PharmacyU Toronto was an absolute blast! The event was sold out and response was incredible. Many thanks to my friends at EnsembleIQ for the incredible opportunity. That’s me onstage BTW holding my arm in a very dramatic fashion. For the story that goes with this picture please go to PharmacyU !
U of T Med Magazine has done a great edition on humour in medicine. I was honoured to be included. To have a look at the other articles please go to UofTMedmagazine.
I’ve been an improviser for a long time, worked for The Second City in Canada and abroad, and to me there is something almost magical about improv.
When I was recovering from cancer, I noticed that when I went to improv shows, good things happened. I would laugh with friends, and then feel noticeably better for days. I had been in and around improv for years of course, but I wondered if this was having a positive effect on my ability to cope with life after cancer. Improv became a tool for me to deal with my condition.
I started making jokes and shows out of my situation and I was invited by some very generous people to teach workshops at Princess Margaret Cancer Centre for patients, and at the Faculty of Medicine for second-year students.
What could improv possibly do for physicians in training? Picture this: You’re in the centre of a windowless room and all eyes are on you. Sweat glistens on your forehead. You’re part of an intense improvisation game called Zulu, where the participants have to make up names for imaginary products on the spot. There’s no right answer and you can’t study for it. You have to get an idea and blurt it out. In other words, you have to be vulnerable.
I know you hate not having an answer the way my dog hates squirrels. I continue to point at you and wait for a response while 40 colleagues look on. I can see your intense desire to win but I wonder if you have difficulty connecting with people. Unfortunately, this lack of vulnerability reads as arrogance. And, as patients, we know it the instant we feel it.
I had an oncologist who shared this characteristic. He was technically competent but so arrogant and distant that he literally dismissed me from his office because he had a dinner reservation at Centro that evening. He wasn’t a bad physician, he had just forgotten how to be a human being. In that moment I felt a desperate sense of isolation. Later, I realized that the worst part about being sick for me was not feeling pain or discomfort, but experiencing isolation and fear.
That’s how I got the idea to bring improv into medicine: It came from my intense desire to increase the sense of connection between people in health care.
I’ve seen improv comedy in medicine do incredible things. I’ve seen it open up a room of physicians, patients and their care givers so that they can actually talk to each other in a meaningful way. I’ve seen cancer patients in real trouble somehow laugh at their situation and then share resources they didn’t know they had. I’ve watched as med students realize that they can relax a bit with patients; that they can (dare I say it?) be a human being with the people they serve.
Many times the laughter itself is enough to help us. Heck, who can argue with something that has been proven to increase serotonin and dopamine levels? Often though, it’s the good stuff that comes afterwards that has the real payoff. After people laugh, the natural release of oxytocin that occurs helps people bond together in an almost tribal way. They are more prone to trust each other and be generous to each other. What does this mean in medicine? It means that by using improv comedy to sneak by the sometimes brittle facade of our intellects, we find a way to our silliness, our vulnerability and our humanity. It creates a safer space for us to collaborate in a meaningful way.
To simply say that “laughter is the best medicine” is a platitude that floats by too quickly. These simple things called laughter and improv comedy can be the doorway to feeling better. There is profound good here that we can use to great effect and we have just scratched the surface.
That was a real person in my improv class, by the way — a terrified second-year medical student. I stayed silent and the group didn’t even breathe. There was no way out for him but to say something, anything. The question swirled in his brain: “What is the name of a car that should be invented?” He looked at me. I saw the light of an idea flash in his terrified eyes. “The Fartinater!” he cried.
The class roared with laughter. I applauded and declared him the winner. His face lit up like a 10-year old who has just had the best birthday ever. He was connected, with himself and those around him. Any sense of arrogance was demolished in the joy of experiencing a huge laugh from his peers. I saw a crack in the protective facade he presented to the world and I hoped that would translate to his work with patients in the future. ■
When I said this to a participant at The Canadian MPN Network Conference, it got a huge laugh. One of the great aphorisms of comedy is “Its funny ’cause its true!”
In this case, the lady I was speaking to was telling me that as a result of her being sick, she said she felt more empathy for people. She could understand others’ feelings more and she could cut other people more slack. Isn’t that fascinating? You would think that after a tough time, a lot of people would become bitter or resentful.
Often we have a chunk of adversity in our lives and somehow we manage to keep on keeping on, but after getting through the stress and navigating our way through a very difficult time often we are different. You could even say we are transformed. Some of us develop more empathy, others of us (like myself) get unreasonably pissed off for a while and pray that someone will steal candy from a baby on our street so we can start a round of fisticuffs. (After a while this anger calmed down into a state of assertiveness. I am really glad because fisticuffs are inconvenient.)
