Dr. Patch Adams was not the first to introduce clowns into hospitals. However, his work has certainly given this field a growing legitimacy within the medical world. The subject of the 1998 biographical film Patch Adams, starring Robin Williams, was here recently at the invitation of the Schneider Children's Medical Center for Israel, the Schneider Children's Foundation and the Diada Centers for Parents and Children on one of his international speaking tours, promoting love and care. Whizzing around the globe to spread his message, Adams has met with Austrian ministers, hospital administrators and an Austrian company specializing in building medical facilities to share his concept of a healthier hospital. In the US, too, his theories promoting a holistic way of practicing conventional medicine are more palatable at a time when natural medicine is gaining ground. In 1994, he was awarded the Institute of Noetic Sciences award for creative altruism. A well-known New York-based hospital-clowning organization recommends using his articles to open doors for medical clowns to work in hospitals. Adams himself has led groups of medical clowns on visits to hospitals and orphanages around the world. This includes annual visits to Russia for more than 20 years, and visits to many European countries, including Bosnia and Macedonia, as well as Afghanistan, Haiti, Cambodia, Cuba, Venezuela and South Africa. His speaking engagements here introduced him to medical students, leaders of the medical and business communities, and other health care professionals. He plans to return in December, and lead a medical clowning visit to Gaza. He'd like Israeli hospital clowns to join the group. What makes a physician devote his entire life to both clowning and preaching about a more caring and loving social order? Adams suffered a suicidal depression in his youth and briefly checked into a psychiatric institute. His experiences there led him to understand that what people really need is love and care, and he decided to become a doctor and make his life joyful and caring. "I decided to never have another bad day," he says. Adams spent his early years living overseas, in several countries, as his father was in the army. When he was 16, his father passed away, and the family returned to the US. Adams was shocked to discover a seemingly undemocratic society: "More tragic than my father dying was experiencing segregation," he says. "People not standing up in a country that said 'of the people, by the people, for the people.' A person couldn't use the toilet because of his color... Because I'm thoughtful, and I was thoughtful young, at first I didn't want to live in a world of violence and injustice..." Adams says it was his mother who served as the real inspiration for his way of living. It was her caring personality that helped him out of his depression into a goal-oriented existence. "My mother wasn't political, she was loving," he says. "And as soon as I realized that you do revolution, then everything fit into place. My mother gave me self-esteem, which gave me the ability to choose any direction I wanted to, and to think I can do it... to know I can do it. And so, as soon as I did it, that was the healing. As soon as I worked for peace and justice, that was the right thing. It wasn't to be destroyed by injustice and violence, but to work for peace and justice... The truth is I'm just trying to be my mom. That's all I am is a person that had a great mother trying to be his mother." Adams attended University of Virginia medical school, where he began to develop his vision of a different, more holistic way of practicing medicine. "I entered medical school in 1967 to use medicine as a vehicle for social change," he says. He became interested in a new model for a hospital that would provide health care for free and would treat patients holistically. Adams's ideal was a hospital that provides a healthy community atmosphere, rather than a sterile, detached clinical institution. In the early 1970s he founded such a clinic in Arlington, Virginia, in a house that functioned as a commune. The doctors, staff and patients all shared the facilities. The Gesundheit Hospital - he now refers to it as a "pilot program" for a future larger medical facility - operated for about 12 years, treating approximately 15,000 patients. "We made no money, so our staff had to work outside jobs...," he says. "For 36 years I've paid to be a doctor. I say that without any sense of sacrifice... It's worth paying to care, it's that great a feeling... So our staff made no money, they paid to work there, they never had privacy and their house was full of suffering and neediness. And our staff had to try to have courtship and raise children in that setting. And no one left, our first nine years. And I think the trick was we were the first silly hospital in history. We made everything fun, living fun, dying funny. If you only have a week to live, I'm your man." Looking back on those years, Adams observes on his Web site (www.patchadams.org) that "good health was much more deeply related to close friendships, meaningful work, a lived spirituality of any kind, an opportunity for loving service and an engaging relationship to nature, the arts, wonder, curiosity, passion and hope. All of these are time-consuming, impractical needs. When we don't meet these needs, the business of hi-tech medicine diagnoses mental illness and treats with pills... We knew that the best medical thing we could do for the patients was to help them have grand friendship skills and find meaning in their lives." IN THE EARLY 1980s, it became clear to Adams that to build a more viable clinic he would have to raise a significant amount of money. His wish is to build a 40-bed, model medical facility. To do this, he says he must raise around $50 million. As part of his decision to focus on raising these funds, Adams agreed to do the film, and decided to postpone the clinic's medical functions until he could get proper funding. Adams says he has in fact raised a substantial amount of money, but not enough to build and run his dream hospital. Much of the money was used to fund volunteer programs, such as the medical clowning activities around the world. The Gesundheit Institute owns 310 acres (1,240 dunams) in Pocahontas County, West Virginia. It currently houses a small community of volunteers who maintain a holistic life style. The institute offers several workshops a year promoting alternative models for health care. Some of the workshops are run on the grounds, others are offered in conjunction with the School for Designing a Society in Urbana, Illinois. An Israeli health care practitioner who attended a workshop said Adams provides "a model that serves as inspiration for everyone to create their own dream... Many people have created lovely projects thanks to this inspiration." The Robin Williams film made Adams very well known, enabling him to embark upon several decades of nearly year-round speaking and clowning tours all over the world. He lectures about the human need for love and care, about his definition of health care and about the dangers of a world dominated by capitalism and wars. His dream of raising enough money to complete the clinic is his constantly-stated mantra. Adams acknowledges that the quest is taking a long time, but he remains confident that his plan will come to fruition. His interviews and diary entries over the years bear witness to his unwavering faith, but also to his recognition that irrespective of the physical building of the Institute, his life's work is making a positive difference. "It's not about whether or not Gesundheit the building exists," he says. "It's ideas... loving all people, caring for all. Gesundheit is a tiny little effort. It's a nice, intelligent effort because I want to end capitalism. So I take the most expensive thing in America and give it away for free, to be a pie in the face of greed. My goal is a world where no one alive can remember what the word war means. Clowning is one of the steps, Gesundheit is one of the steps... everything I do works for that." His social agenda follows similarly idealistic lines. In 2002 he told New Renaissance magazine: "We define success in terms of Michael Jordan and Bill Gates and Cindy Crawford and Julia Roberts. And they're not the success. Success is the schoolteachers trying to teach math and English." When it comes to political subjects, Adams does not mince words and at times irritates his audiences with highly explosive statements, for example about American involvement in Iraq. All the while, he continues to advocate focusing on love instead of violence. In a 2006 letter published in CommonDreams, a Progressive Community Internet site, Adams wrote: "For those who say that a love platform is ridiculous and naive, I ask them to compare the results of the $300 billion we've spent on war in Iraq with what we would get if we had spent that money on setting up health clinics all over the world and feeding people who are hungry. I travel around the world and meet lots of people who fear and hate us. If we spent our energy and resources uplifting people in need - spreading laughter and light instead of bombs and bullets - we'd live in a world that was happier, healthier and safer."