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December 2002

Clown Doctors!

By Dr Peter Spitzer (aka Dr Fruit-Loop),
The Humour Foundation,
Churchill Fellow 2002.

"A hundred years from now it will not matter what my bank account was, the sort of house I lived in, or the kind of car I drove ... but the world may be different because I was important in the life of a child"

A corridor sign in the Boston Children's Hospital, USA.

A still moment - clown doctors visiting Transplant Unit in Paris.

I have recently returned from a three month laughter-filled, thought provoking, inspirational, stimulating and insightful odyssey, made possible with financial assistance given by the Churchill Trust. The wisdom of their Fellowship touches the Australian and international community. In this regard, the Fellowship is a wonderful door opener for learning and exchange.

The purpose of my fellowship was to study overseas-based clown doctor programs and their impact on the health care system. I also wanted to examine the use of humour in the critical and palliative care setting and to investigate the possibility of links between international Clown Doctor programs.

This took me to Clown Doctor Programs operating in hospitals in the USA, UK and Europe. As well I had the privilege of a telephone interview with Dr Patch Adams and attended the 17th Annual International Conference on The Positive Power of Humor, Hope and Healing, at which I presented a paper on Australian Clown Doctors.

"Ministering to sick children goes beyond medication and technology. When a sick child begins to laugh it means he's probably beginning to feel better. I see the clowns as healers"

Big Apple Circus Clown Care Unit (CCU) New York City, NY.

Clown doctors - clowing around in Germany.

Laughter is the best medicine!

Clowns have worked in hospitals since the time of Hippocrates. The entire front page of Le Petit Journal of 13 Sept 1908 is given to a drawing of clowns working in a hospital. Dr Patch Adams put on a red clown nose as he worked in hospital 32 years ago.

Professional clown doctors began working in hospitals in 1986 under a program called the Big Apple Circus Clown Care Unit, which was started by Michael Christensen in New York City. Clown Doctor programs now operate in Australia, USA, UK, Canada, Brazil, Argentina, South Africa, Israel, France, Germany, Italy, Austria, Switzerland, Holland, Finland, Hong Kong, Spain, Czech Republic, Turkey and Belarus (NB this list may well be incomplete).

The Clown Doctors use their skills such as magic, balloon sculpting, storytelling and other clowning skills to treat children with doses of fun to help them deal with the range of emotions they may experience while in hospital fear, anxiety, loneliness, boredom.

The emphasis is on interaction with the patients and their families, rather than entertainment. 'Clown rounds' benefit the whole hospital community.

Laughter is a 'wonder drug' that:

Clowing around in the surgery.

Australia's Humour Foundation clown doctor programs

The Humour Foundation was founded in 1997 by the author, a medical practitioner, and Jean-Paul Bell, a professional performer. It is a registered charity and is supported by the community.

The Humour Foundation provides ongoing training and skill development workshops for their hospital clowns. Clown rounds take place usually 2-4 days a week throughout the year, although this depends on funding. An annual, national conference for all the 32 Clown Doctors is held in Sydney.

Australian host hospitals include the major paediatric hospitals in each capital city and two palliative care hospitals, one for children.

Special Projects include outreach tours to metropolitan and regional, public and private hospitals, that included all paediatric and adult wards during 2000 and 2001. Visits to hospitals, orphanages and villages in East Timor (2000) were arranged as well as a visit to hospitals and schools in Afghanistan (2002).

During my trip, Clown Doctors around the world welcomed me into their day and were very interested to learn more about Australia and the Australian Clown Doctors. The doctors, nurses and allied health staff gave me their valuable insights as well as their time. Children in hospital invited me to be with them, and taught me so much - their inspiration knows no border.

End of another shift - clown doctors leaving the hospital with a cot tied to the coat, in Gernamny.

Interview with Dr Patch Adams

Patch is considered to be the father of clown doctors. Thirty-two years ago he put on a clown nose as he worked in hospitals.

Dr Patch Adams is now a very sought after teacher and presenter all over the world. He regularly visits Russian orphanages and hospitals as well as trouble spots in Europe, South America and other countries. He recently visited Afghanistan together with clown doctors from most continents (including Australia). He has organised 2 planes to bring in 60,000 pounds of food and medical supplies for a paediatric hospital in Kabul.

He is incredibly focussed, energised and driven to establish America's first free hospital in West Virginia. He has a list of thousands of doctors, eager to work at this facility, 60 hours a week for US$3,000 a year. He wants all the staff to experience happiness and smiles. Patients will be actively participating in their healing journey. The full spectrum of the arts will be available alongside the sciences. Building has commenced.

Philosophically he sees that corporate medicine has killed the spirit of compassion. Further, he sees that humour and laughter is one of the ways of bringing compassion back into medicine.

The 'old' model of medicine incorporated the arts and this is what he perceives as missing in the scientific model of medicine. Professional distance or scientific detachment is a tool used so as not to get too close to one's vulnerable parts. Associated with this is corporate and money-driven technology and he makes the comparison between a 'greed' model verses a compassionate model in the provision of health care. Dr Adams sees clowns in hospitals as a way of getting a toehold to bring love back into the health care system and to bring joy into the health setting. No single clown doctor organisation has exclusive mandate to carry out this activity in hospitals.

Fellowship highlights

Clown doctors in pre-op Boston Children's Hospital.

Findings

15 years ago there was no hospital Clown Doctor programs available. Programs are now available on every continent. The rate of introduction and integration of Clown Doctor programs into the health care setting is considered to be a new phenomenon.

Clown Doctors are professional performers (not medical doctors) who have additional training to work with sick children in hospital.

Programs are well integrated into and accepted by the host hospitals, which report high level of professionalism and trust. The hypothetical question of cessation of Clown Doctor programs was universally met with shock and disbelief.

Clown Doctors of the Australian Humour Foundation, are the only ones in the world regularly visiting both adult and child palliative care facilities.

Programs worldwide are run as charities, most have no government funding. Some hospitals partly fund the programs. Since Sept 11, 2001, all have experienced a reduction in funding.

Some Clown Care programs have 'grown up' from an artistic base and some from a business base. Tension exists between these programs and this is hampering closer international ties.

Some research into the Clown Doctor programs has taken place while some is in planning. Research into this area is somewhat difficult and doesn't have funding priority. The basic underlying response of children, parents and staff to Clown Doctors is universal. ie; one of smiles, laughter and elevation of mood.

Dr Fruit-Loop playing a mini violin, with I Love You badge and clown face.

Australia's conclusion

The Humour Foundation's Clown Doctor program is operating at world-class standards and is well integrated into the health care system nationally. On-going training is essential. Establishment of an Annual International Clown Doctor Scholarship would allow cross-cultural and artistic performance exchange. This is planned but cannot proceed due to a lack of funding. Development of further research is envisaged and the continuation of lectures and workshops to the health industry and corporate sector is appropriate.

For more information contact

Dr Peter Spitzer
Chairman/Medical Director
The Humour Foundation

Postal Address: PO Box 1893, Bowral NSW 2576
Phone: +61 2 4861 3148
Email: spitzer@acenet.com.au

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