A man goes to a doctor—that’s how the story always begins. “Doctor, I’m depressed,” the man says; life is harsh, unforgiving, cruel. The doctor lights up. The treatment, after all, is simple. “The great clown Pagliacci is in town tonight,” the doctor says, “Go and see him! That should sort you out.” The man bursts into tears. “But doctor,” he says, “I am Pagliacci.”

This is the foundation of the most riffable joke on the internet. In July and August alone, numerouspeoplewentviral spinning the sorrows of Pagliacci, from questioning the doctor’s medical credentials to flipping the scenario on its head. How, exactly, did the great clown Pagliacci become Twitter’s favorite joke? It all started in the 1800s, but it began in earnest in 2014.

The story of the sad clown and the doctor is decades old. Exactly how many decades is hard to say. In 1876, essayist Ralph Waldo Emerson published “The Comic,” a story that ended with an entertainer named Carlini. In 2012, BBC magazine History Extra noted that numerous real clowns have been referenced in the punch line, one of them the Swiss entertainer Grock, born in 1880. In 1905, the Mexican poet Juan de Dios Peza recorded his poem “Reir Llorando” (“To Laugh While Crying”), which features a clown named Garrick in the gag.

But before Pagliacci, it was the English clown Joseph Grimaldi who most often starred in the story. He rose to prominence in the early 1800s, and throughout the 19th and 20th centuries the tale often ended with the words, “But doctor, I am Grimaldi.” In 1892, the tragicomic clown opera Pagliacci premiered, and “Pagliacci”—the Italian word for clowns—earned its place in the cultural shorthand. Almost a hundred years later, Pagliacci was cemented as the man who visited the doctor.

“Good joke. Everybody laugh. Roll on snare drum. Curtains,” is how the gag ends in DC Comics’ 1986 graphic novel Watchmen, written by Alan Moore. In the superhero satire, antihero Rorschach tells the sad clown story with Pagliacci as the punch line; 2009’s Watchmenmovie echoed the joke.

For a good five years from Twitter’s inception in 2006, most Pagliacci references on the site were earnest reposts of the Watchmen quote. In November 2011, comic book artist Eric Colossal was one of the first Twitter users to riff off the story. “But doctor,” Colossal’s punch line began, “I don’t think you understand depression.” He got 29 retweets.

Colossal first heard the Pagliacci story while studying at the School of Visual Arts in 2000—one of his teachers handed out a bunch of Watchmen photocopies to the class. “I was a little dumb 20-year-old who thought Rorschach was so cool and edgy,” says Colossal, a now-41-year-old who lives in New York. Years later, he enjoyed the opportunity to “subvert that edginess.” But Colossal can’t remember exactly why he joked about Pagliacci in 2011—though he notes that mental health discussion was starting to take off online at the time.

“My partner started talking a lot more about her mental health, and I was just becoming aware that my friends and myself had these things that were unspoken,” Colossal says. Thinking about that, and the fact that “this was clearly a bad doctor” inspired his gag.

Colossal says that a decade ago he tweeted for his friends in comics. Even though Pagliacci references weren’t as popular as they are today, he could be sure at least some of his followers would get the joke. Gregory Erskine, a 43-year-old stay-at-home-dad from Kentucky, subverted the story in a November 2012 tweet, with the patient ending the exchange, “PAGLIACCI? HA HA, BITCHIN, I LOVE THAT GUY.” He was amused by the idea that the doctor’s advice was effective, and similarly assumed at least one of his followers would get the reference (he got 22 retweets).

“I suppose it’s interesting that because the original joke is this kind of hollow, lonely sigh of atomized nihilism, any riffs tend to be subversions of that,” Erksine says, “They’re either cheery or vicious or goofy or something else that suggests that we are all, in fact, far less isolated than the original joke implies.” Erskine says that today, Pagliacci is “just hanging out there in the collective consciousness, like apples.”

But how exactly did Pagliacci references become common, garden-variety apples? Everything changed in August 2014, when comedian Robin Williams died by suicide. Numerous entertainers—from actor Patton Oswalt to author Patrick Rothfuss to podcaster Jason Snell—tweeted the Pagliacci story in response to his passing. Google searches for “doctor Pagliacci” spiked dramatically.

