The aim of the present study was to gain a deeper understanding of the work of some hospital clowns with ailing children. What distinctive features and working methods can be seen in the hospitals clowns' work? The approach taken involved an interview study with 13 hospital clowns, 10 women, and 3 men, between 30 and 60 years of age. The study was qualitative in design and took a hermeneutic approach. The analysis of data included descriptive and theoretical analyses. The descriptive analysis showed that the clowns' strategy of working in pairs enables them to treat the child with empathy and to acknowledge the child in a sensitive manner. The theoretical analysis of hospital clowns' method of working in pairs indicated: (a) a relational pattern, characterized by empathic preparedness: to capture and shelter the current affect climate, to express various child and adult positions, as well as to cognitively process and return, if appropriate, a humoristic message in a "digestible, humoristic form" and (b) a communication pattern, characterized by balanced synchronization of body language and verbal expressions, in terms of pace as well as conformability, which in optimal cases gives rise to an enhanced feeling of presence and mutuality in the communication process between the hospital clowns and the child. The humoristic communication between the hospital clowns and the child worked to create an open space for play-a space in which all affects were allowed. The discussion concerned possible forms of this working method (working in pairs) that function optimally with regard to relational and communication patterns. The discussion also addressed the psychological value of hospital clowns' work with ailing children, as seen from the perspective of the hospital clowns.