Stop me if you’ve heard this one before, but a doctor walks into a bar…
I sat at the bar, feeling nervous and tingling with anticipation. Stand-up comedy was still a new venture for me, but I was eager to dive in. I'd quickly discovered that making people laugh offered a sense of tranquility amid the chaos of my oncology work. Somehow, doing something that was both adventurous and silly gave me a feeling of Zen. The first chuckle or applause from the audience was like a balm for the butterflies in my stomach, filling me with pride and satisfaction until my next performance. That sense of pride and satisfaction would last for weeks upon weeks and provide me with a pleasing memory to think of during tough moments. Amid the stresses of my profession, finding joy in this hobby became crucial. I learned that night that I wasn’t the only one in the bar who needed to feel that same sense of Zen, pride, and satisfaction.
As I mentally rehearsed my routine, a fellow comic asked about my day job. I thought about lying or coming up with something off the wall, but I answered “cancer doctor.” His response, "I really need to quit smoking or I'll make you rich," elicited laughter from the crowd. Behind me, a woman likely in her early 50s with a warm smile and with a boisterous laugh tapped my shoulder. I turned to her and she asked if I was being honest with my answer. I nodded. She smiled and seemed to relish that fact. What followed was a moment I'd never forget. She declared, "My bones may ache, and my vagina may be dry, but dang it, I'm here!" Shocked silence gave way to conversation. She revealed her battle with advanced breast cancer. She told me details of her therapy and how it was impacting her. The aromatase inhibitor had caused her substantial body pain and she was considering stopping her therapy completely. As we spoke, it became apparent that her motivations for being there were similar to mine: seeking moments of Zen in life's chaos. Remarkably, we shared a bond in finding solace through comedy, both seeking respite from our respective struggles.
Her next words lingered with me and helped shape some of my future patient interactions. "I'm tired of people asking if this is on my bucket list. I'm not checking off experiences before I die; I'm simply trying to live." It struck a chord. Much of my day is built around discussions of progression free survival or overall survival rates. But sometimes being able to almost quote clinical trials off the top of my head is insufficient in taking care of the patients. Sometimes, I need to remind myself that battling cancer is only one of my goals. Helping people is the other. Helping patients live fully in the present may be as important as anything else I can offer to my patients. It became a mantra in my consultations: "Let's focus on making your life the best it can be now. We can find ways to tailor your therapy around your goals."
In the field of oncology, we've been fortunate to witness a surge of innovations in recent years. Many cancers once considered untreatable are now entering sustained remission. I often express optimism that our shift from cytotoxic chemotherapies to immune-based and targeted therapies might position our generation as the one that ultimately conquers most cancers. However, we still have a long journey ahead. Regrettably, many of our treatments require indefinite treatment lengths and come with significant toxicities. Even therapies with supposedly "manageable" side effects, like aromatase inhibitors, can profoundly impact our patients' lives. It's a daily reminder for us to focus on the person as a whole.
Encounters like the one with this vibrant, laughter-filled woman serve as poignant reminders of the individuals we strive to care for. Amid thousands of patient interactions, this particular one stood out. Who would have guessed that one of the most profound moments of connection would arise in the midst of stand-up comedy?
How do you bring levity into patient interactions? Share in the comments.
Dr. Landau is the medical director of hematology telehealth for the Medical University of South Carolina. He has served many roles throughout his career at different organizations including Chief and interim Chair.
Illustration by Jennifer Bogartz
