The Humor Code

by Peter McGraw

  Is all this attention and investment worth it? For his book The Psychology of Humor, Rod Martin looked into the matter, reviewing the dozens of scientific studies dealing with humor and physical health. What he found was far from encouraging. As he puts it, “Those who advocate humor and laughter as a pathway to better health seem to have moved too quickly to promote their views on the basis of rather flimsy research evidence.” So far, none of the most common claims about humor and laughter—that they boost immune-system function, stave off various illnesses, and decrease heart-disease risk—have been substantiated by rock-solid research findings. Some studies have found the opposite—that laughter and humor appeared to decrease empirical indicators of good health.5

  Ten years ago, to settle the matter once and for all, a professor from the Norwegian University of Science and Technology named Sven Svebak included a brief sense-of-humor questionnaire in one of the largest public-health studies ever performed: the HUNT-2 study, in which members of the entire adult population of the county of Nord-Trøndelag in central Norway were surveyed about their blood pressure, body-mass index, various illness symptoms, and overall health satisfaction. According to Martin, it was “the largest correlational study of senses of humor and health ever conducted.” In 2004, Svebak and his colleagues unveiled the results: there was no connection at all between sense of humor and any objective health measures.6

  “Well, we have anecdotal evidence that humor helps with cancer patients,” argued one nurse at the AATH conference when confronted about such research. Sure, replied Pete, “But we also have anecdotal evidence that supports the existence of ESP.”

  Still, Pete wasn’t willing to write off humor’s healing effects just yet. That likely had something to do with his relationship with psychologist and “joyologist” Steve Wilson. Founder of the Ohio-based World Laughter Tour therapeutic laughter program, Wilson has been working in humor and health for more than 25 years, and he held court at the Chicago conference in his polka-dot clown hat like a wise old Jedi master. He was eager to welcome us into the fold, since he’s known Pete for years. When Pete was pursuing his PhD from Ohio State University, Wilson and his wife, Pam, welcomed him into their family.

  Understanding humor and its therapeutic benefits, Steve Wilson told us, isn’t as simple as taking saliva samples and comparing blood-pressure readings. “We don’t claim any cures,” he said. “If we have to claim anything, it is adjunctive therapy. It is something that a person can engage in to help a primary treatment work better. The secret to a happy life is balance. If you are running away from humor and laughter all the time, you are going to miss the balance.”

  Maybe Wilson was right. But we weren’t going to take his word for it. To find out for ourselves, we decided to track down the most famous hospital clown of all.

  At the end of the 1998 Hollywood blockbuster Patch Adams, in which Robin Williams portrays real-life clown-doctor Hunter “Patch” Adams and his attempt to inject compassion and humor into the American medical system, the audience is told that Patch ends up launching a medical practice that treats patients without payment, malpractice insurance, or conventional health facilities, just as he always dreamed, and that construction of his world-changing “Gesundheit! Hospital” is under way.

  What the movie never says is that after twelve years of operation, Patch’s medical practice shut down because of doctor burnout and lack of resources. Raising the millions needed to complete the Gesundheit! Hospital in West Virginia has proven next to impossible. To help raise attention to his cause, Patch and his colleagues launched Gesundheit Global Outreach, an international service organization that has sent clown brigades to 60 countries on six continents. Since 2005, Gesundheit Global Outreach has focused much of its attention on one venture in particular: an annual, multiweek project involving international clown groups, government organizations, and NGOs, all focused on helping the community of Belén, a slum on the edge of the Peruvian city of Iquitos that’s one of the most impoverished communities in the Amazon. The Belén project is one of the largest and most ambitious international clown endeavors anywhere.

  Which is why we’re standing in the lobby of our hotel in Iquitos, a building that has been overrun by clowns. The building has become the Belén project’s makeshift headquarters. All around us, folks are in their clown costumes, ready for the first activity of this year’s endeavor: a celebratory parade into the heart of Belén. Meanwhile, Patch Adams is standing at the front of the crowd, lecturing on the dangers of sunburn.

