Fort Worth, Texas,
15:59 PM

Clowning Around Cook Children’s Is Not All Funny Business

An inside look at medical center’s Funnyatrics program

By Victoria Shelton

If laughter is the best medicine, then the therapeutic medical clowns at Cook Children’s have just the right dose to help patients and their families heal.

Each professional clown comes from a different background and different experiences, ranging from the theater to the circus. But they all come together at Cook Children’s with the common goal of making people smile.

“We’re all different, but together we make a great team,” said Susan Keys, a therapeutic medical clown known around the hospital as Dr. Yahoo.

Tiffany Riley brought Funnyatrics, the therapeutic medical clown program, to Cook Children’s in 2014 and has been directing their training workshops since the program’s inception.

“Everyone that does this has a different way of looking at the world. We like to call it clown logic,” said Riley, a therapeutic medical clown and the program’s creative consultant. “They may express that through doing magic or juggling or improvisation or being a musician, so what we do is take those skills and talents that they already have and bring them into a hospital environment."


Although the clowns are able to use their individual skills and strengths to their advantage, they all must have the ability to improvise and think on their feet.

“In our training, we teach them how to engage their audience, whether that audience is a room full of people or one patient in the ICU,” said Riley. “The idea is to be present and aware of everything going on, to have a heightened sense of awareness and to take all of that in and find a way to connect. From that connection, we can create an exchange that creates levity, uplifts the environment and gives the kid some power to make choices, which is not something they often have in a hospital.”

Some people assume that a certain patient might not benefit from interacting with clowns and even discourage a clown visit. But the art of clowning is about making connections with patients and their families, so these clowns will do whatever it takes to bring laughter or a smile to their faces, no matter how difficult the situation may be.

“There was one kid we saw that was blind and my partner played music while I sang and we had the best visit with that kid,” said Keys. “The staff couldn’t believe that he was reacting because he wasn’t doing anything before, almost like he was comatose. He couldn’t see, but he could hear.”

Medical clowns don’t need any words or special equipment to communicate with these patients. From music to magic tricks to bubbles, everything they need comes from their pockets and their imagination.

“We start with the normal stuff that we do and just keep going until we find something that works with that particular patient,” said Grainger Esch, a therapeutic medical clown who goes by the name Dr. Quack. “But there is always something we can do.”

There is something innately artful about the relationship between these clowns and the patients they serve that benefits everyone involved.

We have a gift,” said Keys. “Somehow we give them what they need and it’s just great. One day I was in a room and this kid just wanted to hold my hand for 10 minutes, and I did. I mean, that’s all I did and it was a gift to me.”

Anyone, regardless of their situation, can benefit from spending time and interacting with the medical clowns.

“There are some kids that are ready to play the moment they see us and it’s really a lot of fun,” said Riley. “But for other kids who just look at us, seeing even the tiniest corner of their mouth turn up into a smile is a victory. It’s about us going and meeting them where they are and finding a way to draw them out or help them to get over a hump.”

Medical clowns can be a great distraction to help kids forget whatever pain or hardship they may be enduring, even if just for a moment.

“That’s why I like to teach tricks,” said Keys, “because it focuses them on something other than hurting or not feeling well, and then they forget for a minute that they don’t feel good. Not that they still don’t, but they don’t focus on the pain or how they feel.”

The clowns also assist the medical team by turning things like walking after surgery or taking medicine into a game so that the kids do not realize what they’re actually doing.

“We’re engaging that very healthy, playful spirit of a child that doesn’t go away just because they’re sick,” said Riley, “you just have to work a little harder to find it. And once you find that playful spirit, it makes healing a lot quicker and easier.”

When kids are able to laugh and play, they release endorphins that aid in their recovery.

“Scientific studies have shown that it does improve recovery rates to laugh,” said Esch, “and there is so much stress and worry already, so to have a break from that, even if it’s just for ten minutes, can really change a person’s perspective. To see that you can still laugh is a revelation that gives them the hope they need to keep fighting.”

Aside from bringing magic tricks and fun, the clowns are able to make deep, impactful connections with patients and families.

“Sometimes kids or their families just want somebody to talk to, and at that point it gets real,” said Esch. “Sometimes we go in a room and the kid is asleep, but the parents or siblings might be in there and we’re here for them as well.”

While Keys and Esch say that forming connections with patients and their families is one of the best parts of their job, it is also one of the most challenging. They usually see outpatient kids only once, but they visit oncology, bone marrow transplant unit and ICU patients on a weekly basis.

“We went to one funeral not too long ago,” said Keys, “and we’d known him for two years. That’s the hardest part of our job.”

Since there is a very emotional element to the job, a chaplain comes to the clowns’ meetings to provide counseling once a month.

But the program would not be nearly as rewarding as it is if these clowns did not form genuine connections with people and clown from the heart.

“The kids wouldn’t buy it,” said Esch. “That’s the thing about kids, they can sense when it’s not genuine so you can’t fool them in that way. You can do a magic trick and fool them with some sleight of hand, but you can’t fool them with your intentions and feelings.”

The therapeutic medical clowns at Cook Children’s continue to use songs, jokes, hugs and laughs to bring a smile to anyone who will let them, from patients and families to doctors and staff.

“We’re here for everybody,” said Esch. “It’s primarily for the kids, but everybody here needs a laugh so that’s what we try to do.”


There's an old saying that laughter is the best medicine. At Cook Children's, we believe it's certainly good for you. That's why we offer Funnyatrics, a therapeutic medical clown program. Our professional clowns use humor and laughter to help our patients in their healing. Learn more about the program here.

To support Cook Children's, please call 682-885-4105 or donate online by clicking here

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Lori Dove
Im Gabrials Meme. Thank you to the Funnyatrics Team for all the love, support, and laughter you brought during Gabrials treatments. He is doing very well right now and I'm convinced the visits he received from the clowns helped him through his treatments. Never Ever Give Up!