20: Tim Cunningham - Part 2
Episode Notes Welcome to Circle of Willis, my podcast about science and the scientists who do it, brought to you by generous folks at VQR, the Center for Media and Citizenship, and WTJU Radio at the University of Virginia here in Charlottesville. Folks, sometimes the chaos swirls and the lights dim. Sometimes things go very wrong and we don’t know what to do with ourselves. Sometimes those who’ve dedicated their lives to helping don’t know how to help, or, more likely these days, they don’t have the tools they need. And despite what you may have heard, laughter is not the best medicine. But in Part 2 of our conversation, my guest TIM CUNNINGHAM is here to remind us that sometimes laughter is the only medicine available, that laughter can catalyze the kinds of social connections we need most during our times of trial, and that laughter might even make those medicines that are the best more effective. Maybe that’s why Pablo Neruda once wrote, Take bread away from me, if you wish Take air away But do not take from me your laughter Humor has an almost mystical power to make life a little better, sometimes a LOT better. That’s why, in addition to being the VP for Practice and Innovation at Emory Healthcare, a Registered Nurse, and a Dr. of Public Health, Tim Cunningham is a professional Clown, trained at the Dell'Arte International School of Physical Theatre up in Northern California, and a board member of CLOWNS WITHOUT BORDERS, which you are going to hear all about in just a few moments. Tim is going to tell us how being a professional clown has informed his work, world view, and personal life, and how all of that converged in all too real moments of life and death in a time of pandemic. ———————— Folks, the Music on Circle of Willis is written and performed by TOM STAUFFER and his band THE NEW DRAKES… For information about how to purchase their music, check the “Music if Circle of Willis” page at circleofwillispodcast.com Circle of Willis is Produced by SIVA VAIDHYANATHAN and brought to you by VQR and the Center for Media and Citizenship at the University of Virginia… And that Circle of Willis is a member of the VIRGINIA AUDIO COLLECTIVE! You can find out more about that at Virginiaaudio.org. Special thanks Circle of Willis Associate Producer GRACE BOYLE, NATHAN MOORE, General Manager and swell guy at WTJU FM in Charlottesville, VA, and tough as nails editor-in-chief PAUL REYES at VQR—otherwise known as the Virginia Quarterly Review, winner of the National Magazine Award for General Excellence, in 2019, and finalist for the same award right here in 2020. If you like this podcast, how about giving us a little review at iTunes and letting us know how we’re doing? It’s super easy and we like it! Or send us an email by going to circleofwillispodcast.com and clicking on the “contact” tab. Find out more at http://circleofwillispodcast.com This podcast is powered by Pinecast.
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Jim Coan
Years ago, I worked for a number of years at the Seattle crisis clinic where we were constantly, you know, fielding calls from people in emotional crisis. And, you know, there was some very, very horrible stuff that happened in the three years that I was working the Saturday night night shift there.
Tim Cunningham
Yeah.
Jim Coan
And within the phone bank, where we, you know, we all sat where I was with my colleagues, the humor was constant, and sometimes quite shockingly dark. But it just felt like love somehow. It felt like a form of love that we had for each other that we were making this humor with each other. And first of all, you can comment on that if you if you want, but I also just want you to describe what you made of becoming a clown.
Jim Coan
Hey, guys, it's Jim Coan. Welcome to Circle of Willis, my podcast about science and the scientists who do it. Brought to you by the generous folks at VQR, the Center for Media and Citizenship and WTJU Radio at the University of Virginia, here in Charlottesville. Folks, sometimes the chaos swirls and the lights dim. Sometimes things go very wrong and we don't know what to do with ourselves. Sometimes those who've dedicated their whole lives to helping don't know how to help. Or more likely these days, they don't have the tools they need. And despite what you may have heard, laughter is not the best medicine. But in part two of our conversation, my guest, Tim Cunningham is here to remind us that sometimes laughter is the only medicine available. That laughter can catalyze the kind of social connections we need most during our times of trial. And that laughter might even make those medicines that are the best, more effective. Maybe that's why Pablo Neruda once wrote, "take bread away from me, if you wish, take air away. But do not take from me your laughter." Humor has an almost mystical power to make life a little better and sometimes a lot better. And that's why, in addition to being the VP for Practice and Innovation at Emory healthcare, a registered nurse and a Doctor of Public Health, Tim Cunningham is a professional clown. Trained at the Dell'arte International School of Physical theater up there in Northern California, and a board member of Clowns Without Borders, which you are going to hear all about in just a few moments. Tim is going to tell us how being a professional clown has informed his work, worldview, and personal life. And how all of that converged in all too real moments of life and death in a time of pandemic.