  “Put on sunblock!” demands Patch, gesturing for emphasis with the rubber fish in his hand. “Here’s what happens if you don’t: ‘Ow, ow, ow!’ ” He cringes in mock agony, rubbing at a make-believe sunburn all over his body.

  This is the latest in a long list of instructions Pete and I have been given about joining the Amazonian clown brigade. John Glick, one of Patch’s closest friends and the calm-and-composed director of Gesundheit Global Outreach, was happy to have us along when I first contacted him. But he warned me, “Organizing clowns is like herding kittens.” That meant we were in for a lot of organizing. Soon we were receiving e-mail after e-mail detailing all the things we’d have to do to get ready for the trip. Make sure your vaccinations are up to date for all third-world communicable diseases, we were told, which led me to spend a colorful morning at my local travel health clinic, learning all the unpleasant yet fascinating ways my body could implode in the middle of the Amazon. (“You don’t want any diseases that end with ‘osis,’ ” I was instructed. “ ‘Osis’ means ‘worm.’ ”) Then we were schooled in the basics of Amazonian “clown fashion,” the more colorful, garish, and humidity-friendly the outfit, the better. For starters, Pete and I raided thrift-store racks of their most outlandish Hawaiian shirts. Then my five-year-old son, Gabriel, decided to contribute one of his prized possessions: He offered up his extra-large polka-dot dress-up tie, solemnly handing it over like it was one of the Crown Jewels.

  Last but not least, we were told to get clown noses. “The nose is your most important feature,” noted one of the organizers in an e-mail. “Your magic. Your power. Your passport into the world. It opens doors for you and allows you to do things you never imagined yourself doing.”

  I had no idea what the organizer meant, but I was referred to someone who would: Jeff Semmerling, a Chicago-based mask maker who crafts noses by hand for Gesundheit and similar organizations. Semmerling, I was told, is the Ralph Lauren of red schnozzes.

  “Some say the clown nose is the most evolved mask,” said Semmerling when I called him in Chicago a few weeks before our trip. It’s so simple and elegant—slip a red bulb over your nose, and people the world over know you’re a clown. Semmerling offers a catalogue of nearly two dozen varieties in neoprene and leather, from rotund bulbs to diminutive nose caps to elongated missiles. Since I couldn’t choose, I sent Semmerling photos of Pete and myself and asked him to do the honors. He selected a big round nose for me and a large button cap for Pete, then sent them along with a warning: “Don’t be surprised what you might find yourself doing or becoming when you release your clown.”

  And now here we are, at the start of the parade into Belén, red noses on and ready to release our clowns. Everyone is far too hot and sweaty here to bother with clown makeup, although many never paint their faces at all. “The face is more open without the paint, thus allowing more intimacy,” Glick tells us. “Plus it tends to freak out the clown-phobes less.” Patch is nearby, and he seems to notice my apprehension. He catches my eye and grins like a maniac. “Are you ready to go nuts?”

  With a cacophonous eruption of drums, whistles, and the blaring horns of a Peruvian Navy marching band that’s volunteered to lead the parade, we’re off. A rainbow-colored river of tutus, suspenders, and baggy tie-dyed pants streams through Iquitos—a city whose existence here doesn’t make a whole lot of sense. While Peru is most commonly associated with llamas, mountaintop ruins, and other images of the Andes, a good 60 percent of
the country is taken up by the jungle fed by the gargantuan Amazon River system. And here, in the heart of this vast, nearly uninhabited wilderness, lies a city of half a million people where no city of half a million people should be. Iquitos is the largest community in the world that doesn’t have any roads to it. The only way to get here is the way we did, via aircraft. Or you can take a long, slow boat ride.

  The city blossomed here because it was an epicenter for the rubber boom of the late nineteenth and early twentieth centuries. But that golden age has come and gone. Now grimy three-wheeled motor taxis clog the streets, and the city’s grand European-style river promenade is decorated with billboards demanding “No child sex tourism.” The rubber barons’ once-opulent, porticoed mansions have been gutted, their interiors filled with grocery stores and curio shops.

