By Katy Gosset
It’s been seven years since clown doctors arrived in Christchurch hospitals, bringing their brand of health-giving humour to patients young and old.
Now, they’re spreading the message. The Clown Doctors New Zealand Charitable Trust will launch into 11 rest homes across the North Island from March 2016.
It's the hat that does it - they say.
"Doctor Betty" (Louise Kerr) doesn't feel completely in character until certain key accessories are in place.
"Not 'til I've got a hat on I think... must be an anchor."
And "Doctor Poppy" (Lisa Wingfield) agrees.
"It touches your head and it's a real tooonnk."
And the red nose helps too...
But it's also a mental shift.
Doctor Poppy said, once she arrived for a clown doctor stint, she was aware of a change in consciousness and in the way she held herself.
"It's the way I'm going to walk when I step out the door. It's just this little sort of bubbling - kind of like 'OK, here we go...'"
She also starts looking at everyday objects in a new way, including parts of her or her partner's costume. A cardie might become a puppet, a wall or a superhero's cape.
"Just animating and endowing things in your environment with a different perspective."
The serious business of clowning
The pair work for the Clown Doctors New Zealand Charitable Trust - an organisation that aims to bring humour, and with it health, to patients at no cost to the hospitals.
While its presence in children's wards around New Zealand has been well documented, less known is its work with older patients, including those at Christchurch's Princess Margaret Hospital.
The trust was co-founded in 2009 by Thomas Petschner and Rita Noetzel. Professor Petschner grew up in Europe and worked as a performer and director before pursuing a career in integrated diagnostics and, later, complementary medicine. His interests came together when he created a specialist academic qualification for clown doctors and founded the International Institute for Medical Clowning, at Steinbeis University in Berlin.
"It's not rocket science, really. It's a necessity for clowns working in this environment to know more than just telling a joke."
Professor Petschner sees humour as mental hygiene, and he said there was plenty of scientific research indicating the physical, mental and social benefits of laughter in a hospital environment.
"So we actually created [an] occupation of the future. We created something out of a need right now."
Interacting with clown doctors could bring great benefits for older patients, he said - many of whom missed out on their childhoods through having to work or go to war.
"Now they are at the stage of their life when they are sick and old and bringing humour to [the] elderly is an incredibly nice undertaking."
The trust fundraises to cover the cost of clown doctors in hospitals around the country but they must deliver services to the standard set down by the institute and undergo regular professional development.
"They have to be able to read the mood in a room in a few seconds"
Professor Petschner said they were now ready to expand. From March 2016, following a successful pilot programme, the trust will be operating in 11 Selwyn Foundation villages in Auckland, Hamilton and Whangarei.
The aim is both to improve older patients' quality of life and self-image, and to transform the ways in which societies perceive and interact with their older citizens.
"One important thing is that [the] Selwyn Foundation doesn't see clown doctors just as entertainers. They see clown doctors and humour in that environment as part of essential services that are improving health. That's a big difference."
Reading the room
Clown doctors themselves are very aware of taking the pulse of each ward when they enter it.
And while they respect the wishes of those who don't want to interact, Doctor Poppy said she could usually find a way to connect with a patient.
"Winning an adult over is so much more rewarding [than a child] in some respects... and to see older adults being playful is a delight."
For Phillipa Scott, who had broken her leg, the visit of Poppy and Betty was a welcome distraction.
"I think they're great fun. I think they add colour and humour."
Another patient, Margaret Chelley, was about to have a nap but was happy to postpone it in favour of a sing-along, telling the clown doctors, "You do a great job."
It's not just the patients who notice those connections. Nurses at Princess Margaret Hospital have seen improvements from those visited by the clowns, with Pip Hyde already a fan.
"I love them. They're gorgeous. I love seeing people's faces when they come into the rooms."
Ms Hyde said one patient had very little interaction with staff but was stirred into action by the clown doctors' visit.
"He stood up and started singing for everyone. [The clown doctors] stopped singing and started playing and he sang all the songs for everyone."
The patients and nurses alike were flabbergasted, she said.
Without the clown doctors there, nurses and patients alike would not have known that he had previously been a performer, she said.
"We were all touched. It was beautiful."