Conversations: Stuart Bloom, MD

 

SYNOPSIS

 

Oncologist Stuart Bloom speaks about his staged musical, How to Avoid Burnout in 73 Minutes, which tracks his journey from songwriter to oncologist, and the way he copes with burnout and finds meaning in his work.

 
 
 

LISTEN

 
 
 
 
 
 
 

Guest

 

Dr. Stuart Bloom spent his 20's in New York City as an actor and musical comedian, but after he turned 30, and his own father was diagnosed with cancer, he decided to become an oncologist. After an award-winning, twenty-year run in community oncology, he joined the Division of Hematology, Oncology and Transplantation at the University of Minnesota Medical School. While he remains dedicated to patient care, he is also committed to mitigating the causes of physician burnout, and further developing the intersection of the humanities in medicine.

His acclaimed musical How to Avoid Burnout in 73 Minutes recently played at the Southern Theatre in Minneapolis.

 
 
 

RESOURCES

Mentioned in the episode:

 
 

CREDITS

Hosted by Emily Silverman

Produced by Emily Silverman and Jon Oliver

Edited and mixed by Jon Oliver

Assistant produced by Carly Besser and Rebecca Groves

Original theme music by Yosef Munro with additional music by Blue Dot Sessions

This episode of The Nocturnists is sponsored by Nabla.

The Nocturnists is made possible by the California Medical Association, and people like you who have donated through our website and Patreon page

 
 
 

TRANSCRIPT

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The Nocturnists: Conversations
Stuart Bloom, MD
Transcript

Note: The Nocturnists is created primarily as a listening experience. The audio contains emotion, emphasis, and soundscapes that are not easily transcribed. We encourage you to listen to the episode if at all possible. Our transcripts are produced using both speech recognition software and human copy editors, and may not be 100% accurate. Thank you for consulting the audio before quoting in print.

Emily Silverman
You’re listening to The Nocturnists: Conversations. I’m Emily Silverman. On this show, we love to highlight the work of writers and poets and other artists who are making work about healthcare. healthcare. But it’s pretty rare to find a doctor who is working in the medium of musical theatre. A type of storytelling that I've loved ever since I was a kid, but which entails a lot of legwork, from writing dialogue to composing songs to hiring actors, designing sets, and most impressively, actually performing the show night after night in front of a live audience. But Dr. Stuart Bloom, an oncologist in Minneapolis, was not afraid to take that on. His new musical, How to Avoid Burnout in 73 Minutes, has enjoyed multiple sold out runs in the Twin Cities and has been performed at both the Mayo Medical School and the University of Minnesota. Several months ago, I was fortunate enough to be in Minneapolis during the run of his show and got to see it with my own eyes. It was hilarious and fun and touching, even as it examined some of the more difficult and cynical themes in healthcare.

Stuart spent his 20s in New York City as an actor and musical comedian, but when he turned 30 and his father was diagnosed with cancer, he had an epiphany and decided to become an oncologist. After a 20-year run in community oncology, he joined the Division of Hematology, Oncology and Transplantation at the University of Minnesota Medical School in 2021 as part of the Master Clinician Pathway. As Associate Director of Physician and Faculty Well-Being for the division, he's committed to exploring and mitigating the causes of physician burnout. He’s also an affiliated faculty of the Center for the Art of Medicine. I loved this conversation with Stuart, but before we dive in, let's take a listen to one of the songs from his musical, Boo-Hoo.

