From the buffoon to the hospital clown: the trajectories of ridicule in a society of the spectacle

Abstract

The study presents reflections on the historical relevance of buffoons through an analysis of the artistic and social view from the buffoon to the hospital clown. The subject is discussed in four topics: The mask, the actor, and the audience; The buffoon and the expression of ridicule; The spectacle and the indication of ridicule; and Laughter in the society of the spectacle. The hospital clown promotes a reflection that is similar to that of the buffoon, but the interaction with the audience must present a spectacle of comicality with an ethical stance. It is possible to laugh at oneself in the face of adversity, at the sick body, but respecting the patient, and at postures of professional superiority concerning care, as a way of reversing the logic of power without questioning one’s professionalism, with an equal degree of protagonism.

Keywords
Buffoon; Hospital clown; Laughter, society of the spectacle

Resumo

São apresentadas reflexões sobre a relevância histórica dos bufões por meio de uma análise sobre a visão artística e social do bufão ao palhaço de hospital. É discutida em quatro tópicos: A máscara, o ator e a plateia; O bufão e a expressão do ridículo; O espetáculo e a indicação do ridículo; e O riso na sociedade do espetáculo. O palhaço de hospital favorece reflexões semelhantes às do bufão, mas é necessário que a interação com o público apresente um espetáculo de comicidade com postura ética. Tem a capacidade de rir de si mesmo perante as adversidades e enfermidades, sempre com o devido respeito ao doente. E não somente isso: o palhaço de hospital consegue, através de posturas muitas vezes caricatas, inverter e questionar a lógica do poder do ambiente de saúde, fazendo disso um profissionalismo e protagonismo dele nesse espaço.

Palavras-chave
Bufão; Palhaço de hospital; Riso, sociedade do espetáculo

Resumen

Se presentan reflexiones sobre la relevancia histórica de los bufones, por medio de un análisis sobre la visión artística y social del bufón al payaso de hospital. Se discute en 4 tópicos: la máscara, el actor y el público; El Bufón y la expresión del ridículo; El espectáculo y la indicación del ridículo y La risa en la sociedad del espectáculo. El payaso de hospital favorece reflexiones semejantes a las del Bufón, pero es necesario que la interacción con el público presente un espectáculo de comicidad con postura ética. Es posible reírse de uno mismo ante las adversidades; del cuerpo enfermo, pero con respeto al enfermo; de las posturas de superioridad profesional ante la asistencia, como una forma de invertir la lógica del poder y sin poner en tela de juicio su profesionalismo, con el mismo grado de protagonismo.

Palabras clave
Bufón; Payaso de hospital; Risa, sociedad del espectáculo

Introduction

Popular characters in royal environments and servers of high social authorities, buffoons were “employees of laughter”, entertainers who used comic and sarcastic theatrical games to fulfill their duties in courts. This practice has been observed since the emergence of ancient civilizations, including the theocracies of the Egyptian pharaohs. It has persisted through characters such as the balatros of ancient Rome and the Amerindian jesters of the Aztec courts, becoming widely recognized from the 14th century onward¹.

The main representative of the buffoon was the Middle Ages’ jester, an actor who offered moments of amusement and relaxation for the monarchies of the time. This character navigated between laughter and critical sarcasm, providing themselves with the unique possibility of questioning social structures and situations under the illusory mask of naivety or “stupidity”, according to Braga and Tonezzi¹.

Subsequently, the buffoons gained other nuances and work environments, like the comic roles of Whiteface and Auguste from the Commedia dell’arte, which have inspired and contributed to the development of street clowns from the 16th century onward², as well as the contemporary clowns who perform in various popular circuses³.

Following this legacy and historical path, clowns wearing white coats entered the hospital setting for the first time in the 1990s, requesting “tests” and providing “medical advice”, believing they were physicians. This is a pioneering action in Brazil promoted by “Doutores da Alegria” (Doctors of Joy), professional actors who have been working in hospitals to contribute to healthcare by strengthening affective relationships⁴. The years went by and hospital clown interventions spread throughout Brazil, entering other health services and being developed by various groups, formed by non-governmental organization (NGO) professionals or volunteers linked to university extension projects or religion. But how has the clown migrated from circus rings to hospitals? What brings the clown to the health stages and makes this spectacle so acclaimed?

