Teardrop_IconIt’s been a while since I’ve shared an experience with everyone. I feel that this one should be shared.

Dr. Maladjusted and I were working in Boston. My Horoscope that day read.
“Today the Celestial energy will be trying to teach you something. Specifically it will be teaching you how to share with others. But first you must go to a place where you truly want to share something of yourself. Give other people a chance to know you.”

Toward the end of the day we walked past a room that turned my head. In the room was one of those chrome cribs with the clear plastic tops on it. Inside the crib was a person, by the size, I thought to be 8 or 9 years old. I did recognize that they were probably in for facial reconstruction. I prepped Mal as to what we would see and asked if she was up for singing a song. Mal agreed.

Little did I realize that when we got closer, the person, who we found out later, was a 12 year old girl – had no face, hands or feet. No eyes, no lips, no nose.

The patient was very difficult to look at, yet like a train wreck, I couldn’t take my eyes off her.
NO Eyes, Nose, Mouth, Lips, Cheeks, or Jaw. You could see into nasal cavities, a throat, and maybe a tooth? I have seen a lot in my 19 plus years at Children’s Hospital, but this had been the most physical and traumatizing?

We stood at the door and started to play music. A simple little “soft-shoe” like song, with accents of burps, squeaks, farts, whistles, chicken, dog and pig sounds.  A lullaby arranged for guitar and instruments that we clowns play so well?
The patient placed her, what we thought were hands, up to the side of her head.

A music lover no doubt?

She screamed! It was more like a squawk from a large bird. I’m guessing it was her way of telling us to “Get Out”?We kept playing a little bit more. She slowly pulled her hands down and moved a little to the music, then started moving like Stevie Wonder at the piano.  – Who Knew?

She then thrust her arm through the bars. I didn’t know if she was flipping us off, or pointing to the door? Her arms went back to her head and we took that as our cue to leave.

Mal and I found the Child Life Specialist who apologized for not warning us what we had just witnessed.I explained that we had a wonderful “connect” with her with the music. The CLS eyes lit up and we both said at the same time, “It was the child within that we were taking care of.”                                                    I think the rest of the staff was taken back a little bit with our excitement.

It was wonderful news, that we were making a difference. So to make a long story even longer.

Mal and I went back once more. . .”When all else fails, ‘Slay em’ with a waltz!’”. . . a sweet song  titled ” I Think You’re Wonderful ”

Again the patient thrust her arm through the bars, only this time I reached out and held her Hand? (It was more like a hoof. It had a split and some kind of fingernail almost like a goat’s foot.) She bent it down and pulled my hand towards the bars and just kept it there. I melted. We finished the song, and we left.

Both Mal and I , looked at each other through tears and in shock.
No matter what we have been through in life – “We GOT NOTHIN?”

Her face, or lack of, haunted me enough to call our emotional hygiene person. We talked about this wonderful experience and my associate explained that we might of been the first to ever engage this girl with something?

I still can’t figure why she would reach outward, instead of withdrawing?
We also talked about, who knows, at what level she is mentally. What was going on in her mind?
Music, and silly little sounds? . . . A TOUCH. . .

Bubbles, Juggling, Magic, Physical Comedy, Foam Noses and Stickers wouldn’t do it.

I do know this. She experienced JOY.

When you stop to think about of all the people in this girl’s life of twelve years, Clowns were the ones that were able to connect with the inner child.

I suggested we give her a nickname. . . . . . “Beautiful”

I wanted to go see her again. She had already been discharged… No Goodbyes, No closure. There is no need.

She left, leaving an incredible contribution to my life, our work and this art of Clown Care!

Did I ever say “I love my job!” ?


Pardon Me?

Nurse Moose and I were visiting patient rooms on one of the surgical floors one day when we came upon a young dad sitting beside a small boy. The father looked at us and then asked his son if he would like to sit with him and listen to the clowns sing a song. The boy agreed.

