In a current movie, a brilliant medical student moves through his training thumbing his nose at the establishment, spreading laughter and hope among the medical staff and patients. From the roiling confusion of mental illness, he experiences an epiphany of his life and purpose, and begins forming ideas about how to make a difference. He does medical school his way, including joy and laughter and high creativity in his daily rounds. At graduation, he accepts his diploma with great dignity, then turns his mooning naked backside to the audience.

As of Feb. 8, this movie, Patch Adams, has been in wide release for seven weeks. It still ranks number two in weekly box office earnings. It is a wildly successful hit, with many fans viewing it repeatedly. Already, it ranks as the ninth biggest box office draw for the entire 1998 movie season (at $109 million gross), despite the fact it has not yet been released in overseas markets or into video. When these latter two events occur, the film Patch Adams could well finish in the top three or four movies for 1998.

At the same time, the critical reviews across the country have, with a few exceptions, been remarkably negative. Critics carp that the movie shamelessly plays for laughter and tears, that Robin Williams has played one too many schmaltzy roles or once too often as a doctor, or that the plot is too weak or the love interest too cool, etc., etc. There’s a grumbling, grudging quality to all these reviews. In addition, besides the press coverage of Patch’s ideas and philosophies, the media has enjoyed reporting negatively on the real Patch Adams, as told through the dark mirror of a disgruntled ex-wife, or various other individuals who have played very peripheral roles in Patch’s story and life.

What is this all about? How can one man and his most unconventional life and philosophy engender so much polarity? People and the press either love him or hate him. They either embrace and delight in his revolutionary ideas, or revile and ridicule them.

Whenever an individual or a set of ideas and actions creates such a vocal and varied reaction, it’s a sure bet there’s some deep, common river of pain or joy or discontent or universal principle that’s been stimulated. So what might be some of these currents and eddies of the American psyche as we near the end of a millennium? What are some of the exposed cultural nerves Patch manages to stimulate? What is the meaning of a Patch Adams in America, at this time in our cultural history?

One story that resonates in most of the psyches of the world is the idea of the little man who successfully defeats the giant (David and Goliath, Jack and the Beanstalk, etc.). Patch’s story fits this mold, as this one individual challenges the behemoth of accepted wisdom and behavior in Western medicine and in the austere halls of academia. Again and again the movie illustrates the nearly hopeless odds for him to even finish his training, as those who hold the power in his medical school frown and attempt to squash this irritating bug in their sea of status quo.

In all of our lives, there is that giant we must defeat. The movie audience can, at a conscious or unconscious level, take inspiration from Patch’s story, and can remember the enormous possibility of success is always present for us. Every culture needs an illustration of this story, at regular intervals. It needs a living, flesh-and-blood example of David fighting Goliath, and Patch beautifully fills that job description.

Closely related to this is the movie’s illustration of fearlessness in the face of huge opposition. All individuals in every culture struggle from time to time with their personal demons and insecurities, especially when challenged by the authority figures in their lives. The successful navigation through those dark and choppy waters of fear is an essential ingredient for personal growth and individuation on the often murky paths of life. Every myth, every hero’s journey, offers the challenge of recognizing, honoring and overcoming fear in order to reach the goal. Patch’s story and life illustrate this process, and, as he reaches some of his goals, helps us grasp once again the rewards to be gained from saying “Yes” in the face of fearful odds.

And Patch Adams reminds us that for a culture and for the species to move forward, we must buck the status quo, we must constantly challenge the authorities, whose very jobs and positions are often completely dependent on their maintaining and defending the current accepted wisdom. If this were not true, the earth would still be flat, doctors would be treating serious illness with bloodletting, and no common person would ever be allowed to read the Bible or any other document. In our deepest knowing, we grasp this need, and we cheer wildly for those whose lives light the path of constructive change.

Another absolutely universal human condition is the tendency to feel weak at times. Patch Adams illustrates beautifully how such weakness can often be the firmest foundation for strength, if transmuted in the cauldron of humor and understanding. So Patch, in his youth, suffered suicidal thoughts and depression, and checked himself into a mental institution. And from this most vulnerable position, from this utter defeat by a harsh world, an epiphany arises through the vehicles of a large humanity and an unrelenting sense of humor and the ridiculous. And so Patch’s roommate teaches and illustrates, from the far fringes of schizophrenia. And from this teaching and position of weakness, Patch, with new eyes, envisions ways he can be in service to the ideals of laughter and fun in life and in health care. And we all can understand anew how it’s possible to use our own weakness as a platform for growth and strength.