Some scientific productions have focused on the clown’s action in the field of health. Most of them discuss the so-called “laughter therapy”. The emotional and physiological influence of laughter on patients’ clinical evolution and the clown’s function are related to Complementary Integrative Practices (CIPs) incorporated into conventional healthcare treatments.

Studies that evaluated the benefits of laughter and humor in the pediatric context have reported improved receptiveness, greater adherence of the child to treatment, lower hospital expenditures due to a reduced use of painkillers, and early hospital discharge deriving from faster patient recovery^5-7. The abbreviation of hospitalizations through the use of a technique that usually does not involve costs (volunteer professionals or the hospitals’ employees perform the activities, and even the work of professional clowns is mostly funded by NGOs in Brazil) has caused a great adherence to the proposal^3,8. Therefore, including this art in hospital treatment has brought physiological, psychological, and financial benefits.

Various playful and recreational activities provoke laughter and can be easily introduced into the hospital routine. Why has the clown, in particular, gained space to perform in this setting? Is their presence in the health field justified only by the importance of laughter, which, according to physiological studies, favors the release of endorphin, serotonin, and natural killer cells, among other benefits?

To answer these questions, we must consider the buffoon, their manifestations, and their relation to today’s hospital clown, introduced into this space to play their role of being and existing. Hospital clowns question pain and have dialogued with science and common sense throughout their formation and history, amplifying care by questioning the posture of the greatest hospital authority - the physician. Their parody of the physician produced the term “doctor clown” or “clown doctor”, translating an update of the art of buffoonery. Their intervention enables doctors and all the other health professionals to reflect on their conduct and behavior when they care for the patient’s “body”.

Methodology

This study aimed to analyze the artistic and social view from the buffoon to the hospital clown based on Guy Debord’s text “A Separação Consumada” (Separation Perfected), which is part of his 1967 book “Sociedade do Espetáculo”⁹ (p. 8-20). The study discusses the function of buffoons, with their critical postures concerning human behaviors and their influences on the construction of the clown throughout history, and how the clown’s critical posture is re-signified today, especially in the field of health. To discuss the subject, four topics are presented: (I) The mask, the actor, and the audience, (II) The buffoon and the expression of ridicule, (III) The spectacle and the indication of ridicule, and (IV) Laughter in the society of the spectacle.

The mask, the actor, and the audience

To understand buffoonery and its current manifestations, such as the hospital clown, we will approach basic theatrical aspects and concepts. In the theatrical context, the performance is a means of persuading the audience of something that the actor is not in reality. Therefore, it is a way of deceiving the audience so that it believes in the character and in the truth that the actor is proposing on stage, where they play their role. This is called the “pact of verisimilitude”: the actor’s capacity and need to convince the audience about their character¹⁰.

To achieve this, the actor uses various strategies; for example, the masquerade. Concerning this, Stanislavski¹¹ argues that the use of the mask is a consequence of a thorough study of the character that the actor will be playing. The actor should seek ways of embodying the character when they enter the stage, which is similar to putting on a mask. Tortsov, the director mentioned in one of the theater scholar’s books, teaches students the importance of the mask for character construction and characterization:

[...] Thus, characterization is the mask that hides the individual-actor. Protected by it, they can strip the soul down to the last, most intimate detail¹¹. (p. 60)

He adds¹¹ that many actors fail in their work because they adhere to mechanical and exaggerated performance patterns and clichés that do not truly convince and should be avoided.

[...] the actor is summoned to create an image when they are on stage and not simply to show off before the audience. The mask ends up being a necessity for all of us¹¹. (p. 61)

Therefore, the author argues that the theatrical action based on the masquerade is a guarantee of quality and essentiality in the professional’s performance, as the audience will not be convinced by someone who shows off exaggeratedly on stage, but by actors who persuade the audience of the truth of the characters into whom they desire to transform on stage.

However, it is necessary to point out that no study has focused on the decision to wear a mask. Stanislavski¹², through the director Tortsov, criticizes the so-called inanimate masks, which serve no other purpose than making the actor’s performance mechanical.

