Medical clowns help patients & save lives.

Clown with young child in bed, ? hospital
Biomedical Science

Medical clowns in a U.S hospital health-care team started when a professional clown at NY’s Big Apple Circus founded Clown Care in 1986. Cl­own­ing became a well-established way of helping patients of all ages during their recov­ery. Clowning in health-care sett­ings called for a special way of inter­acting with patients due to the variety of medical and emot­ional aspects in­volved; so it required empathy for each pat­ient’s illness & psych­ol­ogical condition. Clown doctors had to be able to integrate artistic skills with their patients eg mime and magic, useful in eliciting positive emotions.

They investigated the effects of clown intervention in a large variety of clinical British settings: 

1) clown intervent­ion induced positive em­otions, enhanced patients’ well-being, red­uced psychol­ogical sym­ptoms and emotional react­iv­ity, and prompted a decrease in negative emotions eg anxiety. 

2) clown doctors were also well-perceived by relatives and healthcare staff, and their pres­en­ce ap­peared to be useful in creating a lighter atmosphere in hospital.

Dr Patch Adams with patient and wife, Ogden Medical Centre, UT

Adams is a physician, clown and activist

St Lake Tribune.

Studies demonstrated the positive effects of medical clowns on the pre-procedural emotional state prior to the medical interventions or during anaesthesia, on general well-being during hospitalisat­ion, compliance with physical exams, adherence to therapy and on treatment outcomes.

Now for some details. Israel's Dream Doctors was founded in 2002, with 100+ members who work together with medical teams in 33 Israeli me­d­ical centres. Th­ese sal­­aried medical clowns visited patients, acc­ompanying doctors on rounds, sh­ow­ing sil­liness in unhappy set­­tings. Their wacky appearance made the cl­owns the non-intimidating members of the med­ical team. Since the war last year, the clowns have often vis­it­ed comm­unities of traumatised Israeli ref­ug­ees.

Soon after Oct 2023 massacre, medical clown Perla dr­ove from Jerus­alem to Eilat where members of the destroyed kibb­utz­im near Gaza were ev­acuated. She’d been a medical clown for 15 years, work­ing in Jer­usal­em’s Shaare Zedek Hospital, accom­p­­any­ing very ill pat­­ients. De­spite the silly cos­tume and nose, her the­r­ape­u­tic cl­­owning was serious, lift­ing traumatised evacuees’ spirits.

Perla wore a bright outfit, hair flowers, striped knee socks and red nose. She was visiting a lad in Sha­are Zedek’s child­ren’s ward who had to get out of bed post-surgery, but refused. Perla whizzed around the bed, and in a rap­id-fire patter compl­ained loudly to the child about mothers, doct­ors, nurses and boys who didn't want to get up. Soon the boy was moving down the corridor in his wheel­chair, smiling.

In the intensive care ward, a 3-year-old girl was recovering from brain surgery. Perla had been told that the child needed stim­ulation before responding to the outside world. Placing her head on the bed next to the child’s face and singing a song, she tried to get the little girl to react. Throughout the morning she went back to the same child, each time eliciting a reaction. Perla Clown was bring­ing her energy.

Dressed in striped pants, col­ourful shirt, outsized floppy shoes, ridiculous hat and a red nose, Victor’s appearance was striking in the children’s wards Soroka Hospit­al Beer­sheba. He used a joking patter in various lan­guages to every­one he saw: doctors, secr­et­aries, clean­ers. A professional magic­ian, mime artist, story teller and com­edian, Vic­tor acknowledged that some of the chil­d­ren looked terrif­ied when he first entered but they were soon happily grinning. Vic­t­or also worked as a medical clown in Adi Negev, the rehabilit­at­ion village for severely disab­led children and adults. Being in ex­t­reme pain was not unusual, but since the terrorism, it had been much worse; refugee children had lost many family members.

