- Medical Clowning: The Healing Performance by Amnon Raviv
Amnon Raviv offers an introduction to the emerging practice of medical clowning through a brief and readable volume based in his own clown experience and supported by thorough research. This book is primarily concerned with clowns who perform for hospital patients of all ages, drawing heavily on Raviv's experiences as a medical clown in Ashkelon, Israel. The book is a welcome contribution to the growing scholarship on contemporary clowning, especially as it focuses on clowning outside of traditional performance venues. Raviv provides insight into the clown's work with specific types of patients, explores a variety of theoretical frames, and charts some methods toward best practices.
The book consists of thirteen chapters, plus an introductory manifesto and an epilogue, both written "in character" as a clown. For example, the introduction implores in the voice of a clown: "I call upon you to join me. Life is a joke, so leave your synagogues, churches, monasteries … and join the Clown Army" (2). Each chapter addresses a specific aspect of medical clowning. Structurally chapters tend to lay out a general set of principles coupled with a theoretical frame and medical research, then move to examples drawn primarily from Raviv's clowning practice. At times, the chapters can seem a bit unconnected, lacking a clear build or relationship. This is compounded by the fact that the introduction does not lay out an overarching theoretical or historical frame. Chapter 1 provides information on Raviv and the use of laughter, but does not work as a traditional introduction. Raviv uses the concept of "liminality" to link medical clowns, shamans, and witch doctors, but some scholars may want a greater delineation between medical clowning and the practices of the other two. Not enough attention is paid to what audiences and healers believe to be "real" and what is seen as fictional or playful. When Raviv compares the clown's taking the audience to "a world of humor and fantasy," this seems fundamentally different from the types of spiritual or alternate realities with which shamen and witch doctors engage (39). The differences are key and deserve greater articulation. These concerns aside, the observations, evidence, and experiences presented in each chapter ultimately prove a useful contribution to clown scholarship.
Several chapters address clowning for specific subsets of patients, including chapter 2 ("Clowning to Death"), chapter 10 ("Clowning with the 'Enemy'"), and chapter 12 ("Humor in the 'Twilight Zone'"). In chapter 2, Raviv looks at clowning to the terminally ill and finds that "[m]edical clowning is a flexible performance that needs to be calibrated according to the patient's age, personality, and state of health in order to reduce the anxiety of impending death for both the patient and their family" (21). The idea that clowning is suited to the individual and not restricted to children is a running concern for the author. As the chapter progresses, Raviv quickly situates his medical clown practice within a history that includes both the Big Apple Circus and "healers of the !kung tribe and the witch doctors of the Azande" (22). He also incorporates Mikhail Bakhtin and Richard Schechner to position the clown's role in the hospital space. The bulk of the chapter consists of case vignettes that include different forms of clown interactions with terminally ill patients. These practices range from creating playful fantasies to sharing jokes with dialysis patients after another in the room has died. Raviv notes his concerns about how appropriate or effective the work is in particular moments of articulation, but also how appreciated the work can be, with one mother telling him that "she had not heard [her son] laugh like that for years" (31). These personal stories can be remarkably moving and offer a look at the human impact of the performance. Chapter 10 in particular highlights this human impact of clowning within the sociopolitical conflicts of Israel. It is this chapter where the Israeli context is most pronounced, as it is less immediate to the narrative or argument of other chapters. Clowning in a hospital near...