The health benefits of clowning around | Matthew A. Wilson

I danced with Bella for the first time

as Bei Mir Bistu Shein filled the room.

And her blue eyes locked with mine.

We took turns singing

and forgetting the words.

She led, I followed.

A waltz step here,

a shimmy here.

(Rattle sound)

(Laughter)

Hands on our hearts,

our foreheads touching,

as we communicated through movement and music,

making sense through nonsense.

Bella is 83 and lives with dementia.

The dance gives us a chance to find each other.

How did I learn to dance with dementia?

Because I'm not a dancer.

And I'm not a doctor.

But I've played one in the hospital.

(Laughs)

I'm a clown doctor.

Or a medical clown.

My tools are whoopee cushions,

shakers

(Shaker rattles)

and a red nose.

You know the old adage "laughter is the best medicine?"

I hear that a lot.

Now, at the same time, there are studies to support it,

but right now,

I'd like to take you behind the nose and go beyond the laughter

and share a few things that I've seen skating through ICUs.

In my Heelys.

Size 11.

Because I take medical clowning

very, very seriously.

(Deflating sound)

(Laughter)

(Deflating sound)

(Deflating sound)

(Laughter)

My mentor was conducting clown rounds in the hospital

when he was approached by a nurse.

They needed to put a tube up the kid's nose.

Kid didn't want to do it,

so rather than hold the kid down,

they asked my colleague if he could help.

So the clown asked for a second tube

and shoved it up his own nose.

Kid of like this.

Oh, please don't do this at home.

(Laughter)

Now, the kid saw this,

grabbed his own tube

and promptly stuck it up his own nose,

kind of like this.

(Applause)

The clowns, the nurse and the patient

discovered a creative solution for their situation together.

And guess what, there's research to back this up.

Randomized controlled trials in Israel and Italy

show that medical clowns can be as effective as tranquilizers

with no side effects.

In 2004, I started conducting my own clown rounds

at the Memorial Sloan Kettering Cancer Center in New York City.

My colleague and I were invited to accompany a young six-year-old

with the most adorable southern accent,

to accompany him while he got his chemotherapy port flushed,

a very uncomfortable and regular procedure.

We joined him, his mom and the nurse

in this tiny, closed curtain cubicle.

Every medical clown encounter begins by obtaining consent from the patient.

So we ask him if we can be there.

He says, "Sure."

We're often the one element that a child could control

while they're in the hospital.

So we start with a card trick,

fan the deck so he can pick.

But as soon as the nurse approaches with the needle

to flush the port,

he starts screaming and cussing

like no six-year-old I'd ever heard in my life.

So we say, "Hey, should we come back later?"

He stops, mouth open,

eyes wet with tears, face flushed pink with anger,

and he smiles,

"Oh no, you're fine, I want you to be here."

OK.

So we start playing a song,

my colleague on recorder, me on whoopee cushion.

The nurse approaches with the needle,

and it happens again, this torrent of four-letter words.

He went from playing and laughing

to screaming and crying,

back and forth until the procedure was complete.

For the first time,

I experienced this odd duality of joy and suffering.

But not for the last time.

See, when we're there, we're not there merely to distract

or make anyone feel better per se.

The medical clowns work moment by moment

to create connections between the clowns,

the nurse, the parent and the child.

This provides a source of power or control for the child

while supporting the staff with their work.

I've spent over a decade bringing joy and delight

to the bedsides of terminally ill children

in the top hospitals in New York City.

And you know what I've learned?

Everyone's hurting.

Staff, family, patients.

The patient's in the hospital because they're hurting.

The family's hurting as they navigate uncertainty, grief

and the financial burdens of care.

The staff is hurting, only it's more than burnout.

More and more health care workers

are reporting feeling overworked and overextended.

Now, I'm not so naive as to suggest

that the solution is to send in the clowns.

(Laughter)

But what if?

What if the tools of medical clown arts practitioners from around the world

permeated our entire health care system?

In 2018, at the Healthcare Clowning International Meeting,

they represented over 150 programs in 50 different countries.

University of Haifa

offers a formal undergraduate degree program in medical clowning.

Argentina has passed laws requiring the presence of medical clowns

in public hospitals at their largest province.

And this work affects more than the patients.

It makes things better for the whole health care team.

One of my favorite games to play in the hospital

is elevator music.

I love elevators, because they're a place

where paths cross, different worlds meet.

It's intimate,

uncomfortably quiet

and just begging for a little playful disruption.

The doors close

and "The Girl from Ipanema" starts playing on Hammond organ,

because I keep a portable speaker hidden in my pocket.

So for those used to using the silent, sterile elevator,

it's a moment of surprise.

Folks have permission to acknowledge or not this disruption.

The game grows with every stop,

because as soon as the elevator stops,

the music stops.

New passengers get on,

and the current passengers get to witness the new passengers --

their surprise -- as they hear the elevator music for the first time.

You experience the shift of adults

standing silently, strangers in an elevator,

to attempting to suppress their mirth,

to, "Is this a party or an elevator,"

filled with full-on laughter.

Research conducted in Brazil,

Australia, Canada and Germany

confirm that the artistic interventions of medical clowns

improve the work environment for the staff, beyond the elevator,

and support their work administering care.

Promising research in the US indicates

that arts programing in the hospital

can improve the work environment,

leading to increased job satisfaction

and better quality of care.

My work has taught me

how to actually be present.

How to breathe in a room with a person in pain.

How to connect

and build trust, no matter the age, ability or illness.

And how medical clowning is an excellent way of using the arts

to put the care back in health care.

Thanks.

(Applause)