Transcriber: Gabriela Tomkova Reviewer: Denise RQ
I am going to speak in English today,
but I hope this is not a problem.
If it is a problem just raise your hand,
and we will immediately speak only in Spanish.
(Laughter)
(Applause)
No one is raising their hand yet, so —
"Humor in Healthcare."
Someone is raising their hand already.
(Laughter)
I imagine that everyone in this room remembers a time
when it was impossible to put those two words,
humor and healthcare,
in the same sentence.
Today,
humor and healthcare is an idea worth sharing.
I'd like to start with my personal experience
I had here in the Czech Republic.
About 15 years ago,
I had just started presenting this idea of humor in healthcare
at healthcare conferences,
and I was running all over the country like a mad man
visiting hospitals as a clown.
One of my studies was clowning.
I studied at the first accredited clown school in America.
(Laughter)
Like I said, it is not my fault.
(Laughter)
I was presenting this idea
in hospitals, in children's wards, all over the country.
I would come in a hospital
and the first thing I would do is have a consultation with the staff
to get some basic information on the patients that were there,
[the staff] that would help me in my work.
I was talking with the doctor
in the oncology ward of this hospital,
and he was telling me things I needed to know.
And then he said: "Oh, and there is Melissa in room 4."
I changed her name by the way.
"There is Melissa in room 4,
but unfortunately,
the therapy did not work,
and she's in the last stages of the disease,
and her bodily functions are shutting down.
So she cannot see anymore,
and I doubt that she would even know
if you were present or not.
So probably, it does not really make sense to visit her."
And I said, "Can I try?" And he said, "Yes, of course."
So I continued my visit to the oncology ward
— there were actually two wards, younger and older children —
and three, four hours later,
I was left with one room left,
and that was room number 4 and Melissa.
So I knocked on the door.
No answer.
I opened the door slightly and asked if I could come in.
I saw Melissa lying in bed, staring blindly at the ceiling;
she had lost all her hair through treatment.
Her mother was sitting next to her, wringing her hands,
obviously in a lot of stress.
So I asked if I could come in and her mother said yes.
So I came in,
and I started clowning for Melissa.
Because she did not see, I was forced to use sounds.
One of the things that happened was
— and I never knew what was going to happen —
we found a bird in the room.
(Imitating bird chirping)
Melissa liked that.
We decided that we should catch this bird,
and it was Melissa's idea to put it out of the window.
I was racing around the room trying to catch this bird.
I did finally catch the bird.
I caught it under her bed
and put it in a plastic bag
(imitating wing flapping)
and opened the window and let it fly.
But then it flew right back in.
(Laughter)
(More bird chirping)
This went on and on, and we could not get rid of this bird.
Finally, Melissa and I
— she was really enjoying this, she was laughing
and we were having a real good time —
finally decided that the bird would live under her bed.
(Laughter)
This was our decision together,
and so the bird finally lived under Melissa's bed.
At the end, I picked up my ukulele, and I sang a little song
about the bird that lived under Melissa's bed.
(Laughter)
And I left the room.
I left the room
with Melissa in bed smiling,
and there was a very nice atmosphere.
And as the door closed, it opened again immediately,
and her mother was chasing me into the foyer of the hospital
trying to give me money,
tears streaming down her face.
Of course I had to say no.
What I had just received in that room
was worth all the money in the world.
What happened in the room
was that Melissa and I understood the game,
and her mother was completely surprised.
She probably saw this as, maybe,
the last time she would see her daughter smile and laugh.
I don't know, but she was very emotionally charged.
I went on my way,
— I was continually visiting hospitals all over the country —
so it took some time before I came back to this hospital.
I don't know how many weeks, a month, I don't know.
I came back into the same oncology ward,
and I was met with the doctor on duty,
and he said: "Gary, do you remember Melissa in room 4?
I said yes and I knew what was coming.
I had lost patients many times.
I knew what was coming, so I was half-listening
as the doctor was telling me that Melissa, after my visit,
had turned 180 degrees.
All of her bodily functions had returned.
There was no trace of the illness, and they had sent her home.
I know what spontaneous remission means;
I did not see this necessarily as a [result] of my visit.
But that moment
gave me the resolve to continue with this work.
And today, here in the Czech Republic,
there are 87 specially trained certified health clowns
visiting over 75 hospitals and institutions,
on a regular basis,
at least once a week, up to seven times a week.
We make more than 3,500 visits a year here in the Czech Republic.
In the meantime,
I was honored to be able to open a project in Slovakia.
Now I work with
"Red Noses Clowndoctors International,"
whose mission is to develop and to guide
humor in healthcare projects worldwide.
One of the things we do
is we have developed a certification process, a curriculum,
which involves all of the things
these specially trained artists need to know
to do this work correctly.
We have an international school of humor in Vienna
where partners can come and get
the best training in the world.
We believe
that approaching this project in a professional manner
is really what it takes.
Just like other people working in healthcare,
we see it as very important to put energy into the training process.
Red Noses Clowndoctors is also advocating for child's rights.
The right to play, specifically.
We all know that play is an important part of the development process for children.
In hospitals they also recognize this.