Jim Coan
So you're directing this center, and you are full of all kinds of on the ground experience working with a pandemic. It's one of the most deadly diseases ever, and the way people coped with that and your own stories there, and you're now embroiled in that. But somewhere along the way, you also became a clown. And this is also this is unique among people in your profession, doing the things that you do. So, can you tell me a little bit about being a clown and what why? Why and what you did with it?
Tim Cunningham
Absolutely. And I think I can even transition from Ebola and humor and clown I'm gonna give it a try. We might have to edit this out too. We'll see how it goes.
Jim Coan
Okay.
Tim Cunningham
I was in the unit one day, working with my, we had a buddy system when we were in the red zone in the Ebola treatment unit. Which meant if your buddy had an issue and said, "Tim, I need to leave right now." You dropped everything you're doing. You didn't ask questions and you safely get them out of the unit. Because exposure when you're doffing your PPE is one of the highest risks for care providers. Same thing with COVID, you need an extra set of eyes on someone walking you through taking off your gear that is covered in COVID or Ebola. So I'm working with Susie one day. I called her my work wife, she was my favorite partner to work with in the in the treatment unit. So every day we are stationed together, it was so exciting. So Susie and I are going through the wards, our shift is almost over. We were sweating. We were exhausted in these suits it's like 130 degrees inside the suit. So it was like really hard to manage in the PPE. And I look at a patient, and she's down the word from me, and the patient does not look good. And I say, "Susie, come up here, I need you to take a look at this guy. I don't think he's looking very good." And she was busy working with another patient. And she leaned her head back and looked at me and kind of scowled behind her N95 mask. And she was like, "Tim, of course, he doesn't look good. He's got Ebola." And it wasn't that funny from an outside perspective. But for us in that moment, it was the funniest thing.
Jim Coan
It reminds me, It reminds me of my favorite Far Side cartoon, which is-
Tim Cunningham
Which one's that?
Jim Coan
-which is where these two guys are sitting in Hell. And you know, behind them in the distance are people hanging on hooks and fire and screaming. And the one guy is leaning over to the other guy discreetly and whispering in his in his ear, "Man, I hate this place."
Tim Cunningham
Yeah, it's, it's that and like, the mystical power of humor.
Jim Coan
Yeah.
Tim Cunningham
To, in that moment of like, a horrible day of witnessing children dying, to have that comment, which also could be totally taken the wrong way out of context. It was beautiful. And like that's, that's the connectivity that humor allows us. You mentioned working in the call center and sort of the dark humor that arose. Like I think that's really important for caregivers. Now, what's also important is to share that humor in a safe place.
Jim Coan
Yes.
Tim Cunningham
Where there's a mutual understanding that we are not making fun of these people who are suffering, we are making fun of the absurdity of this situation.
Jim Coan
Yeah.
Tim Cunningham
And it's so absurd.
Jim Coan
I don't know if you experienced this. But at the call center, there was there was always, we called it a humor onboarding with new people coming into work there. We had to really ease them in because otherwise it could be quite shocking.
