Originally in Hebrew by Avraham Yisrael Friedman
Translated by Deena Weinberg
A huge, red nose; an enormous heart, and an ear that really knows how to listen: Meet Rabbi Yehoshua Lidesky, the frum medical clown who works mainly with…adults. In a rare peek into the unfamiliar world of medical clowns, Rabbi Lidesky shares unforgettable accounts from the patients’ rooms. From the Holocaust survivor who burst into bitter tears, to the magic trick at a woman’s deathbed, and the old woman who desperately needed her neighbor’s help, Rabbi Lidesky’s stories will move you in a way that you never dreamed a medical clown could.
When Rabbi Yehoshua “Shuki” Lidesky first strolled into the regular wards in Mayanei Hayeshua dressed in his clown costume, the patients’ reactions were mixed and surprised. “The paediatric ward is that way,” they directed the red-nosed man. Yet Rabbi Lidesky, in fact, had not made a mistake at all.
Lidesky’s main work is with…adults. “Children have an innate, natural joy,” he explains in an interview with Yom Leyom in honor of Rosh Chodesh Adar. “Adults actually need [an infusion of] joy more than children do. Whenever adults innocently direct me to the paediatric ward, I tell them, ‘Do you know what the difference is between kids and adults? Only the price tag on their toys…’ Because adults also have this little child inside them, it’s just covered by so many contradictory layers. But as soon as they connect to that inner child, they tap into that natural joy.”
It is a most fascinating shidduch – the medical clown, and adult patients. We had always associated the childish, endearing role of the clown with young children.
Lidestky senses my surprise. It seems he has only been waiting for this to explain. “First of all, you need to define what the goal of a medical clown is,” he says. “I think that there is a general misconception as to the difference between a circus clown or a Purim or birthday clown, and a medical clown. The purpose of the circus clown is to make you laugh. The medical clown’s goal, on the other hand, is to change the atmosphere – not necessarily to make you laugh. When I enter an adult patient’s room, my goal is to lighten the heavy atmosphere in there somewhat. Sometimes I do that through magic tricks, or balloons, or a small show, but not necessarily. There are times when I discover lonely people who have nobody to listen to them, and I simply sit and listen to them. That fills a very important need inside them, because the nurses and doctors are very busy and don’t have time to listen to these people’s personal stories and distresses.
“Every clown has his unique area of strength,” Lidesky continues. “Some people’s main skill is in making you laugh. Some play instruments, some sing, and there’s magic… One of my personal strong areas is to reach a place with people strengthening emunah and avodas Hashem. I’ll begin with a ‘clown’ act – a magic trick or something of the sort, and from there we take it on to a very serious talk about emunah and avodas Hashem. Because many times, the patients’ situations make them very thirsty for some spiritual empowerment or a message that reminds them of hashgachah pratis, emunah, and that everything is for the best. I get there with some people, although obviously not with everyone. Sometimes I pose questions and ask them to talk, reawakening their emunah that may have weakened somewhat because of their sad situation.
“Another strong point that I take with me is [the belief in the importance] of joy. It says in chassidic works that the source of all ailments is a lack of joy, and that goodness can be drawn through joy. We develop that together.”
On that note, we ask Rabbi Lidesky: “Tell us about the halachic perspectives of this particular profession. As frum Jews, it is obviously a very significant factor. Do you have any lines that you would never cross?”
“Well, before anything else, my basic rule is clearly never to transgress any halachah or anything written in the Shulchan Aruch. Another line I will never cross is laughing at someone’s expense, or using foul language. We are connected to the Shulchan Aruch. That is my absolute boundary.”
Until 2009, medical clowns were (quite literally) not taken seriously by the hospitals. Some of them did not allow them entrance at all. Perhaps they were justified; there was very little awareness and as far as the hospitals were concerned, no scientific evidence of the effectiveness of medical clowns in promoting patients’ healing. Slowly, however, there has been a shift in prevalent medical perception of the medical clowns’ role and clowns were invited to the hospitals and given their due honor as agents of healing.
In 2017, a study was conducted at the famous Jerusalem-based hospital, Shaarei Tzedek, proving that medical clowns actually assist in reducing pain. After experiencing only one injection in the company of a medical clown, children reported less pain even in subsequent injections when the clown was no longer present.
The results of the research, which was conducted in the Cerebral Palsy Clinic in Shaarei Tzedek’s Paediatric Neurology Unit, clearly demonstrates that medical clowns assist in reducing the level of pain that children experience.
A multidisciplinary team at Shaarei Tzedek, headed by Dr. Hella Ben-Pazi, director of the Cerebral Palsy Clinic, examined the impact of medical clowns’ presence on the levels of pain reported by 45 children with cerebral palsy who underwent repeated muscle relaxant injections. The results showed that children who received the injections in the presence of a medical clown reported a lower level of pain (!).
