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| I’m with the Clowns |
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| By Jessica Wright | ||
| March 2010 | ||
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“I’m with the clowns,” I answer, as a doctor asks me why I’m standing hesitantly, and hopefully unobtrusively, in the back of a room in a pediatric intensive care unit (PICU). The statement has the same effect as the clowns themselves: he relaxes; he smiles. I am left to observe. I am standing next to a very small child, less than six months old, lying by himself in a crib. Propped up next to him is a portable DVD player. Between quiet cries, he claps his hands to a baby video. Watching him entertain himself is heartbreaking, but, on the other side of the room, a boy is enjoying the human interaction of a pair of visiting clowns. “Do you want to leave?” asks “Dr.” Doodle Doo, wearing a Doctor’s coat, a bright red nose, and a painted buck tooth on his chin, “say the word, we’ll bring a boat alongside, lower you with bed sheets,”—the hospital room overlooks the East River. The boy is extremely pale, clearly weak, but he is smiling and laughing. The family members with him are grinning. “Dr.” Wedgie, a perky clown in a red polka dot dress with two pig-tails sticking out of her red bowler hat, tugs on her hair. The boy stirs for the first time, gently stroking his own head. His mother’s smile deepens. Later, when I talk with the clowns, they will each have stories of parents saying, “I haven’t seen my son smile for weeks,” and even, since families travel to this hospital from all over the country, “I haven’t seen my child smile since Minnesota.”  Dr. Wedgie, Dr. Doodle Doo, Dr. E.B.D.B.D., and Dr. Ukulele Lady pose outside the RU cafeteria. Photograph provided by the author At the Rockefeller University (RU) cafeteria I had often asked myself why there were clowns, in full costume, lunching amongst the scientists. Answering this question has led me here, to Weill Cornell University Hospital, and Clown Rounds run by the Big Apple Circus Clown Care Unit (CCU). Clown Care is a charity arm of the not for profit Big Apple Circus. Founded in 1986 by Michael Christensen, the goal was to bring the healing power of laughter to children in pediatric facilities. It now employs 80 clowns who conduct visits in seventeen hospitals around the country, including six in New York City. I will meet four Big Apple Circus clowns this day: “Dr.” Doodle Doo and “Dr.” Wedgie, who I shadow during their morning rounds, and “Dr.” E.B.D.B.D. and “Dr.” Ukulele Lady, who will join us for lunch. Doodle Doo has been with Clown Care for eleven years, Wedgie for only three, while both E.B.D.B.D. and Ukulele Lady have been working in hospitals for over twenty years. The clowns involved in the program come from various backgrounds, but all have a true commitment to clowning as a profession: these are not just volunteers donning funny costumes. Doodle Doo, for example, attended clown college and traveled for several years with the Ringling Brothers Circus, before joining the program. There are auditions for Clown Care and even university degrees dedicated to hospital clowning: clowning in hospitals requires training in hygiene and the psychology of what is called therapeutic clowning—in addition to the standard juggling and magic skills. As we enter the ICU we wash our hands at a nurse’s station, a ritual that will be repeated several times that day. Doodle Doo then consults with a nurse, who tells him which patients he is cleared to visit. In the first room on the list, a toddler is entertaining himself on the floor. His brother lies asleep on a cot, while his father stares unmoving out the window. Across the room a mother lies across two chairs turned into a makeshift bed. Her son, bandaged and propped up on his bed, plays a video game. Soon the younger boy is popping bubbles blown by Wedgie. The clowns join him in his efforts, but fail comically. The clowns end the brief visit with a magic trick. The older boy puts down his Wii and leans forward; he watches along with the parents, who seem alert for the first time. It is a happier place. We move on to the next room on the list. “Leaving is sometimes the hardest part,” Doodle Doo tells me. I watch as the clowns I’m shadowing enter the pediatric oncology waiting room and go up to a chalk board: “Dr. Wedgie was here” writes Wedgie. “You mean Dr. Wedgie has bad hair?” asks Doodle Doo. They squabble and clown; they are funny. People look up from their magazines and laugh. Laughter in a pediatric oncology room, I would guess, is rare. There is a visible change in the energy of every room the clowns enter: nurses smile; a man delivering packages hands one jokingly to Doodle Doo; a woman with a cleaning cart laughs and Wedgie engages her: “Do you have a present for me?” The lady looks puzzled, then her face lights up with an idea. I expect her to produce some toilet paper, maybe some soap—she pulls out a chocolate bar from her lunch bag and hands it over with a big smile. Wedgie, of course, does not accept it, but the gesture is touching. Ukulele Lady uses music in her clowning. When asked about her most rewarding experience, she tells me of a time she played her ukulele in a ward. A mother began to dance; others joined in; people appeared in doorways to watch. A father of a patient told her afterwards “This place was so sad. But for a moment, just now, it was beautiful.” We meet one adult who has a fear of clowns. She chats with Wedgie briefly, by the end she is making eye contact and smiling. Many find the canonical image of a clown to be frightening, and there is concern that clowns in hospitals could be disturbing to some children. Much has been made of a British study that showed images of circus clowns to patients and concluded that children find clowns more frightening than the hospital setting itself1. The Big Apple Circus clowns, however, are cute and approachable. Their minimal make-up and colorful costumes are a license for humor and silliness in the face of authority, not the macabre mask of a scary clown. Most importantly, they are not still images, but laughing, smiling human beings who are perceptive to the individual needs of each patient and each situation. For a child undergoing chemotherapy, who is feeling unwell, they play a lullaby; for a toddler in the burn unit clinging to his father’s legs and staring in fascination, they juggle; for an older boy reading a child’s magazine in the day surgery recovery room, they tell jokes: “What’s a deer with no eyes? You don’t know? Neither do I. No I-deer.” During my morning with them, no child shows fear or anxiety. If they had, I have no doubt the clowns would have simply left the room. Doodle Doo once encountered a parent with a deep fear of clowns. Despite this, she didn’t want him to leave: the mother hid behind the bed-curtains, while the clown made her child laugh. In opposition to the British survey, there are many controlled studies demonstrating the value of hospital clowning2. Therapeutic clowning has been shown to decrease children’s anxiety before and during procedures, and there is the tacit hope that laughter may truly be healing. The clowns are well aware that there is nothing they can do to make the children well, something that they clearly struggle with, but they do what they can to make a difficult situation just a little bit easier. Doodle Doo explains to me how he works to empower the patients, serving as an antidote to the strict and regulated hospital environment. Not only are the children in charge of each interaction, but often it is Doodle Doo himself, despite wearing a doctor’s gown and badge, that needs help. He approaches several children by asking them, “Do you have any questions?” I watch as each child says “no,” clearly tired of this query they’ve heard so many times before, and then laugh along with them when he replies, “What about answers? Do you have any answers for me? I really need answers!!!” The clowns may not have the answers, but what they do have is their humor, their playfulness, and with that, a sense of normalcy. When the founder of the program first entered hospital wards in costume, he was told by an older doctor that “Clowns do not belong in hospitals.” His response was “Neither do children.” A few days later I will attend the Big Apple Circus show in the big top behind Lincoln Center. I will watch as hundreds of children are entertained by clowns and see, on their smiling faces, the same expressions as on these children, watching from their hospital beds. Maybe, if only for a brief moment, the clowns have transported them outside of the hospital and into the happy world of a Circus big top—where they belong. That, at least, is what I hope. Which is why the next time I get my meatloaf next to a clown, I will still be laughing, but I will also take them seriously. You can learn more about the Big Apple Circus and the Clown Care program here. References: |
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