Clown Doctors in New York City

1) This article proposes the similarity between a unit of professional clowns and shamans, both healers congruent with the folk sector of alternative medical systems. The clowns work in pediatric wards of New York City hospitals, where they interject “joy and mayhem” into the lives of patients, their families, and medical staff via performances of “funny-bone removals, squeakectomies, and bed-pandemonium” (page 462-463). The author argues that adoption of an additive, integrationist model of disease with collaboration between biomedical and complementary practitioners (like clowns) would facilitate better health outcomes.

2) Like shamans, the clown healers are “liminal figures” and “metacultural texts”, reversing and distorting cultural conventions, in the latter case to invoke hilarity, ameliorate pain with mental distraction, or provoke transference or catharsis through humorous devices such as satire and irony. Thus, their technique is production of emotional release by violating or inverting cultural rules. The healers assume clown doctor characters and use mime, farce, physical comedy, children’s theater, magic tricks, ventriloquism, and gags to produce psychological healing for patients and families.

They tailor their performances to the target audience age and affliction and supplement traditional biomedical care without being intrusive; they do not intervene while examinations are in progress, avoid quarantined zones, and employ sterile measures. Their social ranking is inferior to biomedical practitioners, as they must heed restrictions imposed by biomedical practitioners. Their skits are also aimed at patient empowerment, equalizing the doctor-patient power dynamic by parodying physicians and hospital procedures.

Furthermore, both shamans and clowns are viewed ambivalently, enter altered states of consciousness, and use music and rhythm to evoke a different reality. Importantly, they both entail a mystical element to which children are susceptible. For instance, with slight-of-hand, the clowns employ “symbolic healing” via manipulation of culturally-embedded symbols to “promote psychosomatic transformation,” by “enlisting the power of suggestion or placebo effect” (page 464, 469). They also mobilize psychosocial support, reduce family tension, and boost institutional morale by engaging all parties.

3) Although the clowns belong to the folk sector in their resemblance to shamans, they operate within the professional sector of health care. While practitioners in the folk sector share the cultural values of the society and view the body holistically (treating the psychological, spiritual and social realms and the subjective, experiential aspects of illness), the professional sector under which Western biomedicine falls delivers bioreductionist allopathic care geared toward clinical symptoms of disease entities based on a scientific, authoritative knowledge scheme. This latter sector predominates in developed and industrialized societies where the body is viewed through the lens of Cartesian dualism. Whereas practitioners in the professional sector are legally sanctioned and enjoy elite status and reputation, the clowns and other folk healers of traditional, non-Western societies are inferior on the social hierarchy and possess less prestige. The professional sector utilizes specific, compartmentalized approaches to somatic complaints, while the clowns and folk healers treat “the whole person, the social milieu, and the mental predicates of illness” (page 471).

Clown Doctors: Shaman Healers of Western Medicine

The article Clown Doctors: Shaman Healers of Western Medicine, made the comparison of clowns, in western society, to healers from traditional societies, particularly shaman.  It did this both with physical similarities (costumes, make-up, props, music, ventriloquism, ‘magic’ or sleight of hand, puppets, etc.) and with their cultural defying performances, used to employ social healing.  They use suggestion, and manipulation of cultural symbols used in society’s medical system in an attempt to alleviate the patients distress.  The Clown Doctors of The Big Apple Circus Clown Care Unit (CCU), not really doctors but clowns, are a perfect example of a complementary therapy used to enhance the efficacy of medical treatments in developed nations, particularly with children.  The clowns help alleviate stress from the hospital environment, helping not only the children, but their parents, and the staff as well.

The healers of this article are the clowns, in emotional or psychological regards as opposed to the typical biological aspect, both of which are extremely important to proper healing.  I think one could argue about the social status of the clown doctors.  Many are properly educated and probably of middle class outside the hospital.  However inside the hospital setting, its hard to say where exactly they would rank, but I would guess fairly high.  They are allowed to boisterously wander around the hospital, joking with & poking fun at anyone they feel like, including doctors & other staff. And although they have to check at the front desks they are allowed into some pretty specialized areas of the hospital to visit with the young patients there.  Many of their ‘performances’ or props used also poke fun at the hospital or its procedures.  All of this joking and fun having is done, with patients, their parents, and hospital staff, in order to alleviate stress, lighten the mood, and distract from the reality of their surroundings (& illness).  Its a great way to supplement treatments; I’ve seen dogs allowed in the hospital as a way of doing this but not a clown (would be interesting).

