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)
