New York City: Treating The Funny Bone

By Linda Williams

Dr. Stubs pokes his head into the hospital room of five-year-old Dorothy. "I hope I'm not bothering you," he says before entering. At her bedside, he pulls several crumpled sheets of legal paper from his worn leather bag, digs for a pencil stub and begins his examination:

"Are you married?" "No," the patient replies. "Any children?" She shakes her head. "Does your nose ever turn red?" She furrows her eyebrows thoughtfully and answers, "Yes, sometimes." "Aha," says Stubs. "Does it turn red when it's cold outside?" The girl thinks for a moment, then says, decisively, no.

Though he makes rounds in hospitals including Babies Hospital, a unit of New York City's Columbia-Presbyterian Medical Center, Stubs is clearly no ordinary doctor. To those who witness his offbeat bedside manner, Stubs' true trade is obvious. He's a clown, a founding member of the one-ring Big Apple Circus. But to Stubs, a.k.a. Michael Christensen, working with young hospital patients is serious business.

"Have you ever had a how-long-can-you-go-without-laughing test?" he asks Dorothy, continuing his routine examination. "No," she says, eyes widening. Stubs takes a large windup clock from his bag and lets it drop to the floor. Dorothy giggles. "You only lasted about four seconds," he says, feigning disappointment.

"Want to try again?" She holds her breath as the second hand advances and bites her cheeks while Stubs tickles her with a paper flower. But when Stubs gives the girl's mother a rubber clown nose in a red-nose "transplant," the tiny patient erupts with laughter. For a few moments, at least, Dorothy's mind is off the pain and trauma of being ill.

Since Christensen, 43, started the Clown Care Unit at Babies Hospital four years ago, the project has grown to involve 25 trained clowns who make rounds at eight New York City hospitals. Two or three days a week, bands of these performers, dressed in mock hospital garb and bearing such names as Dr. Comfort, Dr. EBDBD and Disorderly Gordoon, visit ailing children and their families. The clowns' purpose: to alleviate the fear and confusion of hospital stays and provide bright moments with humorous routines, such as "drawing blood" -- with red crayons -- and giving funny-bone examinations. Christensen has found the C.C.U. so fulfilling that he quit performing with the Big Apple Circus last fall to devote full attention to improving and expanding the project.

Why would a clown give up the big top for hospital rounds? To Christensen, the C.C.U. is more than work; it's a calling. "This project came out of an unconscious place in myself," he explains. "After going through those feelings of loss and of grief around my brother's death five years ago, this gave me a feeling of celebration and joy, of healing after his loss. Call it love and caring, God, a higher consciousness -- whatever -- I want to give my life to that."

Clown Care got its start in 1986, when an official at Babies Hospital asked if Big Apple Circus clowns would entertain at a gathering for patients and their families. Christensen and fellow clown Jeff Gordon obliged, performing a 20-minute parody of hospital personnel, food and procedures. Patients and staff alike roared with laughter, especially when the clowns coaxed the otherwise formal chief surgeon into participating in a silly bell-ringing routine. The session, says Christensen, was "the most fulfilling 20 minutes of my professional career, and it was from that experience that the C.C.U. plan took root."

With $10,000 in grant money from the Altman Foundation, used mostly for props, salaries and administrative overhead, Christensen and the Big Apple Circus designed a five-week pilot program. As he tuned in to the needs of his new audience, Christensen made changes in his timing and toned down his circus-arena makeup and gestures to suit the bedside. Perhaps the most daunting hurdle was earning the respect and support of the medical staff. "They had to accept that we were there as part of their world," he says.

Dr. Martin Nash, director of Babies' Pediatric Kidney Disease Program, recalls, "Most of us thought it was a wonderful idea, but we were not sure how it would work and if it would be accepted by the parents of sick children. But Michael's and the other clowns' techniques were so disarming, they captivated everybody immediately." Indeed, Nash confides, hospital personnel thoroughly enjoy the shows of Dr. Stubs and his colleagues.

At the end of the program's hugely successful trial period, Christensen and the circus had no trouble finding further funding from a number of local and national foundations and corporations. He recalls only one voice of opposition. "A hospital staff member once said, 'Clowns don't belong in the Intensive Care Unit.' So I said, 'Neither do children.' "

One of the most touching and poignant cases encountered by C.C.U. staffers concerned a gravely ill youth named Carmelo. The boy had a chronic renal condition, epilepsy and heart trouble that left him, at 14, just 43 in. tall and dependent on dialysis and a battery of medications. In addition, family troubles had rendered him angry and very lonely. For more than a year, the C.C.U. "doctors" spent time with the teenager, who rarely talked and refused to walk. Then one day comic magician Mark Mitton taught him a "mind-reading" card game, and Carmelo began to open up. The boy took great pride in fooling one of his real doctors with the card trick. Mitton later said Carmelo was a good enough actor to join C.C.U., except "we've got a problem because you can't walk." "Oh, I can walk!" Carmelo bragged. He hadn't taken a step in eight months.

Within a few weeks, Carmelo had procured a new pair of tennis shoes and was on his feet as a $2-a-day C.C.U. performer. Immensely proud of his new occupation, the boy found the will to battle against mounting odds far longer than his doctors expected. His condition began deteriorating rapidly last winter, however; in July, two months after open-heart surgery, he died.

Often it's just as important to reach the parents as it is to entertain the youngsters. One morning Christensen peeked into a floor lounge and saw a woman sitting in a chair, reading a magazine; a man -- perhaps her husband -- was on the couch, intent on a novel. Stubs asked gently, "Mind if I come in? I need to catch up on some paperwork." He sat on the couch and starting ripping sheets of legal paper off a pad, crumpling them up and stuffing them into his doctor's bag. He soon piqued the adults' curiosity. "Office work, you know," Stubs offered. "Who says clowns are just for kids?" the woman -- now all smiles -- said to the man.

Of course, the clowning isn't always well received. When leading a visitor into one Babies Hospital room, Christensen was greeted with frantic wails. Coattails flying, he rushed out of the room. "That's my cue to leave," he explained. And as with any audience, some patients just refuse to see the humor. Christensen once paid a call on a teenage boy who was sitting by a window with his head lowered. He kept it down as Stubs conducted his exam. "I asked, 'Have you ever had your funny bone examined?' " Christensen recalls. "He said nothing. 'Does your nose ever turn red?' No answer. 'Are you ticklish?' And then, with his head still down, the boy asked, 'Are you retarded?' I said no. 'Then why don't you act like a normal doctor?' I said, - 'Because I'm not a normal doctor.' He looked up, saw my costume and sighed, 'Oh, God.' "

Christensen tries not to let the occasional rejection deter him. "I can hear no, see no, in someone's face," he says. "I don't have to push to make it a yes. That's not my job." He says he learned an important lesson from his dying brother: "My responsibility was not to save him but to love him and give what I could. My responsibility is to love the children, to give joy and celebration, not to make them accept it. That's their choice." Fortunately for all concerned, most do accept the gentle medicine of Dr. Stubs with gratitude -- and giggles.