Meanwhile, a millennial UX designer from Canada created a desktop wallpaper featuring Robin Williams and the Watchmen quote—it received 2,200 upvotes on Reddit. “Robin Williams dying by suicide really rocked me,” says the designer, who asked to remain anonymous for privacy reasons. He felt the Pagliacci comparison was apt, “because the parallels were just so strong. He was such a joy, and brought such happiness to so many people. He probably helped many through their own depression or struggles, and yet he was not able to overcome his own.”

Pagliacci entered the cultural consciousness in an unprecedented way, and in the following years, riffs on the story becameincreasinglypopular on Twitter, a site unashamedly allergic to earnestness. In January 2020, animated comedy BoJack Horseman featured its own version of the joke.

“For virality, you need a social media post or a meme that triggers emotions,” says Anastasia Denisova, a journalism lecturer at the University of Westminster and author of Internet Memes and Society. “Not any kind of emotions, but one of the specific three: awe, anger, and anxiety.” Denisova argues that Pagliacci gags inspire both awe (“from a clever joke”) and anxiety (“it reminds us of the existentialist crises people may face”).

But why is Pagliacci so popular on Twitter in particular and almost entirely absent from, say, TikTok? Denisova argues that TikTok is faster, and Pagliacci gags require more time to unfold. “It is also postmodernist, which may be a bit darker or deeper than your average popular TikTok post,” she says. “The meme serves as a postmodernist remix of so many topics—clown culture, self-reflection, mental health, stand-up comedy.”

I wonder whether Pagliacci thrives because the name itself seems highbrow; would the story spread if the clown was still called “Grock”? The word Pagliacci elicits the thrill of an inside joke—people favorite and retweet as a way of saying “I get that!” Equally, I suspect that a number of people on Twitter might see themselves as sad clowns.

“I think we all tend to wear the clown mask sometimes, pretending to be OK while deep down, we are not,” says Sander van Dijck, a 31-year-old DJ from LA who performs as San Holo. In 2021, van Dijck released his song The Great Clown Pagliacci, which was sampled from Closing Time by musician Mr Hudson. “I never found the Pagliacci joke to be a ‘funny meme,’ I actually thought it was very relatable as an artist performing for thousands of people every night. When I first heard it, it actually touched me deeply, emotionally.”

Pagliacci’s popularity also can’t be divorced from the state of modern mental health care. “I started thinking about the doctor in the joke, and how he reminded me of all the mediocre, generally unhelpful therapists I’ve had over the years,” says Isaac Schankler, a 43-year-old professor of music from California. In August, Schankler received almost 20,000 likes on a tweet in which a depressed man goes to see Pagliacci to cheer up. “Oh well I’m just a silly clown. Shouldn’t you go see a real doctor?” Pagliacci asks. The man bursts into tears. “But Pagliacci—.”

“I think everyone’s in a kind of ongoing mental health crisis right now, and the joke format speaks to the inadequate tools and resources we have to address that crisis,” Schankler says, “It’s a timeless joke, but it feels especially relevant right now.”

Alec Robbins, a 32-year-old comic artist from LA, also recently posted a popular Pagliacci joke: “PATIENT: ‘Hi, doctor. I’m Pagliacci the clown!’ DOCTOR: ‘Well, fuck. Now I don’t know what the fuck to do.’” (4,000 likes.)

“I feel like any good joke can be viewed like a game with its own rules and parameters to work within,” Robbins says. He compares the Pagliacci story to the allegory of God’s footprints in the sand because people are familiar with the twist ending, meaning tweeters can twist the twist. “It’s basically just an approach that’s undercutting all the suspense and trickery in the original joke,” he says of his tweet, “It’s a 100-mph version of a 10-mph joke.”

No one I spoke with thinks Pagliacci gags will die out anytime soon. Although he can’t say exactly why, Colossal doesn’t see the joke being co-opted by big brands, which is normally the kiss of death for a meme. For hundreds of years, the story of the sad clown has alternately troubled and amused us as we cyclically share it earnestly or mockingly. For the foreseeable future, a man will keep going to the doctor. The doctor will know just the cure.