The clowns are quite heavily part of the folk sector, but they are working within the professional sector.  This seems a little odd, and even out of place in western society, but it does make sense and in fact works perfectly well.  The folk sector involves the use of healers which treat patients using holistic methods extending beyond physiological symptoms, allowing patients more comfort through their illness.  The professional sector uses biomedical methods of understanding & treating the body, its illnesses, & symptoms. Some of these illnesses, or injuries are much more severe than others, and even hard for the clown doctors to witness.  These  offer perfect times for the clown doctors to do what they do best, their job. They may not perform any biological medical treatments, but distract and console the patients and families from procedures and illness with humor and laughter.

Clown Doctors in NYC

The article I am referring to is Clown Doctors: Shaman Healers of Western Medicine. This article focuses on a professional group of clowns who work in a pediatric unit. The main point of the article is to make a comparison between shaman healers and clown ‘doctor’s. I did not overly enjoy the article; I’m not entirely sure why. Essentially, the article posits that clowns and shamans are similar because both employ strange costumes, props, and behaviors, in addition to sleight of hand, ventriloquism, music, and feats of skill that break natural and cultural laws. The point about breaking social/cultural ‘laws’ is repeated quite frequently throughout the article. The article also talks about how children are a better focus point because they are less “vaccinated” against belief in magic. While that may be true, I do not agree that children would believe the clowns to be normal doctors with special powers. While convenient in enhancing the analogy between clowns and shamans, it is conjecture only in the article.

 

The healers are clown ‘doctors’. Specifically, they are a group of professional clowns who work in a hospital in NYC with the children admitted to the hospital. In this context, their social status is not as relevant as it would be for other ethno medical systems, but I would hazard the guess that professional clowns are probably somewhere in the middle of the social status spectrum. These healers use comedy to try to cheer up children and their families, helping to make their hospital visit a little less scary. They interact with their patients by telling jokes or performing rehearsed skits with them.

 

These clown doctors operate in regular a NYC hospital, rather than in their own separate institution. Healthcare is delivered through what I would imagine is standard biochemical medical practice in the U.S. This setup focuses only on treatment via medicine or procedures. IT is because of this that the clowns are able to serve a useful purpose. Because the hospital is rather intimidating and impersonal for a child, the clowns are able to ease the tension by cheering them up.

Japanese Healthcare System

I decided to focus on the Japanese healthcare system as was in he frontline film that we watch. I selected this because I thought Japan is a country that I would be interested in visiting at some point in my life therefore how one would receive care is an important thing to know. This film followed a journalist as he travel to and from five different countries to examine how the health care system there worked. he went to the UK, Japan, Germany, Taiwan, and Switzerland. During his investigation the journalist gathers information about the system from doctors, patients, and even health care policy administrators. By Doing this the audience was able to get a good understanding of the healthcare, how it affected the people and how they felt about the way that the program was set up.

With in this film I found that the healers where the Japanese doctors. Their social status is reasonable though it is difficult to become rich because of the regulated price list. The interactions between patients and doctors were very different than than in America. The average appointment last roughly 3 minutes so the patient has to be very to the point about what it is that is a concern of theirs. Another interesting thing about the primary care visits is that you never have to call ahead to make an appointment, the patient can come as often as they want, and primary visits are not might to keep them from seeing a specialist. Overall the patients are very comfortable with their doctors but the visits are very focused and quick not allowing for a deep connection to form between doctor and patient.

In Japan they have what they call social health care insurance which are these insurance policies that everyone has to buy into. This policy is obtained through an individual’s job, a community based program, or if the individual is too poor the government pays for their policy. Almost every doctor’s office is a private business. The patients enjoy going to the doctor so much that they visit the doctor about 3 times more than the average American. The Japanese also get medical scan done at a larger rate. In Japan the government makes a detail list of how much each medical procedure/item will cost. If doctors try to complete more of a certain task for additional income the next year the price of the task will go down. This price list is negotiated yearly.