“Children who had already experienced one injection generally approach subsequent treatments with more anxiety,” Dr. Ben-Pazi explained. “In order to make it easier on them, we had them meet the hospital’s medical clowns while they were receiving treatment, and this made things significantly easier on them.”
As a result, the hospital decided to conduct a study examining the effect of medical clowns on the level of pain that children experience. “Previous studies show that the body has ‘pain memory’. A child who had experienced pain in the past will experience it again based on what his body remembers,” says Dr. Ben-Pazi.
The study was conducted with the cooperation of a paediatric neurologist, medical clowns and psychologists, in two stages: First, the children were asked to rate their level of pain before and after the injections. The children who underwent the injection accompanied by a medical clown reported a significantly lower level of pain in comparison to the children who received the injections without the attendance of a medical clown. Furthermore, reinforcing the view that speaks of “pain memory,” children who were accompanied by a medical clown at a single injection felt less pain in subsequent injections, even when the clown was no longer present.
“No one likes shots; especially not children. We are witness to the ongoing suffering of children who require regular, particularly painful shots. Although there is always an option of sedating them with nitrous oxide [“laughing gas”], there are parents and children who prefer to get through the injections without sedation, but with medical clowns instead.”
Recently, medical clowns received a complete costume upgrade: The “Clownbulance” is a first-of-its-kind initiative that had been launched in Israel a mere year ago. It is a special ambulance of medical clowns that strives to bring joy to sick children in a different kind of way. Smadar Shemesh-Harpak, a medical clown who is at the head of this initiative, described what they do on her Facebook page:
“I am not a mother yet, but I invest tremendous efforts on behalf of other people’s children as part of my daily work as a medical clown.
“As part of my work, I launched a project called ‘The Clown Ambulance’ together with the Keshet Hamishalot Foundation. We conduct free activities for children suffering from serious or life-threatening illnesses, and for a full day, we take them out of the difficult reality and long hospitalisation.”
During the “day of fun” that is devoted completely to these children, they can ask for anything they wish – and the Clownbulance does not disappoint.
“A lot of the wishes revolve around astronauts, animals, and other themes that children dream of and love,” Harpak writes. She then appeals to mothers who might agree to donate their children’s recent Purim costumes for this cause:
“This project was created as a result of a need [that I saw] in the hospitals,” said Harpak in an interview with Arutz 2. “And it’s a fulfillment of sorts for my personal dream. I began to work as a medical clown eight years ago, and I realized that one thing that is needed most is to take these children out of the hospital and give them an exposure to life outside, and a reminder that that’s ‘real life’; not the life in the hospital.
“It’s not a medical vehicle, it’s a clown vehicle, but the treatment that this car facilitates is unique. With the tools and image that a clown has, he can take the child into a world of fantasy and change the way that the child and his family view their reality. Our relationship with the children is extremely close. We accompany them over a long time. The idea is not necessarily to tell the parents to laugh. Many times, we just want to give them a chance to express their emotions.
“For example, if a child needs to express his feelings of aggression or anger now because he is undergoing difficult treatment, there is no one better in the hospital to let that anger on than the clown, because that’s a figure that can absorb; a figure with no ego. Making someone laugh is one thing, but there are other things as well.
“We design the ambulance completely based on the theme that the child chooses, and we want the child and his family dressed up accordingly, as well,” she emphasizes. “On Purim, I noticed how much you invested into the amazing costumes for your children and families. I want to ask if there are mothers who are willing to donate the costumes of this past Purim or previous ones for our work in The Clown Ambulance. It can give us an enormous boost and really bring joy to these precious children, who truly need this joy.”
“Professor Doctor,” they call him affectionately. Meet Amnon Raviv – medical clown at Barzilai Hospital in Ashkelon. The hospital has been witness to quite a number of exceptional experiences that he was enlisted to.
In a recent Qassam attack, a rocket fell near a bus filled with disabled children. Amnon the “Dream Doctor,” also known as “Professor Doctor,” headed to the hospital area where all the children who suffered from PTSD were taken to. The room was filled with doctors, social workers, and psychologists, and they all sat, severe-faced, in a circle along with the distressed children. Suddenly, the children noticed a clown sitting in the same circle, making faces, busying himself and making a mess of his belongings. The children’s taut facial expressions quickly changed, and the silence was replaced with sounds of laughter and cheer. The clown accompanied the children to their physical examinations and made them laugh. The children were discharged happy and excited, as though they had not just undergone an extremely traumatic experience.
This incorporation of medical clowns as part of the treatment of children suffering from PTSD is the first such pilot programme in Israel, opening new options for integrating medical clowns in mass casualty events that involve children.