Stuart Bloom

(Singing) Song: "Boo-Hoo" from How to Avoid Burnout in 73 Minutes

“There's a patient in room four,
Who's staring at the door.
The wait drives her more than insane.
But the scan of her head,
That you have just read,
Shows the cancer has spread to her brain.
You were both so upbeat
When first you did meet, And she sat in that seat, last July.
But that was then.
And now, once again,
It's up to you to tell her when she will die.
There's the door. Go on in.
Let the good times peek in.
Use your hand. Turn the knob.
What's the matter little guy? This is your job.
Boo-Hoo. Boo-Hoo.
Your job is so hard to do.
After all these years, is this something new?
Why do you think that it attracts so few?
Boo-Hoo. For you.
It wasn't always such. But lately, you have lost your touch.
You used to think that you could only do so much.
Then you started thinking you could do so much.
Now you... boo-hoo.
You're not God. You're not a saint.
There's a long list of things that you ain't.
There's so much you cannot control.
You're just a little guy who fell and bruised his soul.
So take a minute. Take five.
Boo-Hoo to prove you're still alive.
Some day, why things go this way may all make sense, but not today.
That patient in room four is still there.
And believe it or not, she really doesn't care
About the pain that you feel
Because she's got a rotten deal.
So you set aside your sense of doom.
Turn the knob; go in the room.
You take a seat. You meet her eyes.
You see her panic quickly rise.
But your words are soft. You take her hand,
As you both try to understand.
Boo-Hoo for her. Boo-Hoo for you.
Boo-Hoo for what everybody born goes through.
But look at you, knowing what to do.
You see her face comprehend
You'll be with her until the end,
And her fear disappears.
But by this time next year,
All you'll feel is shame,
‘Cause now you struggle to remember her name.
You keep hoping this time will be different.
But by the end, it's always the same.
Where does it go? The part of you that's leaving you slow.
Does it regrow? They don't know.
They hope so. Boo-Hoo. Boo-Hoo.”
(End song)

Emily Silverman
I am sitting here with Dr. Stuart Bloom. Stuart, thank you so much for coming on the show.

Stuart Bloom
Thanks for having me.

Emily Silverman
So Stuart, you wrote a musical. And, you just had this run in Minneapolis, at the Southern Theater. It's called How to Avoid Burnout in 73 Minutes. And I was super fortunate to be in Minneapolis during this time and to have the opportunity to attend the show. And I had so much fun there. How was it, performing that run of shows?

Stuart Bloom
Oh, it was... It was really a dream come true. This whole thing has been a dream come true. I mean, the genesis of the show... I went into medicine later in life; I was an actor and a comedian, and I lived in New York City throughout my 20s. And I worked enough to know what it felt like to be a professional actor, and did comedy. I actually wrote funny songs and played them at clubs. So I worked enough to know what it felt like to work, but enough to realize I didn't want to do that the rest of my life. And then, as you know from the show... You know, I turned 30. I wasn't rich and famous. And then my father got stomach cancer. And I'd really never seen anybody sick before. And my wife was reading this book, Love, Medicine, and Miracles. You know, it was a book about a cancer doctor who was taking care of his cancer patients. And it was... just seemed so meaningful. It just sounds kooky, but I heard this internal gong, and I turned to my wife, Carolyn, and I said, "Maybe I should be an oncologist." Carolyn's always been my best friend, and biggest support. And she said, "Yes, I think that makes sense. You'd be a great oncologist." And so, the thing is, I've always written songs. And so, as I turned from the world of humanities to the world of sciences, I just kind of kept writing songs as a way to journal, you know. And I wrote these pre-med songs about science. And then I got into medical school, and I wrote songs about what it was like to keep going through medical school. Like, we do a show a year. I was our class speaker at graduation; I wrote this very long poem, funny and moving. And, as a resident, I wrote an operetta about what it was like to be a resident at Hennepin County Medical Center Internal Medicine, which was called Miserable Wretches Are We. You know... And, you did you did an Internal Medicine residency too, right?

Emily Silverman
I did.

Stuart Bloom
Yes, yeah. So you know about the miserable wretches part. And then, when I was a fellow, an oncology fellow, I wrote a song called "Can’t, Sir" spelled C-A-N'T, S-I-R, about how I can't treat this disease, but I could certainly apply for a grant. And then I got into a practice, and how meaningful and wonderful it was. And I kind of stopped writing songs for a while, but then I started writing them again, kind of a way to process everything that I was going through. I never really felt I would perform them in public; I just needed some way to keep processing what I was going through. And then, about five, six years ago, I started looking at the songs and I realized they had an arc to them. And I realized that the arc was... It was just getting harder and harder to do this thing that I just loved doing. And I realized that, hmm... maybe I had a show. I'm around people who die, all the time. And I realized, you know, I have these songs. I don't want to die without doing something about them. Or I don't want to be 70, and look back and go, "God, I got all these songs, why didn't I do something?" So I wrote the show that you saw the most recent iteration of it. It's called How to Avoid Burnout in 73 Minutes. And the action of the show is, I play an oncologist named Stu, which was a big stretch for me, clearly. Me and my inner voice go through a burnout questionnaire, with songs. So, I wrote this show and, you know, it just... It was like my gift to myself as a 60th birthday thing; I never knew if anybody would be really interested in it. So I rented a local theater, and we did it and Boom! It sold out quickly, four straight shows. It seemed to resonate with people, but am I just kind of dreaming that? So we rented the theater again in early 2020. And then this thing happened, it was in all the papers: COVID, this pandemic... I don't know if you heard of it?