Prof Sancho and teens at Emek Medical Centre Afula
Emek Medical Centre, Israel

A clown listened and tried to be open-minded and open-hearted, said medical clown Piccolo 42, who was also at Shaare Zedek Medical Cen­tre. His clowning wasn’t insane; the clowns were actually like an island of sanity. A patient thought that if a clown was here, life might be okay. If they let a clown into oper­ating rooms, it might be normal. The clown’s mere presence had an influence on the patients and on the staff.

Dream Doctors were all professional performers before going through the extensive training to become medical clowns. That exp­er­ience hel­ped them establish an instant rapport with patients, even in fr­ight­ening situations. One of the Dream Doctors’ projects was the Cl­­ownbulance, a specially outfitted colourful vehicle which prov­ided very sick children a chance to briefly escape their pain­ful hosp­it­al treat­ments. The child made a wish eg going to a football game, and Clownbulance made it happen.


Clown being used to treat dementia
YouTube

This was a very specific kind of training, said Dream Doctors Dir­ec­tor. In 2006, there were 25 people who earned acad­emic degrees in medical clowning from Haifa Uni. Recently a new acad­emic pr­o­gramme was launched at Assaf Harofeh Hospital, unlike in any other count­ry. And while Dream Doctors were salaried professionals, an Is­raeli NGO Medical Clown Association also took on c500 volunt­eers. After a year-long paid course, volunteers visited psych­ia­tric hospit­als, nursing homes, ref­ugee centres and hospit­als, usu­ally working in pairs. The volunt­eers dedicated themselves to uplifting people’s sp­irits in difficult situations, including supporting is­ol­ated peop­le at home.

Israel did­n’t invent the Medical Clown programme but the country became a gl­obal leader. To study the effectiveness of hosp­ital clowning, Dream Doctors estab­l­ished a scientific research fund to provide grants. So far there were 42+ medical stud­ies, 33 published in scient­ific journals. To assess fear of clowns, 1160 children in Carmel Medical Centre paediatric wards were tested. 14 children experienced fear of clowns (1.2%), mainly girls.

In normal times, Israel sent its IDF Medical Corps field hos­pitals around the world to provide medical care after earthquakes, floods and bombs. In addition to medical and rescue staff, the teams included therapeutic clowns who aided in communic­at­ion and offered trauma intervention techniques in missions to Ind­on­esia, Haiti and Jordan. Dream Doc­tors sent 20 teams in their most recent medical missions to the Ukraine, Poland and Moldova, wherever they were needed. Clowning is a universal language.

Reading Simchat Halev's history and photos is fun.

Kenneth Clark's fine tv show: Civilisation

Stourton's book was published in 2017

I knew Kenneth Clark (1903-83) from watching his Civil­is­at­ion series on tv in 1969 and from his involvement with one of my favour­ite art historians Bern­ard Beren­son. And more recently I read Kenneth Clark: Life, Art and Civil­isation by James Stourton (Collins, 2016). 

Born in 1903 into a wealthy textile-based family, Clark progressed through Winchester and Oxford Uni, helped by supportive nannies and teachers. Then he was mentored by Bern­ard Beren­son in Flor­en­ce.

Stourton’s book analysed Clark’s mixed experiences. Clark was a product of the Edward­ian wealthy classes and by 28 he’d became Keeper of Fine Art at the Ashmolean. And King George V (1910-35) per­sonally encouraged Clark to become Keeper of the King’s Pict­ur­es. His classy family back­ground and education ensured a successful career.

Stourton analysed Clark’s emotional and intellectual contra­dictions. He loved his wife Jane (d1976) who had also read history at Ox­ford; they married in 1927 and had 3 children. Jane won his praise early on for her elegance and her role as a host­ess, despite her tem­p­er and booze. Meanwhile Clark’s mistresses fared no better than the wife. Independent women rarely appeared in Civil­isation, neither as creative art­ists nor as patrons. When a woman seemed unfitting, she was des­cr­ibed as an unstable spouse of a long-suffering husband who was forced to seek sol­ace else­where. Clark’s tv present­at­ion of women as objects of desire or insp­ir­ation was close to how his own women were portrayed.

