“You treat a disease, you win, you lose. You treat a person, I guarantee you, you’ll win, no matter what the outcome” – Patch Adams
Dr. Neal Goldberg shares: I am doing hospital rounds as a clown with a friend, and, in one room, a beautiful 14-year-old young lady, clearly battling a serious neurological illness, sits with a tear-streaked face, while her mother and grandmother sob gently in the corner. I really don’t feel like going in, but my clown friends coax me to enter. As one of my friends walks in, he blows play trumpets and calls out, “Hear ye, hear ye. Before us sits the princess for whom we have been searching high and low.” The girl’s face lights up, she wipes the tears from her cheeks, and, amused, asks, “What brings you to my kingdom?” My partner bows his head and replies, “Princess, please tell this foolish jester the details of your exile.” The young patient, now smiling, weaves a tale of her search for magic potions for a strange illness, of battles in foreign lands that left her with head injuries – she isn’t sure she’ll win. We praise her brave survival skills and ask her to demonstrate. The girl acts out martial arts movements, which we mimic in an exaggerated clown way, making the patient giggle, for what is probably the first in a long time. Meanwhile, a third clown sits with Grandma, looking through a family album, while Mom snaps photos, giggling through her tears.
“As a child, I always dreamed of being a real clown,” says Mrs. Esther Leah Zerbib, who goes by the clown name Luly. Today, boasting a clown uniform and the trademark nose –
the proud badges of her profession – Leah’s dreams have come true. But her destination is neither a birthday party nor the circus. Leah heads to hospitals, rehabilitation homes, and mental wards to cheer up physically ill and emotionally fragile patients. Serious clowning, otherwise known as medical clowning, might sound like an oxymoron. But her profession, which sees pain and joy and tears and laughter intermingled every day, makes a most welcome paradox.
Leah’s professional medical training and underlying awareness of her unique calling are what differentiates her from the birthday party performers. Like most professional clowns, Leah has gone through standard theatrical training. Professionally certified by the Simchat Halev organization, Leah has mastered the art of classic clowning, which includes talking gibberish or clown language, the art of improvisation, makeup application, balloon making, and character development. At the end of the course, Leah chose a clown name along with a new identity. Her graduation culminated with a pompous ceremony in which each graduate was awarded a big red nose. But unlike the standard circus performers, Leah has also studied the psychological aspects of illness, how to interact with the physically and emotionally fragile, and how to empathize with their pain.
Lev Leytzan: The Heart of Therapeutic Clowning, Inc., an organization founded by Neal C. Goldberg, Ph.D, is dedicated to this cause. Lev Leytzan gives serious clowning workshops to a diverse group of teens and adults, preparing them for the delicate work of cheering up patients. Their training involves a multidisciplinary team of circus artists, physicians, and mental health professionals who together create a unique synergy that transforms careless levity into practiced care. Professional performers teach the art of using makeup and costuming to create a character; how to tell a story effectively using both verbal and nonverbal techniques; how to build on group energy during play; and how to use body language to create meaningful bonds. Each participant also learns about the physical, psychological, and emotional aspects of clowning from top experts in each field.
“We prepare our clowns for difficult situations because they interact with patients who live in pain or extreme poverty, have life-threatening illnesses, or are coping with dementia or other mental conditions,” says Dr. Goldberg.
In a Day’s Work
Every day, the “wonder doctors” enter hospital wards, mental hospitals, and old-age homes with a touch of classic goofiness and humor, a measure of hard-earned wisdom, and an endless supply of heart in their medical satchels. Armed with the philosophy of Patch Adams – that laughter is a healing experience – medical clowns aim to deliver joyful, restorative experiences to the sick, mentally-challenged, frail, and elderly in order to improve their quality of life and impact the healing process.
Empathy, humor, and imagination are the magical threads that bridge the gaps wrought by age, culture, experience, and pain and foster connections between clown and patient. Unlike the birthday clowning, serious clowning is not performance-based, and the goal is not entertainment but connection.