Emily Silverman
Mmm. I heard of it.

Stuart Bloom
Literally, we cancelled. And then things were just kind of getting harder and harder, and I realized my own burnout in clinic was paralleling this stuff that I was writing about on stage. And there really was no separation between the two. Because things are getting so crazy and awful in clinical medicine, and I could have retired and become an old crank in the community and just complained about stuff. Or I could maybe try to be part of making things better. That's my own particular psychopathology. I'm not nihilistic; I'm not cynical. And I still want to make stuff better. So the show always had this following that I never really trusted. So, to do it at this bigger theater (that you were at), and it sold out in advance, and... And, it's not really because of me, you know, it's because of this thing that we are all going through. The burnout that all of us in medicine are going through. And it turns out the people that I'm with, in the show, who are not particularly medical, but they are theatrical. I mean, it's really happening everywhere, and they feel that there's an audience for it that, you know, are not really medical. But I'm all about the medical burnout piece. So to... That was a really long way to get to the answer for your question of, like, how did it feel to do it? It was a dream come true, you know. I mean, you were there... Right? You... you felt that this kind of... You know, everybody was laughing and crying, and into it. And, and, it just was a dream come true. What can I tell you?

Emily Silverman
Stuart, you are an excellent historian. I feel like that history that you just gave, was kind of like reading an oncology note in the chart where, like, you're just kind of trying to learn a little something about someone's cancer, and you get to the Onc note, and it's like, Boom! And it's like, the first symptom was in, you know, 2008. He just took me all the way through it, and... There's just one of the reasons why I love doctors and talking to doctors, is how great they are at explaining themselves.

Stuart Bloom
I actually copied that note forward from a previous...No, I'm just kidding.

Emily Silverman
So, I want to talk about How to Avoid Burnout in 73 Minutes. But before we do, I wanted to focus on this period of time, because the musical opens with a video. And we see this old, almost like scratchy video footage of young Stuart Bloom before you were a physician. And you're sitting at a piano, I think at like an intimate packed club in, like, the Village, I want to say, and you're playing music, and you're singing. Bring us into that scene. Because I, as somebody who love the theater, and musical theater in particular, like, probably romanticize that when I imagine it. What was it like during that time?

Stuart Bloom
So, it's very tempting to really romanticize it. And there were... I mean, come on, there were things that were so fun about it. So, that show, some of the members of the audience, we were in the national tour of the musical Doonesbury, which was just a musical based on the strip. And there was some really wonderful people there, and we just had this run. And, the thing that I'm kind of amazed about is that, yeah, I could just toss off 15 songs. Fifteen songs, I just would do, because everybody around me was doing stuff like this, too. I didn't even know that I had this clip. It was called Less than an Hour with Stuart Bloom. And I actually have it all. But, I look back at it too, as this kind of very fun time where you really felt anything could happen. But, of course, that dream and that fun thing that you saw, that that video really captured... If only that was the way that it always was.

Emily Silverman
Yeah, I imagine there's an aspect of the starving artist stereotype. You're in it for the passion, but making a living off of writing songs and performing them isn't the easiest thing. And it sounds like that's certainly something you ran into.

Stuart Bloom
Oh yeah, definitely. I think there was a joke later in the show that I was really so appreciative for everybody coming, that if they sent me their ticket stub, I would send them back $2. You know, I've had friends who have "made it", And why did they make it versus other people who didn't? And talent is part of it, but a lot of it is luck and who you are. And the one thing that I did not have, and I still don't have it, even though the opening song is all about me... Me, me, me. I just don't have that driving, burning, ego thing that everybody needs to know who I am, or what I'm going through, or whatever. I just never really realized that there was other things that I could do. And I think that reading that book, after my dad got sick, it was like, wow, could I actually do something that had more meaning than just about my own personal career?

Emily Silverman
A lot of people go into medicine with an idea of what they want to do. Some people come in and they know that they want to do OB/GYN or they know that they want to do Dermatology, because maybe they themselves were a burn victim, or they have kind of a personal reason for going into it. And some people stick with it. A lot of people I've noticed actually changed their mind when they're in med school. So they'll come in thinking they're going to do A, and then along the way, they grow, they change and they switch over to B. But it sounds like you really stuck with the oncology track.

