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Lessons from the Clowns When Going to the Doctor’s

By February 3, 2019February 27th, 2019Caregiver, Clinician, ePatient, Family man, Podcasts
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What can the clowns can teach us as patients and caregivers about relaxing, reading the room, figuring out what you’re there to do, and not ending up more stressed than you went in. Maybe even having a bit of fun. In this podcast we will speak with Jason Stewart, a clown at Boston Children’s and listen in on a working session I led at the National Caregiving Conference in Chicago this past November, entitled, Reading the Room and Yourself. Lessons We Can Learn from the Clowns When We Go to the Doctor’s Office.  Lessons from the clowns? Humor, humanity, failure. Reading the room. You are not alone.

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Episode notes


Time-stamped sections

Introducing the podcast 00:45. 2

Jason Stewart interview.. 2

Introducing Jason Stewart 02:28. 2

From Theater to Ringling Brothers Circus 03:29. 2

From Circus to Boston Children’s Hospital 06:41. 3

Embracing failure. It’s what clowns do. 09:45 4

Embracing failure. Caregivers can do it. 16:29. 5

The best human we can be 18:55. 6

Sometimes shit show at doctor’s office 20:27. 6

Humanizing the doctor. Check body language 23:31. 7

Laughter is the best pain management 26:11. 8

Part of the circle of care 28:29. 8

Caregiving conference breakout session. 8

Intro 29:31. 8

Reading the doctor’s vibe. Now what? 30:31. 9

Mimic. Micro-expressions. Put a spin on. 33:13. 9

Being remarkable, not a factory widget 35:10. 10

Genuine connection. For real? Relationships 38:33. 11

It’s not looks. It’s humanity 41:28. 11

What if I can’t fire my doctor? 47:19. 13

Where’s the humor in failure? 48:32. 13

Stress you can manage, stress you can’t 53:57. 15

Karma. My bad doctor’s mom 55:43. 15

Cranky is, cranky does 57:13. 15

Which Thursday? 59:20. 16

Managing the accoutrements 1:00:20. 16

Having a bad today? 1:01:59. 17

The 30th person before lunch 1:02:42. 17

Closing 1:07:24. 18



Do you ever feel like you’re part of someone else’s play? Especially when you go to the doctor’s office as a caregiver or caree (also known as patient). You and your caregiver or caree feel like crap, you’re exhausted, you’re cranky. What are we doing here? The staff is unfamiliar (really, they’re strange). What were we going to accomplish? With these strange people? I’m a nurse, a patient expert and a caregiver expert.  Yet most of what I know and teach goes right out the window when it’s me in the doctor’s office. It’s 50/50 whether it’s a good appointment or a shit show. I need different skills, an attitude adjustment, something when I go to the doctor’s office.

I used to work at Boston Children’s Hospital where I led the Patient Family Experience Initiative. I took a class there from the clowns. I wondered if we could learn some of what the clowns can teach us as patients and caregivers about relaxing, reading the room, figuring out what you’re there to do, and not ending up more stressed than you went in. Maybe even having a bit of fun. In this podcast we will speak with Jason Stewart, a clown at Boston Children’s and listen in on a working session I led at the National Caregiving Conference in Chicago this past November, entitled, Reading the Room and Yourself. Lessons We can Learn from the Clowns When We Go to the Doctor’s Office. Here’s Jason.

From Circus to Boston Children’s Hospital 06:41

And so, after my Ringling days were done. I met my wife do the circus. Our kids were born out on the road. We traveled for several years and then when the kids got to be about school age, we decided to get off the road. And by hook or by crook I ended up hearing about this team of performers and variety artists and clowns who were performing in hospitals. And I thought, wow. Okay. Well, it’s a gig for a clown, right? So, I’m going to audition for it, and I did. And it was here in Boston Children’s Hospital and just by absolute fluke I fell into this wonderful thing. And I said, okay, I’m a clown for 20 years. I’ve been all over the place, done a ton of things. But this is the hospital and I’m looking wow. What am I going to do in there? You can’t throw pies. You can’t do a bunch of falling down slapstick, you know blowing things up like we did in the circus. And I was thinking I need to really shut my mouth and learn something about what this is. I can’t come in with these guys who have been here for at that time about 15 years, but I can’t walk in here and act like I know more than they do because I may know a lot about wowing, but I don’t know the venue. I don’t know the style. I don’t know what’s required in that in that environment. So, I was that was another one of the very smart decisions I made was to realize you don’t know anything. Come in as a newbie. Come in as the new guy and just learn. And so that’s what I had to do.  I kind of had this impression.  That the kids in the hospital were somehow some kind of different creature. They were some different species. Oh, it’s a sick kid. And I was tiptoeing around and worrying that I was going to do something wrong. And then I realized you know, Jay, it’s just a kid who happens to be sick. The kid doesn’t want you to come in and walk on eggshells and pat them on the hand and tell him he’ll be okay. He wants you to be a clown for him. There’s an expectation that comes with that nose and those big shoes. And the kid wants you. He doesn’t want to be there. He doesn’t want to be in the hospital. Nobody does, right. And so, I’d learned quickly to not walk on eggshells and to not treat them as if they were some special case beyond what is required for the environment, but just to be a clown for him and to bust the joint up a little bit. Because that’s I think what every kid deep down kind of wants. And so, this is now my I’m into my 12th year performing at Boston Children’s and also down in Providence at the Hasbro Children’s Hospital in Rhode Island. And you know, I work two sometimes three days a week in the hospital. It’s an intense experience, but it’s wonderful and I do value it very much.