Patch also illuminates for us the concept of daring to be different—the idea of following our own passion, however counter it might be to the current norms of ideas or behavior. Joseph Campbell spoke of this eloquently, coining the phrase “Follow your Bliss.”

Patch’s story, and all the myths of the various cultures of the world, resonate with the message that it is the individual with the courage to follow a vision, no matter how odd, or difficult, or dangerous, who will change paradigms and find personal and cultural success and satisfaction.

Patch, named some years ago as one of the world’s 25 most eccentric individuals, set his course on a path of vision surrounding the ideas of health care, community, and creativity and laughter. Among his strange new ideas has been the concept of a free hospital, where all the health-care workers would work for free, and share a common philosophy of community, laughter and creativity in a place of healing. In a funny, eloquent, off-beat way, Patch has traveled the world for 20 years with this message, clowning his way through boardrooms and hospital wards, relentlessly addressing hundreds of thousands of individuals, and seeking financial support for the actual building of the Gesundheit hospital.

This financial support has been slow in coming, and the project has been on shaky ground at times. Even so, before the movie came out, Gesundheit had acquired hundreds of acres of Blue Ridge mountain land in West Virginia, and built two preliminary buildings.

But Patch never wavered in following the passion of his vision. While discouraged at times, he never once strayed from following his own bliss. And so a movie was made of his unusual story.

Now, his workshops and lectures are exactly the same as before the movie. He still speaks hard words about the societal problems surrounding lack of community and health-care delivery system problems. He still clowns brilliantly, and never ceases to delight.

But the hundredth monkey has happened. Thanks to the power of a movie and of celebrity, pockets and purses are opening, and the money is beginning to arrive for the realization of his dream. Gesundheit, the hospital, is close to becoming reality, and 20 years of shouting into the wilderness is about to produce the richest of fruit. One man, following his passion, is making a difference, and, by his example, we all understand the same is possible for each of us.

Rarely can one movie or one story illustrate so many universal principles, or touch so many common chords in a thirsty audience. There are many additional riches present in the story and life of Patch Adams.

The Trickster and Fool
In mythology, the Trickster figure, through playing pranks and acting the fool, transforms aspects of the world for the benefit of humankind. Patch, whose personal recipe for health care delivery includes a whopping dose of laughter and goofiness, is a skilled and internationally sought after clown, juggler and rope walker—one who thinks nothing of frolicking in a bathtub filled with oiled noodles. Patch is surely this Trickster for all of us, and, as such, goads us into whatever transformation is needed to be living more fully and in more connection with each other.

But Patch is also clearly The Fool. As those who understand the tarot deck know, this archetype, The Fool, is the most necessary in the whole tarot journey. Without the innocent idiot, the distracted and happy one who steps gaily off the cliff, the journey of transformation cannot even begin. Patch steps off that cliff, over and over again, in very public ways, and with a childish delight that causes us all to understand the transformative possibility inherent in taking the big risks of beginning journeys.

For instance, nearly everyone asks if Patch really mooned at his medical school graduation. He is circumspect, and never directly answers that question. Instead, he always says he has mooned often, and recently. I know this is true, because at a large gathering (more than 1,000 people) on the East Coast in February, Patch not only mooned while on stage, he persuaded all those in the audience who secretly dreamed of mooning to get up on the stage for a large group mooning. I don’t know if you can picture all those business suits and dresses hiked up or dropped down, and all those bright shining butts, but you can be sure this was a transformative experience.

And while Patch would not pretend he has not suffered the same dark times and quagmires we all experience, he does live as a constant expression of relentless joy. Besides, “It’s a huge secret,” he says, “but following a dream is invigorating. If you sink your passion into something, your life will explode into breathtaking vistas.” And so, even in the darkest of times, Patch knows there can and must be joy, and that breathtaking vistas always draw a person on down that path lit by relentless joy.