Moose and I fumbled through “Old MacDonald Had a Farm,” asking the patient “What did he have on the farm? What kind of animal? What does that animal say?”

The boy, thumb in mouth, responded: Cow/Moo. Cat /Meow. Dog/Woof.

Then we switched to that perennial toddler favorite, “Wheels on the Bus,” and again found ourselves struggling to remember the lyrics.

But we gave it our best: The Lights on the bus go Blink-Blink-Blink. The Horn on the bus goes Beep-Beep-Beep.  ” What’s next,” I asked the little boy.

I heard: “You guys suck.” I looked at Moose, who said, “Pardon me?”

The boy spoke. Again I heard, “You guys suck.” I look at the father — could he interpret?

Dad patiently explained: “Open and shut. Open and shut. The doors go open and shut!”

Of course! It’s clear Moose and I have too much baby powder stuck in our ears!

Cancer Schmancer

I don’t have much good to say about cancer. But, in my experience, there have been some positives.

When my Mom needed chemotherapy for colon cancer, I took her back and forth to her treatments. We would often stop for lunch or dinner after these sessions and this time together gave us a chance to know one another better and have a closer relationship.

Then, during a trip to the Bahamas with my wife, I felt something on my back as I toweled off after a swim. I thought nothing of it, but it grew larger. Two months later, I was diagnosed with stage IIIC malignant melanoma.

I tried to stay positive throughout the whole ordeal. My war cry was “Cancer schmancer — at least I’m healthy! I’ll either beat it or die trying!” I was offered a clinical trial. I had nothing to lose and everything to gain.

After a monthlong course of daily IV chemo, I gave myself injections at home three times a week.

My mother passed away.

A second lump metastasized  into my lymph nodes.

After my fourth indoctrination ( that’s what I call an operation), a clown friend told me that I had been “blessed ” with cancer so that I would know what patients feel — inside and out. I believe him.

Another friend, a nurse, asked: “Do you know what makes a good nurse? A sense of humor and an incision.”

I had a lymph node section under my right arm, and stopped all chemo treatments. That was in 1999.

Humor in the healing process really works, and I have the experience on a personal and professional level.

There isn’t much fun in medicine, but a hell of a lot of medicine in fun.

Highs, Lows, and False Alarms

Hospital clowning, like everything else, has plenty of high and low moments. Here are a few of mine:

  • Watching a young girl who received a new heart ready and able to go home after 10 days.
  • Seeing another child whose transplant is failing. This is humbling. Maybe we shouldn’t call it a new heart. After all, it did have a previous owner. Maybe it depends on how that person took care of it?

That’s me, looking up what ails this rubber chicken!

  •  Persuading a young brain surgery patient to turn his head and smile. It’s easy: we start the magic trick on one side of his wheelchair and finish on the other.
  • Getting a 4-year-old stroke victim to play a squeaker.
  • Walking past a young girl’s door and into a wall, only to hear a tiny voice inquire: “Are you O.K.?”
  • Dissolving in chuckles when a young neurology patient jumps out of his bed after a female clown offers to give him a kiss! (Little does he know it is actually a sticker.)
  • Laughing with relief along with a nurse who discovered that the pasty white substance she had scraped off the roof of her patient’s mouth wasn’t dangerous — it was actually just the remnants of the host the child had received during Communion!
  • Bringing a little comic diversion to parents, clustered together silently in the waiting room, whose eighth graders had overdosed on muscle relaxants at a dance.
  • Working miracles in Pre-Op and Radiology. In the Pre-Op waiting room, glazed-looking parents perk up after we’ve been hanging around. In Radiology, families nervous about an imaging study bust a gut thinking about one of us squeezing into the MRI machine.
  • Visiting a little girl who tells her mother she won’t eat unless the clowns come to see her every day. Just what we need — kids going on hunger strikes!
  • Watching the Boston Fire Department race to the rescue after we clowns powder our makeup in the hospital’s Wolbach Building. Our baby powder sure doesn’t smell like smoke, but maybe to a smoke detector it looks like it!

