There was so much to take in at the conference, it is only now, a few days later, that thoughts are starting to filter-in and settle. I wanted to share some of the discussion from the session: Psychosocial care for children with chronic diseases. It really highlighted to me the value of even a short interaction with the Clowndoctors, as well as all of those long-term relationships we build and care for in hospitals and schools in reducing the effects of long-term trauma that can be caused by hospitalisation.
The session started with a testimonial from a patient of the Clowndoctors in Austria:
When Fabián was 5 years old he came into hospital to have the first of many operations on his legs. The first time, he said it was like going to a hotel – he put his things away, made himself at home. He had no concept of what was awaiting him. When he woke up after surgery, he was in a great deal of pain, and couldn't move from his bed. For him, this was torture – he was used to playing, exploring, running around. It was in this state that he met the Clowndoctors for the first time and made friends for life.
As a 5-year-old boy he didn't know the days of the week, but he knew that the Clowndoctors came on a Thursday, so would ask his parents constantly, 'is it Thursday yet?' To which the reply was usually, 'No...it's Monday....'. Every Thursday when he heard the Clowndoctors playing music in the corridor, he knew they were coming for him. He immediately cheered up. He would sit up in bed, waiting expectantly for his friends to arrive. But one Thursday he heard them in the corridor and they didn't come to his room. He waited. And waited. They had forgotten him! Determined not to miss out on his weekly visit, he sent his parents out to find them, to search the whole hospital. Eventually, they found the Clowndoctors ready to go home. As soon as they realised their mistake, they changed back into costume and made a special visit. 'I was so happy, I think about the Clowndoctors often, about that act of kindness and generosity. It really stays with me'.
He said that with all the medical interventions he had during his stay in hospital - the pain, the boredom, the anxiety - it is the Clowndoctors that he remembers and thinks of the most.
When I heard his story, I immediately thought of several children we are visiting in hospital at the moment - all in for long-term care. It is worthwhile stopping to consider the impact we can have on the lives of these young people, even beyond their time in hospital.
Potential trauma for children going into hospital is real. Dr Peter Krajmer PhD, a Clinical Psychologist at Bratislava Childrens Hospital in Slovakia described talking to a child 10 years post treatment who was 2 years old when he went into hospital for the first time, whose lasting, painful memory was of the fear he felt when the nurses took him to take blood. Dr Peter Ahlburg, MD at the Department of Clinical Medicine, Denmark empahasised that the fear children experience going into hospital and surgery is real and must be treated as such. For a young child it might be fear of being absent from parents, but for a teenager, it might be a fear of dying, of not waking up from surgery.
When children and teenagers are experiencing this level of anxiety, they will often refuse all input from medical staff - staff who often don't have time to address the psychological level of pain the child might be experiencing. Enter the Clowndoctors. While we have to be alive to this anxiety in judging where and how and to what level to interact, we have the unique capacity as clowns to open the door to the possibility of hope and positivity in the here and now. From this point, medical staff who spend the rest of the day/week on the ward, can continue to work to build relationships and good communication.
And if good communication is at the core of reducing long-term trauma in children and young people experiencing chronic disease or surgical interventions, then Clowndoctors clearly form a vital and valuable part of a wider team of doctors, nurses and allied health professionals. We have a shared goal.
It was really inspiring to hear from medical doctors who really consider the Clowndoctors to be an integral and important part of the child's treatment plan.
I am a therapeutic clown and performer. Writing here is part of my wider practice and reflection on clowning as an (therapeutic) art form.