Tiffany is 14 now, and her blood condition has been stable for over a year. Yet, visiting the Outpatient Hematology/Oncology Clinic means revisiting the pain and chills of the chemotherapy treatments coursing through her veins; it means staring back into the sad eyes of little kids ravaged by leukemia. But not this time. Today there is something different in the air: a hint of levity. If laughter is, indeed, the best medicine, then the man who just burped up a red foam ball must be the most important specialist at Schneider Children’s Hospital/North Shore Health System in New Hyde Park. He stands in the doorway, finessing his foam balls with mime and sleight of hand, dosing out what Tiffany and her peers need to feel better. His name tag says “Dr. Bobo”, and while he makes rounds and visits children regularly in clinics and inpatient units, he is not, technically, a member of the staff. Dr. Bobo also never went to medical school, although he did have specialty training in safety and infection control. Dr. Bobo is a member of the Clown Care Unit of the Big Apple Circus, which performs (now there’s a key word!) about 200,000 visits a year to hospitalized children throughout the city. The Clown Care Unit serves Schneider, and other New York City institutions like Memorial Sloan-Kettering Cancer Center, Harlem Hospital, Mount Sinai Medical Center, the New York Weill-Cornell Children’s Hospital and Morgan Stanley Children’s Hospital (formerly Columbia Presbyterian). Most entertainers work in one to three facilities simultaneously, making up to eight appearances a week. The tender white-gloved hand of the Clown Care Unit reaches across the U.S. — to pediatric specialty hospitals in Boston, Chicago, Atlanta, Miami, Maryland and Seattle — and alumni are now helping take the concept global, by training professionals in Germany, Paris and Brazil. The unit was conceived in 1986 by Michael Christensen, co-founder of the Big Apple Circus (launched with Paul Binder in 1977). For Christensen, who does double duty as the hairy-legged Dr. Stubs, and who had just lost his brother to pancreatic cancer, this unit presented a personal catharsis, and a natural offshoot of the circus’ community-minded mission. But is laughter really the medicine jargon claims it to be? Drs. Stubs and Bobo and their more than 90 clown colleagues realize what outstanding tools laughter and silliness can be for hospitalized children. After surrendering all sense of control to machines, schedules, nurses and diets, the chance to finally let loose restores a hospitalized kid’s balance. Something shifts when this bunch of staffers comes along, strumming ukes, striking up laughter, and practicing their non-invasive specialty: clown medicine. “You make this wonderful connection with patients and families,” says Deborah Kaufmann, who practices as Dr. Dibble, and took the name from a rare English gardening tool. Her biggest reward comes in the frequency with which parents turn to her and say ‘This is the first time he smiled since we’ve been here.” And that is the essence of clown medicine: giving children a chance to be themselves again, to feel whole and good, without negating how bad they might actually feel. Clown medicine is also a chance to parody real medical procedures and practitioners, as Dr. Dibble does when she plays the stetho-phone (a stethoscope with trombone mouthpiece) or teaches children how to make a slide whistle from a syringe. And it’s something Dr. Stubs does with his version of “The Alphabet Song”: “ABCD, EKG, NPO on your IV. ICU, UC me, CCU RN MD. Now I know my ABCs. I can charge outrageous fees.” This manner of showing irreverence to the real doctors mimics the interaction between clowns and their ringmaster in the tent show venue. What separates the Clown Care Unit…and the Big Apple Circus in general? Christensen believes it is the level of professionalism in their artistry. Practicing clowns have proven experience, talent and training, as well as a recognizable commitment to their craft. Some, like Kaufmann’s Dr. Dibble, have been around for more than 15 years, almost since the Unit was established. And Dr Bobo, whose real name is Vladimir Oshansky, once ran a clown care program of his own, in Italy; it was so well received it earned him an audience with the Pope. Christensen is proud that his circus and its programs are truly different, and says, “They grew right out of the heart of New York.” He believes the very essence of clown entertainment is a New York thing — embracing a certain vitality, energy and diversity, then building it into “an unpretentious celebration of joy.” Big Apple Circus is a non-profit organization, which derives a good percentage of its revenue from the ticket sales of its tent shows (such as the one in Queens’ Cunningham Park, May 17-26). Generated funds help sustain the Clown Care Unit (some of the host hospitals also help) and their other Health and Community Programs. The division runs Circus of the Senses, bringing the circus experience to vision/hearing impaired children; Circus for All, enabling economically/physically challenged children to enjoy their first circus; and Beyond the Ring, teaching circus arts inside inner-city schools. Aside from its in-hospital programs, the Clown Care Unit sponsors a summer program at Paul Newman’s Hole in the Wall Gang Camp, in Connecticut. Donations toward all efforts are always welcome, as are inquiries into upcoming area performances. Both can be explored via the Big Apple Circus website at www.bigapplecircus.org.