On MAS PRESCRIBING THE BEST MEDICINE. Personal Finance: How to be debt-free. Travel: Tel Aviv. Business: Expansion PLUS.

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1 On MAS November 2015 The magazine for MAS Members PRESCRIBING THE BEST MEDICINE PLUS Personal Finance: How to be debt-free Business: Expansion Travel: Tel Aviv

2 MEMBER STORY Prescribing the best medicine Photo: Heather Richardson By Nick Helm Having a laugh is a serious business for MAS Member Thomas Petschner. Professor Petschner is the Director of the Institute for Integrated Diagnostics at the Steinbeis University Berlin and a leader in the field of facial diagnostics, micro expressions and non-verbal communication. He has twin PhDs in nutritional and complementary medicine, and is an internationally respected researcher in the fields of sensory experiences and human behaviour. It s a rather impressive résumé for a clown. But Thomas is no ordinary clown. He s a specialised trainer for a growing number of professional performers known as medical clowns who bring happiness and laughter to children and old people while they re in hospital care. While the doctors and nurses do everything they can to fight the patient s illness, the medical clown works on building up the vitality and energy of the patient, he explains. Medical clowns don t wear coloured wigs or big shoes or have painted faces. We re not circus clowns or birthday clowns those guys can sometimes be scary, he laughs. Instead, we look more like slightly eccentric hospital staff. We might wear a colourful shirt, bright knee-high socks, a silly hat or a large 2 November 2015

3 handkerchief in our top pocket. The red nose is also a dead giveaway. Humour and health The idea of using humour to treat illness is as old as medicine itself and has been proven to provide a range of physical, emotional and social benefits. The physical benefits begin when facial muscles position into a smile, says Thomas. This sends signals into the body, changing the patient s dopamine and endorphin levels. This hormone cocktail relieves pain, reduces stress and calms the patient down. Those are the main things you need when a patient is physically in pain, or distressed and on a high level of alert. It can be a great physiological relief. Humour also makes you feel good and stay emotionally balanced, and encourages a positive outlook through difficult situations. Laughter helps you relax and recharge, and it reduces stress and increases energy, enabling patients to stay focused and accomplish more. And the good feeling that you get when you laugh remains with you even after the laughter subsides. When you give a smile and say, Everything s going to be fine, it s much more effective for the patient s emotional wellbeing than rushing around with a lot of medical equipment trying to fix everything, Thomas says. Over a longer term, the physical and emotional benefits extend to social benefits. Incorporating more humour and play into daily interactions can improve the quality of a patient s relationships and help them to connect with coworkers, family members and friends. Doctors work on health issues, but clowns and humour work by waking up the patient s own resilience resources, he says. As a doctor you fight pain and illness with all the traditional tools that medical science provides whether they be medication, therapy, surgery or whatever. But inevitably you reach a point where you can t do anything more for your patient; you ve used all your tools and your only option is to wait and see what happens. Yet humour still has something to offer at this point. Stage blood Wearing funny hats, bright costumes and makeup might seem an unusual vocation for a learned professor of medicine, but don t be fooled his rational mind is equalled by artistic flair. I started performing as a child in Belgrade, Yugoslavia. Our house was attached to a theatre and the stage was literally my first playground, he says. Even as a boy I never had any difficulties being on a stage or performing in front of other people, and I think the actors realised that. They used to invite me to take part in the productions when there was a role for a child. By my 18th birthday I must have played in dozens of theatre productions, TV programmes and little movies. Even then he was fascinated by people s reaction to comedy. Apart from learning lines I liked performing, but I was always more interested in what was happening behind the scenes. I used to sit backstage and watch the audience and take notes about what made them laugh. But mostly I wanted to work as a stage designer and playwright, he says. Years later he established his own theatre in Nuremberg, Germany. It performed nothing but comedies, which were written and directed by Thomas. My whole life has always somehow related to theatre. I financed my medical studies working as a playwright. Because I was too busy with studies and doing medical research, I didn t act any more but I kept writing for theatre and television the whole time, he says. It was a really interesting phase of my life, which helped me develop a sense for funny situations and understand not just German but also universal humour. Gradually I also found ways to mix together my interests in the theatre and medicine. The idea of using humour to treat illness is as old as medicine itself and has been proven to provide a range of physical, emotional and social benefits. On MAS The magazine for MAS Members 3

