By Deborah Danan
An aptly named 4-foot-8-inch medical clown, “Shorty” stood between two young patients driving coin-operated toy cars in the lobby of Dana-Dwen Children’s Hospital. She was alternately blowing and eating bubbles as the children giggled.
Between mouthfuls, Shorty asked a 6-year-old girl’s mother why her daughter was in the hospital. A tonsillectomy, the mother said, that was performed by a Dr. Shaked.
Shaked is the Hebrew slang for tonsil. Shorty stopped blowing bubbles and turned to face the mom.
“You’re joking,” she said, slapping her palm theatrically to her forehead. “That’s it, I’m done. I have no reason to be here.”
Decked out in a baroque lace cravat, disco-themed baseball cap and a pin reading, “Life is short and so am I,” Shorty is the alter ego of Shira Friedlander, one of seven ‘Dream Doctor’ medical clowns assigned to Dana-Dwek Children’s Hospital at Tel Aviv Sourasky Medical Center.
Over the past two-and-a-half decades, Israel has become a global leader in medical clowning, with two main organizations and the world’s first full bachelor’s degree program in medical clowning at Haifa University.
Since the Oct. 7, 2023, Hamas attacks on Israel, clowning has taken on a renewed role in supporting healing and resilience efforts.
The Simchat Halev association operates a network of about 500 volunteer therapeutic clowns in hospitals, with a focus on entertainment, emotional relief and morale.
‘Dream Doctors,’ founded in 2002, developed a more clinical model, placing about 100 salaried medical clowns in more than 30 hospitals where they work as para-professionals with hospital teams and take part in medical procedures.
At Dana-Dwek, that means the clowns can be brought into operating rooms, oncology wards and transplant units. The nonprofit has also pioneered medical clowning in rehabilitation, trauma care and adult wards.
Send in the Clowns
Prof. Atay Citron founded the medical clowning degree program at Haifa University. In 2014, he wrote that after observing medical clowns in North America, New Zealand and Australia — and interviewing ‘clown doctors’ from Germany, The Netherlands, Russia and Brazil — he did not find stories resembling the “audacity and insane courage” of their Israeli counterparts.
He described their ethos as one of independent spirit, brash humor, bold innovation, risk-taking and creativity, alongside formal training that emphasizes careful listening, hospital rules and cooperation with medical staff.
That difference was clear to Ines Rosner, who co-founded a German medical clowning organization and has traveled to Israel about eight times to learn from Israeli practitioners.
“In Israel, it’s common that you have an idea and you just do it,” she said. “In Germany, that’s not possible.”
While medical clowns are a normal presence inside Israeli hospitals, most German medical facilities “think of them as visitors who come in the afternoons and have some fun,” Rosner said. The pandemic made that status clear, she said, when clowns were among the first asked to leave hospitals.
Independent studies reveal that medical clowning can reduce anxiety in children undergoing hospital procedures, with a 2024 review of 15 randomized trials involving 2,252 children also finding reductions in pain and crying time.
One Israeli study found that children undergoing blood draws cried about two-thirds less when accompanied by a medical clown.
“It isn’t a nice-to-have,” Friedlander said. “It’s part of recovery. We’re part of a giant system.”
On an ordinary weekday morning, shadowing Friedlander proved to be hectic, disarming and downright hilarious experience. She answered questions about medical clowning while breaking off every few sentences to actually do it.
“Wonderful things come out because the ego is put aside, and two hearts meet and the world is blown wide open,” she said.
No Joking Matter
Medical clowns come from mixed backgrounds, with some never having finished high school and others arriving from related professions — such as the circus or theater — or different fields altogether.
Friedlander participated in drama classes since childhood, but acting as a career “felt empty,” she said. At Haifa University’s medical clowning program, where courses include how to step into silliness, she discovered performance as medicine.
“I remember my jaw dropping,” she said. “It was like [the British sitcom character] Mr. Bean falling from the sky. It checked all the boxes.”
Maor Gillerman, whose clown name is “Udi-Lama,” came to medical clowning after Oct. 7th. A scriptwriter who was active in the campaign for better conditions for Israeli screenwriters, Gillerman said his activism no longer seemed like the most useful place to put his energy after the attacks.