Such inefficient techniques revolve around the reproduction of acting patterns and clichés, such as crying hysterically and abundantly to portray sadness, or bringing the hand to the chest and sighing to express passionate love. The truth behind these actions is that the actor has not studied how to represent them, has not sculpted a convincing mask, and, therefore, will not leave a lasting impression on the audience. Thus, “resorting to facial expressions, vocal artifices, and gestures, such actors offer the audience nothing but an inanimate mask that lacks the feelings that do not exist in them”¹² (p. 198).

In opposition to this, a good masquerade requires training, research, and inspiration regarding the true intentions behind each chosen gesture and expression. In this perspective, the chosen mask carries with it an implicit intentionality that is accessible to the audience, eliminates unnecessary characterizations, and ensures the permanence of the character’s essence:

[...] It is crucial to remember something I’ve emphasized many times: in acting, no gesture should be performed solely for the sake of the gesture itself. Your movements must always have a purpose and be related to the content of your role¹¹. (p. 79)

Furthermore, the mask is the object that enables the actor to control when they are performing and when they cease to perform; it is a way of seeing the character as a body, an expression, a life to be lived on stage, but this does not mean that the actor experiences that reality in their daily life. In this sense, the act of putting on the mask helps the actor play their role in a convincing and excellent way, even when it is something they do not experience in their reality.

In short, the mask is the actors’ chance to be someone they are not in the context that needs this representation. According to Braga and Tonezzi¹, this potential has been extensively used at various moments in the history of the theater.

Thus, many schools and theatrical contexts have used masks to favor the effectiveness of the performances. In the Middle Ages, the buffoons used the laughing and sarcastic mask to balance laughter and criticism, with the aim of entertaining and, behind it, revealing to the audience the object of the entertainment: social conventions and contexts that they thought could be criticized and mocked¹.

Similarly, in the 15th century, the Commedia dell’arte used different masks so that the actors could play various roles, portraying certain social patterns with which the audience might identify or not. Here lies the power of the mask that the actor constantly enjoys: wearing the mask of a character provides the professional with the capacity for revealing truths whose verisimilitude is related not to the actor but to the audience. Through the mask, the actor reaches their audience, acting on it and making it identify with what is being performed¹³.

The buffoon and the expression of ridicule

A brief trip through history shows that the buffoons are heirs of the traditional court jesters of Rome, the balastros, whose main characteristic was their work with laughter. Traditionally, they entertained the elite for which they worked¹.

However, unlike the typical and innocent balastros, the buffoons did not limit their actions to the traditional clowneries: they introduced an original and, we might say, avant-garde perspective of criticism behind laughter. They were considered “abnormal” people: crippled, drunk, mad, and for that reason they were the object of ridicule and mockery. What people did not realize was that, in the same way that they ridiculed the “buffoons”, the “buffoons” also ridiculed and laughed at people. Being considered mad and having nothing to lose (as they had already lost their dignity), the buffoons mocked even people of great power, like kings^2,14.

To the kings, the buffoons expressed everything that society would like to say but did not have the courage. Surprisingly, the kings viewed this mockery favorably and with good humor. They believed it brought forth the reality that flattery concealed. Gradually, they gained notoriety, using laughter as their means of livelihood, eventually giving rise to the court jesters^2,15.

These artists formed groups and became popular in the sociocultural sphere of the time, even inside castles, as they were often hired by the elite to perform the “innocent” work of laughter. Thus, they spread within the feudal beams and structures of various courts and places, securing their stage and audience. Their performance consisted in putting on the mask of laughter and humorous mockery, indirectly convincing the spectators of the criticisms, although they failed to recognize that the audience itself was the target of the actors’ criticism¹.

The question is: How could these people, viewed as “outcasts” simply for making people laugh at their problems, become members of royalty in the position of jesters? Understanding the buffoon and their trajectory until they became the court jester is fundamental to understanding the logic of the clown’s laughter in the hospital setting. Many think that the court jester emerged merely to entertain the members of royalty, but what raised the buffoon to this level was not the laughter they provoked by allowing people to mock their own problems. The buffoon mocked and laughed without the fear that the oppressed people of the Middle Ages had of exposing other people’s fragilities.

