Well. Let me tell you. My mind has been blown.

Yesterday and today I observed the Pallapupas clowns visit and accompany children as they went into Surgery to be aneasthetised. I saw children giggling as they walked down the corridor to the Surgical Room, lying on the bed about to go under general aneasthetic and laughing their heads off!  Waaaaaaa!! 

This work is SO EXCITING AND EXTRAORDINARY AND IMPORTANT. 

And it's not that these kids are all unusually brave and resillient. Before the clowns come to meet them, they are often in floods of tears or pale and quiet with anxiety. And that is not to mention the parents...

I will explain a little the mechanics of how it works.

There are 2 surgery rooms and each clown takes responsability for 1 room each. In a morning, each room might have 5 or 6 proceedures scheduled. The clowns are given the list in the morning. Once they are in their surgical garb, they run through who is on the list, ages, what they are in for and check if there are any repeat customers (these can be more challenging as they can be more anxious...or more excited becasue they know they will see the clowns).

Then the child is asleep, and almost without fail, the parent will burst into tears. One of the clowns will accompany the parent out of the room to the cafe or waiting room, and the other goes to check-in on the second child.

Something Xaví said to me that I really loved. 'We are in hospital to make friends'. And they do, wherever they go. Gelocatila, especially is an expert in making friends. She hugs and gets hugs - with hospital staff of all levels, parents, grandparents, children. 

Seeing Pallapupas work in this way - open-heartedly weaving their way through the wards - they are magnetic. They so seamlessly and effortlessly break down barriers of hierarchy or fear or anxiety becasue they clearly love everyone equally and without prejudice or expecation of being loved in return. And so of course, everyone DOES love them in return. Everyone is a friend. 

Ah my heart sings !

As brilliant as Xaví is, he wouldn't have been able to do any of what I saw without Gelocatila – provoking, supporting, managing. She did this with a real lightness of touch and delight in seeing how he might get himself out of the shit she was putting him in. They quite often separated, but always knew where the other was, and it was always really satisfying when they came back together again. Above all, TRUST.​

(When we visited the ward, she prompted one child to squirt Tirotín with water from a syringe as he exited a room. Later, when Tirotín decided to take revenge with an even bigger syringe (knowing that of course it would be Titotín that would end up soaked, and not the boy) Gelocatila called ahead to the boys room to warn him to get ready! Tirotín was ambushed in the corridor!)

I laughed so much yesterday, and it occurred to me again, as I watched those two nurses crying with laughter with me, that the key to integration is being able to be THAT funny! Who wouldn't want them around if that is how they make you feel?

​More on this tomorrow...

After a few days with old friends, and then a few days on my own in the mountains, I am back in Barcelona to visit Pallapupas, for the Grand Finale of my trip! 

It was great to have a few days on my own to reflect a little on what I have seen. And to be honest, I didn't think very much at all. I just walked. And walked. And walked. And then I cried.

​Ooft. Looking at the valley in front of me, the brutality and beauty of it all washed over me like a wave. I cried big fat hot tears. ​

I am sharing this because when I tell people what I do for a living, one of the first responses is something like, 'oh wow, it must be hard seeing all those sick children? I could never do that!' And it kind of irritates me. It implies that, in some way my need to be a good person somehow outstrips my need for artistic satisfaction.  But I don't do this work to polish my halo, or to be a 'good person'. What we do as hospital clowns is an exchange. It benefits me as a human being and a performer enormously. It gives me energy and a sense of purpose, and and escape from my Ego as an Artist (which is sweet relief, let me tell you). It is creatively challenging and interesting and surprising. There is no better job in the world for me, as far as I am concerned. From the very start of my journey as a Clown, working in Hospitals has always made perfect sense.
​
But! So much life and death and laughter and pain – so much beauty and brutality? Well. Sometimes it is true. You just have to let yourself cry.

And today...watching Pallapupas in action...I cried tears of laughter. Nearly all morning. No exaggeration. These guys are wonderful. More tomorrow! 

I'm not sure how many years ago, but let's say LOTS, Lory Leshin and Ami Hattab (and maybe someone else, but I can't remember?) created a system of artistic coaching to support the Le Rire Medédin clowns. I didn't get the chance to get into the nitty-gritty of how it works (they have a big document and protocols on it) but It loosely involves all of the clowns having the same artistic language and all of the clowns having the right to at least 2 artistic coaching sessions per year. The coaches are clown peers who come and observe hospital days and then write a big report on what they see. The coaches also have coaches. At the heart of it is very practical, tangible artistic support with goals that are clear and achievable. Over the years, Le Rire Medécin coaches have identified and worked on general artistic stuff they felt the whole team could do with focussing on - Indirect Play, Complicité (not always being with conflict in a partnership) and playing High Status in a partnership (as they found that lots of their clowns were avoiding this.) 

