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How humor builds trust in pediatric oncology

Diego R. Hijano, MD
Physician
August 10, 2025
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“Dr. Who?” the child asked.

“Dr. Hijano,” I said. “But you can call me Dr. Diego. Like Go Diego Go! Dora the Explorer’s cousin, the one with the baby jaguar who saves the rainforest.”

A pause. A smile. And just like that, the ice broke. In pediatric oncology, that is no small thing.

I work in a pediatric cancer center, most often in the bone marrow transplant unit. When people hear this, they say, “I do not know how you do it. I could never.” The truth is, I did not always know either.

My path into medicine was shaped by loss. At eighteen, I lost both parents in a car accident, and a dear friend a month later. As a child, I endured moments no one should face. They could have left me bitter. Instead, they taught me the value of joy, the kind that persists even in darkness. The kind you find in a child’s laugh, a shared smile, or the lightness of humor in the hardest moments. My father had a laugh so warm and full that his eyes would disappear when he smiled. That sound still echoes for me in every moment of lightness I find with a patient.

Over time, I began to notice that much of this joy came from language, not just what we say, but how we say it. As a native Spanish speaker, I am still surprised by English. It is a slippery language. I try my best, but like every other muscle, my tongue gets tired, especially after midnight on call.

At 3 a.m., I once asked a family if they wanted to see a “baby jaguar.” They blinked, then said, “You mean a baby shower?” We laughed until the tears came, a kind of relief in the middle of a long night. Another time, I told a patient I stay “fit to protect the forest.” They heard “feet.” The medical treatment mattered more than the words, but those moments lightened the room.

These slips are often gifts. They humble me. They invite others to laugh. And they remind me that connection does not require perfection, it requires presence.

Even when I speak Spanish with Hispanic patients, I find the language itself can trip me. I learned early that “caca,” perfectly normal for “poop” in Argentina, is offensive in other countries. The first time I said it here, the patient’s mother laughed so hard she cried. After that, it became our thing. Every morning I would ask, “How is the … caca?” Cue the giggles. In a unit where pain and fear visit daily, that private joke reminded us we were still human.

Humor, I have learned, is a way in. A way through. A way back to myself.

Sometimes I wonder how much more effective I could be with perfect grammar and flawless pronunciation. However, I remember that these slips have built bridges I could not have built otherwise.

Danny Thomas, the founder of St. Jude Children’s Research Hospital, once said: “Success in life has nothing to do with what you gain or accomplish for yourself. It is what you do for others.” As a comedian, he understood that humor is not just entertainment, it is a lifeline. He built St. Jude as a place where hope and healing coexist with laughter. I carry that spirit with me every day, looking for small cracks in the heaviness where joy can shine through.

For clinicians, the lesson is simple. Our words do not have to be perfect to matter. What patients remember is that we were there, that we cared, that we saw them not just as a diagnosis but as a whole human being, someone worth laughing with.

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These days, I try to make sure that every patient and family feels better after meeting me, even if just a little. I cannot always promise a cure. However, I can offer my presence, and a laugh.

The tongue gets tired. The accent stays.

The smile, like my father’s, never fades.

Diego R. Hijano is a physician-scientist specializing in pediatric infectious diseases at St. Jude Children’s Research Hospital and an assistant professor in the department of pediatrics at the University of Tennessee Health Science Center. Born and raised in Argentina, he blends clinical expertise with a deep commitment to human connection, particularly in the bone marrow transplant and oncology units, where he supports patients and families through some of medicine’s most challenging moments. Dr. Hijano’s work focuses on advancing compassionate, equitable, and effective care while shaping institution-wide improvements in healthcare delivery. His research contributions can be explored via his NCBI bibliography, and more about his career is available on his LinkedIn and Bluesky.

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