The health benefits of clowning around | Matthew A. Wilson

譯者: Lilian Chiu 審譯者: Harper Chang

I danced with Bella for the first time

當《我眼中美麗的你》這首歌

as Bei Mir Bistu Shein filled the room.

充滿整間房間時， 我和貝拉第一次共舞。

And her blue eyes locked with mine.

她的藍色眼睛和我對視著。

We took turns singing

我們輪流唱歌，

and forgetting the words.

輸流忘記歌詞。

She led, I followed.

她領導，我跟隨。

A waltz step here,

這裡跳跳華爾茲，

a shimmy here.

這裡跳跳狐步舞。（連續短促聲）

(Rattle sound)

(Laughter)

（笑聲）

Hands on our hearts,

手放在心口，

our foreheads touching,

我們的額頭靠在一起，

as we communicated through movement and music,

我們透過動作和音樂來溝通，

making sense through nonsense.

在無意義中創造意義。

Bella is 83 and lives with dementia.

貝拉八十三歲，患有失智症。

The dance gives us a chance to find each other.

舞蹈讓我們有機會找到彼此。

How did I learn to dance with dementia?

我如何學會和失智症跳舞？

Because I'm not a dancer.

因為我不是舞者。

And I'm not a doctor.

我不是醫生。

But I've played one in the hospital.

但我在醫院中扮演過。

(Laughs)

（笑聲）

I'm a clown doctor.

我是小丑醫生。

Or a medical clown.

或稱醫療小丑。

My tools are whoopee cushions,

我的工具是坐上去會響的坐墊、

shakers

搖響（沙鈴） 、

(Shaker rattles)

（搖響聲）

and a red nose.

和紅色的鼻子。

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

你們有沒有聽過這句古老的格言 「笑是最好的良藥」？

I hear that a lot.

我常聽到。

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

也有研究支持這個說法，

但，現在，我要帶各位

but right now,

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

到紅鼻子的背後，到笑聲之外，

分享我溜過加護病房時 所看到的一些事情。

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

In my Heelys.

我穿的是十一號的 Heelys 單輪暴走鞋。

Size 11.

Because I take medical clowning

因為我扮醫療小丑

very, very seriously.

非常非常認真。

(Deflating sound)

（放氣聲）

(Laughter)

（笑聲）

(Deflating sound)

（放氣聲）

(Deflating sound)

（放氣聲）

(Laughter)

（笑聲）

My mentor was conducting clown rounds in the hospital

我的導師在醫院中做小丑巡視時，

有一位護士去找他。

when he was approached by a nurse.

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

他們得在一個孩子的鼻子裡插管，

Kid didn't want to do it,

那個孩子不願意，

so rather than hold the kid down,

與其壓制那個孩子，

they asked my colleague if he could help.

他們想問問我同事是否能幫忙。

So the clown asked for a second tube

所以那位小丑跟他們 要了另一根管子，

and shoved it up his own nose.

亂塞進他自己的鼻子裡。

Kid of like this.

有點像這樣。

Oh, please don't do this at home.

喔，在家請不要嘗試。

(Laughter)

（笑聲）

Now, the kid saw this,

那個孩子看到了，

grabbed his own tube

抓起他自己的管子，

and promptly stuck it up his own nose,

馬上就插到他自己的鼻子裡，

kind of like this.

有點像這樣。

(Applause)

（掌聲）

The clowns, the nurse and the patient

小丑、護士和病人

discovered a creative solution for their situation together.

在他們所處的情況中一起 找到了一種創意解決方案。

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

猜猜如何？研究也支持這個做法。

Randomized controlled trials in Israel and Italy

以色列和義大利的隨機控制實驗

show that medical clowns can be as effective as tranquilizers

顯示醫療小丑和鎮定劑的效益相同，

with no side effects.

還沒有副作用。

In 2004, I started conducting my own clown rounds

2004 年，我自己開始做小丑巡視，

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

地點在紐約市的紀念 史隆凱特琳癌症研究中心。

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

我和同事受到邀請， 去陪伴一位六歲孩子，

with the most adorable southern accent,

他有好可愛的南方口音，

to accompany him while he got his chemotherapy port flushed,

醫院清洗他的化療人工血管時， 我們負責陪伴他，

a very uncomfortable and regular procedure.

這個經常性的清洗過程很不舒服。

We joined him, his mom and the nurse

我們加入了他、 他的母親，以及護士，

in this tiny, closed curtain cubicle.

處在一間拉上布簾的小型隔間中。

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

每一段與醫療小丑的相遇， 第一步都是取得病人的同意。

So we ask him if we can be there.

所以，我們問他， 我們能不能待在那裡。

He says, "Sure."

他說：「當然。」

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

通常我們是孩子在醫院裡 能夠控制的少數元素之一。

while they're in the hospital.

So we start with a card trick,

所以我們開始玩撲克把戲，

fan the deck so he can pick.

把牌展開讓他挑選。

But as soon as the nurse approaches with the needle

但，當護士拿著針靠近他， 要清洗人工血管，

to flush the port,

他便開始尖叫和亂罵，

he starts screaming and cussing

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

我從來沒有聽過 六歲小孩子這樣子罵。

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

所以，我們說：「嘿， 我們應該晚點再來嗎？」

He stops, mouth open,

他停下來，嘴巴開著，

eyes wet with tears, face flushed pink with anger,

眼中泛淚，臉頰因為 憤怒而呈現粉紅色，

and he smiles,

接著，他微笑了：

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

「喔，不要，你們沒問題， 我希望你們留下。」

OK.