Shamans of Mongolia

The assigned film, The Horse Boy, had a pretty heavy impact on me. Being honest, I thought it was so touching and it even made me tear up a couple of times. Not only was the story one of challenges and triumphs but it expressed two distinct views on the subject of alternative medicine. The father of the child was very open to the possibility of successful treatment from the shamans while the mother was skeptical (although not completely in opposition). I could see myself in both of them, and I think that’s why I enjoyed it so much.

The film followed a child and his parents as they trekked by horseback across Mongolia, visiting a string a shamans. In Mongolia, these shamans are respected and honored. The more talented ones are even hard to meet up with, increasing their value. In the film, they are shown as being fairly quiet and calm people (and were all men). It’s almost as if they have an unidentifiable power that draws people to them. Rowan, the autistic child, loved being around the shamans and usually calmed down and regained focus when they were near. The shamans seemed to tolerate his hyperactivity and fascination with them very well, too, letting him crawl on their laps and touch their clothing. In the cultural setting shown in the film, it is evident that shamans are the preferred “doctors”. They represent more than biological health. They are the gateway to becoming healthy in all aspects, not only physically but mentally and emotionally. They take all aspects of life into account, and I think this is what makes them so trusted. I can personally relate to that desire of being treated as a whole person, not just a physical body with purely biological symptoms. I recently switched doctors simply because I felt that my previous one lacked interest in anything beyond my physical state of being. He did not investigate the minor issues I expressed and failed to ask about my social life, etc. I now see a doctor who makes me feel more individualistic and important, which also indicates her concern for my well-being on a much broader level. Shamans don’t stop there. In treating one person’s symptoms, they may even include other family members. In The Horse Boy, Rowan’s parents are often asked to participate in healing ceremonies and practices. This helps bring the family together, and the parents state that even if the shamans don’t heal Rowan’s autism, they will treasure how the process has united them.

I may have been more like Rowan’s mother a couple of semesters ago but I am beginning to side more with his father after taking various anthropology classes and especially after watching this film. There are some things that are hard for us Americans to see, being so obsessed with logic and science but we much not forget to keep an open mind. We aren’t the smartest culture and I think we definitely are not the most appreciative of the life we are offered. We may be happy and healthy but I think we would be better off if we could acquire a more holistic view of life like the shamans of Mongolia.

“A Doctor for Disease, a Shaman for the Soul”

-In the above titled article, by P.L. Brown, it discussed how a hospital in Merced, California had started to integrate the ceremonies of Hmong Shamans with the more traditional western medical care. This California hospital is in the Central Valley, where a large population of the Hmong settled after fleeing the post- Vietnam War aftermath in their home country Laos. In this particular hospital, Mercy Medical Center, the administration and staff have made a joint effort to incorporate Hmong traditions with the hospital’s medical care. They are doing this in order to integrate themselves within the ethnomedical system of the local Hmong. Before this program, many in the Hmong community would first go to their local Shaman and engage in traditional ceremonies, and only go to the hospital as a last resort. This waiting for treatment led to a high incident rate of ruptured appendixes, complications from diabetes, and end-stage cancers. One of the main reasons for this wait, was the distrust the local community had of western medicine, in their traditional Hmong belief system, they found invasive procedures to be taboo. To gain the Hmong community’s trust the hospital worked with local Shamans, cross-training them in western medicine, and working to accommodate their ceremonies. Although, not all ceremonies are permitted in the hospital, and they typically must keep the ceremonies under fifteen minutes, as opposed to ceremonies that traditionally can last all day. But this integration of non-western, traditional healing methods and the more biomedical, westernized medicine health system is a trend that seems to be gaining in popularity across the country.

-The healers discussed in this article are the Hmong Shamans and the medical doctors. The techniques used by the medical doctors are the “scientifically-excepted” biomedical practices and procedures common in westernized medicine. They interact with their patients in a more generalized manner and are mainly there to treat them biologically, as opposed to all aspects the patient might be dealing with. The Hmong Shamans use ceremonies that treat the person’s soul and their whole body in a more holistic fashion. These ceremonies can include chanting, incense, and animal sacrifice, but more importantly, these ceremonies involve the friends and family of the patient and the healing of that person is a community effort. In their communities, the Shamans are highly revered and are thought to have great powers of healing and spirit. But medical doctors are typically more highly regarded, in the overall population as a whole, than a Shaman would be to people who do not share the same beliefs.

