Hospital Clown: The Science of Therapeutic Humor in the Medical Environment Introduction: From Intuitive Practice to Evidence-Based Medicine Hospital clownery (Clown Care) is a unique phenomenon at the intersection of art, psychology, and evidence-based medicine. Emerging in the 1980s through the American healing clown Patch Adams, this field has evolved from an intuitive humanistic practice to a scientifically supported therapeutic intervention. The modern hospital clown is a highly professional specialist whose work is based on strict protocols and supported by data from neurophysiology, psychoneuroimmunology, and pediatrics. His activity is aimed not at entertainment at any cost, but at targeted improvement of the patient's psychoemotional and, consequently, physiological state. Neurobiological Mechanisms of Impact: Why Does It Work? The impact of hospital clownery on the patient has a clear physiological basis, confirmed by instrumental research: Hormonal profile and stress response modulation: Meeting a clown, especially for children before surgery, leads to a statistically significant decrease in cortisol levels — the main stress hormone. At the same time, an increase in β-endorphins (natural analgesics) and dopamine (a neurotransmitter of the reward system) is observed. This shift creates a neurohormonal basis for reducing anxiety and increasing pain tolerance. Activation of the parasympathetic nervous system: Games and sincere laughter initiated by the clown stimulate the vagus nerve, which shifts the body from the "fight or flight" (sympathetic dominance) state to the "rest and digest" (parasympathetic dominance) state. This manifests in a decrease in heart rate, blood pressure, and normalization of breathing. Diversion and cognitive overload: Techniques of clownery based on absurdity, surprise, and play create a "cognitive shake-up." They redirect the patient's attention from painful procedures, anxious thoughts, and fear to positive, thought-provoking sti ... Read more