Tim Cunningham
Yeah. So I learned about the humor onboarding. Before I was a nurse, I worked for the Big Apple Circus, and I was a hospital clown. And I worked at Boston Children's Hospital, Yale, New Haven and Hasbro children's hospitals, I was living up in New England. And once a month, we had mandatory therapy. But I didn't consider that therapy because it was like a group session and that therapist was like the only cool therapist I've ever met, second to you, second to you. So every, once a month on Monday, we'd have to sit and have a group conversation. And I loved it because the conversations would open with we were given permission to tell inappropriate jokes if we needed to. We were given permission to break HIPAA in that safe space, knowing that what we shared was in confidence. And it really was a pressure valve release. Because it's working in a children's hospital, you see kids suffering all the time. And your job as a clown is to share laughter and love if you can-
Jim Coan
Yeah.
Tim Cunningham
-and read the room and find what you can bring out in that. So it was beaut- a beautiful lesson to learn, the like responsibilities of dark humor. So back that up a little bit. I loved acting, always wanted to be an actor, never wanted to go into medicine or anything like that. So started studying acting, got jobs at regional theaters, connected with some clowns. I was like, this clown work is really cool. Work for the Big Apple Circus as a hospital clown. I started working with an organization called Clowns Without Borders, which if you want to look them up, they're clownswithoutborders.org, I still sit on the board. So my current clown costume is like a really tight necktie, but it's fine. They're all costumes. And Clowns Without Borders mission is to share laughter in zones of crisis around the world. We don't define what the crisis is. It's not our job. We only go where we're invited. We only send professional clowns. This is not a Patch Adams type. Like if you want to like put on a wig and wear a nose and put on some face makeup you can just show up and make people laugh. I love Patch's ethos, I really disagree with the approach of how he has brought untrained clowns and artists into very vulnerable situations.
Jim Coan
Right.
Tim Cunningham
So Clowns Without Borders pushes against that.
Jim Coan
So there are professional clowns, that's a profession?
Tim Cunningham
It is a profession. It is a full on profession. It's a profession that's much more highly regarded in South America and European countries.
Jim Coan
Yeah, isn't Sacha Baron Cohen is a professional clown.
Tim Cunningham
Yeah, totally. And he's brilliant.
Jim Coan
Yeah.
Tim Cunningham
Yeah. Think of Charlie Chaplin. Think of Buster Keaton. Think of these amazing acrobats.
Jim Coan
Yes.
Tim Cunningham
And make things look easy and impossible.
Jim Coan
It's like ballet.
Tim Cunningham
It is ballet, and many of our strongest clowns have dance backgrounds. So Clowns Without Borders sends professional clowns wherever we're invited to share joy. We used to say we used to give laughter but we don't give jack. We catalyze an experience, and from it laughter can arise. From it healing can arise, from it groups of people that have been separated by war, by greed, by poverty, come together and laugh together. And at the end of our shows you see them arms in arm, holding hands, connected. At the end of our best Clowns Without Borders shows, you don't see the audience watching the clowns on stage, you watch the audience laughing with each other and talking with each other and like having these human connections. So I was an actor, fell in love with a clown, work fell madly in love with the Clowns Without Borders work. And in that work, I worked in hospitals and other countries as a clown, like the Big Apple Circus in the US. And I became overwhelmed with the resilience that I saw, like people in the depths of suffering, able to sit up in their bed and laugh and joke. Doing juggling routines with kids in hospital beds, where the kid reaches out and grabs a juggling ball, and throws it at the mom who's like weeping happily in the corner of the room, and mom doesn't know what to do. So as a clown, then we pick it up again, give the ball the kid again, so they can throw it at the mom again. The ability to catalyze joy in whatever the situation that comes from the patient, the human, the child in front of us doesn't come from the clown. The skill of the cloud is the ability to read the room and respond. The beauty of the hearts of the people in the audience, whether that's a kid in the bed or in a refugee camp, are their innate human ability and the desire to connect. So the clown feeds off of that turns it upside down, because the clown lives in an absurd world. But so is a world full of war-
Jim Coan
Yeah.
Tim Cunningham
-and poverty. And so it's only fitting that clowns address it, right? Seeing that level of resilience made me want to understand more about healthcare, and what we can do to change healthcare and also celebrate the humans in healthcare and not the sciences much. I mean, science is important, don't get me wrong. Love my science.
