Transcriber: Gabriela TomkovaReviewer: 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 speakonly 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 everyonein this room remembers a time when it was impossibleto put those two words, humor and healthcare, in the same sentence.
Today, humor and healthcareis an idea worth sharing.
I'd like to startwith my personal experience I had here in the Czech Republic.
About 15 years ago, I had just started presentingthis idea of humor in healthcare at healthcare conferences, and I was runningall over the country like a mad man visiting hospitals as a clown.
One of my studies was clowning.
I studied at the first accreditedclown 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 dois have a consultation with the staff to get some basic informationon 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 methings 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 stagesof the disease, and her bodily functionsare 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 reallymake sense to visit her.
” And I said, “Can I try?”And he said, “Yes, of course.
” So I continued my visitto 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.
I opened the door slightlyand asked if I could come in.
I saw Melissa lying in bed, staring blindly at the ceiling; she had lost all her hairthrough treatment.
Her mother was sittingnext to her, wringing her hands, obviously in a lot of stress.
So I asked if I could come inand 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 knewwhat 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 ideato put it out of the window.
I was racing around the roomtrying 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 birdwould live under her bed.
(Laughter) This was our decision together, and so the bird finally livedunder Melissa's bed.
At the end, I picked up my ukulele, and I sang a little song about the bird that livedunder 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 meinto 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 Iunderstood the game, and her mother was completely surprised.
She probably saw this as, maybe, the last time she would seeher daughter smile and laugh.
I don't know, but she was very emotionally charged.
I went on my way, — I was continually visitinghospitals all over the country — so it took some timebefore 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 methat 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 necessarilyas a [result] of my visit.
But that moment gave me the resolveto continue with this work.
And today, here in the Czech Republic, there are 87 specially trainedcertified health clowns visiting over 75 hospitalsand institutions, on a regular basis, at least once a week, up to seven times a week.
We make more than 3, 500 visitsa year here in the Czech Republic.
In the meantime, I was honored to be ableto 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 developeda certification process, a curriculum, which involves all of the things these specially trained artistsneed to know to do this work correctly.
We have an international schoolof humor in Vienna where partners can come and get the best training in the world.
We believe that approaching this projectin a professional manner is really what it takes.
Just like other peopleworking in healthcare, we see it as very importantto put energy into the training process.
Red Noses Clowndoctorsis also advocating for child's rights.
The right to play, specifically.
We all know that play is an important partof the development process for children.
In hospitals they also recognize this.
So, what you will see in children's wardsquite often are playrooms, but this is not inclusivefor 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 individuallywith children of all ages — they are specially trainedto work with children of all ages — and we work individually with each child.
We use the hospital proceduresand the environment and make fun of it.
Nurses and doctorslove 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 childrenon an individual basis.
(Laughter) As you can see, they are very empathetic.
(Laughter) Children's programsare the basis of our work, but we do work with other age groups.
We have a project called Circus Patientus where we workan entire week with children, in civil, without the clown nose, teaching circus arts, and magic, and music.
These are things that childrenare readily interested in.
And I believe that if we can awakenan interest in whatsoever, then we awaken an interest in life, and interest in life is an integral partof the healthcare process.
So Circus Patientus is a process where they learn something new, they become interested in things, and they become the starsat the end of the day.
We even have circus tents set upon the hospital grounds, which is very invitingfor children in hospitals.
They are the big stars of the show.
Audience includes their parents, hospital staff, other children.
Besides children, we also have developedprojects working with the elderly.
Because actually last yearI reached retirement age, (Laughter) I do not want to be in an institution where there are not clownsvisiting on a regular basis.
(Laughter) So we have developed humorfor the early born.
(Laughter) And quite oftenthis is exactly what they need, they need to be brought back into life.
It is a completely different method.
Clowns that do this projectare trained specifically for this project.
We use old costumes, 50-year-old costumes, we sing the old songs.
A lot of it has to dowith memory training.
Picking mushrooms is very popularin the Czech Republic, so in the autumn we would come inwith a basket of mushrooms, just to smell it, to remember.
It is a beautiful project.
We also have many other projects.
Caravan Orchestrais a special scenario built for the multiple handicapped childrenin institutions.
We have the Humor Baskets projectfor adults.
I have seen magic work with this.
I have seen waiting roomsin an adult oncology ward; and you can imaginewhat the atmosphere is like.
We have come in with these humor baskets, and the whole thing is changedinto 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 projectsI was able to do here, — for the Zdravotní Klaun project hereand also the project in Slovakia — was to introducesomething I had seen in Israel.
Clowns, specially trained for this, accompany children from the hospital wardto the operating theater.
We call it 'NOS, '(Czech) “To the operation room.
” What I have realized is there are specific stress momentsin this process, so the clowns are trained to interject humorat these stress moments.
If you could imagine being a parent— this is not just for the children — and this moment when your childis wheeled through the operation room and the door is closeand you are left outside.
Can you imaginewhat a stress moment that is? The clowns are also specially trainedto work with parents in these situations.
They may take the nose off and just be a human beingwhen 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 expandingthe project even further.
Humor isn't international.
(Laughter) Red Noses Clowndoctors Internationalwere 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 helpingto 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 closelywith the hospital staff — this is something I find very important.
How I see our work specifically is that we are complementto the fine work that other hospital professionalsare doing.
And in that vein, I've also workedwith medical students, teaching humor and healthcare as a communication tool, how to better a relationshipwith the patient, and I have workedwith 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 typesof humor relative to healthcare, the developmental stagesof understanding humor in children, we talked about fear, about focus.
For instance, if I wasto take a blood sample, — and health professionals focuson their work, and that's normal — so if I am to takea blood sample, may I? Just stay seated – The focus is here, where the procedure takes place, but that is not necessarilyconvenient for the patient.
So what I do is introducesome 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 surethe bird stays flying.
(Laughter) Keep it going.
(Laughter) Just about.
Got it! (Applause) Thank you.
(Applause) Good job.
So we do work togetherwith the hospital staff; this is very important.
It is interesting that there areso many hospital wards now which realize that a ward withouthumor intervention can't work.
Things have changed that muchin 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 needsof the patients.
And that is something to smile about.