> ## Content Index > Fetch the complete content index at: https://southpole.blog/llms.txt > Use this file to discover other available public pages before exploring further. # Caroline Simonds - URL: https://southpole.blog/caroline-simonds-le-rire-medecin/ - Published: 2026-09-07T12:56:15.000Z - Updated: 2026-09-07T12:56:15.000Z - Description: Caroline Simonds left premed for the circus, then carried the circus into pediatric wards. Thirty-five years and 160 performers later, she talks about counterpoint in a hospital room, why a child's refusal is a gift, and the discipline that makes real improvisation possible. - Author: John Alexander - Tags: ~Culture, +Craft & Repair, +Ethics, :Interview Caroline Simonds founded Le Rire Médecin in Paris in 1991\. Beginning with two performers, the organization now has 160 red noses and counting. It was the first company of its kind in Europe, and the movement it started has since spread across the continent, and the world. She stepped back from running the company last year but still performs in hospital wards five or six times a month. She has published and spoken widely on the profession, and a feature film, *Sur un fil*, released two years ago, was inspired by her book *Le Rire Médecin - Journal du docteur Girafe* that she co-authored with Bernie Warren. What follows is a transcript, of a conversation that took place on August 20, 2026 between Caroline and myself. It has been lightly edited for clarity. --- **John Alexander** So I discovered that you studied composition with Betsy Jolas. **Caroline Simonds** Yeah, a long time ago. **John Alexander** And I was a student of Iannis Xenakis. **Caroline Simonds** Oh, no shit. Are you kidding? Also in Paris? **John Alexander** Also in Paris. But I think I was after you. I was in the mid-'90s. **Caroline Simonds** Well, you have to be, because I'm 76. **John Alexander** I was there like '93 to '95. **Caroline Simonds** That's when I started Le Rire Médecin. I came back to Paris in '91, and that's when I founded the clown doctor company. But I had been in Paris before. I studied with Betsy in '69, '70\. I had been at Bennington College, and then I was studying with a guy named Henry Brant. I was destined to be more of a composer, musician, and since I was so awkward, I thought I'd learn mime. And that was the first rabbit hole, trying to get my crazy long arms under control. I'm tall. I'm very tall. I went to Paris to study composition, flute, I'm a flautist. And mime. And then I just dove deep into the circus world. **John Alexander** So when you first started going into hospitals, did you think of what you were doing as avant-garde? **Caroline Simonds** No, it was kind of a natural act, to tell you the truth. I first started, I was 38 and a half, and I had been touring since I was about 21, all over Europe. I had auditioned for the Big Apple Circus Clown Care Unit, because in November of 1987 I was asked to come to Sloan Kettering, which is a cancer hospital. And to entertain children who had cancer, as a turkey. It all came together, all these years of performing in the streets and my love of children. I had really started off to be a doctor also. I started premed, of all places, at Bennington, and dropped out as soon as I had done my first small residency. So I went hog wild into music and theater. But suddenly I rediscovered my love of the hospital, and this feeling of how do you stamp out suffering for other people? How do you heal the world? With poetry, with music, with laughter, craziness. Of course, I'm like a fireman. I'm like the person who goes into the fire. I don't think about the danger. I dive in. I just go. My best to put out the sadness. To fight sadness with joyful water. I was a clown, but I didn't wear a red nose. I wasn't a bozo. It was a very Fellini-esque aesthetic. My company in the '70s was called the Palais des Merveilles, the Palace of Wonders. Somewhere between Cocteau and Fellini. So I auditioned for the Big Apple Circus as a giraffe character, with ears and horns, a tail, bodysuit. And I don't know why they took me. I auditioned in intensive care. Michael put me into intensive care. No pre-op. No getting ready for the thing. I was pushed in front of a little girl who was mostly waking up from a heart transplant. Not quite awake. And I just intuitively played the flute. "Over the Rainbow." Eyes fluttered, took out a music box. Eyes open, played the same tune, sang it, because I'm a singer also. And she had a little teeny smile. I think this little girl, Maria, hired me somehow. I think she was the one who pushed me into this profession. I worked in the Bronx, at Montefiore, and at Columbia Presbyterian in Harlem, as a clown performer, always in a duo. The principle was good cop, bad cop. The Auguste, the white clown. And I was in love with this profession. I fell in love with the challenge of adapting anything I knew how to do as a performer to each case. To a baby. To a teenager who had AIDS. It was the period where AIDS was just beginning to peak in the late '80s. In America everything is mixed up, like the food. You go into a diner, you get salad and a coffee and a hamburger. In France it's very separate. You have your entrée and then your plat, and then your dessert, then you have your coffee. But medical places have kids with cancer, kids who have been burned, kids who are in a coma because they drowned. And I had to adapt all my entertainment skills to this milieu. And there was nothing really to teach me. We were a small group at the time, six or seven of us. We'd meet once a month and schmooze. So we taught each other a little bit how to do it. My ambition was to go back to France eventually. I thought the French would understand the work better than the Americans. The Americans were very like, "Ah, bravo! Wonderful work!" And I thought, the French are going to be hard customers. They're going to go, "No. Why are you doing that? What is the purpose? What is your objective?" That whole Cartesian thinking, which I love. So I decided I would create a small company in France