Stuart Bloom
I always wanted to be an oncologist; I didn't want to really be anything else. I wanted to be with sick people. I did not want to be with healthy people, or looking at X-rays in the dark. Not that there's anything wrong with that, of course. But, you know, I really just wanted to be with sick people, because I wanted to learn from them. And, it's really never been hard for me to care about somebody else. It's been such an enormous privilege to be with people. And the more that I got involved with this, even from Step One as a medical student, and you started spending some time with patients, it just felt like home. You know, kind of felt like this river that was just there. And what do they say about a river? That you never step in the same river twice, but it's still a river because there's all this water flowing. And, that's kind of how it felt with me and still does today, this desire to connect with my world. To connect with other human beings, to be part of whatever this stuff that is life is. I mean, that is what has compelled me this whole time.

Emily Silverman
You say that you felt like you wanted to be with sick people. And that's such a powerful thing. I mean, there's a lot of people out there who really don't want to be around sick people. And, to be a doctor, obviously, that has to be something that you're passionate about. And, even though it can be extremely meaningful and gratifying, it can also be emotionally draining. And, you talk about how, for you, songwriting was your way of journaling. So, explain to us how that worked. What's your creative process, and what does that look like for you?

Stuart Bloom
Creativity is an interesting thing. It almost seems like it comes from someplace else. That we are kind of a prism, and whatever our unique spectrum that reflects through us, that is what we do. And so, in my own particular mind... You know, I grew up loving Doctor Seuss and limerick writers, and I just loved fun rhymes, and just kind of internalized it. And you know, I wrote these rhymes since I was eight years old, or nine years old: “I am me, I like to ski.” It's not something that I have to dredge up. It just happens. And so the song BooHoo, that was just a way for me to process, really the most important part of what we do if you're an oncologist, which is to always be honest, and be there with people. And you have to take a step back, and feel how can I help this person? And often the best way you can help somebody is actually to give of yourself. And the question I was trying to figure out while I was writing that song, with the lyrics at the end, was it definitely comes at a cost. And so, where does it go? Does it come back? Where does it go, that part of you that's leaving you slow. Part of you has to leave. But, you know, it turns out that if you are deeply... This is why I've been told I'm gonna burn out my whole career... If you are deeply committed to being part of patients' lives, in the end, you tend to get more than you give. So, even today, a long-term patient of mine passed away from her metastatic breast cancer. We knew it was going to happen. I talked to her husband. I called today. I knew that it had happened and we talked and it was sad, and we shed some tears. And I don't cry with patients during, but sometimes after I do, because it just happens. It's just something that's there. I feel that tears are life's sweat. If you exercise you're going to sweat, and if you live and breathe and experience this life, you're going to cry from time to time. I never do it in front of them while we're still grappling with things, but at the end I will often thank people for the great privilege of me being in their life. And sometimes I'll cry a little bit. And everyone has always said to me the same thing, "Thanks for that." The truth is, it's never easy. There's no substitute for just going in with your heart open, and understanding what this means to everyone there, and just being there. Want to hear...? This is an interesting story. My own father had stomach cancer, and he was dying of his stomach cancer. And I remember it was a Saturday afternoon. I was not in Medicine, yet. Planning on it; I was doing pre-med. And, it was late Saturday afternoon. The pulmonologist was coming in. My father had widespread metastatic cancer, and you could tell this pulmonologist had seen 24 other people that day, wanted to go home. It was late in the Saturday. And he knew my father; they had known each other. (My father was a pediatrician.) And the doctor wanted to just get the heck out of there. And so, he comes in. And we're there, you know, my father is there, slowly dying. The family's there, and he comes in. He says, "Dave, you're dying. Face it, you're dying. Just give it up." He shakes his head and he leaves the room. It's like, Oh, my God. So what we did was, we just thought "What an ass that guy was!" And we focused on what an ass he was, as opposed to focus on the real truth of the fact that my father was dying of cancer. That's with me every time I do a bad news conversation. I don't want to be that person. The truth is you want to give the information in a caring way. You know, people want to know two things. They want to know that you care about them; they also want to know what to do. And so, you try to do it in a caring way and not be that pulmonologist. Here's an interesting postscript to that story. Years and years later, when I was an oncologist, that pulmonologist was being cared for one of my partners, and he had lung cancer. And I was rounding on him on a weekend, I thought, "Oh my God, it's the same guy. The same guy who did that stuff to my dad." So what was I going to do? So I went in. Instead of standing, I sat. And instead of making it seem like I wanted to get out of there, I sat and I held his hand. And I just started talking to him. And we talked. And as I got up to leave at the end, he said to me, "When are you coming back?" Those are the kinds of things sometimes the universe does for you. So, I'm always aware of, like with a bad news conversation, never to be the way that that person was.

