On the telephone, Robert Buckman, a medical oncologist at the Toronto-Sunnybrook Regional Cancer Centre, sounds more like an alumnus of Monty Python’s Flying Circus than of medical school. It’s the accent, of course – the 52-year-old Buckman was born in England and emigrated to Canada in 1985 – but it’s also his off-the-wall sense of humour.


For example, he decided to call his life story, Not Dead Yet, an “unauthorized autobiography” because he figured the word unauthorized in the title was sure to sell more books. But he also admitted he was having a hard time reaching an agreement with himself.

“I was too busy – I kept getting my voice-mail – and I couldn’t get hold of myself, as it were. I’m not sure how that’s going to come out when you print it. But there you go,” he joked during our interview.

George Bernard Shaw once said that “if you want to tell people the truth you’d better make them laugh.” It’s a strategy Buckman has employed in all his projects, and there’s been an impressive range of them. In addition to his medical practice, he is a broadcaster – hosting several television shows on health and medicine in England and Canada – and a writer. He is the author or co-author of 20 books, including eight for the What You Really Need to Know About… series. This fall, Macmillan Canada will publish four new titles in the series, covering irritable bowel syndrome, breast cancer, caring for someone after a stroke, and living with depression.

Buckman’s ability to “cunningly disguise” serious subjects behind a funny approach has also served him well as a teacher. An associate professor of medicine at the University of Toronto, he has been teaching students how to break bad news to patients for 15 years, and has been lecturing on the subject in the business world for the last six. His point is that “you can’t tell people things that they need to know simply by telling them things they need to know. You have to make it interesting – the pill has got to be sugared. You have to do it with wit and style. Otherwise let someone else do it.”

Which is where Monty Python’s Flying Circus comes in. Since 1992, Buckman has been focusing on the flip side of how to break bad news. In a series of videos on common medical conditions, he instructs patients how to talk and listen to doctors. His partner in this project is John Cleese, the Python probably most famous for trying to return a dead parrot to the shop he bought it from.

Buckman met Cleese at Cambridge in 1969. Buckman was performing in the Footlights, the famous university theatre revue where Cleese, Peter Cook, David Frost, and Jonathan Miller got their start, and Cleese came back to see how the new crop of performing undergraduates was doing. He and Buckman had a chat backstage and stayed in touch and in 1992 collaborated on the video series, which is ongoing.

They have made 48 so far, and again humour is an important component. (Some 500,000 Videos for Patients, as they are called, have been sold in the U.K., mainly to pharmacists who then distribute them to doctors; there have been 60,000 sold in Canada so far.) Each video begins with a sketch that has Cleese doing a typically “Cleesian bit” and Buckman playing the straight man. After that, though, Buckman gets serious.

“Our latest was Parkinson’s. If you’ve got Parkinson’s you don’t want anyone laughing at it,” he said. “So the moment the sketch is over – in which the doctor is very much the butt of the joke – it’s just me and the person with Parkinson’s and a direct conversation.”

The video series also led directly to the What You Really Need to Know About… series. “Someone came along and said, why don’t you turn these videos into books. The idea was the same. You can pick the book up not knowing what the hell diabetes or asthma is and this book will give you, as it were, a map of the forest, not a catalogue of the trees.”

Like the videos, the books treat complicated material concisely and directly, with section headings like “Symptoms & Causes,” “Day-to-Day Care,” “Treatment & Prevention,” and “Non-medical Approaches.” But the most important problem the books are intended to address, as Cleese says in a general foreword to the series, is the frequent breakdown of communication in the doctor/patient relationship.

Anyone who has ever been in a doctor’s office receiving any kind of news, especially bad news, knows that one’s mind has a tendency to go blank – to either not comprehend what is being said or not remember any of it later.
“Someone compared it to the recording head coming off the tape,” Buckman explained. “What these books do is give people a clothesline on which they can hang their own particular garment. The one about diabetes, for example, will give them a list of specific questions to ask: ‘In my particular case, doctor, will I need insulin?’ ‘Or, in my case, how much weight should I lose?’”

The emphasis in the books is on not just the informational but the emotional needs of patients. Buckman learned the importance of taking emotions into account the hard way – by surviving two serious illnesses. He contracted dermatomyositis, an autoimmune disease similar to rheumatoid arthritis, in 1979 and nearly died; a decade later, he suffered from an inflammation of the spinal chord, which has left him with numbness in his right arm and leg.

“What my illnesses did was make me braver about talking to patients,” Buckman said. “So even though I was quite a supportive doctor before, I was a little bit frightened the patient would be experiencing something I didn’t know anything about. After I’d been seriously sick myself and after I realized my personality didn’t fall to pieces like a wet Kleenex I got braver.

“I’ve had patients shout at me. I even had a chair thrown at me – or in my direction. In terms of talking to patients, basically, I ended up scared of nothing.”