Tools of the Trade

Cheap rubber bladder

Ever since the Big Apple Clown Care Unit started up at Boston Children’s, we have prided ourselves on our exhaustive Research and Development program. One of the items that underwent close scrutiny is known familiarly to most of you as the “whoopee cushion.”

Hospital management wanted me to take them away from the clowns, but I pleaded with them, saying, “That would be like taking the color red off an artist’s palette. ”

A whoopee cushion is a critical tool (combined with facial expressions and physical movement) that is understood in any language. Kids love it because it’s bathroom humor, but this was a problem in the hospital. Maybe some young patients were hospitalized for malfunctioning excretory functions! Toilet humor is not a road to travel in the hospital for sooooo many reasons. ( Do not follow the yellow drip road.) It also encourages “potty mouth” among the siblings and adolescents.

Chemical gel – FLARP

Do you realize in less than a decade, we have seen the whoopee cushion go from a cheap rubber bladder, to a chemical gel, to a fat rubber hose with two hard plastic ends, to a remote-controlled electronic device, to a self inflating cheap rubber bladder? Who got the grants for that technology?

Due to hygiene and  latex allergies, the electronic device is my instrument of choice in a hospital setting.

I have found it interesting and challenging to use it as a silly little sound and incorporate its use in musical numbers or in hearing tests along with squeakers.  

I like is to let my clown partner hide the main console of an electronic fart machine  in one of their pockets, while I control the remote. Things just slip out as they do and the kids crack up as we try to maintain some kind of composure and dignity!

Use this for high-tech bathroom humor!

Self-inflating rubber bladder. Works every time!

Funny what kind of sound those elevator or vending-machine buttons can make when you least expect it…

“Le tooter”

“Seize” You Later!

My Pleasure?

Sometimes kids with unexplained seizures are hospitalized so that their brain activity can be monitored. So they are outfitted with electrodes hidden underneath a kind of muslin turban. Then they wait, sometimes days, for a seizure to occur.

Making clown rounds among these patients always involves a familiar scenario: Mom or Dad is looking at the child, knowing something is wrong. The child, staring back, is thinking, “I know something’s out of whack, but why is nothing happening?”

One day my partner and I were invited into the room of a teenage boy. The father looked at the kid, the kid looked at the father, the father looked at the mother, the mother looked at the kid, the kid looked at the mother. The ritual repeated. Until we arrived.

I asked the Dad if he had any money and started playing a little street shuffle called “two card monte”  with Dad and the kid.  (The person who holds the cards controls who wins, and I made sure the kid always won.) When I got the Dad up to 35 cents, the kid was thrilled! He was winning!

I told Dad it was time to pay up, and my partner and I started to leave. Just as we were walking out of the room, alarms began sounding, bells started ringing and the medical staff came flying into the room.  I thought for sure one of us had tripped over something. Regardless, we had been trained to scram in this kind of emergency, so my partner and I stepped into the next room.

Later, after everything calmed down, we were walking past the teenager’s room when his mother literally grabbed me. “Thank you so much for giving my son a seizure!” she said.

I was devastated. My jaw dropped. I just looked at her and asked,”Is this a good thing?”

“We have been waiting three days for it,” she said.

“Well, then, it was my pleasure!”

I immediately went down to the charge nurse and said,” I just gave someone a seizure. Should I call my lawyer?”

She replied, “That’s great! See if you can give one to Room 324. She has been here for more than a week.”

Apparently the boy’s seizure was brought on when he was elevated to happiness and just starting to come down to neutral. Because of this seizure, they were able to figure out exactly where in the brain it originated. Later, an operation cured the boy of his seizures altogether.

So every time I am on the neurology floor I think about wearing a two-sided T-shirt. The front will say, “Visit with the clowns” and on the back would be a waving hand and the words “Seize You Later!”

Quotable Quotes

Do you know how important “NOW” is?

