Clown sees serious benefits to therapeutic work

by Erin Allday, SF Chronicle staff writer, 21 June 2011

The first time Jeff Raz met 86-year-old Norma Perez, all she would talk about was coins. So Raz, a professional clown brought in to work with dementia patients at California Pacific Medical Center, did the obvious: He performed a magic trick for her, making a coin disappear before her eyes. “She hated it,” said Raz with a grin. “The trick tanked.” Perez, it turned out, couldn’t grasp that he hadn’t really made the coin disappear. It was only later, while he was talking to one of Perez’s caretakers, that Raz learned he hadn’t exactly failed. Just the interaction alone – getting Perez’s attention, and getting her excited and talking about what was real and what wasn’t – fired up her brain. Raz is a veteran professional clown – he’s had stints with Cirque du Soleil and Ringling Bros. Circus, among others – whose latest turn is creating the Medical Clown Project with his wife, psychologist Sherry Sherman. The project, founded early last year, is an Alameda-based nonprofit trying to get therapeutic clowns into Bay Area hospitals as part of the medical team.

Hospitals show interest The group, which already includes five therapeutic clowns, launched a pilot project at California Pacific Medical Center last July and will start working regularly at several of the hospital campuses next month. They’re in meetings with at least two other hospitals to work with patients in both pediatric and adult units. In addition to working with local hospitals, Raz and Sherman would like to one day get funding for a study of therapeutic clowns to determine just what benefit they offer to modern medicine. “We’ve had some somewhat tough presentations” trying to pitch medical clowning to local hospitals, Sherman said. “But it was really very interesting because they wanted to know what, exactly, do we do. What value is added? It’s easy to say that patients need laughter, but what does that really mean?” While most health care providers agree that clowns can be helpful in hospitals – if only because they obviously cheer people up – there’s little evidence to support medical clowning as real therapy. But there have been at least two recent studies with positive results. A Canadian study last year found that children who saw a clown just before surgery were less stressed than kids who were sedated or with a parent. And earlier this year, a study in Israel found that women undergoing in-vitro fertilization had a better chance of getting pregnant if they visited with a clown just after the embryos were implanted.

Part of the medical team Clowns have been brought into hospitals for decades, usually as a way to cheer up sick kids stuck in pediatric wards. They show up in their full face makeup and silly, brightly colored costumes and do a routine, and then they’re off to the next gig. That’s not medical clowning, Raz said. For starters, medical clowning isn’t just for kids. He spends about as much time on adult wards as he does in pediatric units. But the biggest difference between circus clowning and medical clowning is that in a hospital, Raz likes to think of himself as part of the medical team, similar to a massage therapist or acupuncturist. When he goes into a hospital he’s not necessarily performing – he’s working with patients to alleviate stress or energize them. “They’re essentially using imaginative play as a tool to stimulate the brain activity of the residents,” said Robert Sarison, program manager of the Alzheimer’s program at California Pacific Medical Center. “Someone might start out looking like they’re checked out or not engaged at all, and by the end (of a clown visit) they might be laughing or singing. Seemingly out of the blue this person is much more alert. “We’re not going to suggest for someone who has advanced dementia that’s going to be a cure,” Sarison said. “Our goal is to keep people happy and alive and well as long as we can.”

Easy on the makeup At a recent visit to the Alzheimer’s ward, Raz and another clown wore minimal face makeup – a little white paint around the eyes and mouth, some pink blush on the cheeks – along with white lab coats and, naturally, extra-large shoes. They juggled and told jokes, and mostly they took their cues for performing from the audience: Norma Perez and her coins, for example. One woman loves to sing, and when Raz played a harmonica with her she chirped along with him like a bird. Of course, not everyone loves a clown. Raz is well aware that plenty of people have a fear of clowns – whether they’re intimidated by the “larger than life” look of the big clothes and hair and makeup or they’ve read too much Stephen King. So on his last visit to California Pacific Medical Center, when one 89-year-old man announced that he wanted to leave the room, Raz didn’t even blink in surprise. Instead he took the man’s hand and helped him out of his chair, and he smiled as he escorted him out of the room. That’s the first rule of medical clowning, Raz noted: The patient’s in charge. “Most patients are mostly powerless. You’re not in control of your time, or even your bodily functions,” Raz said. “With us, you rule the roost. So if you say ‘get out,’ we get out.” Click here for a link to the original article.