Emily Silverman
The musical is filled with these different songs that you've written. Sounds like you've written them during different periods of your life, different themes. Some of them are more about being in training and being a beginner. Some of them are more about the perspective of being a seasoned attending, who's been doing this a really, really long time. And, as I was watching, I was thinking to myself, it would have been very easy for this to have been a one-man show, for this show to have been mostly Doctor Stuart Bloom sitting at the piano, and doing kind of a review, and you know, song after song. But that wasn't what you did. You made it a two-hander. And you have this other character in the show, who's played by a wonderful actor, and that character represents your inner voice. So, talk to us about the decision to bring in this other actor, this other character, and how that came about, because I thought that was such a brilliant creative choice.

Stuart Bloom
Oh, thanks. The very, very first thing was like, "Well, do I play my inner voice?" No, that would be horrible. And then the second thing was like, "Well, I get lonely up there." I just don't want to be by myself on a stage. And, Eric Ringham is the name of the actor. He's just a wonderful actor with a great voice. and he's just a terrific guy. We've become very close friends. It turned out that I needed to hear things from somebody else. And I need to hear it every night we do that show. The first iteration, he didn't sing. And then it just kind of made so much sense for him to sing. When we did it the second time, and everybody said, "Yes, he needs to sing." You know, and Eric has a really good voice. And the song that closes the show, "What If Life Really Matters?", is really anthemic. But it's really what I think about stuff. And to sing it as a duet, with me and my inner voice coming together, the synthesis of all of this was, and is, deeply moving and meaningful for me to do every night.

Emily Silverman
I really enjoyed the dynamic between you and Eric and there was just such a great tension there, as you were almost arguing with yourself, or puzzling through this question of: Am I burned out? Am I not burned out? Do I love my job? Do I hate my job? And, I feel like so many of us can relate to that inner tension. And I thought the way that the two of you showed that on stage was so great. And one of the ways that you structured this tension was through using (and I thought this was hilarious), the MBI, the Maslach Burnout Inventory, as a narrative scaffold for the show. So, explain to the audience, what is the MBI? Because it's real. Which, by the way, the people that were sitting next to me... They were a couple of friends of mine; they were not physicians. And then after the show, when I told them that that was a real thing (the MBI), they thought that was so funny. They thought it was maybe something that you had made up.

Stuart Bloom
Right, right.

Emily Silverman
So what is the MBI? And talk about how you decided to weave that in.

Stuart Bloom
Burnout. I've been very involved with burnout at the University of Minnesota. I was at the Chief Wellness Officer training course at Stanford for a week, and understand a lot about burnout. And the truth is, with burnout, you have to measure it. And the way to measure it is with a tool. And there are a couple of tools that are out there, and I can mix them together. But, it just made a lot of sense that with every question on this Maslach Burnout Inventory, you could do a song about. "I am calm at work," or something like that. Which was like, you know, "I'm very emotional." And the fact that this is not being burned out if you're anything but calm? Clearly, that's a nice intro for a song. And so, it just was a nice little scaffold to have throughout the show. But then I realized I had to burn out. I had to go through burnout in the show, in order to come back. The part in my own life, where I burned out the most, was because the place that I was working did not have my values. We all wrote medical school application essays talking about how beneficent and altruistic we are. And we're all end up being employees. And the employers never wrote an essay, right? They're all about other things. They want their bottom line. And so, the juxtaposition of one versus the other really leads to cognitive dissonance, and then moral injury, and then we burn out because our hearts break. Even though I did burn out, I'm still doing this. Right? So I'm much less burned out now, because of the fact that it's still really, really cool to do what we do.

Emily Silverman
As I was sitting in the audience, I was wondering, like, how is he going to land this plane? Because it's so easy to talk about the flaws in the system. And then, to circle back and then just say, "But it's the best job in the world." You know, and it's like, it's more complicated than that.