The Civ­ilisation programme had focused largely on Europe, but Clark saw 2 big problems: 1]he loathed the megalomania of Vers­ail­les and wanted to exclude it from Civilisation and 2]the series avoid­ed Spain because it was still ruled by Franco. I Helen have another problem - why did BBC make a series that excluded the cul­tures of the Far East, In­dia, Africa and Central-South America? His omis­s­ions were not because of other cultures’ inferiority, but because of his ignorance. Yet de­spite the concentration on Europe, Clark’s tastes since child­hood had been far from Euro­cen­tric.

Clark became Director of the National Gal­lery in 1938. He had the National Gallery’s masterpieces evacuated to the Welsh mines; and he rein­vented the remaining gal­lery as a cultural centre in wartime Lon­don, including concerts and temporary exhibitions. And great acq­uisitions of art by Bosch, Rubens, Rembrandt, Hogarth and Ingres were protected. Yet the staff were almost ent­irely against him, which led to his re­signation as soon as the war ended.

Clark defined civilised values as moral virtues, using the Enlight­enment’s rationality and the Victorians’ human­itarianism as great examples. But con­trary evidence from his own life suggested that civilisation may have been imp­lic­ated in acquisitive vice.

Clark was laughed at for his uber-priv­il­eged background but he had a great range of expertise. Unlike other authors, Clark’s books were very readable documents, the most famous: Leon­ardo da Vinci 1939, Piero della Francesca 1951, The Nude 1956 and Feminine Beauty 1980. [Clark’s art hero John Ruskin also wrote very readably]. Many people did think Clark was arrogant and snobbish. Blushing at his own inher­it­ed privileges, Clark saw himself as a toff who’d been pro­moted to the status of a sage. So he did the right thing - he sec­retly depos­it­ed funds in the bank acc­ounts of artists who needed subsid­­ies.

In 1954 Clark accepted the chairmanship of the Independent Television Authority and, to the dismay of the BBC, defended the crud­ity of the new commercial channel. But Clark was a nat­ural on screen and he’d already made dozens of programmes for ITV.

Pazzi Chapel in one of the cloisters

in the complex of the Cathedra of Santa Croce, Florence

Expressing Renaissance values-peace, harmony, order, noble striving

Clark presented his history at a time when TV still had interest in educating and exciting millions. So TV history did not need to be uber-scholarly, but it had to express Clark’s love for the arts in clear English. He was Chancellor of the University of York from 1967-78. 

He was 66 when he made Civilisation. I don’t remember my opinion of Clark way back in Feb 1969, but in the first ep­is­ode he must have looked posh and con­fident. Although some were critical, the programme succeeded; Clark’s tv programme earned him a life peerage in 1969.

1968-9 was an awful time in human history, and Clark was afraid that western civilis­ation might vanish. His programme appeared while Czech­oslovakia was invaded, Vietnam’s wars intensified, civil unrest in Paris was chaotic and Martin Lut­her King was murdered. Sadly for Kenneth, his tough right-wing son Alan Clark became a Thatcher minister in 1983, the year Kenneth died.

Civilisation by Kenneth Clark

published in 1970

Clark studied da Vinci’s works in Royal Collection Windsor Castle,

and then Christ Mocked, by Hieronymus Bosch

The National Gallery

Despite criticisms, he was one of the most influent­ial figure in C20th British art. In 2014 The Tate organised "Ken­neth Clark: Looking for Civilisation", an exhibition that examined his role as a pat­ron, collector, art historian, public servant and popular broadcaster.

Read Michael Prodger, "In Defence of Civilisation", in History Today, 2014. Richard Nilsen, A Civilised TV series, 2014. And The Ideal Museum: Art Historian Kenneth Clark on the Formation of Western Institutions, in 1954 in ARTnews.