to be in the hospitals. It was a real poker play. I took my own savings, which amounted to nothing. And when you network, you have to love failure. I call it high-quality failure. When someone says, "No, we can't help you," I say, "That's great." That's a million dollars for me. That's my way of fundraising. Because I passed the hat for 15 years. **John Alexander** When you first moved into the hospital room, was there anything that stopped working? Anything that worked outside and would not work there? **Caroline Simonds** You have to adjust the intensity and the size of your gestures. Obviously the tone of your voice. It's being like a chameleon. You take on the color of the room. But you're a musician, right? So you're doing counterpoint. Everything for me is music sheets. I perform as a musician. Performing is in harmony with the room. And also to myself at the same time. What works in the street, being very big, very vocal, would not work with a newborn baby who has heart trauma. Could work with a teenager with AIDS who's wild and crazy and needs a little stimulating. So you have to learn where to stimulate, how much to stimulate. How far can you go too far? That's the thing. In French: how far can you go too far. Which is a great motto for working in the hospital. But it is like the street in that it's 360 degrees. So you have to have antennas, and a hard disk. On the hard disk you have all the information. You can't assume you're going to succeed, ever, in making anyone laugh. You never try to make someone laugh. You feel what's going on and your artistic refrigerator pulls out the right gesture and emotion. I'm an improviser. I trust my ability to improvise something that corresponds to what that child and his parents might need. Whereas in the street we worked with a very set repertoire. You can't do that in a hospital. You have to be the village fool. You have to be so strong in your character. And what is a clown character other than putting a frame around your own craziness, your own sensitivity, your own failures. The clown is someone who fails, and that's what makes people laugh. So you have to fail. As Beckett said: fail, fail better. **John Alexander** In the street, people are pretty much random. In the hospital you wouldn't know, or want to know, the background of the child. **Caroline Simonds** We get a briefing every day. We call it la transmission. We don't assume that someone just has cancer. We know he's in pain, he's not in pain. He's French, he doesn't speak French. His parents are alive. They're getting divorced. We get essential information so that we can forget it, basically. You put on your hard disk all the information the nurse gives you in the morning. We work twice a week in every ward and every medical unit, so the kids know us really well. We belong to them. You have to be aware, in the hospital, that emotions can be very raw. People can be very scared. They can be anguished. So it's a bit of a tightrope walk over a swamp with alligators. But you know how to put one foot in front of the other. You have to dare to do things, but you have to dose it. You have to know when to pull back, when to go forward. But you have to take risks. If you don't take risks, it's not funny. If you don't take risks, you're not going to supply the right amount of poetry that someone needs that day. It's a very delicate profession. It's kind of like the free jazz of theater. If you don't know your scales, if you don't know your harmony, you can't play free jazz. ![Two performers in white coats and red noses lean together against a hospital wall beside a round porthole window, eyes closed, laughing. One wears a yellow visor and a pink flower lei, the other a pale giraffe headpiece.](https://storage.ghost.io/c/03/06/03065ed1-c02d-4f1e-a778-2e98d268f8de/content/images/2026/09/Caroline-Simonds---2-2.jpg) Rico and Dr Giraffe looking into a child's room to make sure they are welcome. **John Alexander** What can two clowns do that one can't? **Caroline Simonds** Two clowns is love and hate. Conflict and resolution. Black and white, nasty and nice. You can play off somebody. You need that to do theater. Peter Brook says: someone walks on stage, someone else walks on stage, they meet, then it's theater. Plus there's the third person, which is the child or the parents. There's a triangle going on. The risk of working solo is you burn out very quickly, because in order to make people laugh you're doing the same thing over again. A magic trick, whatever, because it works, and then it gets stale. Solo performers in the hospital do not, for me, work very well. I probably shouldn't say that. But you don't have the richness of the relationship. It's like love, and it's like conflict. Children love conflict. Good cop, bad cop. Everybody loves it. It also means the child has two different people to identify with. He can have more of a tendency of rooting for one of them against the other. Or we can decide we're going to be completely allied that day, work inside two-part harmony. But we can work like Xenakis. We can do things that rub. **John Alexander** When you perform in the hospital room, is it only for the child, or child and parent? **Caroline Simonds** It could be a doctor giving a treatment. There can be two parents, siblings visiting. It depends on the ward. In a bone marrow transplant unit the child is alone with one parent because of the risk of infection, so you have to wear a mask. **John Alexander** So are you sometimes performing for the others in the room too? **Caroline Simonds** Of course, for the others. You're performing for everyone who's there. You could perform for the television if the kid is afraid of you. You have to adapt it. Or if the kid is in a lot of pain, maybe take it way down and play something very beautiful on the flute. I play the ukulele also, and I can sing with a surgical mask on. It's always changing and evolving from room to room. And the hallways are very important. The way the village fool comes into the village, to make your presence known, to have a