Stuart Bloom
Oh, my God. It sure is.

Emily Silverman
I felt like the way that your piece ended, it wasn't like that. It did have a little bit of a dissonance to it, where there was still a question mark. And so, I'm curious how you are thinking about that. Because, in the show, you talk about all of the different ways that the system is crushing you. You even have a screen behind you, with little circles with different faces, and the faces are getting bigger and smaller as you're getting paged. And I thought it was such a creative way to convey to the audience the pressure of holding a pager, and having like eight different voices telling you to do things at the same time. And that's real. And that's not changing anytime soon. So, how did you creatively decide not to end on a note that was too optimistic, but also not too pessimistic? Like, how do you find your way through that middle place?

Stuart Bloom
So, my inner voice says to me, "So, not burned out yet?" And I go, "Not entirely." We can rail against the system. The system has huge flaws. And the song about clicking a box. I feel that song is not a success, unless everybody stands up at the end and runs out into the street screaming, complaining about we're imprisoned by our connection to this electronic medical record. And so, I really had to talk about that. And, in fact, when I wrote the show, I was not aware of a bigger picture. I had more of an ankle view of burnout, because I was going through it. Because everything that happened in that show is true. All the stories that I talk about are true. And, I wanted to figure out how I keep on doing this. And the thing that has kept me doing it is this connection with patients. But that can't do everything, right? I left. I'm now in a place where I see fewer patients. Over 300 of my patients have come with me from where I was before, because they value this, this thing that we have together, and I so treasure it. But I'm seeing fewer patients. And so I'm less burned out. It's easy to demonize the people in charge. Even though there are some for profit, and even nonprofit healthcare systems that really are not doing the right thing by patients, that are just only focusing on profit, I feel that it's more administrative creep that happened, that it wasn't intentional. To keep throwing more and more and more clerical duties on physicians, and advanced practice providers, I think that was administrative creep. And what's happened was is that we all are suffocating under this. But we can really push back; we can change these things. The electronic medical record ultimately should be what we see in Star Trek. "Computer. How do... lalala...?". You know, the computer does it all. I mean, that's what it should be. And, you know, with all this stuff with AI coming, I mean I... You would think that there would be some ways to do this. Then it turns out, if you look at data, the thing that drives burnout the most in physicians, is the electronic medical record. I started to volunteer at the University of Minnesota medical program to help be part of the group that is trying to change this. It's very hard. And so, I had this appointment to talk to an IT person about this. You know, I said, "We have to change this," and I was just getting passionate about it. And then she started to cry, because she felt that I was being so hard on her, and I was just being passionate. My half hour appointment with her, I spent the last 20 minutes just telling her how good she is doing. Good job she's doing, and I get it, no one really means to hurt her. You know, it's really tough. But we can figure this stuff out. We can make the electronic medical record better. We absolutely have to. And will, I think.

Emily Silverman
Talk about the role of comedy in social movements. Because comedy, in my opinion, is the highest art form. I think it's the most intelligent art form. And, for a long time, comedians have gotten in trouble for things that they've said. Lenny Bruce is the one that comes to mind, because I watched Marvelous Mrs. Maisel. And there's a character in there, Lenny Bruce, who's a real historical character, a real comedian, who was often arrested for the things that he was saying on stage. And so, comedy, while offering a release, and an opportunity for fun for people in the audience, can also be really radical. And so I'm wondering, who are your comedic influences? Maybe your musical comedic influences? And how are you thinking about comedy, as a force for change in the system?

Stuart Bloom
There's other people who know much more about this than me. But certainly comedy is a great force for good, and particularly when you have leaders who are pretty awful. To make fun of them is very effective. Even the stuff with our previous president. I mean, there were so many wonderful takedowns of him, which is very important. Comedy, for me, I think that's just the way that I grew up. My dad was from Brooklyn; my mother was from Canada. They were a wacky couple, and I grew up in Minneapolis. And they would play Allan Sherman. Are you familiar with Allan Sherman? Did you ever hear of Camp Granada? "Hello Muddah, hello Faddah".

Emily Silverman
Yes, yes.

Stuart Bloom
Right. So that was...

Emily Silverman
Hello Muddah...