-The basic biomedical doctors of Mercy Medical Center that are discussed in the article are considered to be part of the Professional sector of healthcare. This biomedical system is the dominate ethnomedical system in westernized, American culture and the professionals who practice this type of medicine are more authoritative in their knowledge and are seen as the gatekeepers of the main form of healthcare in our society. On the other hand, the Hmong Shamans showcased in Brown’s article would fall into the Folk sector of healthcare. They are sacred healers that share the patients’ beliefs and treat them in a holistic manner. In America, this form of healing would be a complementary ethnomedical system, because it is not the main form of healthcare in the U.S. These overlapping systems together can help treat the people of the Hmong body and mind.

 

 

Brown, P. L. (2009, September 20). A doctor for disease, a shaman for the soul. The New York Times. Retrieved from http://www.nytimes.com/2009/09/20/us/20shaman.html?_r=3

Clown Doctors in New York

The main focus of the article is the Clown Care Unit or Clown Doctors that work in New York City hospitals in the United States. It describes who they are and what they do. Then, the article goes on to draw comparisons to western and non-western methods of healing. Other cultures in the world have used some form of a clown doctor for treating people in need. The origin of clown doctors has been traced back to shamanism. After being introduced to the general principles of these healers, we get to learn about the day in the life of the New York clown doctors. One day of work is documented from beginning to end with much detail.

In this case the Clown Doctors are the healers. Though their methods are far different from traditional western doctors, they can be very helpful to patients and their family. They begin the day by getting into costumes, which usually means donning some variation of what we know as a clown suit. Working in pairs of three they use props like puppets, bells, amongst an assortment of other wacky items. These are not doctors that heal patients through surgery, but through laughter and diversion they help heal the mind.  The article explains, “Their activities include entertaining bored children and mothers in crowded out-patient clinic waiting rooms, distracting anxious families in inner-city emergency rooms, comforting parents of children in intensive care units, and distracting small AIDS or cancer patients during painful and frightening procedures. In many ways, CCU clowns resemble shamans and traditional healers of non-Western societies.” In the story of Dr. Do More and Dr. Bobo, it describes how they go from different parts of the hospitals to cheer up children and family members. They have to be careful of any children who may react negatively or get too overexcited.

While western medicine usually focuses on healing the body, the methods of the clown doctors focus on helping the mind much like shamans. The main goal of their work is to help patients try to forget about their illness, even for just that short time they are with them. Through laughter, tricks, and games clown doctors attempt to free the mind of negativity. Though, they do not claim to cure anything. They are also no cost to the patients they assist, unlike the medical procedures that doctors and nurses conduct. The health care system in the United States has caused many issues in the recent years. Many people who need treatment are simply refused because they cannot obtain coverage.

“A Doctor for Disease, A Shaman for the Soul”

This article from the New York Times talks about shamans being integrated in to the hospital setting in order to better treat patients.  Although it does talk about other tradition healers, it focuses on Hmong shamans in Mercy Medical Center in Merced, California. The shamans have been given the same access as clergy members.  They have been trained and taught aspects of Western medicine.  Hmong tradition believes that illness is caused by the soul wandering off or being captured.  When the Hmong refugees first came over they did not understand Western medicine, many of the practices being taboo, which led to many complications that could have easily been avoided.  By teaching the shamans about germ theory and having them perform different ceremonies for patients, outcomes have improved.  The doctors are better able to communicate with patients and vise versa.  The doctors have also seen differences improvements in patients because of the ceremonies and that has helped them to better understand the beliefs, although they have related this to the placebo effect.

The healers are the shamans and the doctors.  As Mr. Lee, a shaman, states, the disease is the responsibility of the doctor and the shamans the soul.  I would say that the shamans have a high social status, like healers in most societies.  The techniques they use in the hospital are calmer versions of the traditional ceremonies.  These ceremonies aren’t loud and must be approved by a patients roommate if necessary.  Of course, ceremonies done outside of the hospital are different.  The shamans will chant and use different objects as part of the ceremonies.  Sometimes leaving things in the patients room.

The shamans operate within the folk sector.  They are a traditional healer and treat the patients in traditional ways. They also operate within the a professional sector because they work within the hospital, under certain rules, and with licensed physicians.  The shamans care is delivered to the patient by performing a ceremony; in the hospital in Merced there are 9 ceremonies that have been approved.  In Hmong culture they believe that illness is a condition of the soul and the shamans job is to address those issues.

