Patty Wooten presents ... 
Clowning Around
From Journal of Nursing Jocularity, Spring 1997, 7(1), pp 46-47.I got to go to the circus, the Big Apple Circus, in New York City! And believe me, that city can be a circus. I spent a whole day with the Clown Care Unit at Babies' Hospital, part of the Columbia-Presbyterian Medical Center. It was a dream come true for me. Ever since I'd learned of the hospital clown (caring clown) program that began about ten years ago, I've wanted to see these clowns in action, up close and personal. Finally. I got my wish.
The NBC show Real Life invited me to comment on the therapeutic benefits of the clowns' communication with the hospitalized children. I tagged along with the film crew as they captured the clowns in action. While two of the clowns performed at the bedside, I interviewed the other two in the hall. They spoke of their assessment process to determine each child's special needs. They discussed how they chose specific comedy techniques or routines based on the child's age, disability and enthusiasm that particular day. The clowns emphasized the importance of continued training and development of their performance skills to maintain the quality of their work. As I walked the halls of Babies' Hospital with the clowns, I was reminded of how nurses mentor new grads: first, by clarifying their observations, then explaining the rationale for their clinical decisions.
My clown mentors for that day were Dr. Trikki (Richard Ellis), Dr. Comfort (Deborah Kaufmann), Dr. T.L. (Todd Robbins), and Dr. Full-of-Beans (Suzanne Haring). Most of these clowns have been with the Big Apple Circus Clown Care Unit since its inception almost ten years ago.
Dr. Trikki pushes a golf cart stuffed with props, magic tricks, juggling rings, and much, much more. He also plays songs on a tiny harmonica that he holds in his lips (Look, Mom -- no hands). "I like to empower the kids, so I let them choose what they'd like to see from my cart and I use that prop as a starting point for my routines. Since we are constantly lampooning the physicians, the golf cart works great for me. I tell the kids that I just got in from the links."
Dr. T.L. is a tall clown who appears even larger with his black top hat. I was amazed at how very few props he used. Instead, he worked with quick verbal repartee and interactions with another clown. "What I find continually amazing, is how a room is transformed by our visit. We walk into a room and the sadness and gloom is almost palpable. After we've fooled around and helped everyone to laugh, the room is considerably lighter and brighter."
Dr. Comfort is a short, curly-haired clown in a polka dot dress. She will approach a child or parent announcing, "I know what you need. You don't have a single dot." She then removes one of her dots (a paper circle applied over a polka dot on her dress) and places that on the child's gown. She then proclaims, "Dots just what you needed." And another clown will reply, "Dot will make him feel much better," "Dot certainly will." Dr. Comfort had just returned from Improvisation Camp and explained how essential that skill is for a caring clown. "When we walk into a room, we never really know what we'll encounter, we work with the child and his environment just as they are. We can't work from a prepared routine, although we have many polished routines from which to choose. Instead we take our cues from the child or sometimes the parent, and then adapt our routines and interaction to blend with what that child needs in that moment."
Dr. Full-of-Beans is a tall, thin clown with long braids. Her baseball cap, worn slightly askew, and her high top tennis shoes, give her the appearance of a playful little girl. She has a toy slide trombone with a kazoo built inside. As she enters the room, or when another clown is juggling or doing magic, she plays music. She explained why the clowns use a very small amount of makeup and wear comical hats atop their natural hair rather than a wearing the wig and full face makeup of traditional American clowns. "We want the kids to see our human nature and we rely on our routines and interactive skills to carry the comical impact. We work in pairs when we visit the children, one male and one female clown, because some kids are more comfortable with men and some with women. As a team, we can play our comedy off each other and allow the child to simply observe or to join in the frivolity if they wish."
Dr. Driscoll MD, (a real physician) former chief of pediatrics at Babies' Hospital and a strong supporter of the Clown Care Unit, shared his views on the service the clowns provide. "Children are, by nature, very resilient and hopeful. The clowns support that hopefulness by maintaining an atmosphere of playfulness that is essential for a child. I believe that any pediatric hospital that does not provide clowns is not providing comprehensive care. These clowns are as important to the child's recovery as the highly technical medical therapies we offer."
Last year, the Hinda and Richard Rosenthal Center for Alternative Medicine at Columbia University in New York City provided a $150,000 grant to study the impact the clown visits have on the children's well being. Dr. Driscoll declined to give details of exactly what the study would measure because public awareness, at this point in the study, could contaminate the research by influencing how the staff recorded their observations. He indicated that the research would be completed by summer of 1997 and a full report would be published.
Because of the growing interest in the therapeutic benefits of caring clowns, the Big Apple Circus Clown Care Unit is considering the feasibility of a training program for other clowns who wish to bring this service to their hometown hospitals. At this time, there are no firm plans for such a program, but it would probably be a residential program in New York City. To find out more information about this or about the clown program in general, contact Amy Fleisher, public relations representative for the Clown Care Unit. (Amy Fleisher, Public Relations, Big Apple Circus, Clown Care Unit, 35 West 35th St., 9th floor, New York, NY 10001, )
These clowns bring healing energy to the bodies, minds and spirits of sick children and their worried parents. They offer a complementary therapy to traditional medical treatments. Perhaps the research project will prove what Groucho Marx said years ago: "Clowns are like aspirin, only they work twice as fast."
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This article was originally published in "Jest for the Health of It", a regular feature in the Journal of Nursing Jocularity.
Feature columnist Patty Wooten, BSN, is also a past President of the American Association for Therapeutic Humor, author of two books related to humor, and a national speaker presenting on the benefits of humor.