Stuart Bloom
Hello Faddah. Exactly. Here I am at Camp Granada. But he had many, many albums, and they were always played while I was growing up. And then, you know, my dad had these Borscht Belt albums too, of like these old comedians, and they would play and... In terms of musical influences for me, certainly Tom Lehrer is really... Do you know Tom Lehrer?

Emily Silverman
Maybe? What has Tom Lehrer written?

Stuart Bloom
Poisoning Pigeons in the Park? Have you heard that song?

Emily Silverman
No.

Stuart Bloom
Oh, this is the thing. I have these younger students, and I always... I'm texting my kids, "Do they know this reference?" And, it's like, "No Dad, they don't." Anyway. But, Tom Lehrer was just a wonderful... He was a Harvard mathematician, but just wrote a lot of very funny topical songs. I really like old-time musical guys too, like, E.Y. Harburg. Yip Harburg was a great lyricist, and he wrote Lydia, The Tattooed Lady that Groucho Marx sang. You know, Stephen Sondheim is a great lyricist. I love They Might Be Giants; their lyrics are great. Of course, Randy Newman is a huge influence for me too. I'm sure there's some people I'm forgetting. Doctor Seuss, old limericks. But comedy, in terms of medicine, I don't really talk about very much because I've been asked to. And have you heard anybody talk about comedy and medicine?

Emily Silverman
There is a internet ophthalmologist-comedian Doctor Glaucomflecken, who actually I just interviewed, and he does a lot of short, bite-sized, video takedowns of, like, big insurance and things like that. So it was really fun to chat with him about that. Outside of that I'm not sure who the, you know, big comedic voices are.

Stuart Bloom
The thing is... You know, the... The reason why I don't like to talk about comedy, like when other people have asked me to do it, is because it's just so not funny. You know, it's just funny. I've seen that person and I think his stuff is really funny. Remember, there was this movie Patch Adams? It's a movie I never saw. But I just never loved that movie, the idea behind the movie...

Emily Silverman
I think it was really sad, wasn't it? I think I remember, like, tears coming down my face at the end of that movie.

Stuart Bloom
I mean, it's like, you could put a clown nose on things, and that that is enough to do, but like, I think... One of my favorite New Yorker cartoons is a clown; he's on the phone, and he's saying, "What's the next best medicine?" So, it's interesting: how to be funny with patients. There's a lot of laughter going on in our rooms. But it has a really short half-life for me. Because I can't make fun of myself. If I'm really self-deprecating they'll say, "Well, can we find me somebody who knows what they're doing?" You know, I mean, so I can't do that. And I certainly don't make fun of the patients. Like, something happened the other day. Like, a patient said that she's doing well. She said, you know, "But every time I stand up, I get a headache." And I said, "How low is your ceiling?" You know, stuff like that. But I mean, just little things. Like, you know, it's stupid stuff.

Emily Silverman
Can you tell the audience the story about your patient with the handkerchief up the sleeve? Because I loved that so much. And I'd love for you to share that with our audience.

Stuart Bloom
Sure. So the context in the show is that I've really burned out and my inner voice says to me, "Come on. You really need for me to tell you why this whole thing is important?" Those are not the words. But I say, "Yeah, because when you're burned out, you don't think so clearly." And he says, "Okay, think of your favorite day in clinic ever." And the truth is, I do have one, and it was early in my career, and I was starting to become known as a nice and fun oncologist. Right. So, some patients started to transfer their care to me at the end of their life. They knew they didn't have much time left, but they wanted it to be under the care of a nice and fun oncologist. You know, right? Because this happened. A lot of people were transferring. And this one older woman, with advanced pancreatic cancer, transferred to me and I really fell in love with her immediately because she was one of these ladies who kept a hankie tucked up her sleeve. And it reminded me so much of my dear departed Grandma Ray, with whom I was so close. She was just one of the highlights of my growing up, was with my mother's mother, Grandma Ray, who kept a hankie tucked up her sleeve. And what I would do with her is, I would always kind of sidle up to her, I'd hold her hand, and I'd pluck out the hankie, and I'd say, "And what's this?" And she'd take the hankie back, and she'd say, "That's my hankie." And she'd put it back, but smiling. So my favorite day in clinic, she comes in. And I hold her hand. And I pluck out the hankie, and I say, "And what's this?" But it's a long hankie, and I pull again. It's pinned to another. I pull again; it's pinned to another, and then another. And I look up at her. And she smiles and says, "Gotcha." And I get goosebumps, even now when I think of that. I mean, of course, I asked my nurse to come in and take a photo. So we show the photo of it, right? You know, with her long hankies coming out of her sleeve. And, as I say in the show, whatever the goal of all this is, that I still can't really articulate, it happened that day. And if it happened that day, it would happen other days. And, really, for the first time... My background was always, you know, different. It was non-traditional. But for the first time in my career, I really felt... You know, I had always had these really nice relationships with patients. But when this happened, it was like, "Wow, we really met, my individuality interacted with hers." That's an Albert Schweitzer quote. It really happened, and I knew that I was doing the right thing.