As part of this process, they have all participated in writing workshops, to help them to reflect on their work and analyse it effectively. I thought this was great! I have found writing to be a really useful way of processing the day artistically, but it isn't everyones cup of tea or comfort zone. It is cool that they got training in this, and that it wasn't taken for granted that everyone could do it already. And I like the emphasis and investment in the importance of reflection and analysis as an artistic learning tool.

Apart from the artistic support that this system offers, what I really love is the rigour that it encourages in each artist. You are expected to have clear goals that you want to achieve artistically. To have these, you have to have thought carefully about how you work and what you do on the floor, how you want to improve. It is totally personal to your own development. I find that it is often the case that after artistic training, or a workshop, we have a boost of creativity and ideas on the floor, but over time, this gradually loses its power, until we have more or less completely forgotten about it. Or I have an idea about what I want to work on, but I don't tell anyone, and if i don't achieve it, it sort of fades away. I think this system of coaching might keep us invigorated, and give us the tools and impetus to take responsibility for ourselves artistically. It strikes me as a really sustainable, targeted and efficient system of creative support.

I also imagine that becoming a coach would be great! We have a rather informal mentoring system at the moment which involves more senior practitioners giving artistic support to newer recruits. This can create an artistic imbalance as well as an imbalance of artistic responsibility in a partnership. It can deplete the more senior clown's artistic and creative juices, and inhibit the growth of the newer clown's artistic and creative juices... There is no escaping the fact that some clowns have more experience than others, and nor should we try to escape that! We can learn loads from them, after all! But they still have the right and necessity to learn and grow as artists. That should never stop. And a healthy clown duo on the floor is an equal one. It seems to me that some form of artistic coaching system might be just the way to keep us all on our creative clown tippy toes.

​And a way of keeping those experienced 'dinosaurs' on the floor and working with us forever! Although I wouldn't like to identify the dinosaurs in the Hearts and Minds team...

I had the good fortune to be visiting Bondy on the day that the clowns had planned their meeting with The Interns. This is something that they do once a year, a month after the new intake of interns have started in the hospital (once they have settled in a little), to let them know about the hospital clown programme -the whys, the wherefores the dos and the don'ts.

What struck me the most was the authority that Lory and Patrick had - they have been working in this hospital for over 20 years and these interns started a month ago. Lory explained that one of the interns that they met with years ago is now one of the heads of service in the hospital. As far as being integrated members of the team goes, this initiative is really interesting - they get to them while they are young and establish themselves right away as valuable members of the team, tools in the box.

They do it at the end of their clowning day. As Lory says, if you are looked after as an artist, and fulfilled in your work, not everything has to be paid - we are not in this for the money, after all. It is just a part of the job they do. The clowns provided drinks and sweets (a gentle bribe!) and co-ordinated the meeting with the secretary to make sure it fitted with peoples schedules.

The meeting lasted just under an hour, with plenty of time for questions and general conversation at the end. Lory and Patrick briefly went over the history of the project, and the benefits and purpose of the work they do. They explained how they go about their day - why referrals are important, and what they might need to know, how to interact with them while they are wearing their red noses, how they can play a really important role as the 'straight person' in interactions with children. They are given an information pamphlet to take away and a red nose as a 'diploma'.

One of the interns asked how they approach interacting with children with Autism - she had been watching a visit with a young boy earlier in the day. It struck me that the clowns can play a really important role at this point in the life of a medical intern or student nurse - rounding out their experience in how to interact with children in hospital, giving ideas and ways-in that perhaps aren't covered on their regular curriculum.

Le Rire Medédin also offers workshops for medical staff in the hospitals where they work, 'Formation Ludo-Soignant' to help with, amongst other things, communication skills and the quality of interactions that medical staff have with the children they see.

I would love to have meetings like this - at the very least with student nurses in the hospitals we visit. It is so hard to communicate the finer points of what we are up to in a chance conversation in the corridor, and new medical staff are often so anxious to do the right thing and maintain their status, that interacting with us once we are in costume must seem like the last thing they want to do.  A meeting might not change that, but at least they would have a better understanding of why we are there in the first place.

