry … Spread a little happiness as you go by.’
So we used to sing in our medical school revue a quarter of a century ago. Back then, it was recognised that doctors needed to have some knowledge and a reasonably steady hand, but our vital role was as morale-boosters, to raise the spirits among the ranks of the nearly dead and hopefully recovering. It was also recognised that mood could spread like a disease. A wise psychiatrist once told me that depression was contagious. If you surround yourself with negative emotions and self pity, it tends to rub off on you, which is perhaps why so many psychiatrists get the blues.
But is the opposite also true? If you surround yourself with happy people, does it make you happy too? Using the data set from the Framingham Heart Study cohort, which has studied nearly 5000 people over 20 years, researchers have discovered that social networks contain a non-random clustering of happy and unhappy people.1
Cause and effect is as tough as ever to prove here. Do happy people have happy friends because they catch the happy bug? Or do happy people stick together by ditching anyone vaguely melancholic?
The Framingham research appears to suggest that happiness clusters aren’t just about selfish, shiny, happy people sticking together or miserablists having a big whinge, but can actually cause happiness to spread to others. Happiness apparently extends up to three degrees of separation (i.e. if you’re happy, not only your friends, but the friends’ friends’ friends will also benefit).1 And the geographically closer your happy friend is, the better. A chuckling chum within a mile increases the likelihood that you’re happy by 25%. And you can even analyse your happiness network to predict how happy you’ll be years into the future.2 No man is an island and ‘emotional contagions’, appear to be unavoidable.
As a locum, I work in lots of different practices and you quickly spot whether you want to come back again. Some radiate positive energy, optimism, and cheerfulness; others are as dysfunctional as the Middle East. All teams need to be inspired, and as a rule, happy practices have happy leaders.
But what makes us happy? The Framingham research doesn’t delve into this but an excellent book by the economist Richard Layard (Happiness: Lessons from a new science) provides some clues.2 Humans are social animals and are most content in communities where people unite around, and conform to, a shared ideal. We like to trust each other, we don’t like change—particularly if it’s constant and we don’t understand it—but we’re very resilient and adaptable if needs be. We’re happier being involved and figuring out what to do ourselves rather than being dumped on from on high. Excess money, above a comfortable level, doesn’t make us happier and neither does the aggressive, competitive attitude needed to earn it. Compassionate, positive people tend to be happiest of all, and also the healthiest.
By these measures, the NHS should be the happiest place in the world to work in. It’s easy to unite around caring for everyone according to need, and not ability to pay. The NHS should foster compassion among the staff (they don’t do it for the money), and those who use it should help and support each other. So why do we get so bogged down in cynicism and negativity? All we need is a few ridiculously happy people to lead us out of the mire. Let me know when you find one.
- Fowler J, Christakis N. Dynamic spread of happiness in a large social network: longitudinal analysis over 20 years in the Framingham Heart Study. BMJ 2008; 337: 2338.
- Layard R. Happiness: Lessons from a new science. London: Penguin, 2006. G