Ruth was normally dour and dismal about the world and her place in it. She got particularly testy when considering politics and the wayward ways of the government. That's why she decided to be a clown.
Laughter feeds laughter and it made her feel lighter of heart when she saw the smiles she coaxed out of kids just by forgetting the world. And her place in it.
Besides, Mr. Ostermeyer at the hospital paid her some extra on the side.