Best Medicine
If laughter is contagious, some young patients have caught the bug, thanks to the medical mischief made by clowns in the Children’s Center

They are called in on cases that baffle some of the greatest minds in pediatrics. How do you entice a determined 5-year-old to eat? Prompt an angry teen to accept an IV? Distract a burn victim while her bandages are changed? Ever since 2001, when a troupe of zany characters with a special knack for bringing laughter to the bedside arrived at the Children’s Center, the experts have known what to do: They call for a clown consult.

Sent in by the Big Apple Circus, the performing arts organization founded in New York City 25 years ago, the clowns are professional performers specially trained to work in a hospital’s sensitive environment. They are part of the non-profit Big Apple Circus’ Clown Care Unit (yes, CCU) which dispatches more than 90 clown “doctors” to 17 pediatric hospitals nationwide.

Clad in white lab coats and big shoes, armed with small pocket tricks and ridiculous humor, the six clowns at Hopkins travel in pairs. Led by William “Dr. Boots” Boots, they are masters of improvisation who take their cues from their audience. “In our world, patients rule,” says Boots. “We’re very willing to give children control. Whatever they empower us to do, we do. “

A young patient recovering from an injury was wary of the clowns. He asked them to disappear. They did. Later that afternoon, the child waved to the clowns from his window overlooking the Children’s Center’s fourth-floor play deck and motioned for them to come to his room. To the child’s delight, Dr. Boots and Dr. Short, who is actually very tall, tried to climb in through the window. Eventually, they entered through the door. “He had to invite us in,” says Boots. “Giving him the power to say yes or no did the trick. We’re among the few people in the hospital a child can say no to.”

Among the pleasant surprises at the Children’s Center, says Boots, has been the willingness of faculty and staff to embrace the Clown Care Unit. Encouraged by Child Life, a child facing a blood draw calls in the clowns for company. At the bedside of a slowly recovering preteen, a physician solemnly prescribes “large doses of clown.” On cue, it’s filled.

For all their horsing around, the clownish “doctors” hold the distinction among their professional comrades of knowing when to drop the guise and empathize in the emotion-charged environment of ill children and stressed or grieving families. “We’ve all kinds of magic and tools for play, but we’re always very aware of the physical and emotional environment when we visit,” says Boots. “There are simply times when you have to stop and change gears and be human.”

Boots credits a large portion of their success to their training and ongoing support from the program’s founders. Michael Christensen, co-founder of the Big Apple Circus and founder of the Clown Care Unit, has described clowns as trained professionals “who have committed their entire life to creating loving anarchy.” Anarchy, not even the “loving” variety, is hardly compatible with the highly ordered hospital environment. And yet, like the tightrope walker under the Big Top tent, these six clown doctors manage to perform with a mixture of joy and empathy an exquisite balancing act.

- Wendy Mullins

(adapted from the Fall 2003 edition of Children’s Center News)