Jacki Kwan, licensed clinical social worker, master practitioner of neuro-linguistic programming, registered laugh leader with the World Laughter Tour and therapeutic clown, uses her first book, Almost Home, to give a first-person account of her life's journey with humor. She describes her small stature, "giggly" personality and many failed attempts to fit into a regimented religious school climate and a home life centered on two serious, high-achieving parents. Father was a plastic surgeon, and mother was a lawyer for the U.S. House judiciary committee during the civil rights movement of the 1960s.

Kwan felt isolated, anxious and depressed during much of her early developmental years. Later, she complied with parental expectations by going into a college pre-med program but gave it up for mundane medical lab jobs, then turned to social work and later became a private psychotherapist. Finally, through a series of fortuitous mailings and events, she met Patch Adams, MD, at an airport, along with more than forty other professional clowns-in-training. She joined the clown-training expedition to China, which launched her career as a therapeutic clown and humor advocate.

The author discovers special working relationships and joyful refuge volunteering, training, and working in hospitals and Hebrew nursing home settings as a therapeutic clown. She deepens her experiences with varied expressions of humor and comes to appreciate the unique positive effects of laughter on children, staff, severely ill and dying seniors (e.g., dementia, Alzheimer's, cancer) as well as for herself.

The author defines positive humor broadly as a "positive state of mind" which may range from staying in the present with someone by mirroring their behavior to mirthful, childlike laughter. She asserts that connecting and sharing with others can offer hope physically and spiritually -- by staying in sync with someone, breathing, singing, smiling, and giggling rhythmically with them when they experience difficulties speaking and verbalizing feelings coherently.

Kwan recalls a number of transitions on her way to becoming the outrageously costumed, painted and caring clown, "Elfina" ("the-elf-in-ya") and the evolution of "Ha!-Ha! Logy" with planned Laughter Club meetings. The author finds insights, shares experiences, and friendships that aid in the creation of an original therapeutic program for healthcare settings with the seasoned mentoring of fellow clowns and the reactions of patients who follow comedian Victor Borge's dictum, "Laughter is the shortest distance between two people." These humorous, touching, relational and emotional experiences represent what the author describes in various subjective terms as "going home."

Almost Home touches symbolically a number of universal human themes and emotional meanings associated with birth, life, death, rebirth, love, struggle, pathos, hope and salvation often reflected in professional social work values. These cherished values in social-psychological terms underscore the human need for mutual security, respect, recognition, dignity, belonging, sharing, humility and humor while one grows and establishes a stable identity. A healthy personality can enjoy laughter and have fun on purpose within many varied roles and, at times, for serious, face-to-face, communicative, health, and healing functions.

In spiritual terms, the author's beliefs suggest an even larger connected social order and a more serene afterlife greater than one's self. Kwan captures in humor the "ah" of wonder and the "ha" in laughter which can be communicated to motivate, empower and heal us and others along life's bumpy lanes.

Appendix B outlines the original proposal with budget and itemized costs which Kwan's hospital administration accepted to establish a Division of HA!HA!LOGY as an adjunct to medical treatment and nursing care. The goal was to reduce stress and increase resistance to disease processes (e.g. neuroendocrine and immune functions). The humor program generated goals, laughter activities, shared creative humor resources for patients, staff, visitors ("Customer Elations"),and health providers. The Appendix provides an excellent list of web sites, books, resources and organizations devoted to positive humor services and the need for more laughter in healthcare systems.