Clown doctors: shaman healers of Western medicine.

The Big Apple Circus Clown Care Unit, which entertains children in New York City hospitals, is compared with non-Western healers, especially shamans. There is not only superficial resemblance--weird costumes, music, sleight of hand, puppet/spirit helpers, and ventriloquism--but also similarity in the meanings and functions of their performances. Both clown and shaman violate natural and cultural rules in their performances. Both help patient and family deal with illness. Both use suggestion and manipulation of medical symbols in attempting to alleviate their patients' distress. Just as traditional ethnomedical systems have been integrated with Western medicine in other societies, clown doctors can provide complementary therapy that may enhance the efficacy of medical treatment in developed nations, particularly for children.