Thus, the buffoon gains notoriety because, as insulting as they may seem when the spectator’s ridicule is exposed through their mask, regardless of social role, they enable a reflection. The audience starts to see a performance that is much more related and similar to reality than it expected. Moreover, the spectator visits this place of reflection proposed by the buffoon and their mask amid the lightness generated by laughter, which enables them to break the hierarchy for some seconds. However, this must be used carefully and wisely because laughter can be dangerous, seductive, powerful, and disputed. Bergson¹⁶ asks: “What does laughter mean? What lies deep inside the laughable? What do a clown’s funny face, a play on words, a Vaudevillian quid pro quo, and a scene of refined comedy have in common?” (p. 9). To him, the understanding of laughter depends on the understanding of society and human relations, as laughter plays a social role.

According to the philosopher Aristotle¹⁷ in his apology for laughter, humor, and virtues, “Man is the only animal that laughs”. In this context, laughter has a therapeutic value when it spotlights the pathology that affects man. It is a counterpoint. There is an intentionality when the buffoon makes people laugh at hierarchized ridicule and bizarre situations, which become matters at which society is allowed to laugh.

The buffoon not only entertained the powerful but also advised and warned them. Sometimes, they were given the power to predict the future. In Germany, some were called “amusing advisers” because in their jokes and games there was always a piece of advice or a wise warning¹⁵.

There are also reports on laughter as synonymous with intelligence, and that is why not everyone understands jokes. It is necessary to make emotional connections with the interlocutor, which favors a reflection on the matter at hand and promotes understanding in a lighter and more comprehensible way. Smiling in the face of adversity does not imply solving the problem; it reveals the maturity attained when one reaches this level of relaxation in the face of difficulties and is able to rethink the demands that need to be tackled. Intelligent people can control the situation with their sympathy, laughter, and entertainment. Laughter is an open door to novelty because it expresses receptiveness and empathy.

A quality joke does not imply attacking a person’s image by using prejudiced words and reproducing homophobic, sexist, and racist attitudes, among others, because this is an easy type of laughter. These stories, repeated as “truths” over time, mock vulnerable groups in society. Quality laughter requires intelligence to make constructive criticisms of oppressive situations that are so bizarre that become laughable.

What the buffoon, the court jester, and the clown have in common is the power to provide a critical and reflective view through laughter. According to the Aurélio dictionary¹⁸, ridicule is something that provokes laughter and mockery, and is synonymous with the word “laughable”. The clown exposes their own problems, vulnerabilities, and faults in a joking way. They embrace self-deprecating humor and invite the other to laugh with them at their vulnerabilities. The laughter provoked by the clown is a similarity laughter: I laugh at what is familiar; I allow myself to look at certain facts and characteristics that live in me, in my family, in society¹⁴. Laughter becomes a reaction of the audience that identifies with and is convinced by the clown’s performance. The clown’s construction of laughter occurs in the subjectivity that permeates the construction of this encounter, which enables the clown to laugh at the ridicule that exists in the other by laughing at themselves first. This distances the laughter from an offense or aggression.

There are various theories about laughter and its meaning. For example, according to Bergson¹⁶, laughter is a mechanism of criticism, that is, humans only laugh at what they know and when they recognize themselves. At this moment, they activate critical and reflective channels, which reminds us of the Latin expression castigat ridendo mores: it is through laughter that customs are corrected.

Making a comparison with the comedian’s work, this professional uses a script, a formulated idea that has a beginning, middle, and end. Through nuances in the comedian’s voice and small adaptations based on the spectators’ reaction, this very well-conducted performance provokes laughter. In opposition, the clown works with real situations. They live in the present and have keen perception, attentive listening, and consistent dialog. The clown does not portray a character; they are! We laugh at the comedians’ jokes, but we laugh at the clowns themselves. We also laugh at how, despite their clumsiness, they reveal how we all are, used to be, or will be¹⁹. Thus, the clown is the mask itself, worn by the person who performs before the audience.

Thus, since their emergence at the end of the 20th century in Brazil, hospital clowns have been materializing what used to be seen in courts with the buffoon and have established themselves in healthcare environments in different ways, ranging from initiatives of professional groups like the Doctors of Joy⁴, whose work started in 1991 and reached other spheres of society, to extension projects in various Brazilian universities.