 

http://www.nytimes.com/2009/09/20/us/20shaman.html?_r=3

Clown “Doctors” in New York City

The article I read was about Dr. Winona Do-More from New York City. She is not a true medical doctor but in charge of the Big Apple Circus Clown Care Unit. This group is made up of circus-trained clowns who help to “treat” and cheer up children in various New York hospitals. They dress up in a white doctors lab coat, bright red clown noses, and different medical tubing that many of the kids have to deal with. The article says, “Satisfied that all is ready, she leaves the changing room for another day of funny-bone removals, queakectomies, and bed-pandemonium” the clowns start to entertain the children in the pediatric units (Blerkom). Some of the people that they entertain besides the patients are families waiting to hear the results of their children’s emergency room visit. They are very useful in distracting patients who are able to undergo a painful procedure or situation. These clowns also benefit the hospital workers by increase mood and morale.

The clowns role in medicine is being compared to the shamans we have learned about in non-traditional medicine. The article states, “In many ways, CCU clowns resemble shamans and traditional healers of non-Western societies. The inclusion of clowns in pediatric hospitals reflects growing interest in and respect for alternative, or more correctly complementary styles of healing” (Blerkom). These clowns are concerned with the patients’ well being, mood, and an increased enjoyable experience of treatment. This focus is shifting away from western medicines belief in treating the physical symptoms of a patient’s illness. The best quote comparing these clowns to shamans is when they say, “Both clowns and shamans mediate between order and chaos, sacred and profane, real and supernatural, culture and anti-culture, or nature”(Charles 1945:32-33; Willeford1 969:100-150).

Physicians that do more than just treat symptoms are following more of an integrational model. In order to treat the well being of their patients, doctors need to consider psychological and social health. These clowns are a great example of doctors reaching beyond these comfort zone and applying techniques used by other cultures of improve the health of patients. The direct exposure patients receive from the clowns in New York City is very beneficial because they can help children in difficult times. I thought this article was great and reminded me of the movie Patch Adams with Robin Williams.

 

Clown Doctors: Shaman Healers of Western MedicineAuthor(s): Linda Miller Van BlerkomReviewed work(s):Source: Medical Anthropology Quarterly, New Series, Vol. 9, No. 4 (Dec., 1995), pp. 462-475Published by: Blackwell Publishing on behalf of the American Anthropological AssociationStable URL: http://www.jstor.org/stable/648831 .

Shamans within Western Medicine

The article that I found most interesting was, “A Doctor for Disease, a Shaman for the Soul”. In this article the focus has been placed on integrating cultural practices with Western medicine. In particular, in the Hmong culture, Shamans are seen as very important members of this community and are healers/protectors of the human soul that is believed to lead to healing of the body. In a hospital in Merced, California, a policy has been implemented to allow for Shamans to interact with Hmong patients in cooperation with Western medicine in order to give the patient the best medical care with respect to their cultural beliefs. Other hospitals are starting to adopt these policies as well on the behalf of their patients. This new policy and interactions has allowed for better understanding between the Hmong patients and doctors, easing fears among the patients and enabling better doctor/patient relationships.

The Shamans treat their patients by securing their souls from being lost or stolen. It is believed that a person’s soul is just like a child and can be lost or stolen by evil spirits so when someone is sick, a Shaman utilizes different rituals to protect the soul while the body is healing. One ritual that they perform is the transference of evil spirits from the body to another vessel such as an animal by allowing the animal to walk across the patient’s chest while performing a chant. Another ritual that is performed is encasing the patient in an invisible protective shield. The Shaman draws symbols in the air over the patient’s bed and this shield is supposed to keep their spirit from being taken by evil spirits.

This collaboration between the protection of the soul and the use of Western medicine to treat the body has shown improvement in the healthcare provided to Hmong patients. Hmong community members have gained an understanding of how Western medicine helps to ride the physical body of illnesses and ailments. In turn, Western physicians have gained an understanding of the importance of body and spiritual healing amongst the Hmong people and with this new found cultural understanding medical practices can be improved to provide all refugees, immigrants and culturally different communities with better healthcare.