But what I have found after working with healthcare professionals and people going through life altering diseases is that our most arduous experiences change us.
One of my favourite questions to ask during a keynote is “In the experience of your journey with cancer (or another issue) what learnings or insights have you made?” People always have an answer. Nobody ever says “I feel exactly the same!” I have heard people say they are more sympathetic, more adventurous, more thoughtful, less resentful, more independent, more open to new ideas, more resilient and that they eat more dessert– to name a few.
All of this is good stuff don’t you think? I do. I love all of those things (especially the one about dessert).
So, where does this come from? Well, you may heave heard of a friend of mine called Joseph Campbell. (OK, He’s not my friend, but I like to pretend he is.) He came up with the idea of The Hero’s Journey which in a very tiny nutshell, is the idea that when we go on an adventure and face challenges and adversities that we are transformed and even improved by the experience.
I really think that is what happens to us when we deal with a transformative experience with our health. Our experience changes us, it molds and shapes us until we can look at who we used to be in the past and say “Hey, I’m a better person than I used to be.”
“Even if you are a happy person, I want you to read this book. What Rob Hawke has done is to boil down the best of positive psychology, self-help, and sage advice into a very readable (131 pages of goodness) guide to, as he says “uncovering the hidden benefits of feeling good.”
I just completed my new book “Doing Happiness: Uncovering The Hidden Benefits of Feeling Good” The good news is there are simple things we can do everyday to help us feel true happiness. More than that, I talk about the many tangible benefits our happiness brings to us and those we care about the most.I could use a bit of help.
Would you be willing to read it and write a review on amazon? It would take all of two minutes and it’s really easy.
It sounds like the set up for a joke doesn’t it? But that’s what we had on June 30th. The very first Self Care Movement Summit in Toronto went off like crazy.
People came from far and wide to participate. We had folks drive in from 5 hours away just to be there for the evening.
When you see a large conference room packed tight on a Monday night, you know that there is a real need for this. Folks needed to not only learn about what they are going through and how to deal with their situation, but they also wanted to connect with each other.
Some of the things we addressed were mindfulness, dealing with chronic illness at work, sex, intimacy, and using humour as a tool to help us every day. We had a patient panel that shared stories about what it was like to deal with our different conditions and we even managed to squeeze some laughs out of it.
OK, so we may have tried to cram too much really good content into one evening, but can you blame us? That’s like complaining that a meal has too much food or that somebody gave you too much chocolate or that your birthday present is too big to fit into your car. You get my point.
After working with cancer patients and their families for years, one of the most common things that I have heard is that once we are finished our primary care, we often feel lost. That was certainly how I felt after I got over my initial cancer treatment. My physician even looked at me and said “You’re cured” I was expecting triumphant movie music to come in as we hugged in a manly way, but the hug didn’t happen. Instead I thought “Really? I don’t feel cured. Besides, the cancer might be gone but I have this chronic situation to deal with for the REST OF MY LIFE. So, how is that cured?”
That’s what the summit was for. We were all there to talk about what happens now. How do we adjust to our lives in this “new normal”. How do we not just exist but help ourselves to thrive with the capabilities that we have?
When several hundred committed, smart and passionate people stand up and start sharing ideas, you feel it. You feel the energy shift from complacency and acceptance of the status quo to hopefulness and possibility. On Monday night a group of patients who were strangers just hours before, shared their wisdom and strategies to help people just like them.
So, back to our original question: What do you get when you have 400 people dealing with chronic conditions in one room?
Answer: A huge amount of courage and hope.
Celebrity Fan Moment
Don’t you love when you meet someone famous and they’re more impressive than you thought? I was very excited to meet Margaret Trudeau and I actually got to say hello to her backstage. I am rarely at a loss for words. However, in meeting Margaret, I was virtually tongue tied. When she did her keynote, she spoke with such wit, honesty and vulnerability that I became a fan immediately. The standing ovation she got was proof that she connected with our group.
Many Thanks Margaret!
Hey Patients, Come meet other people just like you and get some terrific resources. I am thrilled to co-host and speak at the Self Care Movement Summit at the MARS Building in Toronto.
THE SELF-CARE MOVEMENT SUMMIT
If you’re a patient, you know about getting through tough times. If we reach out to other people, things get easier.
