If your physician walked into the room wearing a tiger costume, what would you say? How about if he broke into song during a procedure?
For Taizo Nakano, MD, and his patients, this is all in a day’s work. (Dr. Nakano, pictured at right)
Dr. Nakano is a pediatric hematologist–oncologist at Children’s Hospital Colorado. He is particularly passionate about working with children with bone marrow failure—predominantly aplastic anemia—and is a strong believer in not taking himself too seriously.
“For many of our patients there is no roadmap toward a cure. You have to go on a journey with the family and build relationships that last a number of years. It’s important to try to find common ground and use humility and humor to bring down the seriousness that can come with these diagnoses.”
David Brumbaugh, MD, associate chief medical officer, said that despite being a junior faculty member, Dr. Nakano has built a reputation for having excellent rapport with patients. “Taizo is well known for his bedside manner and ability to connect with families,” he said. “He is beloved by his team for his humor and creativity.”
This creativity can take many forms, with dance parties and music videos not an uncommon sight on the ward.
“I can’t think of a clinic where I don’t have music playing,” Dr. Nakano said. “Sometimes music, dance or creativity are the best ways to find a common ground, and they can greatly improve quality of life. If we’re having such a good time that you don’t notice you’ve had blood drawn, or a four-hour infusion went by very quickly, then my job is done.”
“Some of our patients are at the hospital a lot, and I’m living this with them. It’s more enjoyable to be able to share those moments with lightness and creativity than to dwell in seriousness and the difficult aspects of life.”
Adapting to the Audience
Aside from being more enjoyable for the patient and the provider, creativity also allows for stronger relationships that could improve patient outcomes. This is especially important when there is no textbook treatment plan, as is the case with many of Dr. Nakano’s patients. Here, buy-in from the patient’s family is critical for the treatment to have a chance to work.
“Several years ago, we had a patient with aplastic anemia who was very ill – not even healthy enough for a bone marrow transplant,” Dr. Nakano said. “We spent six months playing defense, strategically suppressing the disease and trying to get his organs functional enough that we could attempt a transplant. He is now healthy and in college, but it’s not just the feat of his survival that is amazing. It’s the rapport that was necessary to get him and his parents to buy into such a long-term, unknown process.”
“Sometimes you have only minutes to gain a rapport, and you have to make sure it’s there before delving into anything too heavy. It’s through building rapport that you find out what a child needs. Some families might need you to be blunt, while others would appreciate humor and potentially even some laughter. You have to adapt to your audience.”
Lia Gore, MD, is section head of pediatric hematology/oncology/bone marrow transplants at Children’s Colorado. She explained that Dr. Nakano is known for readily taking on complex patients, helping other practitioners and answering consults from many states away.
“Dr. Nakano is a calm, careful thinker, a shrewd analyst, a compassionate colleague and an energetic and enthusiastic physician who seemingly never tires of even the most complicated patient problem,” she said. “He jumps at any chance to help a patient, a colleague or a collaborator, and imparts a sense of sheer excellence, academic intrigue and personal good spirit at every encounter. … Somehow he always magically gets the audience and the message just right.”
Opening the Lines of Communication
For Dr. Nakano, the most important thing is that families feel there is structure and that they are not on their own with what can be a frightening diagnosis.
“I’ve always viewed what I do as a lifestyle,” he said. “And if this is going to be my lifestyle, it’s got to be fun. Whether or not it’s the right approach, all my patients have full access to me at all times. They know just as much about my family as I know about theirs, and they’re welcome to ask me as many questions as I ask them. If I’ve done my job right, they’ll feel much more ownership over their medical care.”
Joanne Hilden, MD, director of clinical services, hematology/oncology/bone marrow transplants, said, "I recognized these attributes in Dr. Nakano when he was a fellow here. His upbeat attitude and innovative thinking are constants. He makes it fun for everybody."
As for the future, Dr. Nakano isn’t planning to put away his dancing shoes anytime soon. This Halloween, he’s arranged for the Boulder Circus Center to teach him and the team how to put on the best show yet.
“The chance to incorporate creativity is what draws people to stay in pediatrics as opposed to any other medical setting,” he said. “The seriousness of our job is never lost on us, but my colleagues and I always walk in the door with a sense of optimism and purpose. It’s a long-running joke that pediatricians get paid in warm fuzzies, but it’s true—I do get paid in the emotions I experience every day.”
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