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Humour and love: the origination of clown therapy

Patch Adams

Postgrad. Med. J. 2002;78;447-448

doi:10.1136/pmj.78.922.447

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PERSONAL VIEW 447

The love strategy dramatic and growing shortage of

................................................................................... nurses.
There is never a concern for profit or

Humour and love: the origination of solitary power in the love strategy.
Throughout history, I think the love strat-
egy has been practised by women, often
clown therapy invisibly. Even though most of the service
professions are notoriously low paying,
Patch Adams women have historically done the major-
ity of them, freely acting out their love
...................................................................................
strategy. Now, greed and power-over have
so infected our culture, it is getting harder
Compassion, joy, love, and humour are essential to build for the love strategy to prevail, even in
healthy and peaceful societies health care and education.
It used to be hard for love and fun to

T
he events of terror in the United we declare the intention to be peaceful get in the door at hospitals. Mostly,
States on 11 September 2001 have and loving and, being present in all situ- volunteers became the carriers, glad to
provoked many reactions and the ations, observe how we perform our trade in love and fun because the
traditional revenge/fear action. The intentions. We notice the consequences personal rewards were so powerful. Hos-
casual, quick acceptance of this response of each performance, and if it puts our pital clowns have become the locus of
globally, instead of outrage over more intentions forward, we add that strategy humour and love, and what they do has
senseless carnage, is symptomatic, in to the ongoing performance of our public been classified a therapy. But this greatly
medical jargon, of a massive malignant selves. shortchanges us! We don’t need a puny
cancer in human society. Also sympto- I know, as a pacifist, that I never see love-and-fun therapy! We need love and
matic is that, on the same day, over more violence as a strategy. Strategy fun as a context; the very stage on which
30 000 children died of starvation and implies thoughtful consideration. Vio- we act out the dramas of health and life
there was no noise heard. lence mostly feels visceral. I try to imag- and death. When love and fun are the
As I explore the health of the human ine generals giving up on the “war context, every hospital employee will be
society, with the same tender, thoughtful room”, heading instead for the “love and loving, joyful, tender, and fun.
compassion I have explored individual humour” room to strategise an end to If we allow our strategic love to remain
patients, I find the “patient” in critical violence. a therapy, we’re implying that there are
condition, needing global universal at- I have asked myself often since then, times it isn’t necessary. But if we commit
tention. Why do we revere our diver- what is my love strategy? I know, at my to growing love as the context, we are
sions, and neglect our collective health? deepest levels, that deciding in my teens called to continually create an atmos-
We live in a country where athletes and to be universally and publicly friendly phere of joy, love, and laughter. There are
actresses are multimillionaires. Though and a celebrant of life, was the strongest so many simple ways to do it: I often feel
school teachers are second only to moth- strategic step I’ve ever taken for love. like the clown costume is a trick to get
ers in supporting a healthy human soci- Surely love and humour will never defeat love really close to patients.
ety, in the US, 60% have to hold second violence and injustice, for they never As soon as we see the health value of a
jobs to support a family. exert power-over. But they are capable of context that is joyous, loving, and funny
Mechanisms need to be found to help irresistible transformation. We must with the dying patient and the person in
midwife a human society that never practise compassion and generosity in the street, we can decide to contribute to
needs war again; where all are cared for ways that seduce those drunk on per- a context of love and fun every day. This
(and all of nature too), and life is a sonal power and greed and lovers of makes our communities healthier, and
celebration. At this point in human power-over and money to consciously helps to build a peaceful and loving soci-
choose compassion and generosity. ety. This one decision and the gestures
history these goals can no longer be con-
So how does that seduction work? The and connections which are sparked by it
sidered idealistic or naive. They are
strongest transforming mechanism I can bring sweet meaning to anyone’s life
thoughtful imperatives if we want to get
know is to give people the opportunity to daily.
humans off the endangered species list.
help others who suffer. Over time, many I have done vast numbers of clowning
I know, after September 11th, every-
feel a powerful inner glow that drives experiments in public all over the world
where I travelled I heard the nation
them to make helping part of their life. every day for 38 years now, and have
echoing our president’s immediate call to
Add learning about the problems and found friendliness and celebrating life to
war. I started to ask my audiences if any
solutions (you can find a rich bibliogra- be the heavy artillery of the love strategy.
of them had wondered what “love strat-
phy at www.patchadams.org) and you’re Add generosity and one can taste the
egy” could effectively respond to terror?
primed for creative leadership. revolution of care. It easily calms stress-
I’ve never heard any nation or people
It is inherent in these concerns that ful situations and comforts countless
discuss a love strategy in the face of vio-
clowning needs to be a context, not a griefs. My experiments have shown me
lence. We have to be the pioneers. First,
therapy. It is funny to this clown to say that public love and fun are so important
“clown therapy”. Of course it is thera- that I have chosen to wear only clown
peutic! If a love strategy existed in our clothes publicly every day for over 20
society, no one would need clown years, to do my part. It enhances the
therapy. But modern hospitals and medi- richness of my life and has made the
cal practices around the world scream whole journey enchanting.
out to reconnect the delivery of care to By the time I entered medical school
compassion, joy, love, and humour. For in 1967, I had taken the power of clown-
over 30 years I’ve heard thousands of ing to heart, and was trying to bring
medical students, doctors, nurses, and humour, love, and joy to every situation.
patients weep for love’s absence in their When I began to see patients (of any
medical setting. The lost “love strategy” age) I insisted on being funny with all of
is the single strongest cause of the them, even the profoundly ill. What was