King James VI ridding Scotland of witches.

The evidence. 

A witch kissed the arse of the Devil

Witch-hunting plagued Europe, as soon as the idea that witches worshipped the devil took hold. Read an excellent book, Scottish Witches and Witch-Hunters by Julian Goodare ed, 2013. In Scotland, this was common by the late 1500s. Locals talked about Satan’s ability to raise storms, kill livestock and spread deadly illness. Satan tried to undermine human society from within and was recruiting se­cret agents i.e witches to do his bidding. So Satan’s agents had to be eradicated, for the sake of the kingdom.

Scotland was not alone in falling victim to witchcraft panics; Bur­g­undy, Italy, Switzerland, Germany and Scandinavia all endured out­breaks of witch panic. Burning witches alive was common in Ger­many and other parts of Europe in the late C16th and the early C17th. Note in Scotland the convicted were usually strangled first.

After the Reformation split Europe into Protestant and Catholic in the C16th, both sides worried about witches. But during this period of religious reform, Protestant rulers were most com­m­itted. Witch-hunting was virtually an ext­ension of the Protestant Reformat­ion as parish ministers and government authorities sought to create a “godly state” in which everyone worshipped correctly; sin was wiped out; and disorder prevented.

Scot­land’s witch hunts were frequent. From 1590, intense pan­ics erupted in Scotland: 1590-91, 1597, 1628-1631, 1649-1650 and 1661-62. As a result, c2,500 accused witches out of a popul­at­ion of a million people were executed, mostly wom­en - 5 times the average European execution rate!

Scottish Parliament criminalised witchcraft in 1563, just be­f­ore King James VI's birth. Nearly 30 years passed before the first major witchcraft panic arose in 1590, when King James and his Danish Queen were personally targeted by wit­ches. These enemies conjured dangerous storms to try to kill the royals during their North Sea voyages.

One of the first accused in this panic was Geillis Dun­can, from Tranent in East Lothian. In the late 1590 her employer accused her and tortured her into a confession in which she named several acc­om­plices. Duncan later retracted her confession, but by then the panic was well under way.

So Scotland’s widespread panics over witches was largely determined by the role of King James VI. He sanctioned witch trials after an alarming confession in 1591 from an accused witch, Agnes Sampson, revealing that 200 wit­ch­es heard the devil preach to them, to plot the king’s ruination. 

  

Torture of the women identified as witches. 
Supervised by King James VI of Scotland

The trial, at Berwick

Capital punishment, by fire

Image credits: History of Scotland

Many witches were put to death. During the North Berwick trials (1590) alone, 100+ people were implicated. The Scottish king pers­onally supervised the torture of witches, whenever he could. 

Six years later another panic broke out. Again witches were reported to be conspiring against King James personally. A woman named Margaret Aitken, Great Witch of Balwearie, claimed a special power to detect other witches, many of whom were put to death on her word alone. This panic halted abruptly when Aitken was exposed as a fraud. This incident embarrassed witch-hunters great­ly, so partly to justify the recent trials, King James published his intellectual treatise, Daemonologie in 1597.

Daemonol­ogie explained how Satan operated in the world. He was the leader of fallen angels who became demons. These dem­ons made pacts with people and granted them powers to work harmful magic. Thus witchcraft was a secret conspiracy between humans and demons, and against this conspir­acy, true Christians’ only hope was to appeal to God.

Consider the wit­ches in Shakespeare’s tragedy Macbeth. First performed in 1606, the play was a compliment to the newly crowned King James I and his book Daemonol­ogie.

After the death of Queen Elizabeth I in 1603, King James VI inher­ited her throne and moved south to London as King James I of Eng­land. There was a new religious opponent: militant Catholics. Cath­olic conspiracies threatened his claim on the English throne, in much the same way the North Berwick witches had threatened him in Scotland. After the Gunpowder Plot of 1605, Guy Fawkes’ plan to blow up Parliament and kill the king, James turned away from hunt­ing witches in favour of rooting out Catholic conspiracies. 

