【Let Love Stream 3】A Catalyst for Life Care and Social Inclusion (Dong Wei-Hsiu)

On an afternoon just after the beginning of summer vacation, two performing arts workers from the “Red Nose Care Clown Association” entered the pediatric ward of a large teaching medical center somewhere in southern Taiwan. They began preparing their performance for the children who had been hospitalized in the ward for extended periods. They reviewed, one by one, the materials provided by the hospital—including information on the wards they were about to visit, the children, and the patients’ recent treatments and physical and mental health conditions. They then began applying makeup, getting dressed, and discussing the performance arrangements. Afterward, they transformed into well-trained “Dr. Red Nose,” presenting performances for patients, family members, and medical staff; their professional performances incorporated forms such as theatrical clowning, storytelling, physical improvisation, and original songs. They entered every corner of the hospital to care for children confined to their beds, bringing them laughter, encouragement, and support, helping reduce the tension associated with hospital treatment, strengthening their motivation to recover and look forward to healing, comforting the exhausted hearts of relatives and friends assisting with their care, and relieving the heavy workload and pressure of the medical team.

Imagine the workplaces of patients and medical personnel in healthcare institutions. Everyone in these hospitals—whether patients, family members, medical teams, or social welfare workers—may be undergoing physical and psychological distress because of illness or the missions, duties, and responsibilities of their work, and may consequently be indirectly deprived of opportunities to experience the emotions stirred by art. If healthcare is still on its journey and cannot yet treat every disease, patients need spiritual care in facing illness, something that medical actions alone cannot fully provide. Could art be brought into these medical settings in some way, providing hospital audiences, or even a particular individual, with a performance tailor-made for them? Since 2015, the “Moo Theatre Company” has launched the “Dr. Red Nose Project,” with the aim of realizing this ideal—to use performances by professional “healthcare clowns” to help hospital patients show their smiles again and regain their passion for and hope in life. These performing arts workers perform for children with a strong sense of mission; perhaps seeing pairs of curious, exploratory eyes and hearing laughter beneath masks is their greatest reward. They believe that, for patients and the public, a hospital can also be a space that transcends illness and allows room for imagination and creativity.

The performances of Dr. Red Nose constitute a public art project combining performing arts and social service. Their philosophy is to warm everyone in the medical setting—each important, unique, yet potentially vulnerable individual—by visiting hospital wards at regular intervals and performing for patients. The international concept of healthcare clowning originated in the 1980s. In 1986, the combination of “clown performance” and the “medical setting” reached an important milestone. That year, one clown troupe and project each in the United States and Canada entered local hospitals to give regular performances, opening a new chapter in the history of integrating clown performances into medical settings. The medical clowns of the United States and Canada later established organizations in various countries, primarily in Europe, and healthcare clowning began to flourish worldwide. Clowns performing in hospitals subsequently became a professional community with several names: “Medical Clown,” “Medical Clown,” “Hospital Clown,” “Health Care Clown,” or “Therapeutic Clown.” ^[1]

Healthcare clowning was inspired by the need to improve patients’ hospital experiences. It uses clown elements to ease patients’ emotions, anxiety, and stress in medical environments and to promote mental health. Becoming a healthcare clown requires professional training, including not only clown performance skills but also basic knowledge of psychology and medicine, so that appropriate support can be provided in medical environments. Early care clowns entered hospitals to comfort patients through humor and interaction, particularly pediatric patients. This concept gradually gained acceptance worldwide, with many countries introducing similar programs and localizing them according to their own cultures and healthcare environments. As research and empirical support for healthcare clowning programs have increased, they have gradually become important psychological support tools in many medical institutions—not only for children, but also for geriatric wards and adult patients—improving the overall quality of healthcare services.

Originating from Le Rire Médecin, France’s association of smile doctors, the “Dr. Red Nose Project” brings a group of clown performers trained in professional performance, psychological care, and health education into hospitals to perform for children whose lives are restricted by long-term illness. The project allows children to enjoy interactive performances they could otherwise experience only in a theater, while also enabling children, parents, and medical personnel in wards normally characterized by quiet and dreariness to temporarily withdraw from anxiety and stress and enjoy moments of relaxation. As early as 2015, Ms. Ma Chao-Chi, founder of the “Red Nose Care Clown Association,” and Mr. Luc Ducros put on their makeup, brought their instruments, and entered the wards of National Taiwan University Children’s Hospital. That was the first day a Medical Clown entered a hospital in Taiwan. By 2024, the Red Nose Care Clown Association had trained more than 30 professional Dr. Red Nose, stationed in hospitals across northern, central, southern, and eastern Taiwan to provide regular, long-term performances.

In contemporary art history, the legendary artist Joseph Beuys (1921–1986) proposed his classic phrase in the 1960s, “Artist as Sherman,” to describe the role of artists in contemporary society and express their capacity to heal society and individuals. When discussing how artists connect with communities and exert a certain degree of influence on society, British artist John Latham (1921–2006) suggested that an artist is much like an “incidental person.” He pointed out that when an artist enters a particular group or institutional organization, the creative thinking proposed through interaction and dialogue with that community, and the exchange and practice it generates, are sufficient to promote the well-being of social organizations or transformation within communities^[2], inspiring artists of subsequent generations to courageously and actively develop forms of intervention in fields beyond art, dedicate themselves to contributing to community life through artistic practice, and bring richer imagination to the problems and dilemmas faced by individuals and collectives.

