Therapeutic or medical clowning is a new concept across various healthcare settings around the world [1]. It is a para-medical practice in which clowns are associated with healthcare system to mitigate anxiety, stress, fear and sadness in admitted patients, thereby augmenting the healing process [2]. They create a more positive and constructive hospital environment and trust between patients and medical teams. Research has concluded that medical clowns have a significantly positive effect in adults [3]. A consistent observation has been seen that clowns are always appreciated by pediatric patients [4].

Idea of medical clowning was conceptualized by Michael Christensen in 1986, in the United States. At a physiological level, laughing stimulates release of endorphins modulating immune system. Laughing also replaces negative feeling with positive ones at and emotional level. Clowning distracts the child from the current situation at the cognitive level. Socially, laughing stimulates better interaction between children and health care personnel [4,5].

This practice is still nascent at present in India. Sir JJ Hospital Mumbai has begun with medical clowning in pediatric wards recently. As a pediatrician, our primary responsibility is better health and quality of life of our pediatric patients, and hence, this novel idea of therapeutic clowning is worth trying, especially to begin with vaccination sessions. Further research is warranted to replicate its results in the Indian settings.

1. Finlay F, Baverstock A, Lenton S. Therapeutic clowning in paediatric practice. Clin Child Psychol Psychiatry. 2014; 19:596-605.

2. Nuttman-Shwartz O, Scheyer R, Tzioni H. Medical clowning: even adults deserve a dream. Soc Work Health Care. 2010;49:581-98.

3. van Venrooij LT, Barnhoorn PC. Hospital clowning: A paediatrician’s view.　Eur J Pediatr. 2017;176:191 97.

4. Barkmann C, Siem A-K, Wessolowski N, Schulte-Markwort M. Clowning as a supportive measure in paediatrics – A survey of clowns, parents and nursing staff. BMC Pediatr. 2013;13:166.

5. Bennet MP, Lengacher C. Humor and laughter may influence health: III. Laughter and health outcomes. Evid Based Complement Alternat Med 2007; 5:37-40.