  But the shabbiness of downtown Iquitos resembles Beverly Hills compared to what comes next. The parade route makes a left at an intersection, snakes past a fragrant open market, and slopes downhill toward the river. The street becomes a packed-earth lane lined with open-air sewage ditches, and the brick and cement buildings shift to thatch-roofed wooden shanties perched on ten-foot-tall stilts or resting on horizontal logs lashed together like rafts. We’ve reached the slums of Belén. The 60,000 inhabitants, we’ve been told, live in destitution. Rampant unemployment. Minimal electricity and no sanitation system. Spotty health care and extensive malnutrition. Widespread alcoholism and drug use. Wide-ranging family violence and crime, with no official police presence.

  Each year, during the rainy season between January and June, the river here rises several meters, which is why the houses are built on stilts and rafts. But this year, the area experienced 100-year floods. Marching past the stilt-legged homes of Belén, we can see water stains and washed-away paint reaching halfway up the houses’ walls, marking where a few months earlier, the buildings were half-submerged. Scores were killed, and hundreds more were forced out of the area, relocated to schools and shelters. When they returned, they found new disease epidemics taking hold, including dengue fever and leptospirosis.

  In other words, we’re in the poorest part of the poorest part of a country that’s fairly poor to begin with. And right now, this situation is worse than ever.

  Stomping down these dusty streets, something happens to me. Maybe it’s the beat of the parade music, or the infectious glee of 100 marching fools. Maybe it’s the delighted smiles of the barefoot children who flock to us, or the shy grins and waves from the adults who peer down from the porches of their homes. Maybe it’s just heatstroke. For whatever the reason, I begin to clown.

  I traipse past throngs of onlookers, slapping high fives left and right. I chase children beneath the buildings, leaping over the sewage ditches and weaving through support beams. In the hazy afternoon light, I dance with other clowns as a loudspeaker jerry-rigged to a motor taxi blasts the clown expedition’s theme song: an up-tempo tune about washing your hands to prevent dying from dengue fever. At one point, a little girl in a purple shirt takes my hand, and she never lets go. We march through Belén, side by side, and eventually I’m carrying her in my arms.

  When it’s all over, when the parade music wraps up and the purple-shirted girl scampers away with a smile and a wave, Pete looks at me and grins. “Your dad training is coming out.” Pete, in his goofy floppy hat and shiny red nose, didn’t do too badly himself.

  “That place came alive,” he says as we trudge back to the hotel. “You see the difference, with all the smiles and laughter.” On the other hand, he adds, “What a monumental problem this is. You need millions of dollars to help Belén. You essentially have to move the whole city.”

  “It’s worse than I ever expected,” he concludes. How can a bunch of clowns ever hope to make a difference?

  Clowning in the Amazon, it turns out, is like summer camp—if summer camp came with a moderate risk of malaria.

  There are “clownings” all over Belén and other spots around the city, including an old-folks’ home, a shelter for abandoned children, even a local prison (don’t bring your “stabby” toys, prison-bound clowns are warned). Some activities involve teaching kids how to hula-hoop, make shadow puppets, and bang out rhythms on plastic-bucket drums. Others take the form of door-to-door clown interventions, hammering the importance of throwing away trash and tossing out stagnant water through pratfalls and squirt-gun gags. Many clownings are just about gathering up a group of street kids and having fun.

  While most of the 100-clown squad are in their twenties, many among this assortment of college students, social workers, nurses, and professional circus performers are still relative old-timers, coolly reminiscing about Belén escapades from years past. (“Remember that time Levi and David had stolen earrings planted in their luggage in El Salvador and had to spend a week in prison before paying off the right officials? Those were the days!”) Others are newcomers, timid and awkward, trying to find their standing among the clown pecking order.

  Complicating matters are the different clown styles among the group, far more than we knew existed. The South American clowns, from professional squads in Peru and Argentina, are practiced and polished, with carefully tailored jester costumes and refined routines. They’re the New York Yankees of clowns. And then there’s us, the ragtag Americans under Patch Adams.