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Embracing failure. It’s what clowns do. 09:45

What I consider a failure is that if I go into that room and I don’t have an effect. If I go in and it’s kind of, not a positive reaction or not enough. I can’t get through. If I can’t bring them up If I can’t leave them a little better off. I mean nobody bats a thousand There’s going to be room to go in and it’s just ice cold and they’re not going to engage and their in a hospital. You can’t blame them for that, right. In some ways It empowers them to be able to say no to us. Okay, they cannot say no to anything else in that environment because the kids get the kid even the parents if they walk in. We got to do a blood draw. There’s no parent wants to hear that. But you got to stick a needle in my kid’s arm. It doesn’t matter but they can’t say no, they cannot you’re not in control of their experience right then and they probably feel like a failure because of it when we can come in and let them say no to us they can you know in some ways I feel like even the rejection of, not today, clowns. We’re not up for it today. In a way that’s an empowerment and it if I see that as my failure, it’s their win. And that’s why I’m there.

Humanizing the doctor. Check body language 23:31

Health Hats: I think that humanizing is good. Sometimes when I work with caregivers and patients, they try to put a smile on their face, even if they’re not necessarily feeling that because they find that the other person the professional will mimic them. Right, helps to diffuse some of the tension I think a lot of this about you know, it’s so tense.

Jason Stewart: We are all human beings. With our subconscious mind we’re all reading nonverbal communication. And that’s part of what that Workshop was we did back in the day. Was that idea of how can you read that to know how to respond in any given situation? What is the person telling you without saying it? What is their body language say? What are their expressions? What are the emotions that they’re giving off? What does all that say? And it’s all sort of subconscious and not something that that they’re choosing to communicate. But it is probably closer to the truth than whatever words they’re choosing to express themselves. And so, it’s being to me part of our work as the clowns in the hospital is to read those nonverbal communication opportunities.  That’s the that’s the skill that I think the hospital clown develops because of the focus of our work. We aren’t necessarily just trying to cure anything, you know, we’re not there to see the charts and understand what this medication has done and what this procedure may have helped with. We don’t know any of that. We do know the spirit in the room. We do know the emotional values that are present in this unique setting. Because each room is different. Every room has different people in it and different people responding in different ways. It’s an exhausting mental process for the clown and everybody who does this work will tell you. About end of the day you’re probably shot. You’ve been at that heightened level of its of awareness of kind of read every little expression and every little body language type movement and see what you can do that’s going to contribute and instead of detracting from. The last thing you want is to make it worse for those folks. Yeah, tell me that is that’s the old medical value. First, Do no harm. And that’s us.

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Part of the circle of care 28:29

But I do feel like we’re part of The Circle of Care in our way and how we can use our strengths. We can contribute and often with stress reduction and with distraction and with raising emotional positivity. that it can contribute to things like needing less sedation or needing less painkillers later on. There’s truth in the fact that laughter releases endorphins which lead to healing and to just lower blood pressure and that kind of stuff. And so in that way I’ll take you that I’m sort of a medical person. Not really see myself as a doctor other than the fake name that I use when I’m clowning there at the hospital.

