In Israel, cheering up hospital patients isn't just about clipping on a huge polka-dot tie and a red foam nose. Medical clowning is serious business, with a college degree available to those who want to take on this paramedical profession as part of a hospital's therapeutic team.

On October 23-26, Israeli physicians will share scientific research on the therapeutic benefits of clowning with about 250 participants from other countries. The congress, to take place at the Ma'aleh Hachamisha Kibbutz convention center near Jerusalem, is sponsored by Dream Doctors, the primary beneficiary program of the Magi Foundation.

The schedule includes plenary sessions on the history and theory of medical clowning; practical workshops; and field trips to see the professionals in action at Jerusalem-area departments.

"The fact that physicians will be chairing sessions, and it's not just clowns talking to clowns, is symbolic," says Dr. Arthur Eidelberg, the recently retired chief of pediatrics at Jerusalem's Shaare Zedek Medical Center and professor of pediatrics at the Hebrew University's Faculty of Medicine. "About eight years ago, I was contacted by Dream Doctors to see if they could introduce their program at Shaare Zedek," relates Eidelberg, who is chairman of the scientific committee for the conference. "After learning more about it, I decided to be their advocate because what they are doing is unique."

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Beyond Patch Adams

Eidelberg was well aware of existing medical clowning programs, such as the one run by the American doctor "Patch" Adams, that aim to entertain kids within the stressful hospital environment. "Traditionally, they'd come in and put on an act in a room for gathered children. If one child was not responding, they'd give extra attention to that child, but that was the end of it," says Eidelberg. "I perceived of medical clowns as being part of the therapeutic team, and Dream Doctors intrigued me as a means to that end."

And this was the model adopted, not only at Shaare Zedek but at 18 hospitals throughout Israel. Rather than dropping by to put on a show, trained Dream Doctors work for the hospital and accompany physicians on their rounds, assisting in medical procedures and helping to make therapeutic assessments in the same way occupational, art or music therapists do. "If a trained clown sees a child who is not responding, he'll report it to the nurses and doctors - not as an outsider, not as an entertainer, but as a therapist," says Eidelberg.

Since it's not unusual for Israeli hospital patients of different ethnicities to share rooms, Dream Doctors also play a unique role in facilitating cross-cultural liaisons mediating across religious, ethnic and national lines.