Medical clowns, we are told at Barzilai Hospital in Ashkelon, are special clowns that the hospital calls “Dream Doctors.” Medical clowning is a relatively new field that makes use of the healing power of humor to improve the function and quality of life of hospitalized patients; especially children.
Medical clowns fill the emotional and social needs of the hospitalised children. They divert their attention away from the painful and scary procedures and assist them in adapting to the hospital routine. The atmosphere of fun and laughter that they engender helps the children forget their illness and fears for a while.
Medical clowns use skills such as magic tricks, balloon shaping, storytelling, and more to provide the children with moments of fun and laughter that will assist them in dealing with the many emotions that they might experience during their hospital stay, such as fear, worry, loneliness, and boredom.
Using humor as a means of bringing relief to the patient categorizes medical clowning as alternative healing. The healing power of humor and laughter has been proven in a number of studies as assisting in relaxation, pain reduction by increasing endorphin production, boosting the immune system by activating T Lymphocyte cells, and lowering the levels of cortisone in the blood system. Humor has also been proven to assist patients in managing medical procedures and to hasten healing.
The Dream Doctors project, employing medical clowns at Barzilai Hospital, has been launched in 2003. It is funded by the Magi Foundation which assists in financing the employment of two medical clowns at the Southern medical centre. The medical clowns work with children in the paediatric ward and any other ward where children are hospitalised, such as the orthopedic and ENT units.
Hospitalisation involves a lot of anxiety, uncertainty, and pain for the children. The goal of the Dream Doctors project is to infuse joy and hope into the hospital surroundings, assist the children in getting through the hospitalisation and anxiety resulting from the treatments they are subjected to through humor, laughter, and fantasy, to strengthen their coping skills and to reduce fear. The clowns’ antics also provide relief to the families of the children and support for the medical and nursing staff in their stress-filled work.
“‘Medical clown’ is quite the oxymoron,” we wryly point out to Rabbi Lidesky. “What is the connection between clowning and healing – a topic generally associated with painful treatments and injections?
“If you find a different name for our job, it would probably do a better job defining it,” Rabbi Lidesky agrees. “The name that has become universally accepted is ‘medical clowning,’ but that’s not an accurate description of our job. Sometimes I walk into a patient’s room and don’t do anything that is related to joy or fun; I only listen.
“People who study medical clowning learn a lot about the way the hospital works, the patients’ feelings. Beyond doing magic tricks and [shaping] balloons, you learn about communication and active listening, which are important tools for life outside the hospital, too. It can help with shalom bayit, educating children… Among the group that studied in our course, there were educators, and they use the tools of medical clowning for their educational work.
“The job of a medical clown is to divert a person’s attention away from everything going on in a place like a hospital. I work with everyone, including the doctors and even maintenance workers; not just the patients.
“The significance of that is that from now on, every patient of a doctor will receive a different level of care, more courteous treatment, a nicer attitude… My job is to improve the distressing image of the hospital.”
Rabbi Lidesky stumbled upon this job almost coincidentally. A few years ago, he became interested in performing “magic show” performances. He viewed it as an opportunity to convey messages for avodas Hashem; “to steal the show,” in his words. His friends encouraged him to pursue professional studies, and he began learning various stunts from magicians and professionals. That was not enough, however. His friends explained to him that he still needed to improve his communication with the audience and dramatic abilities. “Right now you look like a lecturer, not a performer,” they told him. The problem was that there were no professional drama studies at the time for frum men. He did, however, stumble across an ad inviting people to study medical clowning in a course that also included drama studies. Rabbi Lidesky took this course, and was immediately drawn to the new profession.
For four years he has been working in Maaynei Hayeshuah Hospital in Bnei Brak, and the stories he’s accumulated between its sad walls can fill a book. Rabbi Lidesky agrees to share a few stories:
“About two years ago, I entered a room in the oncology ward at Mayanei Hayeshua, and found a man sitting there at his wife’s bedside. I looked at the man and ‘threw’ a riddle at him that had to do with a certain magic trick, and that led to a conversation about avodas Hashem and chizuk in emunah. I asked him to tell me about things that initially seemed impossible yet did happen, helping him become stronger in emunah. We spoke like that for twenty minutes, and he told me different stories of emunah and hashgachah. The conversation was very pleasant. When we finished talking, just before I turned to leave, the man asked me to daven for his wife, who was in a very serious condition. He told me her full name for davening and I left.
“A week later, I found myself in the same ward, but could not find this man. I went to the nurses’ station and asked the nurses where the woman’s room is. They told me that she had died on Friday. I felt my heart drop. I went and did something completely outside my role – I found out where the family was sitting shivah. I felt that I had to talk to this man again. I found out where they were sitting [shivah] and I went there.