Jim Coan
We'll take that as a given. We'll take that, we'll stipulate that.
Tim Cunningham
Yeah. So how do we elevate the humans being affected by the science?
Jim Coan
Yeah.
Tim Cunningham
I keep thinking like people say laughter is the best medicine that's dumb, that doesn't exist. Like they're great, great medicines out there. But the sad reality is, laughter is often the only medicine available.
Jim Coan
There it is. That's what it is. And not only that, it's a potentiator of medicine.
Tim Cunningham
Yeah.
Jim Coan
I mean, so you know, we want to set the stage, so to speak and talking about acting, but well, let me stop and just say this. We've talked many times before, and I-and I think about your clown work all the time. Because I think about how, you've just mentioned it yourself, how the center of humor is a shared experience of absurdity, right? It's shared, but with real emphasis on the sharing. There's all kinds of research that you're probably aware of that people do not laugh much or as intensely when they're alone. They laughing is for-for being with other people. And I don't think we even understand it terribly well, psychologically yet, because there's so much complexity to the fact that Charlie Chaplin falls down the stairs holding a stack of dinner plates, which is horrible. And it makes you laugh your head off. Right? Especially because of the dinner plates. And, you know, what is that exactly? Why, why is that? But I think that that sort of is a center of gravity for you, an intuitive center of gravity for you around which so many of the other activities you engage in sort of orbit. And I could be wrong about that. But I sense a deep interest and belief in the human side of how we operate. The human side being these more sort of intuitive capacities we have for connection.
Tim Cunningham
Yeah. I've got two thoughts on that one, you reminded me of a quote that Joseph Campbell said he, there was a series of PBS interviews, and he was talking about his work and the origin of myth. And he says at one point, he says, "The reason mankind created poetry was to try to explain the nature of God." And whether you believe in God or not, this way to explain this incredibly abstract thing, you can only begin by explaining through abstraction, which you can never fully analyze a poem the same way. Like you can't do, use the scientific method on it, because it's designed to be all about interpretation. And I kind of hope, though, I'd love to understand more physiologically and chemically and spiritually what laughter is and does and see some good research on it. I kind of hope we don't see that. I feel like there's some things that need to remain mystical.
Jim Coan
I wonder if Camus gave us a little bit of a clue of when he developed absurdism. That uh-
Tim Cunningham
Maybe, yeah.
Jim Coan
-that the most fundamental choice is to either commit suicide or accept that your existence is absurd.
Tim Cunningham
Yeah. Keep calm.
Jim Coan
And carry on.
Tim Cunningham
Yeah. Oh, man. Another side note, one of my self care practices when I was in quarantine, I read Camus "La Peste," the plague.
Jim Coan
Oh, yeah, I've read that too.
Tim Cunningham
He nailed it. He nailed it. Yeah. So laughter at at core for me, yes. And I think it's ironic because I struggle with depressive thoughts a lot.
Jim Coan
A lot of comedians do.