“Coming to the hospital is my favorite time of the week,” he said. “It feels like the most meaningful thing I do, even if I don’t always know what difference I’ve made.”
Smadar Harpak, whose clown name is ‘Shemesh,’ is one of Dream Doctors’ most veteran medical clowns, with 17 years in the group.
When someone is hospitalized, she said, the family and the patient “can’t think of anything at all except getting better,” and the role of the clown is to break that tunnel vision.
In 2015, Harpak helped create the ‘Clownbulance,’ which is “like an ambulance, but for treating the soul, not the body,” she said. The vehicle takes out seriously ill children, and others carrying trauma, for a day of fun. Rosner is developing a German version of Clownbulance in Baden-Württemberg based on the Israeli prototype, after training with Harpak.
After children taken hostage in Gaza on Oct. 7th were released, the Clownbulance took some of them on a jeep excursion.
“There are kids who have really lost faith in humanity,” Harpak said. “They can’t just be trapped in a hospital. I want them to go out, remember life outside, and just be normal for a day.”
Asked what, exactly, was normal about riding around with clowns in a Clownbulance, Harpak slipped back into the character of Shemesh, put her hands on her hips, cocked her head to one side and asked, “Do I look normal to you?”
The model had also been tested in trauma settings before Oct. 7th. Citron described a Dream Doctor at Ashkelon’s Barzilai Medical Center entering a room full of schoolchildren from the nearby town of Sderot after a rocket exploded near their bus, ignoring a psychiatrist’s signal to leave and helping turn the encounter into play.
The hospital later changed its protocol, putting medical clowns first in line to meet shell-shocked patients after a missile strike in Ashkelon.
But after Oct. 7th, medical clowning took on a much larger role in Israel’s trauma wards. Rehabilitative clowning, a subfield developed in Israel with wounded soldiers before the war, became part of the emergency response, with clowns working around the clock with traumatized soldiers, civilians, evacuees and hostage families, and alongside psychiatrists, psychologists and therapists at an IDF rehabilitation center.
One Dream Doctors clown said she worked with more than 1,000 traumatized soldiers in the year after the attacks.
Harpak also organized an event bringing together former hostages and wounded soldiers in the Sourasky Medical Center’s rehabilitation ward, calling it a “full-circle moment” in which soldiers were able to say, “This is what we fought for.”
Make ‘Em Laugh
Harpak rejected the idea that certain moments are inappropriate for clowning.
“The clown can be present even in the most sensitive spaces,” she said, because the work begins with “choosing not to see any of them as a victim.”
“When I clown, I’m saying, ‘This happened and what can I do about it?’” she said. “I choose to emphasize the positive.”
Friedlander took it a step further. Medical staff, she said, must focus on the part of the patient that is sick. The clown looks for the part that’s still healthy.
“Whatever situation the patient is in, there is always a healthy side,” Friedlander said. “The clown’s job is to help a person look at things from a different place. When everything is stuck and clogged, finding and opening that part allows things to flow, to move.”
That also means accepting when a child is not in the mood. Friedlander said the clown persona gives her an “anchor” for the rejection.
“It’s not personal against Shorty,” she said. “The clown comes to say, you don’t have to play by any rules. You don’t have to please me or play the game of, ‘OK, clown, be funny.’”
Gillerman described the same idea as a rare form of control inside the hospital.
“It’s not always about making the kid laugh,” he said. “It’s also about their freedom to choose. The clown is the only one a kid can tell, ‘Not right now.’ With the doctors and nurses, the child has no choice but to do what they say.”
Back in the lobby, the girl who underwent the tonsil operation watched Shorty eat another bubble, then opened her mouth and did the same.
Her mother stared at her, astonished. She explained that her daughter had not eaten at all in two days.
For Friedlander, it was a small but meaningful win. Through bubbles and play, the girl was practicing the motions of eating again.
“That’s exactly the idea. Just be a clown,” Shorty told the mother. “Bubbles are the best food for tonsils anyway.”
Deborah Danan wrote this article for the JTA global Jewish media source.
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