  For the Gesundheit clowns, many of whom have never clowned before, there are no crash courses in buffooning, no how-to handbooks or ironclad rules. Patch doesn’t believe in it. “It’s too restricting,” he says. “I don’t want any mystique about it. I want everybody to be a love revolutionary.” He’s less like the group’s leader and more like a very bad influence, delegating logistics to others so he can focus on the work of play. After growing up as a troubled, bullied kid, Patch says that one day in high school, “I decided to serve humanity and be happy the rest of my life.” He’s been clowning every day since then—clowning through med school, clowning during the twelve-year operation of the Gesundheit! Clinic, and now clowning all over the world.

  He’s doing so in Iquitos and Belén, clowning everywhere we look. One moment, he’s eating lunch at a ceviche restaurant wearing underpants on his head. The next, he’s sauntering down the street sporting a face-distorting set of false teeth beneath his handlebar mustache. Later, he’s chasing after squealing children with his half-gray, half-blue ponytail flapping in the wind, stopping only to wrap up elderly ladies in big, sweaty hugs.

  During what turns out to be one of many long, rambling conversations I have with Patch, I discover formal clown training isn’t the only thing he doesn’t believe in. He doesn’t believe in the cold, corporate machinations of Western medicine, or much else about capitalism. He doesn’t believe in computers, instead responding to each of the hundreds of monthly letters he gets by hand. He doesn’t believe in organized religion, preferring the more basic spirituality of love and compassion. He doesn’t believe in traditional family structures, figuring we’d all be better off living in communes. And he doesn’t believe that humanity has much chance of long-term survival. “Nothing I’ve studied suggests we will stop our extinction soon,” he tells me, scratching at the underpants he’s wearing on his head. “Humans are an embarrassment.”

  There’s one other thing Patch doesn’t believe in. “I never said laughter is the best medicine,” he declares the first time we talk. Instead, he believes the key to a healthy life is connected, loving relationships with anyone and everyone, and he sees humor as the perfect tool to break down the social mores, boundaries, and anxieties that often get in the way. After all, he points out, clowns are all about shaking things up: “The jester is the only person in the king’s court who can call the king an asshole.”

  It’s true. Clowns, like comedians, are outsiders and rebels. All over the world and through most of civilization, clowns, jesters, tricksters, and picaros have stood apart from the crowd, with full license to break all the rules. They can spit in the face of conformity. They can say what no one el
se dares to say.

  Maybe that’s why in the United States, the image of the clown is now often associated with the dark and the scary, a staple of haunted-house rides and serial killer stories. After all, the chaotic and disorderly nature of clowns can be frightening. (It doesn’t help that in the 1970s, two different amateur clown performers—Paul Kelly, aka “Weary Willie,” and John Wayne Gacy, aka “Pogo the Clown”—killed multiple people.)7 A few years ago, a study at the University of Sheffield in England found that 250 children, aged four to sixteen, all believed clown images were too scary for hospital décor.8 Of course, there’s a difference between a clown painting on the wall when you’re trying to sleep in a hospital ward and a real clown face peeking around your door during visiting hours, wanting to know if you want to play. Maybe that’s why a follow-up study at a British children’s hospital found that children, their parents, doctors, and nurses all agreed that clown interventions at the facility were beneficial.9

  The rebellious nature of clowning is likely why, maybe for the first time ever, my wife is wrong. I’m not a bad clown. I throw myself into games of hide-and-seek and jump-rope contests, play peekaboo with giggling babies, and chase rumbling taxis down the street like a maniac. After one of the clownings, Gesundheit director John Glick approaches me. “You’ve got it, man,” he says with a grin. “You are a regular Patch.” I soak up the compliment, not minding that I’m drenched in sweat and probably sewage, that my mouth feels like it’s been sandblasted, that I look like a fool. Jeff Semmerling was right: the red nose gave license to my clown, stripping away all the hang-ups I’ve accumulated over the years.

  The best part of my clown costume, the biggest hit among the youth of Belén, is the clown tie loaned to me by my son Gabriel. The children never tire of tugging on it, of using it to lead me around like I’m a pet buffoon on a leash. Their love of this game makes sense. These children are some of the most put-upon, least-powerful people in the world. And thanks to a clown costume, they have complete power over a grown white American man. Their world is turned upside down.