not clowning around

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The operating room is not the most pleasant place for any patient. But for children about to undergo surgery, it is especially frightening. At Rambam we’ve learned that there is nothing to fear but fear itself. Now, as part of preparation for surgery, children become familiar with the operating room through the guidance of a medical clown called ‘Bermula’

Writer: Roberta Neiger, ProText

Medical clowns have been active at Rambam for the last eight years. Now, they have entered the hospital’s ‘holiest sanctum’: the operation room, where they help children arrive for surgery calm, relaxed and even happy. Outfitted with the latest medical equipment – a mock medical mask, imitation oxygen balloons, IV stands – and a bright red nose, Bermula (zoya Hite) gets to work.

Bermula may “argue” with children about their pajamas, take orders for a special dream, or act like someone who wants an examination. Through games, she acquaints children with the operating room and its equipment, makes them laugh and helps them pass the stressful pre-op hours. “My routine calms many children,” says Hite, who initiated this service. “Some learn to breathe in the oxygen balloon, and some run and laugh on their way to the OR.”
Bermula is part of the medical clown program at Rambam. With their bright red-rubber ball noses and day-glo garb, medical clowns move through hospital wards, clinics and now, operating rooms. Active at Rambam for the last eight years, the clowns create a fantasy world with the patient – usually a child – at the center. Bringing light to young patients and restoring their sense of self and security, medical clowns are an integral part of hospital treatment.

Rambam’s clowns work through Dream Doctors, an organization active in 17 hospitals throughout Israel. Rambam was among the first to become involved, and now has seven clowns who work with children and one with adults. The ‘Dream Doctors’ accompany children to surgery, remain with them in post-op recovery, and through treatments for burns, physiotherapy, psychiatry and plastic surgery. They are also present in outpatient, dental and other clinics.

All the clowns are actors, many with experience in street theater. None have difficulty connecting with patients from different religious, cultural or linguistic backgrounds. Often working without words, the clowns coax laughter from patients representing Rambam’s diverse populations.

“This is the most satisfying thing I’ve ever done,” says Hamutal Ende ('Suzy'), who has worked as a medical clown at Rambam for three years. “When a sick child smiles, you get immediate feedback and thanks. It’s addictive.”

Medical clowning requires versatility and flexibility, and more than a little intuition. “I work according to who’s sitting opposite me, and depending on the person’s age, illness, mood and mobility”, says Hamutal.

“In the hospital, children become powerless,” says Hamutal. “They are told what to wear, what to eat, when to take medicine. They are pricked and prodded, and perhaps most difficult of all, their parents become, in their eyes, impotent.” Within this scenario, the clown attempts to return the child’s sense of self, center and place.

Hamutal believes this can be done even in the most difficult situations. As part of the Israeli medical delegation to Haiti after last year’s devastating earthquake, she was able to bring some comfort. Armed with her ukulele, playacting and pantomime skills, Hamutal wandered the field hospital. “I tried to give the wounded children special care and attention to help them heal,” she says. “Amidst the overwhelming tragedy, pain and misery, even the soldiers and health care workers sought me out for some relief.”