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448 PERSONAL VIEW

less obvious, was that it was just as learn to make fun, compassionate, crea-
important to be fun (loving and joyful) tive housecalls—in the hospital or
with the staff and visitors to the hospital. out—on all sorts of people. Recommendations for doctors
It was bringing humour to all of it that The hospital clowns have spent most of
was the point, clearly knowing it was their time in paediatrics, and I have from • Study the infinite literature on love
also wonderful for my own health. I was the beginning encouraged clowns to go to and loving. You will find a clear call
a stranger to that burnout which is the adult wards as well. I actually prefer for more love everywhere—poetry:
endemic in modern hospitals. clowning for adults because they have a Neruda’s Love Sonnets, May Swen-
I know the clowning was mostly much broader life experience. I can only son’s Love Poems; psychology: Erich
carried by smiling eyes and mouth, an hope that when people see the clear value Fromm’s The Art of Loving; medicine:
impromptu song, and a patient, listening of bringing love and humour into a hospi- Dean Ornish’s Love and Survival.
attention. Over time I’ve added props tal setting they will connect with the need • Do five years of field work with
and become a character. I’ve been the to do it everywhere. Maybe a next step is people, everywhere you go, being
“guy with the fish” for many hundreds to get clowns (fools, jesters) back into the loving with them and receiving any
of hours. When we had our own hospital political arena next to the leadership, both love offered. Find your loving selves.
the humour was much more outrageous political and corporate. I cannot see • Add humour to your practice; this is
and integral to the life in the commu- George Bush and his cronies so flagrantly easiest when you are already being
nity; even its social glue. serving multinational corporations if the compassionate. If a patient perceives
I began to lead group clown trips in inner circles were held accountable by you love them, they will forgive (even
1985. I never required any clowning truth telling fools. delight in) any humorous experiences
experience of the participants. I simply When clowning (or humour, love, joy) you share. You can always cite refer-
asked people to wear clown clothes and to is thought of as a therapy and the clown ences about the healing effects of
spread love and fun. I knew performing as a specialist who can do it, others can humour.
would come with time. I wanted people to think that love, humour, and joy are • Be a keen and tickled observer of
see that anyone could do it. The idea covered and they don’t have to help create people.
slowly grows of taking this loving, fun that context. So the staff and visitors • Choose to put humour in the public
context to many diverse settings from don’t see that they are also creators of this space with a smile on the face, a
death rows in prisons, to orphanages, context. In the past, when having a “good twinkle in the eyes, and a willingness
nursing homes, refugee camps, even war bedside manner” was high accolade to to greet each person.
zones. It transforms the toughest places. I nurse or doctor, it had nothing to do with • Practise with various props. Farts are
took clowns to refugee camps in Kosovo their scientific expertise. In truth, it was a the only thing I’ve found to be univer-
in 1997. The camp elders came to us after comment on their ability to bring love, joy, sally funny in all countries. There are
our first day to say that it was the first and humour to the bedside. many little devices on the market,
time they saw children playing in the So I call all people to support any even a glorious remote control farter.
camp, or couples holding hands; love and clown work in hospitals; for their job is to • Society gives full permission to laugh
humour breathed life back into these suf- be the presence of something precious out loud, always assuming good
fering people. and necessary for all who suffer and all reasons caused it. So practise public
I applaud hospitals for opening them- who do not. I hope that all who see the laughing.
selves to staff clown positions, and to the potency in action will be stimulated to • Study videos of funny people and
clowns who take on this healing work. make themselves an instrument of joy, steal bits from each. There is a gold
And I want to put in an encouragement love, and humour. mine there.
for each person, professional clown or • Study books on the history of cos-
not, to imagine that what they do each Postgrad Med J 2002;78:447–448
tumes. Have a few made to fit you
day can be a potent part of creating a and use them regularly.
context of love and fun. Each one of us .....................
• Declare a personal intention to be an
can be an instrument of the love Correspondence to: Dr P Adams, Gesundheit instrument for peace, justice and
strategy! If you need ideas, I wrote my Institute, 6855 Washington Blvd, Arlington, VA care. Then take action!
second book, House Calls, to help people 22213, USA; Heidi@SillyStuff.org

BOOK REVIEW ................................................................................................

Gesundheit (Patch Adams, Healing Arts Press, £13.99; ISBN 0-89281-781-X)

F
or anyone who has seen Robin Williams in Patch Adams this book is essential reading. The issues
raised in the film about the relationships between doctors and their patients are explored in greater
detail. The book provides a surprising analysis of the research base on which Patch’s approach to
clinical care is based. The confidence with which he approaches patients is refreshing, especially in a
country where malpractice cover is so essential. However, that very basic element of clinical practice has
never formed part of Patch’s approach. He has survived without it and indeed thrived. The need to put
humanity and humour back into clinical practice is the driving force behind Patch’s clinical work and is
also the basis of his message to other clinicians and patients across the world.
Although you may not always agree with the ideas propounded in Geshundheit, you will not be able to
ignore them. Patch believes doctors must empathise with their patients and share in their experiences. It
is only then that we can hope to limit the spread of medical litigation and restore the traditional trusting
relationship between patient and doctor.
There are many memorable quotes in this book. However, the one I like the best concerns patients and
how to be an ideal patient:
“Try to care for your caregivers, no matter how poorly other health care professionals may have treated you
in the past. Once you choose a caregiver, enter the relationship full of trust, excitement, openness and
friendliness. There is a lot of pain in the healing arts. Many healers feel burned out, frustrated, angry and
depressed. So act as if you wanted to enrich their day . . . . . . Be a patient patient”.—John Mayberry, Editor

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