Send in the Medical Clowns Lessons behind the Laughter

Before coming to Einstein, many medical students seek to gain experience in a healthcare setting. They may intern in hospitals or volunteer with programs overseas. First-year students Channa Ovits and Barrie Cohen took another route: they donned red noses, make-up and colorful clothing, becoming medical clowns that entertained sick children in Israeli hospitals.

First-year medical students Barrie Cohen and Channa OvitsBoth students, who are alumnae of Yeshiva's Stern College for Women, spent their first year of college (2006-2007) abroad in Jerusalem. "Through the school's charity program, you choose what you''d like to do in the community," explained Ms. Ovits. "I chose the medical clown program because it involved going to hospitals and seeing medicine up close. I love children and I thought that would be the perfect fit for me."

While their training was limited, the students were taught some rudimentary clowning skills. "I learned how to make a lot of balloon animals, but never quite mastered juggling," said Ms. Cohen.

Ms. Ovits, who called herself Kukuim – the Hebrew word for pigtails, which were a defining feature of her clown persona – worked in several hospitals in Jerusalem where the pediatric wards were filled with patients ranging from age 3 years to pre-teen. The children were being treated for cancer and other illnesses. "Their parents were usually with them, worried about their kids, but when I'd come in they'd smile a little bit," she recalled.

Even the few clown-averse kids warmed up to her. "I remember this one six-year-old girl who was shy at first, but then hugged me around my knees and wouldn't let me leave."

Ms. Cohen's experience proved more challenging. She was assigned to Mount Scopus, a hospital in East Jerusalem that serves a large Arab population. As a result, language was a significant barrier, leading communications with patients and their parents to be difficult. At times, she and her fellow clowns also experienced attitudes that reflected the cultural divide in Israel.

Barrie (left) with clowning partner, in Israel"There were times when it was great and we were able to play with the kids because we didn't have to talk, and we could give them balloon animals and be silly," said Ms. Cohen. "And then there were instances when the parents seemed uncomfortable about our being there and would let us know they didn't want us in the room."

Still, she and the other clown volunteers at Mount Scopus made the most of things, for example, improvising how they communicated by pantomiming rather than talking. The experience taught her an important lesson, as well. "I came to realize that I shouldn't take things personally. Kids often don't know any better. And their parents were frightened for their sick children and were influenced by longstanding biases they'd been taught."

While Ms. Ovits' experience was more positive on the whole, she also experienced the occasional communications difficulty on the ward and found non-verbal communication helpful. "You use whatever you can to tell a joke…through your body, your eyebrows. You do whatever's necessary to get your point across," she explained, describing how she played cards with a sick child (and let the child see her hand) and created a menagerie of balloon animals.

Channa, a.k.a. Kukuim, (right) with clowning partner, in IsraelAfter taking off their red noses, the two women sought more intensive medical training. Ms. Ovits joined an Israeli ambulance corps during the summer of 2007. "I was a first responder, going on eight-hour shifts all over Jerusalem." Back home in New York, while attending college, she also volunteered as a patient advocate at Bellevue Hospital.

During the summer of 2010, Ms. Cohen spent several weeks with the Amazon Health Project, helping to provide dental care for children and adults in Peruvian villages. "It was a very different experience, because they were always happy to see us," she said.

Instead of a sterile hospital, she worked in the heart of the jungle, with screeching monkeys and the occasional tarantula. Not fluent in Spanish, she found her clowning skills came in handy for keeping kids and parents calm while they had their cavities filled.

Now in the midst of their hectic first year, neither student knows what her specialty will be. Even so, their medical clowning experiences have provided valuable lessons.

"Clowning helped give me a better sense of people," said Ms. Cohen. "You realize how fearful patients can be and how important it is to keep them calm. And you recognize that we all have certain biases, and that it's important to look past your own in order to treat patients effectively."