Emily Silverman
So, what's next for you? What's next for the show? Are you going to continue performing? Are you going to take it on tour? Do you have a new project that you're working on? What is coming down the pike for Doctor Stuart Bloom?

Stuart Bloom
So, the answer to all that is "Yes." I'd be very interested in your thoughts on this. We just did it at the Mayo Clinic last week, and it was well received. And I wouldn't mind doing it at other places. But the truth is, I have this day job, that I really like. It's tough to take a lot of time away from that. So, we are going to do it again at the same theater, because there's just a lot of people who couldn't get tickets. Isn't that crazy? So, we're going to do it again next year there. I do have some contacts at other medical schools, and we'll see. It seems to really resonate with people. So I love that... People bring their spouses to it, so they can see: this is what happens to us. And so that's fun. So, I think it'll keep on going. But, you know, I want to write new stuff, too. And I have an idea for another musical that is going to be more of a musing on aging as well as academics. I always wanted to write a door-slamming sex farce that takes place in an assisted-living situation. That's going to be called Assisted Loving. And, but it's going to have a lot of meditations on mortality and aging. And I have a number of songs already written for it. And so, hopefully that'll be something that I don't have to be in. And I'm working on a graphic novel now about a lot of these things too. You know, I just want to have fun. And so, um... But, you know, all these things that are happening... They asked me to be on The Nocturnists. Isn't that crazy? All these things that are happening, I just so... I'm so grateful for it. Because when I was really just burning out in practice, I did not, you know... I just, I...I was hoping these things could happen, but I just really wasn't sure what was gonna happen. Things were pretty tough.

Emily Silverman
Well, I am a huge fan. I so enjoyed the musical. It sounds like there's a lot of potential to bring the musical to other medical centers. So, if you're listening, and you're a musical theater nerd, and you want to bring Stuart out to your institution... Not to become your agent, Stuart, but, um...

Stuart Bloom
I'd love it.

Emily Silverman
Tell us, where can we find you? Because, you know, the show isn't playing in all cities right now, but there is a website that has some videos on there. So, tell our audience, if we want to learn more about you and your work, where can we find you?

Stuart Bloom
It's www.burnoutmusical.com. It needs a little updating, because we have a new video version of the show that we just did, that I really like. We'd love to think about doing it other places, and that would be just something that all of us involved in the show would love to do.

Emily Silverman
I have been speaking to the wonderful Dr. Stuart Bloom: oncologist and composer and lyricist. And we were talking about the new musical, How to Avoid Burnout in 73 Minutes. I so enjoyed it, and I so enjoyed having the opportunity to chat with you. Thank you so much for coming on the show.

Stuart Bloom
Oh, thank you so much for having me, Emily. It's a dream come true.

Emily Silverman
Thanks for listening. This episode of The Nocturnists was produced by me, Emily Silverman, and Jon Oliver. Jon also edited and mixed. Carly Besser and Rebecca Groves assistant produced. The Nocturnists Executive Producer is Ali Block. Our Chief Operating Officer is Rebecca Groves. Our original theme music was composed by Yosef Munro, and additional music comes from Blue Dot Sessions.

The Nocturnists is made possible by the California Medical Association, a physician-led organization that works tirelessly to make sure that the doctor-patient relationship remains at the center of medicine. To learn more about the CMA, visit cmadocs.org. The Nocturnists is also supported with donations from listeners like you. Thank you so much for supporting our work. If you enjoy the show, please help others find us by telling your friends about us, posting your favorite episode on social media, or leaving us a rating and review in your favorite podcast app. To contribute your voice to an upcoming project or to make a donation, visit our website at thenocturnists.com. I'm your host, Emily Silverman. We'll be back in 2024. Have a wonderful holiday and new year.

 
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