“I came to the mourners’ house – it was a mourners’ tent, really – and stood at the entrance to the tent. It was in middle of a rabbi’s inspirational talk. In the meantime, I made eye contact with the husband. He looked at me and tried to remember where he knew me from but could not figure it out. After a few minutes, he suddenly pointed to his nose, as if asking me, ‘Are you the one with the red nose?’ He immediately called me over to him. We sat again, and the man told me about his wife, who had been an important and beloved teacher and did amazing things in the educational field. Then he told me in inspiration, ‘Do you remember that magic trick that you did for me at the hospital?’ I nodded, and he said, ‘Can you do it again now?’ I explained that this wasn’t exactly the proper occasion for a magic trick, but he persisted. ‘There might be a few more people here who can draw chizuk from it. It’s fine.’ So I did the trick there, and he added his own words of avodas Hashem, and people heard and drew chizuk from it.
“Sometimes I meet Holocaust survivors who tell me their painful memories of the camps,” Lidesky shares and his voice suddenly takes on a fragile note. “Many times they start crying as they talk. Once, I visited a very old woman who really did not get along with the medical staff at the hospital. The staff wanted to transfer her to a different hospital but she refused. They got to a point where she refused to speak to the nurses at all. Not a word. She wanted some things but maintained zero communication with the medical staff. When I came to visit her, she grabbed the opportunity to use my phone and call her neighbor for the things she needed. She was confused. She was feeling very lost in her situation. She called the neighbor, but the neighbor didn’t answer. She thought that maybe she had dialed the wrong number. After I left, I tried the number again and her neighbor did pick up this time. I told her what her elderly neighbor had asked for, and she agreed to do it. It really gave me satisfaction to be able to help in that way.”
“What do you say in an oncology ward?” we ask Rabbi Lidesky. “Just visiting there is extremely difficult for most people!”
“One of the things that we work on there is ‘circles of joy,’ working on bringing joy into our hearts. We usually do it through mental work, by searching for good things that do happen to us, thanking Hashem, finding the good inside the bad, learning Torah. But many times it’s hard for people in painful situations to reach these kinds of insights of gratitude or searching for good things. It’s just not the right time for it. Even people who have worked on it all their lives, in the oncology ward it’s much more difficult.
Chassidic works offer two ways to extricate oneself even from such excruciating situations. One of them is ‘milta dishtuta’ [humor], and the other is that ‘the heart is drawn after external actions.’ These are external ways of improving a person’s mood and enabling him to begin thanking Hashem, davening, learning. One of the things that I did with people with this terrible illness, lo aleinu, is these kinds of exercises. One of them admitted to his brother that after the exercises he felt less pain. That’s a really incredible thing.
“But the truth is that we don’t need to reach such agonizing situations. We can always practice it. Everyone searches for joy, and we can reach it with a few exercises for improving our moods. It’s helpful and good also for our everyday lives. Obviously there are many benefits, mainly the fact that a happy person has the tools to contain much more. A person who is sad, because of stress or other reasons – every little thing upsets him. He becomes angry, explodes, it’s harder for him to accept the other person. A person who works on feeling joy, on the other hand, is more patient, and his chinuch and shalom bayit are completely different. Their entire avodas Hashem is different. The Torah tells us, ‘because you did not serve Hashem, your God, with joy.’ A [happy] person creates a joyful atmosphere around him. Today there are studies that show the connection between the body and the soul. Joy also helps prevent physical illness.”
“Hospital.” A word synonymous with pain and gloom. IV poles, tear-stained tehillims, hearts pounding in fear, tired eyes and shattered hopes. “Don’t the constant visits to this place affect you?” We ask Rabbi Yehoshua Lidesky, a regular visitor to the most difficult wards. “Other people leave the hospital with tears in their eyes!”
“One of the things that you learn at the course,” Lidesky explains, “is to accept reality and deal with it. These are things that we process and work on all the time. I can’t tell you that it never happens that I come home and take the feelings along with me, but in general, the moment you have the right preparation, you can contain a lot of the sights and process them differently.
“I’ll give you an example. One of the things that they teach you in the course is to completely remove yourself from what you are seeing and ‘translate’ it into something else. If I see a person with an IV pole, as far as I am concerned there is an earphone with music plugged into his arm. It’s a different perspective; different than what you see. There are many ways that they teach you while you’re training that help deal with the sights. In general, you learn that now you’re the person who is there to bring joy, so in a way you absorb less of the sad atmosphere.”
In the last week of November 2019, Professor Rael Strous, the South African-born medical director of Mayanei Hayeshua’s Mental Health Centre, and professor of psychiatry at Tel Aviv University’s Faculty of Medicine, was in London for a busy round of meetings and events organised by the British Friends of Mayanei Hayeshua.