Laughter is her best medicine

But to Tic Toc the clown, the bleak weather is just another excuse to have fun. “Look! It’s raining!’’ the clown exclaims in a congested trill, gesturing toward the water-spattered window. Another clown joins in, opening a giant color-paneled umbrella. Tic Toc hops underneath and cues “Somewhere Over the Rainbow.’’ As the clowns sing, they twirl the umbrella until it turns into a prism, casting a rainbow of colored light about the room and across the boy’s now smiling face.

“When a child has been put into a hospital situation or an institution, and they are in pain, fun is one of the things that falls away, and so is choice. So to be able to go in and touch on that, even for a few moments, it’s just what I’m good at,’’ says Cheryl Lekousi, who, as Tic Toc, has been part of the Needham-based Hearts and Noses Hospital Clown Troupe for 12 years.

Lekousi’s steadfast optimism and intuitive connection with children led Hearts and Noses founder Jeannie Lindheim to ask her to take over the troupe in 2005 as executive and artistic director. “She really understands how to empower the kids. She understands what hospital clowning is all about,’’ Lindheim says.

Lindheim founded Hearts and Noses in 1997 after training with famed hospital clown Patch Adams in Russia. The nonprofit troupe, now consisting of 18 clowns, operates with a mission of empowering children, providing them with the control and choice that their illnesses have taken away. Lekousi’s office acts as the hub for communicating with hospitals and other venues, as well as scheduling clown visits and training workshops.

While Tic Toc favors bright, frilly layers and thick-soled black patent-leather Mary Janes, Lekousi likes jeans and T-shirts - casual staples that can survive the daily onslaught of spit and spit-up at the day-care center, Tiny Hearts Playgroup, that she has run out of her Needham home for 25 years.

Tic Toc weaves ringlets of gift-wrap ribbon through her short auburn hair, pencils on a smattering of freckles across her cheeks and perches a tiny, glossy red orb on the tip of her nose. Lekousi, 51, wears very little makeup, and follows one of Audrey Hepburn’s famous beauty tips: “For beautiful hair, let a child run his or her fingers through it once a day.’’

Lekousi’s decision to become a hospital clown was a natural extension of her knack for understanding children. When one of her day-care mothers, also a clown with Hearts and Noses, approached her about joining, she was immediately interested.

Clowning “kind of augmented these aspects of her personality that were already there. It is a very natural fit for her to be doing this sort of thing,’’ says her husband, Steven, a biochemist at Mass. General Hospital.

Her late father, Irv Weiner, was a popular Boston-based magician known as Mr. Fingers who performed as a clown at Children’s Hospital Boston in the 1950s and ’60s, and Lekousi often tagged along. She keeps one of his magician cartoons hanging in her day-care room, and its message - “Have a day you can be proud of, do something good for someone’’ - was always important to her father and her family, even during times of struggle and chaos, she says.

Lekousi’s older sister died of a throat infection before she reached her fifth birthday. Lekousi was born two years later. “I am kind of the replacement kid,’’ she says.

The tragedy drove her father to drink and her mother to close in on herself, she says. But the family was able to right itself after her father entered a program for alcoholics. Lekousi was 13.

“When he got help, the whole family got help. And I learned that something that feels completely hopeless isn’t. And that message feels so wonderful.’’

Lekousi has two children from a previous marriage. Her 22-year-old son, Charlie, attends Westfield State College, and 26-year-old daughter Sarah works as a teacher at the New York Center for Autism.

When she’s not clowning or running her playgroup, Lekousi watches “I Love Lucy,’’ sews, or walks through Needham with her husband. She is an avid baker - she decorated her own wedding cake and specializes in “the best baklava a Jewish girl ever made.’’

“What else do I like to do?’’ Lekousi calls out to Sarah. She is speaking over the phone from New York, where she is helping Sarah move into a new apartment.

“Everything for everybody else!’’ Sarah yells back.

Lekousi says her husband “works with doctors and scientists, and they are wonderful people and I get along with them, but it’s not what I am good at. It is not the world I am good in.

“I am really good at getting down on the floor, seeing a child, accepting them where they are, understanding where they are and developmentally what they can do, what scares them, what doesn’t scare them, and playing with them.’’

Back at the Franciscan Hospital, an adolescent girl sits at a nurse’s station inside a large plastic wagon lined with sheets and pillows. She’s wearing a pink patterned dress and a striped straw sun hat. She has severe facial and physical deformities, and she is unable to see.

Tic Toc approaches the girl, and kneels down to meet her at face level. “I want you to be my new friend,’’ the clown says. Tic Toc softly starts to sing “Little Red Wagon,’’ and the girl gently sways her head.