The Clowns actually visit the Trousseau hospital 4 times a week, in 2 different services. On Tuesday it was Hematology - lots of infection control procedures, lots of long term or repeat patients.

It was really lovely to see how they adapted their play depending on the situation and I want to share 2 visits with you.

One highlight was seeing them both come into the consultcy waiting room. Before they arrived, it was a typical waiting room scene. Boredom, anxiety. Everyone in their own world. I honestly wondered to myself how the clowns would be received. Even me, who sees the positive effects all the time! But everyone looked just generally a bit pissed off and grumpy. Did they really want to see 2 clowns right now?

But in they came. Mimi-Trompette totally distraught because her minature pig (toy) was broken!  Melodramatic, weeping and totally unconsolable, 'is there a pig doctor here? Are you waiting for the pig doctor?' More outwardly worried and impatient than anyone in the room, giving voice and physical presence to everyones personal experience. Beautiful Clowning. And Dijon, her biggest fan and friend, cheerfully and optimistically helping her to find a solution.  It was so lovely to see people lifting their heads, smiling, looking at each other, laughing and offering solutions, and of course the clowns said 'yes' to each one, and so by the end of the visit, the pig had turned into a cat, one child was holding a rubber chicken that was a cow and several were wearing red noses. When they finally were shooed outside by a playful psychologist, the whole room was smiling and transformed. 

On the other end of the spectrum, later that day they visited a young boy who was in protective isolation. Before entering the ward, we all had to put on gowns and shoe covers. His room had an additional plastic wall around his bed. When the clowns went into his room, they were between this plastic and the outside wall, in a narrow corridor, wearing masks as well as the gowns. 

As they entered the room, their 'opener' was that they were trying to escape from me (the spy!). They ended up going on an epic journey: They became birds flying over the ocean and the little boy and his mum also flapped their wings to help them along, then polar bears trudging through the deep snow. At the end they made a giant ice cream to give me as they left the room...it was a trick! It tasted disgusting!

All the plastic, the gowns, the layers between the boy and the clowns didn't make the slightest bit of difference in their ability to connect with him and his mum. In fact, the effect of the plastic sheeting was quite poetic! And in an environment that is so controlled - where even your mum has to put on a face mask to come into the room to be with you - these wild escapes with the clowns seem all the more exceptional and precious. 

Thank you Mimi and Dijon!

So I observed Lory and Patrick at the Hôpital Jean-Verdier in Bondy. It is a teaching hospital that serves a very diverse and socio-economically deprived community in the North of Paris. That is to say that most of the families that the clowns see here are poor, and many don't speak French as a first language.

The clowns here take referrals from the medical staff - usually the Nurse in Charge - before changing into costume. I was struck how on each ward, the Nurse arrived without any prompting. It was clearly a regular part of their working week that they were expecting and gave time to.

The referral process was pretty full on - one child had been kidnapped by her father and taken abroad, only to be sent back to Paris covered in bruises and cigarette burns. Another boy was a suicide risk - age 9. Lory said that they are always relieved to leave at the end of the day, but that she loves to work here because of the relationships with the staff and the hospital, and the effect the clowns can have. As a teaching hospital it is very popular with medical interns, as they are all looked after well, and it is home to a huge amount of medical expertise, but it is clearly under-resourced in some respects. When I looked around me on the wards, it was clear to see how the clowns would have a positive impact.

And boy did they! Watching these two on the floor was a masterclass! Lory's physicality, clarity, use of Melodrama & sensitivity was totally delightful. Seamlessly adapting her level of play to suit each situation. A brilliant clown through and through, from the tips of her fingertips to the tips of her toes. Patrick totally embodied the pleasure to be there, always excited to see who was in the next room, and never wanting to leave once he was there! Their status switched throughout the day, but was always clear (although for me their play worked best with Tata Jeep as Boss Clown). I was transfixed. And despite really trying to be invisible all day, guffawed out loud on several occasions. They have both been working for the company for many, many years, and their experience shows. As a clown baby, I have a lot to learn from these 'dinosaurs' as Caroline calls them (and herself!) lovingly.

One of the very last visits of the day is especially worth recounting (although many were memorable). For reasons my french didn't stretch to understand, Broccoli ended up in 'clown jail' – trapped inside an unused babies cot. Tata Jeep was totally unwilling to help him out, pushing him out from this boys room and into the corridor, leaving him to his own devices, playing indirectly so that another boy stuck in his room with chicken pox could see. After a few minutes, the first boy came along from his room, quite serious and without a fuss, and released him. Broccoli exploded into celebration, Tata Jeep hailed the boy a hero, and he walked off down the corridor with a smile on his face. 

