Mending a patient's funny bone

At first glance, the accolades that adorn the clinic walls where Dr. Stuart Gold works read more like warnings. One patient calls him a bonehead. Another says he's out of control. The doctor's mean streak is a recurring theme. But the harsh words don't faze this childhood cancer specialist. As he points out, most of them were written in crayon.

Chunky colored writing instruments are the preferred medium at the North Carolina Children's Hospital Pediatric Hematology/Oncology Clinic, where for the past 17 years Gold has practiced his medical skills -- and a 1970s, Vegas-style lounge act.

"I'm going to get you well," he guarantees Brad Chambers, a 17-year-old who suffers from acute lymphocytic leukemia. "But you're still going to be ugly. Maybe we can get you some plastic surgery so you can get a date."

Chambers -- pale, tired and beaten after a round of intense chemotherapy -- giggles like the teenager he is. Which is precisely Gold's aim. Providing comic relief in the deadly serious business of treating childhood cancer has a practical application.

"If you treat kids like they're sick, they'll act sick. I want them to be as normal as possible," he said in one of the few straight lines delivered during my tour.

I sought out Gold after learning of his legendary pranks. His calling card is squirting patients with water-filled syringes, often while they're sitting defenseless, receiving chemotherapy. He has little interest in giving patients fair warning, as Chambers can attest. One day the young man awoke from a diagnostic procedure to find a spider tattooed on his butt. (The tattoo was temporary; his mom keeps the picture.)

OK, so Gold can be a lot of yucks, but I wondered if the doctor had become more concerned with developing his persona than his expertise. After all, he's a state employee, and North Carolina taxpayers don't need to fund a comedy revue. We already have the General Assembly for laughs. Above all, I wanted to find out if Gold was a good doctor. He's not. He's an excellent doctor.

That assessment comes from Carolyn Viall, the hospital's clinical director of Women's and Children's Services, and a woman whose fashion sense Gold openly questions. She filled me in on Gold's extensive clinical skills, his hunger to learn the latest research and the dogged determination he puts into diagnosis.

Not only would she trust Gold with her life, she trusts him with her child's life. Four and a half years ago, her daughter, Sarah, was diagnosed with a primitive neuroectodermal tumor -- a brain tumor to you and me. Today, the 19-year-old is healthy and a student at the Savannah College of Art and Design. Gold was, and remains, her physician.

Watching him interact with patients and colleagues, it's evident why he's earned trust and respect. The change from comic to doctor brings on a physical transformation. Concentration erases the smirk from his face. His whimsical, relaxed posture stiffens. He leans forward and listens more than he talks. Although eager to reassure patients and their parents, he doesn't deflect or back away from questions that have hard or heartbreaking answers. His ability to connect with patients and co-workers is rooted in his genuineness, not his jokes.

It would be easy to "Oprahfy" Gold's comedy as a shield against the daily ordeal of facing kids stricken with cancerous blood disorders or tumors. Hardly. His humor is a reflection of his well-grounded optimism. He rejects the notion that pediatric oncology is a depressing field. He points out that the clinic now saves more lives than it loses. The growing number of survivors has spawned a new medical field -- the care of adults who survived childhood cancer.

However, it was when the conversation turned to patients who had died that the core of Gold's optimism revealed itself. Instead of being forlorn, he remembered the special character each brought to the clinic, and he was grateful for the lessons their struggles taught him.

As I left, I caught Gold toting a bag of Christmas presents that needed wrapping. He couldn't resist out one last quip.

"I really don't like kids," he said. "I only became a pediatrician because they don't make us wear ties."