Enjoy it as much as you can because no matter how much you want you hold onto “NOW,” it’s going to be “WAS.”

-Sid Caesar-

To know humor, one has to know life. Good and bad.


A keen sense of humor helps us to

Overlook the unbecoming

Understand the unconventional

Tolerate the unpleasant

Overcome the unexpected and 

Outlast  the unbearable.

 -Billy Graham-

Get all the good laughs you can.

 -Will Rogers-

Hospital Orientation

Raise your hands now: How many of you have never seen the clowns before?

Raise them again if this is your first time seeing the clowns.

Don’t I look like I know something about fun? Many thanks to photographer George A. Taylor, MD.

Interesting. About the same!

Each member of Big Apple Circus Clown Care a is a professional performer – not a volunteer – selected for skill and sensitivity during a grueling audition process. Our training prepares us to work in the hospital environment. We learn proper hygiene and hospital procedures. We’re screened, we’re vaccinated, and we undergo an annual safety review. Our artistic quality and hygiene procedures are evaluated on a regular basis by our own “Joint Commission” on clowning.

Eight of the most talented and dedicated of these clowns can be found in the Clown Care program at Children’s Hospital Boston (CHB). There, they work with the hospitalized children, their parents and the hospital staff to ease the stress of serious illness by reintroducing laughter and fun as natural parts of life.

Collectively, and without boring you with details, some of their outstanding credits include:

  • Ringling Brothers Clown College graduates and teachers
  • Nationally and Internationally recognized
  • Performances from the streets to the center ring. From comedy clubs to the Lincoln Center. Broadway to Cirque Du Soleil.

Ironically (or maybe not), three of them were hospitalized at CHB as small children.

Patch Adams drew attention to the positive effect of humor and healing. Unlike us, however, he is a doctor who plays a clown. We are professional clowns who play doctors (one of my colleagues calls himself “Dr. Gongolfin.”)

Making clown rounds

Since 1995, the Clown Care Unit has been making clown rounds at Children’s. That’s 325 inpatient beds a week, 3 intensive care units, 11 floors of clinics and everything in between. We get our rundowns from the charge nurse or childlife specialist on all the floors we enter. They let us know any special details that will affect how we do our jobs. Do we need to take special precautions with any of the patients? Is anyone vision impaired? Unable to hear?

Here are some of our DOs and DON’Ts:

DO have fun. Join in! A problem shared is a problem divided, and a joy shared is a joy multiplied.

DON’T ask us to be associated with a painful procedure. Wait till after.

DON’T assume that someone is too young or two old for clowns. We have age-appropriate material for newborns to adults.

Professionalism and sensitivity, combined with the commitment to our art, are the keys that unlock the many doors of the hospital and bring us into the hearts of the children, families and staff. In the short time that we’ve been at Children’s Hospital Boston, I have discovered how important  and what an honor “IT” is to be able to “Walk someone to the door.”

There are many doors of the hospital. Registration, Admitting, Pre-Op, the elevator, the exam rooms, the cafeteria, the garden, and the front door. Even the door from this life to the next.

All these doors taught me a trick that is sure to make anyone smile:  Miss the door and walk right into the wall!

Bunny Tales

It was Eastertime and I was doing my classic bit where I would take this 2-inch stuffed rabbit and do a little puppet routine on a table top. I would sing the “Hokey Pokey” and perform a little dance with the toy.

” You put your right foot in . . .You put your right foot out . . .” STOP.

I would look around the room, sniff the air, and continue: ” You put your left foot in . . . You put your left foot out.” STOP.

I’d pick up the rabbit, smell it, and make a face as though I’d just noticed a foul odor.

Then, I would ask the person next to me to smell the rabbit and tell me if they thought it smelled  funny. In most cases people were hesitant to sniff. They were afraid that it was going to squirt water at them. However, I assured them that it wouldn’t.

When they finally placed it to their nose, I asked. “Does it smell funny?”


“It should. It’s the ETHER BUNNY!”