When we were all back in the changing room, chatting about the visit, we all remembered that this was the boy who was on the ward because he was a suicide risk. And what is more, his dad was in jail. If the clowns had remembered this detail when they were on the floor, almost certainly wouldn't have done a whole clown jail routine. If they hadn't been told at the start of the day, they might never have had the 'idea' to do it. Either way, in my mind, it was great that they did. The boy walked back to his room a hero, and about a foot taller.

The Le Rire Medécin team comprises of over 100 clowns, who visit hospitals across Paris, as well as in Nantes, Angers, Orléans, Tours, Nancy and Marseille (46 services in total). They visit every unit (with a few exceptions) twice a week. The same wards twice a week. Apparently, Caroline doesn't really consider it a 'programme' unless this is the case.  I have to agree that the difference in relations on the units we visit with more regularity is huge. Just the simple fact of being on the ward that often would have a huge impact on our integration on the wards.

As at ONV, the clowns give 2 months notice for 2 months of work. Continuity of partnerships and hospitals is ideal, but not always possible as many of the clowns are involved with other activities outside of the organisation. And it being France, as artists they are well supported by the state on the days they are not employed by Le Rire Medécin.

They can also put 'Clown' as their profession on their I.D cards and no-one bats an eyelid. Oh France!

They also run a hospital clown school. It is not a direct route into work with the company, but does totally prepare individuals to take the work out to hospitals on their own if they so wish. Le Rire Medécin do take on a percentage of new recruits from the course, but it's main focus is to maintain a high artistic quality of hospital clowning in France in general. It is a full time course, 19 weeks long, 665 hours of training in total...

The clowns on the team meet once a month for training and a catch-up, and have coaches who support them artistically. They don't have a formal emotional hygiene session, but instead, are each allocated a 'guardian angel' (another experienced clown on the team who wants to take on this role) who they meet with twice a year, and who is available to them whenever they need to talk about the emotional content of the work. 

The whole operation feels huge and I have to keep reminding myself how small Scotland is - that in many ways we are not comparing like with like. Paris alone has 21 services and 48 clowns working in them.

In my 2 days in Paris, I got to see 2 of them, Le Hôpital jean-Verdier and Hôpital Trousseau and 4 wonderful clowns: Lory Leshin is an extremely experienced clown, has worked with the company for years, teaches, directs, and is co-creator of the companies coaching programme (more on this later). Patrick Dordoigne has also been with the company for many years, and outside of this work is Artistic Director of Adhok street theatre company. Selena McMahon is the President of Clowns without Borders USA, and Marie-Elisabeth Cornet used to perform with Cirque du Soleil (and trained at the École Philippe Gualier with Magdalena all those years ago!) Paris is at the centre of the explosion of Theatre Clowning across Europe, and I can't help but be impressed by the breadth of experience Le Rire Medécin has at it's fingertips.

First up - I observed Lory and Patrick or Tata Jeep & Broccoli at Le Hôpital jean-Verdier in Bondy.  But now I have to get on a plane to Barcelona, so more on that tomorrow!

For starters, Caroline Simonds, Founder of Le Rire Médecin, Artistic Director and Artist met me for lunch on Sunday when she probably had a million and one better things to do. Workaholic springs to mind, but there is absolutely no escaping that this woman is extraordinary and inspiring and passionate. When I feel like I don't have enough hours in my day, I will think of her, and find some more!

Over lunch, she told me about how Le Rire Médecin came to be 26 years ago - she worked in New York with Michael Christensen at the Big Apple Circus Clown Care Programme for 3 years, (after having worked in as a street performer for 10 years before that) and decided to move back to Paris and see if she could make it fly there. And it did. Almost immediately they were up and running in three hospitals. (her version was much more entertaining, obviously!)

She talked with love about the clowns in the company and the ones I was off to observe, and with much pride in the artistic quality of the work, and the artistic support that her artists are entitled to. This, she says, is something she has had to fight for, tooth and nail, in a financial climate that is keen to make savings wherever it can, and commodify us as artists. Since she works on the floor 2 days a week, she is still totally connected to the work, the artists and the hospitals they serve. Trés cool. Trés, trés cool.