Mimic. Micro-expressions. Put a spin on. 33:13

Health Hats: Another participant talked about micro-expressions and their impact on the vibe of the room. Again, the sound is uneven and there’s sounds of the mic being passed

Geri Lynn Baumblatt: Your micro-expressions imitate them and that’s actually feedback to your own body. So, I think, you know that experiment where they make people put a pencil between their teeth? And it actually makes you feel happier. Well, yeah because your mind takes its cues from your body. So, when you mimic other people’s self-expressions, you do actually feel what they’re feeling. So, I think there is something to forcing yourself, even when you see somebody coming at you like this. My husband’s really good at this. I am not. I just get pissed and angry, but he’ll go into hi, smile mode and like really lay it on. Because people actually then if they if you smile at them and they’re forced to smile back. Basically, it actually changes their emotions too. So, it changes your emotions to mimic them but then it changes their emotions to mimic you so you can actually work at changing that if you realize this person’s in a pissed-off mood. I’m going to be in a really good mood and like change their day and their emotions. Right? Right, right because when they give people Botox, they actually have a harder time reading your emotions because they can’t mimic your facial expressions.

Participant: So I am not a caregiver, but I have been on the receiving end of the care and one thing that I found with my oncologist was that she really connected with my spouse and even though I didn’t need to take him to my appointments like he brought a bit of  levity  to the situation and he has a good sense of humor. And she also really got his sense of humor. So, I started just encouraging him to come because I think she enjoys you.  I think we get more attention if you if you come.

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It’s not looks. It’s humanity 41:28

Health Hats: Your example is from the point of view of the medical system to the patient. I’m really interested in what we do in terms of that.  I know except for my mother who would never leave the house without her face on, caregivers and patients are not really thinking about how they look and whether they’re wearing a nose or a funny hat. It’s really not that often It’s about looks. I mean, sometimes it’s about looks, and you know as the office manager said, cookies donuts flowers, some people like that. But let’s think about what we do. Because I think it’s important. It is hard to be proactive when you’re a caregiver. But you’re going to need them when the shit hits the fan. You need them and so having a relationship Is important and when you’re like feeling like crap and it didn’t go that well having a relationship there’s more forgiveness. Yes,

Participant: So I am not a caregiver, but I have been on the receiving end of the care and one thing that I found with my oncologist was that she really connected with my spouse and even though I didn’t need to take him to my appointments like he brought a bit of  levity  to the situation and he has a good sense of humor. And she also really got his sense of humor. So, I started just encouraging him to come because I think she enjoys you.  I think we get more attention if you if you come.

Health Hats: I think that’s a great strategy. I mean, I’m sort of a whatever it takes. That it’s unique. Office is a different thing. So, yeah, thank you. That’s great. Anybody else? What do you do? What does anybody else do yes?

Participant: So, I was a long-distance caregiver and I had to do a lot by phone. And when I would call the office, I’d always be like hi I’m Mary’s daughter. My name is Anne. What’s your name? Because I wanted to know who I was talking to in terms of following up or something and be like, “oh mom always liked you best.” You know, I would just try to do something. Yeah to kind of soften it, you know when I needed them to fax something or get a renewal or something like that. So, I always try to personalize it and you know trying to be genuine.  She didn’t always liked all of them best. So, I try to find something to say to them, but mostly just, as much as possible avoiding getting into a crisis situation. So, if you could be proactive so that you’re not putting them more burden on them. It’s being organized and communicating well needed but as much as possible also trying to personalize it.

Participant: Yes. My mother had and I shared the same doctor. She’d been going to him for I don’t know how many years. But they were all very pleasant in the office and I was always pleasant with them. So, it got to a point when then Mom was bed bound and I couldn’t really get her out and things like that. I could call up and say okay Mom has another UTI. Because I could tell by the symptoms and okay, we’ll call in a prescription. So, it was that relationship that we had and the fact have how well the doctor knew her and knew me from how much I when I would bring her in and things like that.  I had that relationship. When she passed in August and I went in to tell them that she had passed. They took time out in between their patients to come out and speak with me and every person in the office came out and said something to me about how wonderful she was. And you know, what a great job you did she wouldn’t been here that long if you hadn’t taken such great care. But it meant a lot then from the office staff because I had this relationship with them. Yeah. that you know, the doctors came out, the nurse practitioner came out, the medical assistance the billing department everybody, you know, it was just nice, you know that kind of and it wasn’t anything that I didn’t have to bring them cookies. I didn’t have to do anything like that. It was just. Not yelling at them. Yeah, you know understanding where they were what they were doing.

