Being in the hospital is no laughing matter—especially for a child. But the sound of young laughter can be heard in the halls of Saint Barnabas Medical Center—when the "clown doctors" come in. Three times a week, professional clowns from the Big Apple Circus travel the Medical Center's halls, looking to make kids and their families smile, laugh and forget about their cares, at least for a few moments.
Wearing clown costumes that are appropriately understated for the hospital environment—topped with white lab coats—the visitors perform "clown rounds" with physicians in all the pediatric units, including intensive care, burn and inpatient units. They juggle, play music, perform silly skits and generally "act silly," says Andy Sapora, the head clown and supervisor for the Big Apple Circus at Saint Barnabas.
Sapora has been clowning around at Saint Barnabas since the Clown Care program was introduced there in 2008. (The program itself dates back to 1986.) Two clowns always appear together. "We play off each other, so one can be terrible and misbehave, while the second one can take the side of the child and chastise the first," Sapora says. "It reassures the kids to see that one clown is on their side."
Along with entertainment, the clowns can use humorous techniques to parody the medical environment. They also get nurses, staff members and even doctors to play along with their gags. "Some of the doctors will see us and say, 'Hello, Doctor,' very pretentiously, even though the person is just a clown," Sapora says. But not all is silliness. All the clowns are specially trained in adhering to hospital protocols, including infection control, the privacy rules of the health insurance portability and accountability act (HIPAA) and general medical procedures.
"They understand that a hospital is a unique situation, so to be properly trained and aware of things is critical," says Tim Yeh, M.D., chairman of Pediatrics at Saint Barnabas. "You can't just have an entertainer come in who doesn't understand child development, infection prevention and patient privacy."
The clowns also know how to "read a room," Sapora says, and never enter a room without permission. "Some assume we run around jumping out at people, but we work to make sure patients know they can say 'no,'" he says. "We may try to coax the 'no' into a 'maybe' or a 'yes,' though. But some do say 'no,' and we leave. That gives them power as well. If we can be the one thing in the hospital they can control, that helps too."
This opportunity for control is just one of the benefits the clowns bring. "The hospital is a strange environment, and the children are going through things that are completely alien to them and that can be very disorienting and potentially frightening," says Dr. Yeh. "The clowns provide distraction and grounding for the kids. They're something they can understand and interact with. Plus, there is an element of truth to the saying that laughter is the best medicine. Studies have shown that emotional states affect recovery."
The Clown Care program is funded by outside grants, including the initial one, from the Gross Family Foundation. Ron and Etai Gross, New York City real estate developers were looking to make a direct and visible difference in their community. "With this program you know exactly whom you are benefiting: the children and their families," Ron Gross says. "The smiles and laughter brought by the 'clown doctors' surely help their morale and speed healing. They are gifted and talented people who make a difference in everyone's lives."
The hospital continues to seek grants to keep the program going, says Tricia Balsamini, vice president of the Saint Barnabas Medical Center Foundation. "We have a very busy pediatric service, which makes the clown care program all the more important," she says. "It is an extraordinary program, and it brings something special to the patients."
The clowns bring joy to the staff as well. "It helps the doctors and nurses when we relax the kids while they do their work," Sapora says. "And sometimes they just want us to go back into a room because, they say, 'I want to hear that giggle again.'"
The clowns benefit too. "There is the professional reward—as a performer, you don't get many opportunities to perform as a clown in the New York area," says Sapora. "It's tremendous to go to the hospital on a regular basis, work your comedy muscles and stay loose and funny. And it is rewarding on a human level. When you're doing something like this that is clearly useful, it feels good."