THE TOTAL PATIENT On call with Dr. Bovine: Clowning around helps young patients cope with cancer Bette Weinstein Kaplan hen you are a sick child lying unit at Memorial Sloan-Kettering, the not in the best circumstances. I chose in a hospital bed, constantly performers are specially trained in all to work at Memorial Sloan-Kettering W getting poked and punctured hospital hygiene protocols and famil- Cancer Center because the children or being wheeled away for procedures iar with all forms of medical clear- there were facing such a tough battle. that are uncomfortable or downright ances; they are even compliant with Also, the long-term inpatient aspect of painful, the last person you would want the Health Insurance Portability and the facility made me come up with new to see coming toward you is one more Accountability Act (HIPAA). material and kept my skills sharp.” white-coated doctor. That is, unless Considered the innovator of this art When asked what skills are needed to that doctor is Dr. Bovine. form, the Big Apple Circus Clown Care do what he did, he said, “You start with Dr. Bovine describes himself as “a program has inspired many other similar patience, resilience, the ability to listen, benevolent, almost plodding, always programs throughout the country since the ability to check your ego at the door, hungry, not so smart, pretty patient its inception in 1986. This type of activity and an open heart. Then add music, goofball with a porkpie hat, a short lab is nothing new for clowns and other per- magic, storytelling, juggling, tap dancing, coat, and round glasses.” He says the formers, Heroy says, since they have been jokes, singing, bubble blowing, puppets, bovine identity was especially appeal- entertaining in hospitals “for eons.” origami, comic timing, trivia, imper- ing to him because “cows give every sonations, riddles, Abbott and Costello part of themselves for something.” This BUT A CLOWN DOCTOR? routines, etc. You name it.” He said an extremely giving person is actually the How does someone become a Big Apple oncology nurse or other practitioner can clown, Glen Heroy, and his persona as Circus clown doctor? Heroy explained: learn and practice those skills, too. “It’s Dr. Bovine for the Big Apple Circus “While I was Santa Claus at Macy’s in beautiful to see a nurse or doctor sing or Clown Care program made a huge dif- New York’s Herald Square, I did some play along when we get goofy.” ference in the lives of many patients outreach appearances for disabled chil- at Memorial Sloan-Kettering Cancer dren and found that I had a very strong CLOWN ON CALL Center in New York City. A clown can connection with many of them. This Although he was usually found in the provide palliative care like no one else. inspired me to try and find a job where pediatric unit, Heroy worked with I could perform, get a paycheck, and patients ranging in age from newborns CLOWN COMMUNITY OUTREACH do some good for children [who] were to adults. He learned that at Memorial The Big Apple Circus Clown Care program employs specially trained SEE THE ONLINE VERSION OF THIS ARTICLE TO LINK TO: professional performers to be clown doctors. Working in teams of two, Glen Heroy www.glenheroy.com they go to children’s hospitals or the Big Apple Circus Clown Care www.bigapplecircus.org pediatric units of large medical cen- PBS series Circus www.pbs.org/opb/circus ters several times a week for about 5 Circus Physics: Newton’s Laws of Motion hours a day. According to Heroy, who www.pbs.org/opb/circus/classroom/circus-physics/newtons-laws was also supervisor of the Clown Care www.OncologyNurseAdvisor.com • MARCH/APRIL 2011 • ONCOLOGY NURSE ADVISOR 37 THE TOTAL PATIENT Sloan-Kettering if a patient is diagnosed HELPING STAFF “all-or-nothing mind-set.” He said he as a child, that patient always returns AS WELL AS PATIENTS had a strong connection to the children, to the pediatric floor for treatment. Of Dr. Bovine said he tried to “weave [him- which, combined with the mortality course he assisted the staff with patients of self] into the fabric of the community.” rate over 8 years, “is an intense equa- any age, and he was always in demand. He was primarily there for the children, tion.” It was time to move on. “I’ve distracted and entertained kids but he also tried to include all those during all sorts of injections and finger around him in his antics. Not everyone PROVOKE A SMILE sticks. I’ve had children race me, hit me, was receptive to his colleagues and him, When Heroy left the cancer center, he and arm wrestle me, all in the name of though. He noted that there are always became a featured clown in the touring physical therapy. And I always tried to be people, including medical and admin- production of the Big Apple Circus. with a child who was having a particu- istrative staff, who think that having He starred in the PBS series Circus and larly bad day. I remember an 11-year-old clowns walking around a medical facility taught a lesson in physics using the boy (whom I had known since he was is inappropriate. However, he added, hilarious Big Apple Circus dog act as 7 [years old]) who got hysterical when “Often their opinions are turned around part of an educational supplement to he was brought into the pediatric ICU. when they hear children laughing.” that series. He said he is “astonished” He demanded, ‘I WANT TO SEE DR. that the children and their families BOVINE!’ and I was paged. A new DID HE MAKE A DIFFERENCE? stay in touch with him. He even has a nurse later inquired, ‘Who is Dr. Bovine, When asked if he made a difference in number of Facebook friends who were a psych counselor?’ The charge nurse patient care or outcome, Heroy said, patients when he was at the cancer said, ‘No. He’s the clown.’ ” “I made children forget they were sick center and who are now “all grown up There were many requests for Dr. for 5 minutes. I didn’t cure any dis- and healthy and beautiful. That kind Bovine to see specific patients. He eases. Although Farid Boulad, MD, of makes it all worth it.” made birthday visits. He visited adults medical director of the Pediatric Day Does Dr. Bovine have advice for in other parts of the hospital. He was Hospital at Memorial Sloan-Kettering oncology professionals? “Try keep- all over the place. “I used to love being Cancer Center, told us (in regard to the ing a sponge ball clown nose in your present when a child came out of anes- clowns), that patients heal faster when pocket (see Sources for inexpensive thesia or being there to escort a kid to they are in a better mood.” clown noses). You never know when radiation or to push their wheelchairs Dr. Bovine stayed at Memorial Sloan- the unexpected provoking of a smile when patients were leaving to go home. Kettering for 8 years, entertaining as might come in handy.” n (I’d also get in the car with them and well as supervising the Clown Care unit demand they take me home with them there. He also spent six seasons as a Big Bette Kaplan is a medical writer based in and give me cookies!)” Apple Circus Clown-in-Residence at Tenafly,N ew Jersey. Coulrophobia is the fear of clowns, and Paul Newman’s Hole in the Wall Gang over the years Dr. Bovine has encoun- Camp. He took his commitment to tered a few cases of it in children and the children very seriously and often adults. Heroy’s solution was to design would visit them at home, meet them Sources for and print a “No Clowns Today Please” and their families at the carousel or inexpensive clown sign, which had a picture of Dr. Bovine the zoo, or join them on a Ronald noses in a red circle with a red bar across his McDonald House excursion to Disney www.windycitynovelties.com face. He explained that his plan back- World. He made time to go to every www.justclownnoses.com fired because the sign had a picture of fund-raiser, every talent show, and www.orientaltrading.com a clown on it. every pediatric prom because he had an TEll US What YOU thInk! Go to www.OncologyNurseAdvisor.com to comment on this article. 38 ONCOLOGY NURSE ADVISOR • MARCH/APRIL 2011 • www.OncologyNurseAdvisor.com .