Why Do Hospitals Need Clowns?

With this love and innocence, clown art enters the challenging space of healthcare.

Article 31 of the United Nations Convention on the Rights of the Child clearly stipulates that children have the right to engage in play and recreational activities—an essential developmental right that cannot be taken away. However, when children become ill and are hospitalized, their world is highly controlled. When to eat, when to receive injections, and where it will hurt are all beyond their control. They lose control over their lives and occupy the lowest position in the medical power structure. This feeling of confinement can easily cause stress and trauma.

At this moment, the Red Nose Doctor knocks and enters.

Medical clowns usually work in pairs. This is not only for performance design, but also to create a situation. Luc Ducros, education director of the Red Nose Doctors, once gave an example: faced with an anxious child, one clown wants to enter the hospital room, while the other is “too afraid” and gets stuck at the doorway, unable to go in.

Watching these two clumsy adults, the child may feel a sense of resonance: “He’s afraid just like me!” Then the perspective is reversed. A child who normally can only obey adults now becomes someone who can comfort the clown and help the clown overcome fear. “It’s no longer me who’s afraid—it’s him who’s afraid, and I can help him!”

Through this kind of improvisational play, clowns return the “right to decide” and the “right to refuse” to children. In the hospital room, children can even loudly order the clown to leave. This psychological empowerment helps children regain a sense of control and confidence in an unstable environment.

People often ask, “Are Red Nose Doctors drama therapists?” No, we are professional performing artists. Drama therapy has clear medical objectives; what clowns provide is a kind of “joy without expectations.”

A professional clown is an actor who works with “emotion.” Rather than preaching, they incorporate the emotions of sick children into the situation through improvisation.

Fear can be transformed through play. A young girl with brain cancer, Little Hong (pseudonym), was about to undergo surgery to remove her eye. When the clown asked what she wanted to play, she said bluntly, “I want to remove your eye!” The clown did not shy away, but immediately played along in an absurd scene of “performing surgery on the clown.” By “practicing” surgery on the clown, fear was no longer taboo, but became enveloped in laughter.

Anger, too, can be freely released. Faced with an incurable illness, a boy named Little Zhi stabbed himself with a toy knife every day to express his resentment. The medical clown brought out red ribbons and a toy gun and played an exaggerated “death competition” with him. In that magical safe space, death became an opponent who could be challenged, and his anger finally found an outlet.

Sadness can be met with quiet companionship. In the intensive care unit, Little Xin, whose condition was deteriorating, was covered in tubes, with tears pooling in her eyes like a small lake. The medical clown did not rush to make her laugh, but stayed beside her with an extremely slow rhythm and soft humming. This let her know that being afraid is normal and that emotions need an outlet.

Under strict infection-control measures and medical regulations, every performance by the Red Nose Doctors requires extremely meticulous preparation. They do not interfere with medical procedures and even provide substantive “medical companionship.”

Once, a baby under one year old was preparing to have blood drawn. With the clown’s gentle guitar music and soothing presence, the baby not only did not cry or fuss, but did not resist at all, allowing the nurse to complete the procedure smoothly. For infants and young children with severe physical or intellectual disabilities or covered in tubes, clowns slow their pace and accompany them with simple sounds and gentle movements. One infant with congenital heart disease had breathing that gradually become steady while being gently held and hummed to by a clown; the blood oxygen saturation shown on the monitor even reached 100 percent at one point.

Pushing open the door to a hospital room is like entering an entirely new world. The Red Nose Doctors are responsible for bringing children’s boundless imaginations to life.

Once, a little girl’s hospital room had been decorated by her parents as the castle from Frozen. The clowns immediately transformed into attendants and guards, accompanying the girl in her princess dress as she pushed her IV stand in a parade down the hallway, turning the entire hospital ward into her kingdom in an instant. They also once met a four-year-old boy who enthusiastically taught a clown all kinds of Spider-Man’s superpowers, even performing “web-slinging” that sent the clown flying to the other end of the hallway. In that space, no one is a passive patient; everyone is the magician of their own life story.

