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:
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.
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.
Reading Simchat Halev's history and photos is fun.
I am not sure how I feel about clowns but I do think having them visit or treating sick children can be a dam n good thing, as long as the child doesn't get scared and freaky out as do when seeing a clown.
ReplyDeleteJo-Anne
DeleteThe clowns have long and careful training. If a child really is freaked out, the clown won't pursue a connection that isn't going to be therapeutic.
Clowns is another way for human interaction and engagement.
ReplyDeleteroentare
Deleteonce I read all the journal and newspaper articles, I agreed with you totally. What a shame the concept wasn't thought of before the 1980s and wasn't tried and analysed in other countries until even later.
It's nice clowns help ill kids.
ReplyDeleteIrina
Deletesimple, relatively cheap and very helpful, yes!
Hello Hels, I don't know about worldwide, but in the U.S. a great many people are terrified of or intensely dislike clowns. Of the people who reported a favorable reaction, I wonder how many were just trying to be polite because they knew that the people dressed as clowns were making an effort to please them.
ReplyDelete--Jim
Parnassus,
Deleteafter I read what you and Jo-Anne wrote about fearing clowns in some countries, I looked up a paper called 'Fear of clowns in hospitalised children: prospective experience' and added the reference to the post above. There is clearly a lot more to think about, especially for girls.
I sometimes wonder if medical clowns aren't the most important part of any hospital or care place. And I don't understand why so many people are afraid of clowns.
ReplyDeleteRiver
DeleteThe research discussed in a paper shows the positive impact of medical clowns in paediatric settings:
They reduce children’s anxiety and their experience of pain in operations.
They aid in healing children’s respiratory infections.
They improve the mood and well-being of severely disabled children.
They improve autistic children’s ability to communicate.
They reduce the stress experienced by parents and the nursing staff.
... and that is just the children!
https://www.qualityhealth.org/wpsc/wp-content/uploads/sites/3/2018/02/Benefits-Medical-Clowning-White-Paper-2017-Final.pdf
Who would have thought. That was all very interesting and clearly clowning in such situations works.
ReplyDeleteAndrew
DeleteI am guessing that humour programmes best relieved anxiety and sleeplessness in patients who were young, lonely, autistic, those who fear doctors and the elderly.
Interesting Hels. I believe clowns make so much difference to some of the children if not all. I wouldn't personally care for one though 😉
ReplyDeleteMargaret
DeleteBecause patients need less medication and less anaesthetics, and because the children and adults stay in hospital a shorter time, clowns save the hospitals measurable money for each patient.
But more importantly, clowns make the patients, families and staff happier.
I don't like clowns and have never found them funny, but if they are not the circus -type clowns with heavily painted faces, I can see they would help to relax people. Humour is very important in life.
ReplyDeletejabblog
DeleteI come from a medical family, yet when I had heart surgery, it was a totally anxious time. Every professional in the hospital represented pain and possible death - cardiologist, surgeons, anaesthetist etc etc. Overly melodramatic, I realise, but some humour may have reduced the fear.
The Humour Foundation is a national, registered charity co-founded by the late GP Dr Peter Spitzer and professional performer Jean-Paul Bell. The first Clown Doctors outing was in Tasmania in response to the Port Arthur massacre, with the first regular Clown Doctors program established at Sydney Children’s Hospital, Randwick in 1997, and at the Royal Children’s Hospital Melbourne in 1998. In 2011 we responded to the need for laughter therapy and human connection in the residential aged care sector and launched our first Laughter Care program in Melbourne.
ReplyDeletehttps://humourfoundation.org.au/our-history/
Humour Foundation
Deletemany thanks. I must first follow up the Laughter Care programme in Melbourne and see if they have published any analysis of their goals and the results.
Those clowns look sweet. I don't like clowns myself, so I wonder if these work for everyone. I personally would like a medical dog visit to cheer me up. Have a super weekend Hels.
ReplyDeleteErika,
ReplyDeletewhatever works, I say :)
Do medical dog hospital visits try to achieve the same goals as medical clowns?
Really, what an interesting post!
ReplyDeleteSince these days I very often go to a hospital for serious illnesses that has both teenagers and young adults, I think about how far behind Greece is in medical care.
Every time I go I get so upset that I take a week to recover!
How far ahead these countries are, in this area Greece hurts me deeply!
Thank you for this post🧡
Katerina
DeleteGreece is not behind at all! Ioanna Fevranoglou wrote she is a clown, physiotherapist and nurse, graduating with a Master of Science in Metabolic Bone Diseases. She has worked as a clown doctor since 1999 in Athens hospitals but didn't say which organisation manages the clown doctors in Greece.
https://web.acg.edu/web/touchbase-issue43/ioanna-fevranoglou-d12-the-clown-doctor/
There are many other clown doctors (at least in Athens) on line, but only under their own names.
For some it's a good idea to make the patients laugh with clowns. But there are many adults and children who are very afraid of clowns, it's a delicate question. We clowns in hospitals too, but children and the elderly love more a dog or a cat, which a trained to visit disabled and very sick people. As our manager allows visitors to bring their dogs whenever they want to visit their relatives and friends, I have seen that even untrained dogs first go to the very disabled people and put their head on their lap and allow to be petted. That makes the patients happy. I have a friend who has a cat which is trained for visiting sick people, the cat likes it and the people too !
ReplyDeleteGattina,
Deleteit depends on what role the clown, cat or dog needs to perform. If the intervention was to reduce depression and anxiety, and get the patient to trust the doctors more, then probably clowns might be most successful. If the role is to increase sleep and to increase the patient's food intake, dogs might be just as successful.