University extension, in turn, has an inclusive nature targeted at the population in the university’s surroundings and ensures that knowledge, discussions, and practices reach society in a community-based, voluntary, and committed way²⁰. Many projects across the Brazilian regions engage with the ideal of clowning and its use in the sphere of health, which shows the need for studies that quantify and gather information from various extension groups. Among the many existing groups, we can cite the pioneers: “Enfermaria do Riso” (Ward of Laughter), of Unirio²¹, and “Clowns Visitadores” (Visiting Clowns), of Unicamp²².

When we ask what allowed the clown’s entrance in healthcare contexts, we need to understand their functionality. Many justify the clown’s entrance in the health area mentioning happiness, relaxation, and laughter. As we explained above, this is not the main justification; after all, many professionals elicit laughter (actors and comedians, for example), and, if laughter is the reason, any professional who provokes it can occupy this space. It is possible to say that clowns were only admitted to the field of health because they are artists of laughter who work with real situations, live in the present, and extract joy in a context of pain and vulnerability. The clown navigates through suffering, illnesses, and death, observing the processes, questioning these situations, sharing experiences, and, whenever possible, bringing light and joy to spaces and moments where there would only be sadness.

Concerning this, one of the members of the group of hospital clowns from the State of Alagoas, the university extension project “Sorriso de Plantão”²³, reported an experience in which the character was entertaining and interacting with a child while a professional was preparing herself to perform a procedure on the patient. During the procedure, when the clown noticed that the patient was crying and uncomfortable with how she was being treated by the professional, he used the clown’s mask to criticize the attitude he was witnessing and said, in a comic way, that the “game” played by the professional was not fun, her “toys” were not cool, and he was going to tell everything to his mother (the affectionate way in which the group members call the coordinator). The professional immediately recognized her mistake and stopped, while mothers and other people present in the room laughed at the caricatured way in which the clown spoke.

The spectacle and the indication of ridicule

According to Debord⁹, the current society has not overcome the modern logic of production and, therefore, has become an accumulation of spectacles in which representation has replaced life. Existing in a society of the spectacle means living what has not been lived; it means building the very lies that build a false life; it means performing a false “self” as if it were the being. What sustains the current society is a reciprocal alienation in which reality produces the spectacle while the spectacle produces reality⁹.

The clown represents a raw, unfiltered being, stripped bare and as close as possible to what is natural and real. They are the rebel who contests the supremacy orders within the self²⁴. Disobedience builds new concepts and destroys old ones²⁵. New ways of viewing old esthetic concepts and such incorporations help to form a human being who has their own identity, free from prejudice and open to creativity¹⁴. In a society of the spectacle, the clown is the reverse of the reverse, as the truth is as unreal as the lie.

In his thesis number 9, Debord⁹ expresses, in one single sentence, the intertwining between reality and lie: “In a world which really is topsy-turvy, the true is a moment of the false”⁷ (p. 11). Can the clown be an approximation to reality amid so many spectacles? The history of the clown shows that they are a subversive character who gains ground as they ironize and criticize society’s logic of power. The court jester’s outfit, for example, is a parody of the royal outfit:

[...] With no kingdom, stupid and silly. Their hat resembled a misshapen, upside-down crown. The green and yellow [and sometimes red] of their clothes did not resemble the power of a true emperor [...]². (p. 28-9)

Understanding the origin of the clown, having the buffoon as one of the references, means understanding the clown’s social importance: an outcast, a marginalized person who climbs the social ladder by exposing the ridicule that is present in the logic of power. Just as, in the Middle Ages, the court jester satirized kings, in the Modern Age the clown satirizes social relations in the circus ring through the representations of Whiteface and Auguste. Originating from the Commedia dell’arte, Whiteface is pompous, intelligent, sagacious, and tries to take advantage of their scene partner: Auguste, a naïve, stupid, clumsy clown^2,13.

In the Commedia dell’arte, the characters were caricatured representations of social roles seen in the daily life of the audience, like the cunning and flirtatious individual who takes advantage of other people’s situations, the tragic and bitter betrayed person with their daydreams, and the intelligent and manipulative person who dresses in innocence and fragility. Characters like the ones described above, respectively, Arlecchino, Pierrot, and Colombina, who seemed to just elicit laughter from the audience, gradually revealed to everybody the countless realities that each human being present there experienced¹³.

