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Flora the Clown - Camilla Gryski 7T1

Flora the Clown

When Flora the Clown walks down the hall at Toronto's Hospital for Sick Children, even the adults smile. Harried staffers and visitors grin shyly as Flora—in red nose, flowery pantaloons and mismatched vest— waves a hopeful hello. Standing at the elevator, a middle-aged doctor sneaks a curious look at the colorful toy kit she carries with her everywhere. In that look you can see the five-year-old he once was.

Flora invites this sense of wonder. Gentle and soft-spoken, she bears no resemblance to the garishly painted circus performers many people assume clowns must necessarily be. But Flora—the alter ego of Camilla Gryski 7T1, a former teacher and librarian— is a different breed entirely. As a therapeutic clown working with the Palliative and Bereavement Care Service at Toronto's Hospital for Sick Children, Gryski's work requires that she be small, not outsized; soft, not loud. "It's not about me, it's about the child," she says. "I can hold my energy in so much, it's as if I'm not even there."

Gryski began work as a librarian at the hospital in 1977. Eighteen years later, she decided she was ready for a change. Clowning seemed a natural fit: she had worked extensively with children, was also an authority on string games, and had been an avid "circus mom," overseeing the burgeoning career of her son Damian, a juggler and busker.

It was a time when the new profession of therapeutic clowning was coming into its own. In Canada, clowns have been working in health care settings for the past 23 years, offering patients (adults as well as children) a chance not only to laugh, but to take time away from what can be a gruelling regimen of treatments, appointments and operations. As a member of Sick Kids' palliative care team, Gryski offers moments of respite to children at the end of their lives that have a particular urgency and poignance.

Gryski's first persona was Posy, a pretty, lavender-haired vision in white greasepaint. "For the first couple of years I didn't speak [while playing]," she says. "Then one day I was with a little boy, who asked me my name. Of course, Posy was written all over me, but he said: 'I'm only 6, I can't read!'"

That was the first step toward Flora, a more "Camilla-like" figure who jabbers gently and wears no makeup. But as Gryski says, both Posy and Flora truly resemble her: a distilled essence, perhaps, of who she really is. "The true clown is authentic, honourable, works from the heart," she says. "There's not a lot of artifice there." Indeed, she believes that clowns represent us all: "My vulnerability and joy is on the outside—but inside every single one of us is someone who'd like to skip through shadows in the sun."

Working with young people at the end of their life's journey presents many unique challenges. First, Flora must keep children safe, ensuring that hands are washed and toys sterilized. When patients are feeling well, play can sometimes be "wild," but the clown must be mindful of things such as stitches and equipment. In one of the numerous articles she's written about her work, Gryski recalls a four-year-old's vocal command: "Power Rangers, attack!" He then added: "Bring my IV, Posy."

This episode epitomizes Gryski's philosophy— that play must offer the dying child a sense of empowerment. "Lots of choice gets taken away from kids [in this situation]," she affirms. "They are always being told, 'You can't do this,' or 'You have to do that.' So every time I offer a piece of play, what's built in is choice. And the best thing for me is when the child takes over the play."

Gryski calls herself a play facilitator, and her stories illustrate how mortally ill children ingeniously develop strategies to deal with their threatening reality. She recalls one ten year- old girl who developed a special connection with a hand puppet from Flora's toy kit. "She had a lot of skin problems, and her dressing had to be frequently changed. One day she was screaming and screaming, and nobody could figure out why. But she felt comfortable telling Bunny—the puppet. She explained to her that she wasn't in pain, particularly... screaming was just something she had to do, to calm herself. Still, she wouldn't talk to me. She'd talk to Bunny."

Palliative care—in which a dying patient's needs are looked after, with the underlying acknowledgment that no cure will be possible—is a relatively new field in Canada, having been introduced here little more than thirty years ago. Its very existence makes many uncomfortable, especially wherechildren are concerned. "It's hard, becausethe medical profession tries to cure people;that's its thrust," says Gryski. "It's hard not to see a child dying as a failure. That's why there has to be more education in this area, so that families don't become invisible to staff when there's no longer hope for a cure."

Gryski works as part of a child's support team, alongside doctors, nurses and such other complementary professionals as massage, music and art therapists. These last provide critically important services; while doctors try to add time to a child's life, Gryski insists she is there to "add life to a child's time." She works largely within a home setting, providing play opportunities for siblings and friends as well. And in a recent article, Gryski wrote about how Flora sometimes offers parents their own opportunity to "express the inexpressible." While she was showing a nine-year-old girl that a wind-up bear needed to be tapped on the head to move, her mother commented: "if I tapped you on the head, would you go on?"

The work can be emotionally gruelling, but Gryski has learned to take care of herself. Having the support of a team is important to her, as is the cultivation of calming rituals. After rounds, midweek, she sometimes walks labyrinths or draws mandalas. "You have to come to a personal belief about why children die," she says quietly. "You might believe that they are old souls, or that they had a special purpose here. Or you might hold to the Buddhist belief that this was one life, and there will be another one."

But play with children at this time in their lives gives great pleasure, too. To hear, as Gryski once did, that she was responsible for a little girl's last smile is inestimably rewarding. "It's an absolute privilege to have a child who is days from dying wake up and play with you," says Gryski. "There comes a time in their journey when all they can do is say paint me a bee, or a butterfly. Just my presence, my being with them, is tremendously simportant."