The Smile Squad

Betty Mills dons her finest purple polyester outfit, makes sure her slip is showing, jams on a hat, adjusts her overbite, shifts her sagging body parts into place, and takes one final look in the mirror.

Ahh, yes—perfect.

Once again Mills has materialized into Pansy, a character clown who dispenses a healing dose of humor to patients at Kootenai Medical Center, a 225-bed hospital in the Idaho panhandle town of Coeur d’Alene (pop. 25,000).

“I’m a busybody, the perfect purple polyester person in that persona,” says Mills, who coordinates the hospital’s Smile Squad, a cadre of volunteer clowns. The group uses the healing power of humor to help speed patients’ recovery, and to keep the care staff smiling as well.

“People really appreciate humor in this setting,” says Mills, a 22-year employee who works in the hospital’s community relations and education departments. Mills has always relied on humor as an antidote to cope with family death, illnesses, and steady pain.

At 26, she was diagnosed with Addison’s Disease, the absence of adrenaline, which causes difficulty in dealing with stress. In her early 30s, her teen son died in a bicycle accident. At 39, rheumatoid arthritis struck. At 62, she became “an insulin-shooting, card-carrying diabetic.”

“You play the hand you’re dealt,” she says. “I learned long ago that you either curl up in a corner, or work through it and get to the other side. I’ve always used humor as a crutch. I forget about my own health problems when I clown. It gets all those endorphins running around. I walk away feeling wonderful.”

Former nurse Bev Toelle started the Smile Squad in 1997. Her mother-in-law died of cancer the year before, but even in the midst of that loss, Toelle was impressed by the healthy use of humor among the nurses to help loved ones get through crises.

Following that experience, Toelle began researching humor programs used in large hospitals nationwide—from periodic clown parades to nurses providing carts with joke books and funny videos. She found that several medical studies have documented how humor stimulates the immune system, increases neuroelectrical activity, and relieves stress to help prevent heart attacks.

With that information in hand, Toelle persuaded hospital administrator Joe Morris to try a clown program at KMC. Since then, about 100 clowns have been trained. Participants pay $35 for the 18-hour class.

“We have 25 to 30 active clowns,” Mills says. “About eight to 10 are devoted to coming regularly.”

Mills knows firsthand how clowns make a patient feel. Last year, she was unexpectedly hospitalized due to complications of diabetes. Two days after her arrival, the clowns were making their rounds. Mills recognized all of them and was still surprised at how strongly they affected her.

“I was so tickled,” she says. “I burst into tears. They boosted my morale tremendously. It was so uplifting.”

Two or three clowns work together, spending about five minutes with each patient. It takes about three hours for the Smile Squad to make its rounds in all the hospital’s units.

“We don’t randomly pop into people’s rooms,” says Toelle, who has clowned in three characters—Greta von Frettin’ Vine, Toots, and Sweetie Pie. “We stop at the nurse’s station first to see who might benefit the most.”

Mills recalls how patients with Alzheimer’s or similar diseases have responded to the clowns when they hadn’t responded to other stimuli. “Last week, it took us 20 minutes to get to the floor. First we were mobbed in the cafeteria, then at the elevators. The staff, visitors, and kids had to give us hugs and visit.”

Dietary aide Gary Gonzales often waltzes along with the Smile Squad. “They’re a lot of fun,” says Gonzales, who enrolled in the most recent clown class so he could join the Smile Squad.

Pansy does more than entertain patients. “At employee orientations, she teaches the safety management portion,” Mills says. “The employees love it. They seem to remember things better when Pansy tells them.

“Nothing makes you feel better than laughing,” Mills says. “All the clowns here receive more than they give.”

Healing With Humor

When they get their medications, patients at Duke University Medical Center in Durham, N.C., also get their funny bone tickled.

A rolling cart dubbed the Laugh Mobile offers whoopee cushions, magic wands, games, rubber chickens, yo-yos, funny faces, bubbles to blow, and humorous books, tapes, and movies.

At Fox Chase Cancer Center in Philadelphia, patients can keep themselves in stitches with a humor cart that includes a Mr. Potato Head, kaleidoscopes, and squirt guns.

“Laughter is a positive contagion that’s spreading in the medical world,” says Joel Goodman, who founded the HUMOR Project Inc., in Saratoga Springs, N.Y., in 1977. Since then, the project has awarded grants to more than 300 hospitals, schools, and social service agencies to help tap the power of humor.

The humor-in-hospitals movement is gaining momentum nationwide, says Dr. Ann Weeks, president of the Association for Applied and Therapeutic Humor in Phoenix.

“More hospitals are offering humor carts and baskets to patients,” Weeks says. “We’ve also seen tremendous growth in programs in which volunteers prepare to be clowns in hospitals, nursing homes, and pediatric care centers.”

Shobhana “Shobi” Schwebke, editor and publisher of The Hospital Clown Newsletter, attributes the surge in caring clowns worldwide to the film Patch Adams, which contained lots of hospital clowning around. There are thousands and thousands of caring clowns nationwide, she says. Most are volunteers.

“It’s fun, heartfelt, wonderful, necessary work,” says Schwebke, who travels worldwide teaching caring clown seminars. “A lot of seniors make great clowns because their life knowledge helps them deal with what they come in contact with. It’s a lot more than doing jokes.”

Humoring patients is nothing new. Greek physicians advised the sick to visit the hall of comedians or the theater as therapy; and, in modern times, researchers have documented the healing power of humor.

Drs. Lee Berk and Stanley Tan of Loma Linda University in California have researched the curative power of comedy in bolstering the immune system. Their studies show that laughter lowers blood pressure, reduces stress hormones, improves muscle flexion, raises levels of infection-fighting cells and disease-fighting proteins, and triggers release of endorphins, the body’s natural painkillers.

Jeers to Your Health

To learn more about humor therapy, several sources are available, including:

Association for Applied and Therapeutic Humor, Phoenix. (602) 995-1454

Jest for the Health of It, Santa Cruz, Calif., (831) 475-9570 or check out www.jesthealth.com.

Patch Adams Gesundheit! Institute Hospital Foundation, P.O. Box 98072 Washington, D.C. 20090-8072

Dianna Troyer is a freelance writer from Pocatello, Idaho.

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