Dedicated to service
So Patch moves in his unpredictable way, as the Fool and the Trickster, traversing the planet as an Ambassador of the Possible, illustrating and demonstrating the unlimited power of creativity. One of the possibilities he constantly represents is what can happen when individuals and societies and governments dedicate themselves to the idea of Service. There are dozens and dozens of stories of individuals all over the world who, inspired by Patch’s message, created something new to provide needed care and service to others.

One of the most remarkable is that of Maria Eliseeva, a Moscow mother of four, whose dream was to somehow help orphans. With some input both financially and philosophically from Patch, she began to do just that, and now runs a thriving and paradigm-shifting project that has the attention of all Russia. She teaches the orphans to tap their previously unknown powers of creativity and make spectacular folk art murals of brilliant color and life—and they sell all over the world. In this way, the children understand, usually for the first time, the possibility hidden in their grim lives, and their own enormous self-worth. And she models Service for them, so the ripple effect from Patch moves ever wider in the world.

Through the sale of artwork, Maria’s orphans now financially help support another orphanage, which cares for children with cystic fibrosis. These orphaned children, brutalized and devoid of any possessions themselves, are joyfully in service to others. And of course they also clown in hospitals, other orphanages and nursing homes.

American health care
Another very big nerve the movie jolts is the vast American dissatisfaction with their health care delivery system. We have all witnessed the steady deterioration of the physician and patient connection, with the resulting depersonalization and businessification of the healing arts. We are all frustrated by bait-and-switch insurance sales, lack of continuity of care, hard-hearted runarounds about coverage in the midst of illness, and an endless assortment of other difficulties. Patients and health care workers alike are discouraged. Hospitals have become buildings filled with depressed workers and angry consumers.

In the midst of this, Patch, as Ambassador of the Possible, offers one alternative for health care delivery—an alternative that includes free medical care provided by a cadre of volunteer health care workers in a milieu of silliness and laughter and high creativity.

Patch takes very seriously the solid research and knowing that humor and laughter heals, and he feels the hospital environment must nurture these activities to provide the most efficient healing. He sees no reason why a sick person shouldn’t have fun while recovering. What could be more healing than a hospital filled with health care workers who love being there and who live as an expression of laughter and joy?

So while this idea has been roundly dismissed as crackpot for the last 18 years, the movie has now provided the impetus for its fruition. Hopefully, the actual hospital can soon begin construction. The idea of one man, holding to a strange, paradigm-busting vision, and actually causing wheels to turn in the direction of the millions of dollars needed to build a hospital—well, that’s just plain inspiring.

And while the mainstream media has had its fun with Patch-bashing, the editorial pages everywhere have had other opinions. For instance, The Kansas City Star published an essay by the chairman of the central governing board of Children’s Mercy Hospital in which he illustrated the many ways in which the spirit of Patch’s ideas is alive and walking the halls of that hospital. And the CEO of Children’s Hospitals and Clinics in Minneapolis and St. Paul also wrote a Guest Commentary for some of Minnesota’s papers along the same line, comparing Patch’s ideas to the family-centered care philosophy at work in his hospitals.

And finally, Patch reminds us all about our need for community. While we might not all choose to live in a commune or wear outrageous clothes or participate in snot-blowing contests, most of us do need other humans to complete the palate of human experience, and to be our safety net in times of need.

And so Patch, a very human man and a generous humanitarian, skips and shuffles and farts and belches and sings and poetically recites his way around the planet, sprinkling a generous dose of transformative fairy dust wherever he goes. And in his wake, the huge possibilities of Service and Joy sprout and fly and green the lives of countless individuals everywhere. And the planet smiles.

Patch Adams and the Gesundheit! Institute welcomes help and donations of every kind. For more info, see the web site at www.patchadams.org, or write the Gesundheit! Institute, Hospital Foundation, P.O. Box 98072, Washington, D.C. 20090-8072, or phone (877) SILLY-DR.

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Jan Thatcher Adams, M.D., has been in active Family Practice at Sundance Clinic in Shakopee for 20 years. In addition, she is Clinical Professor in the Department of Family Practice, University of Minnesota Medical School.

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