The discourse on new genre public art and socially engaged art that emerged in the 1990s argued that the public space and public connections of public art should be realized not only through works exhibited or performed in public spaces, but also through concern for interaction and exchange with the “people” and “communities” in public spheres. New genre public art focuses on issues related to their lives and living circumstances; the public also participates in the process of creating the work, completing the work or performance, and becoming part of it. ^[3] In recent years, the public art project “Electricity ✕ Art ✕ Everyday Life” initiated by Taiwan Power Company has broken away from fixed sites and creative forms, proposing an “artistic concept that flows like electricity”^[4] to initiate participatory art actions. When the current of art flows into communities and encounters the public, it warms the children lying in hospital beds and corners, flows into their bodies to awaken each heartbeat, and brings the wonder and emotion of artistic experience. This art project undertaken for the public not only embodies the principles of new genre public art, but also resonates perfectly with the spirit of the “Dr. Red Nose Association,” composed of performing artists: “Like an electric grid that fears no hardship, let services reach every corner; let clowns enter hospitals and become part of them, so that hospitals are no longer cold cages but spaces for recovery filled with positive energy and warmth.” Dr. Red Nose also adhere to the continued use of medical institutions as sites for social artistic practice, hoping that “through this project, society’s attention to and emphasis on child-friendly healthcare can be deepened.”^[5]

In hospitals, patients often feel that illness has deprived them of their freedom and their power to say “no” to disease. This is especially true of patients with rare diseases and serious illnesses, whose prolonged treatment and illness result in social isolation. If healthcare is still on its journey and has not yet been able to treat every disease, patients need spiritual care in facing illness; however, this is not something that medical treatment alone can fully accomplish. The positive relationship between art and health has long been scientifically proven. This is not a practice arising from a passing enthusiasm; it has received considerable international response and is an inevitable trend in future healing systems. Although medicine has its limits, how to improve patients’ experiences and quality of life during the process may be more important. ^[6] Taiwan possesses advanced medical facilities and technologies, but the concept of “whole-person” care requires greater attention. On the path toward “whole-person” healthcare, Medical Clown attempt to become catalysts for individual life care and the promotion of social inclusion. Senior healthcare clown Tseng Ching-Wen of the “Red Nose Care Clown Association,” which has long stationed performers in hospitals in southern Taiwan, stated: “‘Treatment’ is not the intention of Dr. Red Nose; rather, through clown performances filled with humanity, they bring about a sense of healing that may arise naturally.”^[7] Before entering a ward, Dr. Red Nose design their content according to age, condition, and mood. The gifts they wish to give patients—their improvised performances—are intended to return smiles to children and to every person. Through the power of humor, healthcare clowns become partners in the hospital’s emotional care.

In November 2024, the Red Nose Care Clown Association specially organized the documentary exhibition “A Day in the Life of a Medical Clown” at the Pier-2 Art Center in Kaohsiung. During the exhibition, it promoted the ideas and stories of Dr. Red Nose through public performances, documentary images, guided tours, interviews, workshops, and other activities; actively advocated the importance of child-friendly healthcare; and hoped to help more people understand the work of Dr. Red Nose while introducing their professional training and mission to the public. The exhibition text stated: “A day in the life of a Medical Clown means—creating a magical time and space in the hospital where sick children can regain the right to play carefree, encounter art, and explore the world.” Yet perhaps, whether children or adults, patients, caregivers, or medical personnel, everyone has a child living within them—or was once a child with memories of childhood. Through the care and artistic actions of Dr. Red Nose, we hope to continually use the power of love and smiles to support patients through the darkness and pain in life that are difficult to bear, bringing gentle companionship and comfort.

^[1] See the official “Dr. Red Nose” website. https://drn.org.tw/?fbclid=IwY2xjawGa7qlleHRuA2FlbQIxMQABHV1_b4xODMtCrkIwG7o2d8zS8eTyP6PvzIGYn6mKgu9DoZSLGknnK4HOOw_aem_EC1_7msVv2FCqCIj6dgrGg. Accessed: 2024.11.8

^[2] Rycorft, S., The Artist Placement Group: an archaeology of impact, Cultural Geographies, Vol. 26 (3), 2019, 289–304.

^[3] Lacy, S. (ed.), Mapping the Terrain: New Genre Public Art (Seattle: Bay Press, 1994).

^[4] Taiwan Power Company, “City of Aura: Taipower Kaohsiung Public Art Installation Project Results Album,” Taipei: Taipower, 2019, p. 88.

^[5] Ibid.

^[6] See the National Culture and Arts Foundation’s “Subsidy Achievement Archive,” 2022 “HCIM World Medical Clown Congress International Exchange Project,”https://archive.ncafroc.org.tw/result?id=619be93857974650915eee3e272b2cf4 . Accessed: 2024.11.8

^[7] See the official “Dr. Red Nose” website. https://drn.org.tw/?fbclid=IwY2xjawGa7qlleHRuA2FlbQIxMQABHV1_b4xODMtCrkIwG7o2d8zS8eTyP6PvzIGYn6mKgu9DoZSLGknnK4HOOw_aem_EC1_7msVv2FCqCIj6dgrGg. Accessed: 2024.11.8

Art critic and professor in the Department of Visual Arts and Design at National University of Tainan; PhD in Art from Birmingham City University, UK; and Master of Art and Design Education from the University of Warwick. Her research interests include contemporary art and social practice, art in public spaces, visual culture, and art education. She has served as a visiting scholar in public art at London Metropolitan University. She has long participated in curatorial projects, academic reviews, and National Science and Technology Council research projects. Her publications include “Aesthetic Counterattack: The Social Practice of Contemporary Art” and “The Social Practice of Contemporary Art: Embracing the Power of Reality and Change.” Her work focuses on the connections among art, society, and place.