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Karma. My bad doctor’s mom 55:43

Participant: I can’t solve it either. My husband has Alzheimer’s and 15 years ago, maybe 12 years ago his primary care physician was bad. And we got out of that situation, but it was bad for a long time and now 20 or 15 years later, my husband is in a memory care facility and lo and behold that physician’s mother is there. There’s Karma. I mean there is karma.  When they walked in the physician and his wife and I looked on the hall and you know, what is he going to do here? I am sitting here with my husband, who he was horrible to. Who now has Alzheimer’s?  I’m kind of saying, “I told you so” but not really. But I handled it so well when we broke it off before it was just a break off and I never talked to him again. But now that his mother is there, it’s a whole different situation with he and I were people we’re all just people. He’s not the shit doctor that he was before. He’s somebody’s son who’s in the same situation as my husband is and what goes around comes around. And it kind of gave me a little fun feeling but then again, His mother is one of my favorite other clients. She and I get along so well, and he comes she comes to my husband’s room all the time. I find her sleeping in his bed. It’s really it’s kind of funny.  If you can’t laugh you cry.

The 30th person before lunch 1:02:42

Ben Carter: That was great. I think and it made me think of a situation when I was caring for my mom and my mom was a diabetic. When I talk about diabetes, I talk about the personality of diabetes because everyone’s experience with it is so different and I think when you go in to see a clinician. It’s not like they’re jaded or cynical. They’re busy and they’ve seen cases over and over and over and over again and sometimes we talk but we don’t listen. And what I found was when my mom would explain what her experience was there wasn’t a lot of listening. And so, I think from the opposite side what we can start doing is acknowledging what’s happening for the clinician.  So, I might be the 30th person they’ve seen before lunch. So, if I can listen to how they even say hello to me. How the phone shuffles as they’re picking it up and if I hear paperwork in the background or if I’m with them I can tell that they’re physically with me. But they’re also paying attention to these seven other patients in each room that they stick us in, right? So, they stick you in this room you wait for 20 minutes. They come in two minutes to check in on you. Okay, the nurse will have something for you at the desk and I think sometimes that’s what a lot of clients walk away feeling. No one heard me.  And then we get into the right or wrong. I’m right about how I feel today. And you’re making me feel wrong because you’re not either hearing it or you’re saying something that doesn’t make sense to what my condition is. And I hear that now as a coach in Telehealth for my clients with diabetes and cancer. My oncologist sees so many people. That he doesn’t hear what my experience is. And now when I go see him before we even communicate there’s tension. So, when you call over on the phone, you’re on your there’s already tension based on the conversations you’ve had in the past. And so, I think sometimes if we just stopped and intuitively listen and then respond right without I’m right he’s wrong. Because that’s what’s happening. You’re in the position that you’re in and you know what, you know, right and it might even be right and he’s the doctor. I’m right. And so, where do we meet where we take that off the table and we hear each other?

Participant: So, I think part of the reason why sometimes conflicts happen is it’s not about the patient anymore. It’s about who’s right and who’s wrong and sometimes when we sent her it back towards I just want the best care for whoever it is you’re caring for and how can we work together to achieve that? And like even though you’re still accomplishing the same thing as what you were doing earlier or what you’re trying to do earlier, whatever it was. It can be a more pleasant experience. Not that it always works. But sometimes like reframing the logic or the thinking and reasoning behind why it is that you are acting the way you are can help the other person also understand you a little bit better too. Because no one can read your mind. I make that mistake all the time with my husband. I’m like, what do you mean you don’t understand this and then we realize we just really have to. It’s a lesson in communication I suppose and figuring out how do we reach a new understanding of each other.

Health Hats: And I would just to end I would add on to that what the clown said, they’re professionals and they fail more than half the time at it. They just and they just say we just got to tell a funny story and move onto ourselves and move on to the next thing because it’s too heavy. I personally like that. Well, thank you all very much. This was a different kind of… Keep the hats. Please keep the hats, keep the noses. Keep the beat

Closing 1:07:24

Lessons from the clowns? Humor, humanity, failure. Reading the room. You are not alone. Thanks for your time.

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More about Jason Stewart

Photo by Diana Feil in Unsplash

Music by permission from Joey van Leeuwen, New Orleans Drummer, Composer

About the Show

Welcome to Health Hats, empowering people as they travel together toward best health. I am Danny van Leeuwen and I have worn many hats in my 40+ years in healthcare as a patient, caregiver, nurse, informaticist, and leader. Everyone wears many hats, but I wear them all at once.  We will listen and learn about what it takes to adjust to life’s realities in healthcare’s Tower of Babel.  Let’s make some sense of all this.

My guests and I reflect on what works for people, professionals, and communities in their journeys toward best health: learning, making choices, communicating, and adjusting to realities. We can range from personal, clinical, technical, entrepreneurial, organizational, to whatever interests me at the moment. Join the ride!

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