The Whiteface, deeply entrenched in his social status and assured sense of superiority over the Auguste, fails to recognize that he is the one truly deceived. It is in this game — in which the deceiver becomes the deceived — that laughter happens. The laughter of a society that could recognize itself in the Auguste, the naïve jester, and exploded in joy when it saw his triumph. Furthermore, the spectator perceives the underlying criticism, the irony, and laughter as a potentializing, subversive agent.

In modern times, we can also look back to Charles Chaplin²⁴ (1889-1977) and his clown, the Tramp, who, in silent film, criticized the industrial society, the factory production method, and the pursuit of capital accumulation. Unlike society at the beginning of modern times, where the ironic relationship between the Whiteface and the Auguste affirmed the power of explored workers through laughter, in the cinema the criticism loses its reverberation force. In the society of the spectacle, “what appears is good and what is good appears”⁹ (p. 24), and what used to be a criticism of the capitalist and productivist society ended up reinforcing and potentializing the industrial society.

The spectator who does not experience their essence, who is merely an accumulator of patterns and a reproducer of archetypes, can only apprehend what is familiar, what they reproduce, consume, and “live”. Satire, irony, and mockery are not sufficiently powerful to modify the Being and awaken them from their inertia beneath countless layers of a thick blanket of spectacles. Representation is only one more layer, one more element that has been conquered, but not felt. The spectator is not affected by art, and what takes place is a superficial appropriation of Having.

When we think that the clown is essentially a subversive agent, it is natural that they continue occupying spaces of dominance and power, “climbing” from palaces to circus rings, from rings to the cinema, and from the cinema to the health field. Just like the court jester imitates the king’s mannerisms, posture, and clothes, the clown who enters the field of health satirizes the physician, who has always been the representation of power in healthcare. In this context, the white coat, the stethoscope, the ordering of tests, and the consultations represent the parody of a sector in which medicine expropriates health²⁶.

The hospital clown is the caricatured materialization of the physician’s ego, pompous and full of flourishes to express their arrogance, intelligence, and superiority. We present below the representation of an interaction between a “Whiteface” clown and a hospitalized child:

- Good morning, everyone! As you probably know, I’m Doctor Stethos Cope. I have the patient’s test results with me, but I believe the patient must have been discharged, because this boy who is lying in bed is handsome, rosy-cheeked, pleased, happy, joyful, and completely healthy! My secretary must have given me another patient’s papers... Or could it be that the patient is hiding somewhere in the room?

The discourse above represents the pompous Whiteface entering the health stage to expose the Ridicule Physician. But if the Whiteface is there, who is the Auguste?

The 9-year-old patient, hospitalized after being submitted to an orthopedic surgery due to a fracture in the forearm, bursts out laughing while the clown looks for the patient inside cabinets, under the bed, and in the bathroom.

The Auguste is the patient himself, whose protagonism is annulled in the physician-patient relationship. The physician represents authority and power, while the patient, as the name itself denotes, represents passivity and submission. The clown’s performance enables a new configuration, a playful game in which physician and patient talk and construct the scene as protagonists, in a horizontal logic of relationship, exchange, and sharing.

Many authors have called this complex process of criticism of the logic of power and dominance “Laughter Therapy”^3,8. Laughter is therapeutic not because it is funny, joyful, and produces serotonin. Laughter is therapeutic because it strengthens the patient’s existence as a Being who acts in the therapeutic process, distant from the logic of reification of this individual who is taken into account only to the detriment of the existence of the physician’s action. In healthcare that focuses on the illness, the absence of the ill person prevents action, and their presence affirms the existence of the physician.

Laughter in the society of the spectacle

Where the real world is converted into simple images, these simple images become real beings and efficient motivations that are typical of a hypnotic behavior [...], where there is an independent representation, the spectacle is reconstituted⁹. (p. 13-4)

In the Contemporary Society, marked by spontaneous and independent reproductions, the artist-clown’s role is that of performing an unreal reality. It is the hypnotic game of the Society of the Spectacle on stage: the reproduction of reproduction, the false representation of a false reality. What about laughter? What is it?