When I had cancer, I lived alone in a one bedroom apartment and quite frankly I had no idea how hard it was going to be. I thought I was tough enough to handle the challenges on my own. I wasn’t. Not only were the physical symptoms of my disease difficult, but I also suffered from depression and isolation. My story isn’t unique, or even close to the toughest one you’ll hear. Many patients like us stare down dark nights at 3 am and wonder how we’re going to make it to the morning. Being alone makes the journey much tougher. Helping each other makes it easier.
You are invited to the Self Care Movement Summit in Toronto on June 27th at Mars.
If you or someone you love is sick, connecting with other patients can be the difference between languishing alone and feeling completely overwhelmed or tapping into a sense of community and accessing resources to make your journey easier.
The first time I connected with other patients was 3 years after my treatment. I sat in a circle with other folks in recovery and thought “Oh My Gosh! I should have been doing this from day one!” There was such power in meeting people who had similar challenges. People shared ideas and strategies on how to get through a tough day. We all breathed out as we realized that we were not alone in what we were facing.
It has been my honour as a speaker and author to work with groups of patients and their families for years now. Something almost magical happens when patients get together in the same room and support each other. It would be great if you could come to the…
Do you know who’s going to do the keynote? Margaret Trudeau! Really. Impressed? I am. There is also going to be incredible content on wellness, self care and managing chronic illness in the workplace. As well, I will be doing my presentation “Taking The Laughter Pill: Humour and The Patient Journey.”
Oh, Did I mention its FREE? And there are APPETIZERS? (At least there will be until I get there)
The link for the event is here.
All of this content is valuable. Just as important is the opportunity to connect with people who are going through similar challenges and help each other realize that we are all going through this together.
See you there.
Have you ever felt like your concerns are utterly different from anyone else’s?
Sure you have! We all have different circumstances in our lives. For instance, I am wondering… Will the tires last on our car? Will the vacant lot down the street become a giant condo complex and ruin our view? Will Stephen King come to my poker game?
(Ok, maybe I made up the one about the car).
We all think our concerns and problems are completely unique, but are they?
I am currently working on a program for people who are having a really hard time. Now, this group is facing incredible challenges that are very specific. However, I’ve noticed in my years working with different groups that a lot of the things we face can be really similar.
Some few years ago, I thought the challenges facing me as a cancer patient were unique not just to cancer patients but to me. Yup. I thought my story and my bit of hardship was incredibly important and oh so precious. And to a degree it was, as an experience with cancer should not be diminished at all. What I am saying is that if we hang around on the planet long enough, chances are, we’re going to experience some kind of hardship. It’s part of this thing called being human.
Think about the people you are closest to. Do they have their gooey, unresolved human bits? Do they have a challenge in their lives that they find really tough, be it addiction, an emotional issue or just getting through the day in this ridiculously complex world? I’m going to guess that’s a big “YES!“.
You see, it’s really easy to look at the shiny happy people (to quote REM- and why not? They rock.) and think that we are the only ones struggling to get out of bed in the morning, or working really hard to connect with our family, or dealing with a health issue. I was listening to one of my favourite podcasts by Alec Baldwin and he had Paul Simon on as a guest. Alec said he wanted to know what it was like to grow up being Paul Simon. Paul paused for a second and said “Hey, Everything happens to everybody.” I think that sums it up really well. Everything does happen to everybody. Especially over time.
You could say that this statement is trite and patently untrue. In a literal sense you would be correct. You could say to me “Hey Rob, This thing happened to me. It did not happen to you. Do not lessen the importance of my experience.” Point taken. After all, I once barfed in the train station in Hanoi at 5:30 am.
Has that happened to everybody? I sure hope not. Especially for the train station. However, I’m pretty sure we all go through some very basic human experiences that really seem to be the cost of the ticket to this ride called life. I think we all experience joy, love, loss, fear, connection, frustration, envy and of course a desire for a Led Zeppelin Reunion (ok maybe that’s just a few million of us).
But in my work with cancer patients, their families, corporations, healthcare professionals, executives, and young people, I am starting to notice that the specifics of our challenges may be very different, but we are all out there, trying to find our way, trying to make a better life for ourselves and our families and trying to make sense of a world that may not make sense*. Wherever you are, to quote another great musician, keep on rockin’ in the free world.
*When Stephen King does come to my poker game, I’m sure he’ll call me on that run on sentence. Hey Stephen, read it out loud and it sounds fine! By the way, I just finished Finders Keepers and I loved it.
