Oncologist, former comedian: Sharing ‘individuality’ with patients builds connection, trust
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Editor’s note: This is the third in a series of five stories from ASCO Voices, a session during ASCO Annual Meeting that focused on the human side of oncology.
CHICAGO — Of the thousands of cartoons to grace the pages of The New Yorker, Stuart Bloom, MD, has a clear favorite.
The image shows a clown on the phone posing the question: “What’s the next best medicine?”
Bloom — a former comedian and actor who became an oncologist after his father was diagnosed with stomach cancer — is well aware of the value of laughter, even in oncology. Yet, he generally declines invitations to participate in talks on humor in medicine.
“Have you ever been to one of these humor in medicine talks? They’re earnest, they’re sincere, and they’re absolutely the most unfunny thing anyone could experience,” Bloom said during his ASCO Voices presentation at this year’s ASCO Annual Meeting. “There are always pictures of clowns and clips from the Robin Williams movie Patch Adams. Clowns have always scared me.”
Bloom is not scared, however, to share a bit of his personality with his patients. This often means sharing moments of laughter with them.
“Albert Schweitzer said that medicine is not just a science, it’s the art of letting our own individuality interact with the individuality of the patient,” Bloom said. “Humor is an integral part of who I am, and I use it as a means to care for another human being.”
‘I keep my heart open’
Bloom spent 20 years in community oncology practice before joining University of Minnesota’s division of hematology, oncology and transplantation in 2021.
He also wrote and stars in the musical How to Avoid Burnout in 73 Minutes, which has had multiple sold-out runs in theaters around the Twin Cities.
Bloom’s colleagues in the oncology clinic often ask him what the laughter coming from his examination room is about.
“The weird truth is, I can never remember,” he said. “I don’t mine a patient’s experiences for material. I keep my heart open and I listen, often without solving. We usually bump up against something to chuckle about.”
Bloom is careful how he deploys humor in a patient care setting.
He enjoys being self-deprecating when he isn’t working, but he tends to avoid self-mockery in clinic. Although such jokes might be entertaining in the moment, they may not always inspire patient confidence in an oncologist.
“You don’t want to come off like a total goof to someone who is putting their life in your hands,” he said.
Likewise, Bloom said he would never make a joke at a patient’s expense. The closest he came was when a patient reported having a headache upon standing.
“I quickly replied, ‘Well, how low is your ceiling?’ It was a reflex,” Bloom said. “It did precipitate laughter, but then we drilled down, found the cause and moved on, because the point is not to be entertaining. In my experience, though, humor leads to connection, and that’s where the care takes place.”
Building connection and trust
Bloom shared the story of a 30-year-old patient who had metastatic breast cancer.
After it became clear further treatment would not provide benefit, Bloom went to the patient’s home to visit.
Hospice had been set up in the apartment, where the patient lived with what Bloom described as “three sloppy young men.”
Strict protocols were in place as far as neatness and cleanliness, and the patient’s father explained these rules — including the requirement that visitors remove their shoes — to Bloom as he entered the home.
Bloom did as he was asked, got down on his knees next to the bed and covered is patient’s hand in his own.
Bloom’s greeting was met by a flickering of the patient’s closed eyelids. He told her he had removed his shoes as instructed, and the patient gave a barely perceptible nod.
“Then I said, ‘I did keep my pants on,’ and the corners of her mouth turned up in a smile,” Bloom said.
Having made this connection through laughter, Bloom went on to tell the patient what he really wanted to say: It had been an amazing privilege to be her doctor, he was grateful to have gotten to know her, and he would never forget her.
He then sat in silence with the patient, continuing to hold her hand for a few more minutes.
“Then I got up, went to the door, put my shoes on, got out to my car and had a good cry,” Bloom said.
When oncologists give patients a glimpse of their own humanity and individuality, it makes for a more meaningful connection, Bloom said. It’s a bond neither the patient nor the clinician will soon forget.
“It doesn’t have to be through humor, unless that’s who you are,” Bloom said. “I always tell our fellows and our doctors in training that it is OK for them to share something of themselves with the patients — their personalities, their passions, their interests — because that engenders connection and trust.”
For more information:
Stuart Bloom, MD can be reached at afield@umn.edu.
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Bloom S. Why I don’t give talks on humor in medicine. Presented at: ASCO Annual Meeting; May 31-June 4, 2024; Chicago.
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