Even though King James’s attentions shifted, witch­craft fear had already permeated Scottish society, and witch-hunting took place in areas near the centres of state power eg Fife and Lothian. And fear of the devil was at its peak when the state was determined to enforce religious uniformity. 

King James' book Daemonologie, in 1597

Most practical measures to weed out witches were taken by the local leaders of Scottish society, the lairds/local aristocrats and min­is­ters. They formed kirk sessions/parish committees to super­vise the people and to bring them to godliness. Kirk sessions were not criminal courts, but they could arrest and interrogate suspects and pass cases on to the secular authorities. Especially extra­marital sex cases!

The main type of an accused witch was an elderly, crabby female – a woman who irritated her neigh­bours. But once the in­it­ial suspect was tortured to name accomplices, they too could be accused of hav­ing made a pact with the devil. Remember that 85% of the convict­ed witches were wom­en.

Sleep deprivation was the most common method of torture. After 3 days without sleep, the suspect would lose the ability to resist the questioners, and would also start to hallucinate, giving very strange con­fessions. These were not sober accounts of real activ­ities; they were fantasies from terrified women, desperately trying to satisfy their interrogators.

In the late C17th religious pluralism became more acceptable. New scientific ideas undermined the dogmatic certainty about witch­craft. Courts refused to accept confessions that might have been extorted by torture. Witch-hunting became less vital to the state, and there were no more national panics after 1662.

In the small fishing town of Pittenweem in 1704, an event illust­rated what happened when the locals feared witches, but the author­it­ies would no longer ex­ecute them. Four of the women confessed to witch­craft, then retracted their con­fessions. The central auth­or­it­ies in Edinburgh forbade a trial, and the suspects had to be rel­eased. For all the horror of mob justice, the Pittenweem case was among Scotland’s last witch panics.

In 1736, Britain's Parl­iament repealed the old (1563) witchcraft stat­ute. Since then small monuments have been erected in Scotland to witch panic victims, 400 years ago.

The Armenian Genocide: 1915–16

The Kingdom of Armenia adopted Christianity as its national religion in the C4th, loyal to the Armenian Apostolic Church. Armenian Christ­ians were just one of many ethnic groups in the Ottoman Empire. But in the late 1880s, some polit­ical organisations seeking greater autonomy for Armenians, reinforcing Ot­to­man doubts about the loyalty of the wider Armenian comm­unity inside its borders. By 1914, c2 mill Armenians lived in Anatolia, in a total population of 16 mill.

armenie-historique

 
The Armenian minority in Ottoman Turkey had been subject to episodic torment over the centuries. In 1894-96, these were stepped up with more violent pers­ecutions. The massacres began in the SE and E pro­v­inces of Anatolia and the Caucasus as early as Aug 1914, several months before the Otto­mans entered WW1, on the side of the Central Powers. But the worst of the Armen­ian cat­astrophe in the Ottoman Empire started in early 1915 when Otto­man authorities, sup­ported by aux­il­iary troops and some civ­ilians, per­pet­rated mass killing. The Otto­man govern­ment, cont­rolled by the Committee of Union and Progress-CUP/aka Young Tur­ks, aimed to solid­ify Muslim Turk­ish dom­in­ance in the cent­ral and eastern regions of Anatolia, by elim­in­ating the sizeable Armenian presence.

From 1915, inspired by rabid nationalism, secret gov­ernment ord­ers and WW1 fever, the Young Turk government drove Armenians from their hom­es and massac­red them in greater num­bers. The Young Turk Regime rounded up thousands of Armen­ians and hanged many in the streets of Is­tanbul. Then they began a genocidal deportat­ion of most of the Ar­menian population to the southern desert. This meant they were murd­ered en route to the desert or died when they reached there. Alth­ough fig­ur­e­s on the death toll were uncertain, hist­or­ians believed 800,000-1 mil­lion people were killed, often in unsp­eakably cruel ways. Unknown num­bers of others survived by converting to Islam, lost to Armenian cult­ure.