Tim Cunningham
Yeah. I'm not the happiest of people. And yet, there's a feeling I get when I have a real laugh. Not those, like fake laughs that we have to put on sometimes, but like, there's this feeling of wholeness that I feel. We had kids dying of Ebola laughing with each other. There was a kiddo, 10 year old boy, his sister was eight, both came to our treatment unit really sick, both positive for Ebola, you could see it from a mile away, and brought him into our unit. And I remember this boy said to his sister, he's like, "do what the docs and nurses say, eat and drink," like that was the theme. And his sister hated me because I was the one who would start IVs and give her injections for antibiotics. And I would walk into the unit and she would glare at me, and like, start to like, try to walk away and her brother would always be like, "stop right there." And he'd make her hold still, get her medication. When we bring food, he would make her eat all of her tray, and sometimes he would even wait and watch her finish eating before he started eating off his own tray. He got worse, she started getting better. It got to the point where he couldn't really eat anymore. And he would conserve enough strength when we would come in with a food to sit up and put his tray on his sister's bed and watch her eat. And then he'd lay down. He would do the same with the medication. She still hated me for giving medication, he would conserve enough energy to scowl at her and say "hold still, take your medicine." Last day I saw him alive, we were in the unit we were rounding. And one of my colleagues was like, "Hey, Tim, you should juggle for these kids." And we had like little nutrition packets called Plumpy'nut that they're like seal- They look like a kind of astronaut food you get at the Smithsonian. They're high protein snacks full of sugar, full of protein. They have saved millions of lives. It's an amazing innovation. It's called Plumpy'Nut. And, so we had those packets. And they're really easy to juggle. So she's like "Tim, juggle." And I was like, okay, whatever. I was not in a good mood that day, because everyone had Ebola. And so I started juggling. And it was really cool, because people in the unit that were able to sit up, started sitting up, laughing, some of the older women started kind of clapping a little bit. And the young girl was sitting up watching, scowling still, because she hated me. And then her brothers sat up. And her brothers smiled at me juggling. And she looked at her brother smiling, and she started laughing. And she kept laughing. And then her brother reached out his hand. And my friend Yunus, who I love dearly, she's one of those people on speed dial that like we will be connected for the rest of our lives. She elbowed me, she's like, toss it to him, give him one of the Plumpy'nuts. And I was like this kid is... he's sick, and he's weak, he never sits up. She's like, "just toss at him." So I tossed the plumping up in the air, and he catches it. And his sister sees and she laughs even harder. And then he smiles. And then he chucks it back at me. So I catch it. And then I toss him another one. And in just a matter of seconds, we have this brief juggle-passing routine going, back and forth, back and forth. His sister's smiling, he's smiling, people are sitting up laughing. And then at one point, he raises his hand, kind of like a stop sign hand and tells me in Temne, that's enough. I'm done. And so I juggle by myself a little bit, and then we leave the work to go treat other people. And he died that night. I just... that. Like, what is that, Jim? You know? And that ability to laugh in the face of the most extreme suffering, and it comes naturally, like none of that... None of that was forced. And the best clowns are the ones that don't force anything. Because the second someone says, Hey, Jim, do something funny-
Jim Coan
It's not funny.
Tim Cunningham
Right, it's not funny at all.
Jim Coan
It's like, yeah, you asked what that is? And I don't know the answer. But as you were describing that story, there's an arc to it that includes some kind of phosphorescent, emotional light. That is just true. It's true. And it's true for eternity, right? That that humor isn't going to... It didn't save his life. It didn't keep him from dying. It didn't keep him maybe from suffering immensely more in between the fun time in the- in the time that he died, that night. But the fact that he had that moment with his sister, with you, smiling and experiencing joy and connection - which in a sense is how we create ourselves, is to have that connection -will never not be true. And it's immensely valuable for that reason alone.
Jim Coan
And in that moment, it was the only thing
Jim Coan
The only thing.
Tim Cunningham
Yeah.
Tim Cunningham
Kind of makes it worthwhile when you think about it that way, doesn't it?
Jim Coan
I don't know, worthwhile is one way to put it, but essential is what's coming to my mind. You know, people often think about the end point, the goal, you know, especially in medicine, you know, do we save the arm? And people like you Tim, you face those kinds of questions all the time. But the question of what happens right now is a little bit harder for us to get our minds around. What is it like to be right now? What does it like to be you? And what is the value of that, regardless of the outcome? You know, it's tempting, I think, when we get too stuck thinking about the outcome to discount the value of moments of joy right now, but that's what we're here for. If we're here for anything. There's nothing else than that.
Tim Cunningham
Yeah. I was speaking with a nurse just before this phone call, when I was in the hospital, just asking her how things are going. And she was saying that it's really hard. And for her, it was really hard to think about the family members that can't be with their sick loved ones, because most hospitals in the country have a no visitor policy now.
Jim Coan
Right, yeah.