To move with ease through hospital rooms where life and death hang in the balance requires extremely rigorous training behind the scenes. A qualified Red Nose Doctor must undergo six months of intensive training, including artistic techniques, medical education, and child developmental psychology.

The healing power brought by this professionalism has already been rigorously confirmed by science.

In 2021, a quantitative study by Associate Professor Wei-Wen Wu’s team from National Taiwan University’s Department of Nursing, published in the authoritative international journal Journal of Nursing Scholarship, found that intervention by Red Nose Doctors can significantly improve the short-term emotional states of hospitalized children with cancer, including young children aged 4–10 and adolescents aged 11–18. In 2023, a further study by the team confirmed that medical clown services can significantly reduce the psychological distress of parents of sick children.

The World Health Organization defines health as not merely the absence of disease, but a state of complete physical and mental well-being. Experiencing happiness is a basic human right. Laughter and humor can activate the body’s self-healing mechanisms and reduce stress hormones—this is the scientific value of a clown prescription.

Many people believe that medical clowning is work that consumes tremendous psychological energy. Yet, as the Red Nose Doctors genuinely experience, what we receive in hospitals far exceeds what we give. No matter how immense the life challenges faced by sick children and their families, the resilience they demonstrate always brings the clowns tremendous energy.

A mother who had lost her child once made a special visit several months later to thank the Red Nose Doctors. Through her tears, she said: “Thank you for allowing my child, during the final period of life, to be happy and enjoy the childhood every child deserves. Knowing that my child left this life with a smile is the greatest comfort of my entire life as a mother.”

Clown art, born from the theater’s exploration of humanity’s truth and vulnerability, is elevated into selfless companionship and love in healthcare settings. We are the Red Nose Doctors, and we bring clown art into hospitals. We are not only responsible for making people laugh; at the most difficult moments, we are responsible for helping you hold the unavoidable tears of life. And when we laugh together, we are all held in love.

【Citations and References】

• 《In-Depth Research on the Red Nose Doctors Organization》 (2025 compilation), Red Nose Clown Care Association of the Republic of China.
• 《Red Nose Doctors—A Collection of Stories》 (internal records of hospital-room stories), Red Nose Clown Care Association of the Republic of China.
• 《Red Nose Doctors—Statistics on Performance Locations and Frequency and Number of Performers》 (statistics through February 28, 2026), Red Nose Clown Care Association of the Republic of China.
• 《2025 Introduction to the Red Nose Doctors》 annual report presentation, Red Nose Clown Care Association of the Republic of China.
• 《2025 Seventh Red Nose Doctors Actor Selection Guidelines》, Red Nose Clown Care Association of the Republic of China.
• 《Supplementary Materials on the Red Nose Doctors》: Legal and Administrative Information, Red Nose Clown Care Association of the Republic of China.
• Maa Chao-Chi (2021), “The Clown Theater You Don’t Know,” Cross-Strait Children’s Literature Journal.
• Maa Chao-Chi (2022), “Returning the Right to Play to Children,” CommonWealth Magazine Independent Review.
• Maa Chao-Chi (2024), “Laughter Is a Human Right: When We Laugh Together, We Are All in Love.”
• Luc Ducros (2021), “All Actors Need Clown Training—It Helps Actors Liberate Themselves.”
• Luc Ducros, “Why Clowns Should Be in Hospitals” (Pourquoi le clown a sa place à l’hôpital).
• Tseng Ching-Wen (2023), “Red Nose Doctors and Drama Therapy: Creating a People-Centered, Friendly Healthcare Environment Through Clown Performance,” Red Nose Clown Care Association of the Republic of China.
• Wei-Wen Wu et al. (2023), 《A Quasi-Experimental Study of the Emotional Impact of Medical Clown Services on Parents of Children Receiving Cancer Treatment》 (Medical clowning influences the emotions of parents of children undergoing cancer treatment: A quasi-experimental study), Journal of Pediatric Nursing.
• National Taichung Theater (2021), 《Summer Fun Time Festival Full Program》 Guidebook (including an introduction to physical theater).