So, what you will see in children's wards quite often are playrooms,
but this is not inclusive for all children in the hospital.
Consider children who must stay in bed;
they are not allowed into the playroom,
so that is where our clowns come in.
They bring this atmosphere of play,
the possibility to play
and the expertise
to draw the children into this play mode
right to the children's bedside.
We work individually with children of all ages
— they are specially trained to work with children of all ages —
and we work individually with each child.
We use the hospital procedures and the environment
and make fun of it.
Nurses and doctors love it as well, believe me.
(Laughter)
By doing this,
we get around the mystique.
If the child can laugh about a procedure, he will not be afraid of it.
So our clowns are specially trained
to work with children on an individual basis.
(Laughter)
As you can see, they are very empathetic.
(Laughter)
Children's programs are the basis of our work,
but we do work with other age groups.
We have
a project called Circus Patientus
where we work an entire week with children,
in civil, without the clown nose,
teaching circus arts, and magic,
and music.
These are things that children are readily interested in.
And I believe
that if we can awaken an interest in whatsoever,
then we awaken an interest in life,
and interest in life is an integral part of the healthcare process.
So Circus Patientus is a process
where they learn something new,
they become interested in things,
and they become the stars at the end of the day.
We even have circus tents set up on the hospital grounds,
which is very inviting for children in hospitals.
They are the big stars of the show.
Audience includes their parents, hospital staff, other children.
Besides children, we also have developed projects working with the elderly.
Because actually last year I reached retirement age,
(Laughter)
I do not want to be in an institution
where there are not clowns visiting on a regular basis.
(Laughter)
So we have developed humor for the early born.
(Laughter)
And quite often this is exactly what they need,
they need to be brought back into life.
It is a completely different method.
Clowns that do this project are trained specifically for this project.
We use old costumes, 50-year-old costumes,
we sing the old songs.
A lot of it has to do with memory training.
Picking mushrooms is very popular in the Czech Republic,
so in the autumn we would come in with a basket of mushrooms,
just to smell it, to remember.
It is a beautiful project.
We also have many other projects.
Caravan Orchestra is a special scenario built
for the multiple handicapped children in institutions.
We have the Humor Baskets project for adults.
I have seen magic work with this.
I have seen waiting rooms in an adult oncology ward;
and you can imagine what the atmosphere is like.
We have come in with these humor baskets,
and the whole thing is changed into almost a Christmas atmosphere,
where somebody says: "This is a great book, I read this,"
and somebody says, "I read this, so let's change."
We had some real magic moments.
And just lately, one of the last projects I was able to do here,
— for the Zdravotní Klaun project here and also the project in Slovakia —
was to introduce something I had seen in Israel.
Clowns, specially trained for this, accompany children
from the hospital ward to the operating theater.
We call it 'NOS, ' (Czech) "To the operation room."
What I have realized is
there are specific stress moments in this process,
so the clowns are trained
to interject humor at these stress moments.
If you could imagine being a parent — this is not just for the children —
and this moment when your child is wheeled through the operation room
and the door is close and you are left outside.
Can you imagine what a stress moment that is?
The clowns are also specially trained to work with parents in these situations.
They may take the nose off
and just be a human being when a human being is needed.
When I introduced this project, I was met with some skepticism,
but after the three-month pilot period,
I had nothing but positive feedback,
so we are expanding the project even further.
Humor isn't international.
(Laughter)
Red Noses Clowndoctors International were invited to speak at conferences
in Saudi Arabia.
This is a picture taken in the hospital
with the head of the pediatric ward.
When I first started helping to develop a project in Palestine,
I thought: "Wow, the clown
is not an element in their culture",
but they learned; now they know.
We found that they understood immediately
and went with us wholeheartedly.
We worked very closely with the hospital staff
— this is something I find very important.
How I see our work specifically
is that we are complement to the fine work
that other hospital professionals are doing.
And in that vein, I've also worked with medical students,
teaching humor and healthcare
as a communication tool,
how to better a relationship with the patient,
and I have worked with the Czech Association of Nurses
to teach accredited seminars for nurses
because I really believe, not that they are clowns,
but they can use humor in their work.
So we talked about types of humor relative to healthcare,
the developmental stages of understanding humor in children,
we talked about fear, about focus.
For instance, if I was to take a blood sample,
— and health professionals focus on their work, and that's normal —
so if I am to take a blood sample, may I?
Just stay seated -
The focus is here, where the procedure takes place,
but that is not necessarily convenient for the patient.
So what I do is introduce some other ideas.
May I see your other hand? Just one finger.
Now I am going to take a blood sample
(Laughter)
I am going to take a blood sample,
and your job is to make sure the bird stays flying.
(Laughter)
Keep it going.
(Laughter)
Just about... Got it!
(Applause)
Thank you.
(Applause)
Good job.
So we do work together with the hospital staff;
this is very important.
It is interesting that there are so many hospital wards now
which realize
that a ward without humor intervention can't work.
Things have changed that much in the last 15, 20 years,
and what it tells us in the global picture
is that healthcare is changing,
that healthcare is becoming more humane
and more aware of the psychosocial needs of the patients.
And that is something to smile about.
Thank you.
(Applause)