This is a big question and it can fill people with fear. You find out someone has cancer, maybe its a family member or a friend. What do you say? Do you say anything? Do you completely ignore the 2,000 pound Tyrannosaurus in the room and just hope it goes away? That might seem like the easiest thing in the world to do, but is it helpful? Do you drop your documents and run from the photocopier crying when you see them coming around the corner? That’s probably not the best strategy, but I’ve seen it happen. As a decent human being, how the heck do you handle this?
You see, 30% of us will get a cancer diagnosis at some point in our lives, so at some point, someone you know is going to be dealing with this issue.
Don’t worry, I’ve got you covered.
As a cancer survivor myself, I have had my share of uncomfortable and yes even hilarious conversations when well meaning folks were trying to talk about something that is tough to talk about. So how do we do it?
Here’s a strategy that works for me.
Wait for a time when you have a modicum of privacy and say something like “Hey, I heard you got some bad news lately.” Then …let them talk. What’s great about this is you haven’t said what the bad news is. This gives them the opportunity to talk about it or not. They might shut it right down by saying “Ya, uh that’s private” or “I don’t want to talk about that right now.” This is totally fine and you should respect that. However, they may want to talk about it. They might say something like “Ya, I just got a diagnosis and I am totally freaked out.” or “Its still early days so we’ll wait and see” They might go into a lot of detail and that might surprise you.
If they are anything like me, they will have a LOT to say. Some of my conversations went like this…
Rob: So, ya, I’ve got surgery scheduled for next week and I think the surgeon is good, but he asked me if he should take out my whole thyroid or just part of it. How am I supposed to make that decision? what do you think?”
Bus Driver: I don’t know sir but you still need to deposit a token.
You might hear a river of opinions and worry that have been damned up for a long time. You might hear about doctors, hospital parking, and ultrasounds. You might find yourself in a 20 minute conversation that is remarkably one sided. Here’s how to handle this…
That’s right. Listen. Listening is quite honestly one of the greatest gifts you can give someone who is going through cancer. In all likelihood they will be under a tremendous amount of stress. Being able to talk to you might be just the thing they need to feel a bit of relief.
You’ll notice I didn’t say “Listen and offer advice”. Please don’t offer advice unless you have a DR in front of your name. You will really want to because you’re a nice person and you will want to fix it. Listening is enough. Please don’t mention that they should eat more veggies or take raspberry keytone or got to Mexico to take a weird drug or talk to your Uncle Lou who beat cancer by eating only radishes. This will not help. Listening and giving them a safe place to share what they are going through will. You might be the only person in their life who they feel they can talk to. If so, then you are even more important to them than you realize.
They may ask for more kinds of help later and that’s terrific, but when a diagnosis first happens the best thing you can do is talk less and listen more. If you pull this off, you will be giving them a gift that very few know how to give.
Good on you. I like you already.
Wow! I wouldn’t have guessed that, but congratulations on being so acrobatic!
My favourite two minutes in the world is right before going onstage. Its a total blast. Its this incredible feeling that something big is about to happen and you really have no idea how its going to go. You’re completely in the moment and nothing seems to matter except the experience that you are about to have. As one of my heroes, Mr Robert Plant says “There is no place to hide”. Its especially fun when its 8:30 AM and you’re hopped up on three cups of joe.
I’m the guy in the red shirt who looks like he’s bringing in a plane.
Yesterday I had the absolute pleasure to speak at the 3rd National Forum on Patient Experience in Toronto. It was my job to stir up what I call the “Wisdom in The Room” and get folks cranked and ready to collaborate. After a few minutes this very generous crowd was sharing ideas and having a blast. There were medical professionals and patients there from all over the country who care deeply about the patient experience and how we can make it better. I was so taken by the depth of talent and integrity in the room.
All of the content was amazing and here are a few of my faves. There were folks from North Bay Regional Health Centre who are doing great work with patient stories with Photovoice. People from Mississauga Halton CCAC who are improving the patient experience by actually involving patients in the health care system. (What? That’s crazy!) They backed up their research with some incredible stats on how they were actually able to reduce patient time in the hospital. Wow. I’ve also got to mention the amazing Dr. Shah from Anishnawbe Health Centre in Toronto. His dedication to service was quite inspiring.
The patients in the room really had their voices heard as well. My friend Zal Press from Patient Commando is always ready to kick butt and take down names. And he did.
The silence in the room was palpable when a patient told her emotional and moving story to the audience. She was asking hard questions that need to be answered. It was a terrific event and I was very proud to be a part of it.
With committed people like this working in Health Care in Canada, things are changing and I dare say its for the better.
Shout outs to Dr Joshua Teller and Angela Morin for hosting a great day.