“The ultimate goal of Lev Leytzan,” says Dr. Goldberg, “is to lift broken spirits and heal fragile bodies through open-hearted, imaginative play. Lev Leytzan clowning experiences are built on an open and trusting partnership between the clowns and the patients. Together, we create a unique work of art and a transformative journey by entering the reality and space that a patient initiates.”
The ability to improvise is an essential skill that medical clowns develop and use. When colorful props are placed into the hands of a talented artist, they become magical tools to transport the patient out of the painful, anxiety-ridden atmosphere of the hospital or institution. “My aim is to distract the patient from his pain through the use of improvisation and imagination,” says Leah. “For example, I’ll point to a medical machine and say, ‘Hey, what are you watching on TV?’”
Serious clowns are not just beneficial for patients. The presence of a clown in the hospital can transform the entire atmosphere, alleviating the stress for family members and providing much-needed downtime. “They give a degree of relief,” says Fraidy Leibowitz, in a recorded series of interviews. “I can sit and relax for five minutes (while the clown is present), knowing that, for the time being, my daughter is calm.”
“When you’re bringing your child in for all sorts of tests and treatments and there’s a clown present, it makes it easier for the parent to tolerate as well,” says parent Rivki Reuveni in the recording.
With continuous ongoing studies proving the manifold benefits of medical clowning, the medical clown initiative – and opportunities for the serious clown – continue to expand. The project is not limited to the confines of the hospital and, over time, has expanded its wings to benefit people in special education centers, old age homes, rehabilitation centers, and shelters. Lev Leytzan also has an Elderhearts program for those who are suffering from Alzheimer’s and dementia, and a second project, ClownCorps, which sends a group of clowns to spread joy to patients around the globe.
Leah shares: Sarah, an older patient, was one of the most difficult cases in the hospital. Clearly suffering from depression in addition to the illness that brought her there, she remained largely uncommunicative and hadn’t walked for months. It all changed when one of my teachers at Simchat Halev walked into her room together with a medical clown. The clever clown snuck behind her, began to blow bubbles in the air, and then placed a ball in her hand. Thinking that the ball was a bubble she caught, Sarah jumped out of her bed and started chasing bubbles around the room. Soon, an entire audience of nurses and medical personnel entered the room to view the spectacle while calling out, “Sarah, you’re walking, you’re walking!” She was released just two weeks later.
It is our hope that the day will come when we will no longer need medical clowns or doctors to heal the seriously ill. But until then, the serious clowns amongst us deserve a hats off for attending to those broken in body and soul, in fulfillment of the verse (Mishlei 18:14), “The spirit of man will sustain his illness, but a depressed spirit, who can lift it?”
* * * * *
The Dream Doctors Project
The Dream Doctors Project, born in 2002 at Hadassah Hebrew University Hospital in Israel, takes the concept of medical clowning in a different direction. With the ultimate hope of speeding up the healing process and shortening a patient’s hospital stay, hospitals don’t just hire clowns but integrate them as an integral part of the medical staff. Today over 111 clowns, many professionally-trained in the field at Haifa University, bring joy and laughter to 29 pediatric wards throughout Israel.
“These are professionals, not street performers,” stresses Dr. Eidelberg, a professor of pediatrics at the Hebrew University’s Faculty. “I don’t see them differently than any other part of the medical team.” These “doctors” work hand in hand with the medical staff during hospital procedures, effectively lessening the patient’s anxiety, reducing the discomfort of the procedure, and enhancing the patient’s cooperation with the medical staff.
“With the help of medical clowns, patients are able to sustain invasive procedures with less or no anesthesia,” says Professor Johnathan Halevy, Director of Shaarei Tzedek Medical Center, in a recorded series of live interviews in connection with the Dream Doctors Project.
* * * * *
The quote “Laughter is the best medicine” is more than just an overused idiom. In an Israeli study reported by the NY Daily News, a clown visit to patients undergoing IVF treatment increased success rates by 16%. Other healing benefits of laughter include: a decrease in stress hormones and an increase in immune cells and infection-fighting antibodies, thus improving resistance to disease. Laughter triggers the release of endorphins, the body’s natural feel-good chemicals. Endorphins promote an overall sense of well-being and can even temporarily relieve pain.