Dr. Pedro Nunes, former President of the Order of Portuguese Physicians in his speech on the 23rd of February 2005, in official recognition of the merit of the work of the doctor clowns of Operação Nariz Vermelho in the Portuguese public hospitals, said, “… medicine, after everything else, is summed up in... COMMUNICATION.” Clown doctors use serious play in surgery wards to create a fun atmosphere which helps improve work attitudes, actions, and relationships. Every surgery is an encounter, a new story. Using one’s head, heart, and hands, Open Heart Surgery builds a bridge between reality, where real things take place, and fantasy, where fun-tastic things can take place. Both are necessary!