4 Professional clowns Unlike Thomas, most medical clowns aren t real doctors dressed as clowns they re professional performing artists who have achieved academic qualifications from the International Institute for Medical Clowning, an organisation Thomas established at the Steinbeis University Berlin. I was very, very lucky that I managed to convince the university Board to establish an institute to bring artistic education into the medical field. What began as an academic concept became reality and has grown enormously. Now there are almost 100 medical clown graduates in Europe, Singapore and New Zealand, he says. I think it s important to understand that medical clowns are not well meaning volunteers running around in colourful wigs acting silly, he says. They have to undergo a specialised training, because when a medical clown visits a hospital they re there for a therapeutic as well as an entertainment purpose. They need to be aware of a patient s condition and diagnosis, and be sensitive to their psychology, social conventions and cultural diversities. He says it s a big field and medical clowns have a great deal to learn before they are allowed to perform. To be certified as a medical clown, the lowest-level qualification, a student needs to complete at least 1,200 hours of theory and practical work. Specialist and BA qualifications require similar additional time commitments. We also have quite a stringent process for selecting potential medical clowns, says Thomas. After a very specific audition process, followed by a week of initial training where we get to see each candidate s abilities and put them to the test the final selection is made. Most candidates who go on to graduate go to the Institute with an academic education and years of performance experience behind them, but it is no guarantee of success. Thomas says students can learn performing arts, psychology and about medical procedures, but they need to have what really matters compassion. We don t look for people who can juggle 25 balls while swinging on a trapeze, he says. We look for people who are sensitive and caring, who understand others, people who are open to different cultures, people who are mature, who have personal as well as artistic qualities. Medical clowns are often called upon to work with terminally ill patients. The training helps them deal with these difficult situations, but the most important ability comes from within some people instinctively understand the fine line between being funny, being present and being virtually invisible, and when each one is appropriate, he says. Once the students are selected and they complete the one-and-a-half-year course, they have ongoing training every six weeks, so we have more than enough opportunities to see how their abilities are developing. If they re not suitable they don t continue, because we can only provide patients and hospitals with the highest standard of professional medical clowns. Many people have a perception that anyone can be a clown doctor that it s easy to go to a hospital and pretend to be funny. They may be well meaning but a lot of the time they just end up being annoying. Just because you think you are funny doesn t mean that you have the ability to make someone who is unwell laugh or feel better. That requires comprehensive training. Thomas also works with medical staff and management to share with them some of the skills he teaches his medical clowns. Empathy and compassion can make a huge difference in a healthcare setting and can really influence the services a hospital provides, he says. For example, many doctors don t know how to tell a patient they are terminally ill. They may not have the experience of how to behave in that situation, so they try to lighten the blow by acting casual or offhand. They might look at their computer screen and say, By the way, I got your results back and you have cancer. That could come across as a lack of empathy, so I try to teach doctors and nurses how to deal with patients in a more sensitive and empathetic way. Homegrown humour Shortly after moving to New Zealand in 2005, Thomas realised that medical clowns were virtually unheard of in this country. I was practising in Christchurch at the time, so I asked my colleague Rita Noetzel if she would be crazy enough to help me get clowning off the ground here. She agreed, and the Clown Doctors New Zealand Charitable Trust was born, he says. But it proved much more difficult to convince the medical establishment. The concept of medical clowning is still pretty new and many people have negative perceptions of clowns. It took a while to explain the purpose and benefits of medical clowning, and how it differs from other types of clowning, he says. When we approached the first few hospitals, for instance, we had to 4 November 2015

5 repeat our presentations several times first for the doctors, then the nurses, then for play specialists, then for management, then for the social workers, and so on. Everyone had to be convinced before we were granted a 3-month trial period. It s understandable that most hospitals wanted to gauge how the clowns were received by staff and patients before making a commitment. The Starship Foundation, which is Clown Doctors exclusive sponsor for Starship Hospital, did an independent survey and got an incredible response of 100% satisfaction from nurses and doctors. Our ultimate goal is to bring medical clowns into the biggest hospitals in New Zealand, so I presented the idea to another 18 hospitals around the country, Thomas says. All of them were receptive, especially since we provide our services free to the hospitals. But as a charity we have to fundraise and find supporters in the local community, as this enables us to train the clowns and pay them for each hospital visit. You need a lot of clowns and a lot of sponsors to cover all those hospitals. to that kind of thing. All the search and rescue teams, doctor teams and family members were under huge physical, emotional and psychological pressure and they needed immediate support. Learning how to deal with situations like this is a key part of the specialised medical clowning training for relief and recovery work. You have to find the fine line between being humorous and supportive, without being disrespectful. Finding a way to relieve the pressure in such critical moments is enormously important, he says. These types of crisis situation are really about giving people permission to laugh when there is absolutely nothing to laugh about, but knowing that it will help them to feel better. It is this kind of work that is going to be my focus for the rest of my life. For more information on the Clown Doctors New Zealand Charitable Trust, visit clowndoctors.org.nz. Students can learn performing arts, psychology and about medical procedures, but they need to have what really matters compassion. That takes time, but we re getting there and we now have 26 fully trained medical clowns and seven trainees across Auckland, Wellington and Christchurch, he says. Fortunately I was also able to establish Clown Doctors Asia-Pacific with the aim of bringing medical clowns to that region. The first professional medical clowns in Asia started in Singapore last year, he says. I ve just got back from China where we have plans to train Chinese artists and introduce medical clowning into the country s largest children s hospital. Relief and recovery Despite the interest in medical clowns in hospitals, Thomas says his work across Asia- Pacific will have a different focus. There is a great deal of demand for emergency response teams to provide psychological and mental aid for children and people in crisis situations, he says. I spent quite a bit of time with the search and rescue teams in the hours and days following the Christchurch earthquakes, he says. In those first days they pulled several bodies out from under the rubble. The whole team was under enormous pressure, even though they d experienced the same thing many times before. I don t think you ever get used On MAS The magazine for MAS Members 5