好。

So we start playing a song,

所以我們開始演奏，

my colleague on recorder, me on whoopee cushion.

我同事操作錄音機， 我坐在會響的坐墊上。

The nurse approaches with the needle,

護士拿著針靠近他，又來了，

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

他又狂罵四個字母的髒話。

He went from playing and laughing

他從玩樂和歡笑，

to screaming and crying,

變成尖叫和大哭，

back and forth until the procedure was complete.

來來回回，直到程序完成。

For the first time,

這是第一次，

I experienced this odd duality of joy and suffering.

我體驗到這種喜悅 和受苦的怪異二元性。

But not for the last time.

但那並非最後一次。

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

我們在那裡時， 並不只是要讓任何人分心

or make anyone feel better per se.

或是感覺好一點。

The medical clowns work moment by moment

醫療小丑一點一點地努力，

to create connections between the clowns,

在小丑、護士、父母，

the nurse, the parent and the child.

和孩子之間創造連結。

This provides a source of power or control for the child

這樣便能提供孩子一種 力量來源或是控制感，

while supporting the staff with their work.

同時支持員工做他們的工作。

I've spent over a decade bringing joy and delight

我花了超過十年的時間， 把喜悅和歡樂帶到

to the bedsides of terminally ill children

紐約市頂尖醫院中

in the top hospitals in New York City.

晚期病童的床邊。

And you know what I've learned?

你們知道我學到什麼嗎？

Everyone's hurting.

每個人都在痛。

Staff, family, patients.

員工、家人、病人。

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

病人住院是因為他們會痛。

The family's hurting as they navigate uncertainty, grief

家人的痛在於要經歷不確定性、 悲痛，及照護的財務負擔。

and the financial burdens of care.

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

員工也會痛，因為他們不堪疲累。

More and more health care workers

越來越多健康照護工作者感到

are reporting feeling overworked and overextended.

工作過量、負擔過多。

Now, I'm not so naive as to suggest

我並沒有天真到會暗示

that the solution is to send in the clowns.

派一個小丑過去就能解決一切。

(Laughter)

（笑聲）

But what if?

但如果有用呢？

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

如果全世界從事醫療小丑藝術的人

permeated our entire health care system?

滲透到我們的整個 健康照護系統中呢？

In 2018, at the Healthcare Clowning International Meeting,

2018 年，在健康照護 小丑服務國際會議上，

they represented over 150 programs in 50 different countries.

他們代表五十個不同國家中 至少一百五十個方案計畫。

University of Haifa

海法大學

offers a formal undergraduate degree program in medical clowning.

針對醫療小丑服務 提供正式的大學學位。

Argentina has passed laws requiring the presence of medical clowns

阿根廷通過法律，

規定該國最大省份中的

in public hospitals at their largest province.

公立醫院一定要有醫療小丑在。

And this work affects more than the patients.

受到影響到的不只是病人。

整個醫療照護團隊的 狀況都會好轉。

It makes things better for the whole health care team.

One of my favorite games to play in the hospital

在醫院，我最喜歡玩的 遊戲之一就是電梯音樂。

is elevator music.

I love elevators, because they're a place

我很愛電梯，因為在電梯中

where paths cross, different worlds meet.

有不同的路徑交叉， 有不同的世界交會。

It's intimate,

電梯很親密，

uncomfortably quiet

有種不舒服的安靜，

and just begging for a little playful disruption.

好像在乞求一點玩樂的打擾。

The doors close

門關上，

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

哈蒙德風琴開始演奏 《伊帕內瑪姑娘》，

because I keep a portable speaker hidden in my pocket.

因為我口袋裡都會藏著 一個攜帶式的擴音器。

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

所以，如果你習慣使用 寂靜、無生氣的電梯，

it's a moment of surprise.

這是驚喜的一刻。

Folks have permission to acknowledge or not this disruption.

大家可以選擇是否 認可這樣的打擾。

The game grows with every stop,

每停一次，遊戲就會有新進展，

because as soon as the elevator stops,

因為每當電梯停下來，

the music stops.

音樂就會停下來。

New passengers get on,

新乘客進來，

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

原本的乘客可以目擊新乘客——

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

他們的驚訝——當他們 初次聽到電梯音樂時。

You experience the shift of adults

你會體驗到成人的轉變，

standing silently, strangers in an elevator,

本來是安靜地站著、 電梯中的陌生人，

to attempting to suppress their mirth,

變成要嘗試忍住不笑，

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

變成「這是派對還是電梯啊」，

filled with full-on laughter.

充滿了開懷大笑。

Research conducted in Brazil,

巴西、澳洲、加拿大，

Australia, Canada and Germany

及德國都有研究

confirm that the artistic interventions of medical clowns

確認醫療小丑的藝術干預方式

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

能為員工改善工作環境， 不只是在電梯中，

and support their work administering care.

並支持他們去施行照護。

Promising research in the US indicates

美國前瞻性的研究指出，

that arts programing in the hospital

醫院中的藝術活動安排

can improve the work environment,

能夠改善工作環境，

leading to increased job satisfaction

導致工作滿意度增加，

and better quality of care.

照護品質提升。

My work has taught me

我的工作讓我學到

how to actually be present.

如何真正處在當下。

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

和痛苦的人身處在一個 房間中時要如何呼吸。

How to connect

如何連結

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

及建立信任，不論年齡、 能力，或疾病。

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

以及醫療小丑服務為什麼 能把藝術做很不凡的運用，

to put the care back in health care.

把「照護」重新放回到健康照護中。

Thanks.

謝謝。

(Applause)

（掌聲）