The laughter that the clown provoked in their origin is of identification, affirmation of problems, and recognition of the humanity that exists in themselves and the other - a powerful laughter that can construct a subtle and refined self-criticism. In a society of the spectacle, of a reality that is unreal, performative, and image-based, the laughter elicited by the clown is one of stupor, a spasm reflecting the society’s prostration and indolence. An involuntary laughter from an insensible and inert body, numb in the accumulations of a false being submersed under layers and layers of representations.

We are not questioning the legitimacy of the patient’s laughter, perhaps because we believe that their place in the context of healthcare and the place where the patient is allowed to be on stage legitimize their laughter. Perhaps, due to this, their laughter has a therapeutic action. We are questioning here the laughter of the spectator (the companions, the healthcare team) and the legitimacy of this laughter. The person who laughs at the clown laughs at themselves. They laugh at their own problems, at their ridicule. The ridicule that the clown presents on the health stage is the role of the oppressor, controller, and subjugator of the sector, considering that the clown laughs at the ridicule of the represented situation, not at the person. Is the spectators’ laughter a reflex of the clown’s action as an agent of reflection?

Today, it is considered that the hospital clown plays a role not in healthcare, but as an object, a tool of a market system²⁶. Interestingly enough, the concept of Laughter Therapy views the clown as a mere resource that justifies their existence in the field of health. The field of health reifies the clown to appropriate it, to HAVE it, while laughter is merely the product of a legitimate service of the Society of the Spectacle⁹.

At the end of the introduction to The Society of the Spectacle, Debord states: “The reader should read this book bearing in mind that it was deliberately written to oppose the Spectacular Society. It never hurts to say it”⁹ (p. 9), strengthening that the reader should read the text bearing in mind that it was deliberately written to oppose the use of the clown merely as someone who provokes thoughtless laughter. Stating that the clown’s power lies in the therapeutic power of laughter is misleading.

Final remarks

In a society of the spectacle, the clown is a caricature of an unreal and performative society that reproduces stereotypes. When the hospital clown enters the healthcare setting knowing their social role, they can criticize the mercantilist and centralizing logic, the verticalization of healthcare, and the patient’s lack of protagonism. When the criticisms are not perceived, the clown-tool is reified as the object of laughter, an object to be captured, appropriated, and consumed like a medicine that can bring comfort and cure.

The laughter elicited by the clown is of identification of the relationships of control, dominance, and oppression; therefore, it is a powerful tool to re-signify the social relations of work and power. In the hospital setting, discomfort is perceived - a dissociation from a reality of stupor. It is necessary to revisit the archetype of the clown mask to compose the several layers of spectacle that exist in the hospital, in a critical, strong, and resistant way.

The clown in the hospital setting has critical and reflective characteristics that are similar to those of the buffoon. However, it is necessary to produce quality laughter by fostering the ability to laugh at oneself amid adversity, not at prejudices expressed by racist, sexist, homophobic, and transphobic jokes. The clown laughs at the sick body but respects the sick person; they laugh at attitudes of professional superiority concerning the provided care as a way of reversing the logic of power and subordination. The clown can laugh at “everything”, as long as the interaction with the audience presents a spectacle of comicality grounded on an ethical, respectful, and receptive attitude.

Thus, we highlight that we do not intend to frame the clown’s action in a Manichaean logic, polarized between good and evil. After all, the clown is not dissociated from the logic of power. We propose to reflect on the clown’s actions and potentialities and think carefully about the use of such a provocative and reflective tool.

• Funding
  This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.
• Silva MR, Marques MCC, Caires S, Guedes MM, Neto VPM. From the buffoon to the hospital clown: the trajectories of ridicule in a society of the spectacle. Interface (Botucatu). 2025; 29: e240462 https://doi.org/10.1590/interface.240462

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Edited by

• Editor
  Elizabeth Maria Freire de Araujo Lima
  Associated editor
  Flavia Liberman

Publication Dates

• Publication in this collection
  28 Oct 2024
• Date of issue
  2025

History

• Received
  08 Dec 2023
• Accepted
  19 Aug 2024