Tim Cunningham
And she was like, "I'm a nurse, I know what I'm doing. I know how to, like, use the PPE that I have, like, I'm okay with that." But she said, she's so worried about those other folks that don't know what's going on. And then at the same time, she said, she kind of loves it right now. Because so many distractions are pulled away from the hospital where she feels like she has time to be present with the patient in front of her. And we talk about resilience is this idea of bouncing back, right? Sometimes people use that as sort of a general definition. I have another nurse colleague who says, "Well, what if resilience is bouncing back to remembering why you became a nurse? Remembering why you went into the field in the first place? To then face the challenges in front of you." And this nurse talked about that today of how she was able to reconnect with what inspired her most about being a nurse, which is caring for people. It's not doing all these crazy- using all this crazy technology, much of which we have to throw out the window because we don't have enough of it. We don't have enough people or we don't have enough computers in the room. So to get this computer out of the room, many of our care providers are having the opportunity just to sit with people, and are maybe relearning what the moment is. And one of my hopes, with this crisis as healthcare is crumbling in the US, I would argue it was crumbling before COVID.
Jim Coan
Oh, definitely.
Tim Cunningham
The crumbling is just exacerbated. Can we refine what healthcare is really about? And when we move forward, can we remove some of these financial, greed driven obstacles that we have created in our health system? With the goal of making money with the goal of... tried with the goal of status, with the goal of can we? Because all that stuff is falling away right now, can we maintain a new sense of health care? That goes back to the roots? That's resilience, right, going back to the roots, to face what is now. And I'm up at night worrying about my nurses. And at the same time, I'm not as worried about them when I hear these stories of like, yeah, this sucks. But at the same time, we have the ability to be really great nurses. And give the core of what the care is. And who has time to chart, we don't have time to chart so forget about it. We're just caring for people.
Jim Coan
Tim, this has been one of the most profound and enjoyable and moving conversations I've just about ever had. So thank you, sir.
Tim Cunningham
Yeah. Thank you, Jim. You um, I don't know if you remember, one of our first meetings, you came to my office. And like an idiot, I had put my smartphone in my back pocket. And I got so excited about our conversation. I think we went over time, and we were both like, "Oh, we got to get on the next thing. But we don't want to," it was such a great conversation. I realized I was rocking in my seat so much that I frickin cracked my screen. And the phone died a week later because of you. Yeah.
Jim Coan
Happy to oblige.
Tim Cunningham
It's so good. I really, really appreciate the space for this conversation.
Jim Coan
Yeah. And, for what it's worth, keep me on speed dial if you need.
Tim Cunningham
I will. Thank you.
Jim Coan
With all that's going on.
Tim Cunningham
I will.
Jim Coan
All right, man.
Tim Cunningham
Cool.
Jim Coan
Talk to you later.
Tim Cunningham
Alright. Thanks, Jim. Be well
Jim Coan
Okay, that's it. Thanks to Tim Cunningham for the rest of our stunning conversation. And, and thanks to our many listeners for sticking with us after our long hiatus. We appreciate it a lot and are on board for another series of episodes coming up in season two of this podcast, starting in about two weeks. I started to run out of air there while I was talking. Folks, the music on Circle of Willis is written and performed by Tom Stauffer and his band the New Drakes. For information about how to purchase their music, check the about page at circleofwillispodcast.com. Circle of Willis is produced by Siva Vaidhyanathan and brought to you by VQR and the Center for Media and Citizenship at the University of Virginia. And Circle of Willis is a member of the Virginia Audio Collective. You can find out more about that at virginiaaudio.org. That's virginiaaudio dot O R G. Special thanks to Nathan Moore, General Manager and swell guy at WTJU FM in Charlottesville, Virginia. And tough as nails editor in chief Paul Reyes is at VQR, otherwise known as the Virginia Quarterly Review, winner of the National Magazine Award for General Excellence in 2019 and finalist for the same award right here in lonely, little 2020. If you liked this podcast, how about giving us a little review at iTunes and letting us know how we're doing? Super easy. And we like it, or send us an email by going to circleofwillispodcast.com and clicking on the Contact tab. Okay? Until next time, bye bye.