Called the First C20th Genocide, the Armen­ian genocide referred to the annihilation of Armenian Christian people living in the Ottoman Empire from 1915-16. There were c1.5 million Armenians living in the multi-ethnic Ottoman Empire in 1915. c1 million died in the gen­ocide, either in mass­ac­res, from ill treatment, exposure or starvation.

Mass atrocities were often perpetrated within the con­text of war, so the timing of the Armenians genocide was inevitably linked to WW1. Fear­ing that invading enemy troops would induce Armen­ians to join them, the Ottoman government began the deport­at­ion of the Armenian population from its N.E border regions in 1915. In the following months, the Otto­mans expanded deport­ations from almost all pro­v­inces, regardless of distance from combat zones.

Victims of the Armenian genocide included people killed in local mass­acres that began in 1915; others who died in deportations, from starvation, dehydration, exposure and disease; and Ar­m­enians who died in the desert regions of the southern Empire [today: Nth and E Syria, Nth Saudi Arabia and Iraq]. Plus tens of thousands of Armenian children were forcibly removed from their families and conv­ert­ed to Islam.

Were there any locally written reports and photos? In 1917 John Elder, a divinity student from Pennsylvania, joined the American Committee for Armenian and Syrian Relief Team that was aid­ing refugees. For 2 years, Elder did volunteer work with Armenian orphans when he photog­raphed re­fugees and conditions at camps. Arm­in Wegner ser­ved as a nurse with the German Sanitary Corps. In 1915 and 1916, Weg­ner travelled throughout the Ottoman Emp­ire and documented at­rocit­ies carried out against the Armenians, including children lying dead in the street.

And some influential foreigners spoke out against these atrocit­ies eg British Prof of International History Arnold Toynbee. But how is it that other Christian countries didn’t intervene? Or at least take those Armenians who survived as refugees? US Ambassador to Cons­tantinople Henry Morgen­thau Sr (1856-1946) was deeply tr­oubled by the atrocities com­mitted against the Armenians and was one who sought to stir the U.S’s conscience in resp­on­se. The plight of the Armenians triggered a gen­er­ous public re­s­ponse, involving President Woodrow Wilson and thousands of or­d­inary Am­erican citizens who volunteered both at home and abroad, and raised $110+ million to assist Armenian orphans.

This genocide almost ended 2,000+ years of Armenian civilis­ation in east­ern Anatolia. The First Republic of Armenia (1918–20) was the first modern establishment of an Armenian nation. And it enabled an eth­no­-nationalist Turkish state, Republic of Turkey in 1923, as the successor state of the Ottoman Empire. Note that the Turkish gov­ernment always maintained that the deportation of Armenians was a legitimate action, and therefore was never genocide.

The word genocide wasn’t formally coined until 1944, although the or­igin of the term and its codification in intern­at­ional law had their roots in the 1915–16 Armenian massacre. Lawyer Raph­ael Lemkin, himself a Polish Jewish refugee, was the man behind the first UN human rights treaty, the Convention on the Prevention and Punishment of the Crime of Genocide. He repeat­edly stated that early exposure to the Otto­man Armen­ian genocide in newspaper was key to the need for legal protec­t­ion of groups, the core element in the 1948 UN Genocide Convention. In any case, it has only been since the 1970s that scholars have offered close at­t­­ention to this human catastrophe.

 

Refugee camp

Bodies in a field, a common in Armenian provinces in 1915 .

Britannica

Ottoman military forces march Armenians to an execution site

Holocaust Encyclopaedia

Armenian-Syrian refugees Red Cross camp, 

Jerusalem, 1917-19

Wall St Journal

The modern Republic of Armenia became independent in 1991 with the dis­s­olution of the Soviet Union. Most Armenians today are Christians (97%) and are members of the Armenian Apostolic Church.