parade. So people see you're there that day. **John Alexander** Was there a time when you realized the best performance was to do nothing? **Caroline Simonds** There was a kid who hated us. Once, a kid who just hated us. And my partner said, we said, "Listen, we're going to get fired if we don't stay in here for three minutes. Just put up with us. We're not going to do anything. Really, we're going to be quiet." And we were just there like this. And then one of us farted. Then it was great. Accidents are the best thing in the world. **John Alexander** Children having agency, and the opportunity for a child to say no. A lot of times a child is the least powerful one in the room. **Caroline Simonds** Something awful has happened to them. Maybe they don't know what's going on. And giving them the ability to, at minimum, say no. No clown today. I always say to people starting the profession, you have to celebrate rejection. And treat it as the child being empowered. Giving him that gift of empowerment. I remember a child who was afraid of me once, in the Bronx a long time ago, and I was learning what it meant to scare someone, or for him to reject me. He said, "No, no, no, no, I don't want a clown." I said, "That's fine. Just don't blow on me. Just don't blow." And he went \[blows\], so I flew backward, hit the wall, hurt my head, he laughed, we laughed, and then I went away. But you can also just leave. No problem. I go. Or sometimes with a teenager, they say, "I'm like 15, give me a break." I said, "Can you say that in a really mean way? I would love that." "Get the fuck out of here." I said, "Now can you say it in a really elegant way?" And then they start playing. So you have to trust your improvisational skills to not force something. And give them the power to play if they're a little bit open to it. I had teenagers as well. "I'm not into the clowns today." So that's fine. "Can I take off my nose? Would you like that?" He said, "Yeah, I'd like that." So I take it off. I said, "You realize I'm naked. I like my nose. This is terrible for me. But now, for you, I take it off." Sometimes you say, "Listen, we don't want to make you laugh. Could we just play something pretty for you?" And then we play a song he might know. "We'll give you a little concert. Your own little concert." So you have to be extremely flexible. Rejection is very important. But it's not that often. It's more often from a parent who's overprotective. **John Alexander** It really seems to be a volatile environment to perform in. **Caroline Simonds** But that's why it's so interesting. **John Alexander** So, after all these years, is there something you thought you understood about people that you've come to realize you don't understand at all? **Caroline Simonds** It's a definite maybe. I'm kind of an in-the-moment person. I like here and now. I'm not a Buddhist, but I'm really very here and now. I have trained myself not to have an opinion about anybody, and not to project anything on anyone. It's a big lesson to be learned in clowning. I've done it so long that I'm sort of like that in life. I'm basically a chronic optimist. And I have low tolerance for dishonest people and cheaters and mean people. But I don't go to war. I go to war with sadness, and I go to war with anxiety in other people. I'm a natural fixer-upper. Part of the world's destroying itself, and the other part is trying to rebuild it. I'm just part of that other side, trying to make the day better, make the moment better. So what I understand about people is that they're people. You can sometimes not like what they do, but you kind of like them as a person. I'm actually from a Jewish family, and I once had a patient's mother say, "Oh, you're singing. You must be a dirty Jew." To the clown. And immediately you have to let that go. The clown is just like, "Whatever, lady." Because I love that lady, and I love her kid. The kid has cancer. They all have need. They have a need to not be afraid. They have a need to not be in pain. They have a need to heal. So I'm there for that need. I'm not there for other things, politically. I actually wrote a code of ethics very early on with my company, because I felt we needed a strict framework to give the parameters of behavior. You are not allowed to break character when you perform in the hospital. Until you take off your nose, you go into your dressing room. Or you can go into the nurses' station and take it off and have a cup of coffee and cry. That's fine. What I don't understand probably is meanness, or racism, or phobias. I don't address that. I address what's right in everybody. I try to address what's healthy in every child, even if they're in a coma. **John Alexander** Code of ethics. You have to know your scales in order to do free jazz. What's interesting to me is the structure. Having this structure, maybe an extreme structure, in order to be completely free. **Caroline Simonds** You have to be free, but you have to know how to stop on a dime. Freedom doesn't mean just doing anything. Freedom means control. Going far, but being connected to your heart and your feelings at the same time. It's like when you touch a child. You don't just put your hand out. The gesture starts inside your heart, and then the hand goes out. It starts in the interior, the gesture. ****Where to find Caroline** ****Website** [Le Rire Médecin](https://www.leriremedecin.org/?ref=southpole.blog) ****Book** [Le Rire Médecin - Journal du docteur Girafe](https://a.co/d/0beyL5dt?ref=southpole.blog) ****TEDx Talks** [Professional clowns to make hospitalized children laugh | TEDxLaRochelle](https://www.youtube.com/watch?v=2DrsPDxM8oU&ref=southpole.blog) ****IMDB** [**Sur un fil* (film, 2024) heavily inspired by the real-life experiences and writing of Caroline Simonds](https://www.imdb.com/title/tt27811106/?ref=southpole.blog) ## ****SouthPole Dispatch** Essays from the borderlands of technology, art, music, and culture — about the systems we build, and what they do to us. Subscribe Email sent! 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