Sunday, January 25, 2015

Sweetie.



He'd been in the hospital for what felt like a million years. The complicated problems we treated him for required lots and lots of invasive interventions. He'd take a step forward but then there would be a setback. And we'd be back to square one.

Ugh.

That said, I loved seeing him each day. His attitude was mostly positive and, at least when I saw him, he was cheerful on most days. Whenever I greeted him, he'd respond by calling me "sweetie" which I loved. I really did. And after so many days of him calling me "sweetie," eventually I started calling him "sweetie," too.

One day it was recommended that a big meeting take place to figure out his discharge plan. The medical doctors were all there along with the social workers and case managers and pharmacists, too. And everyone was talking and thinking and pow-wowing on how to help get him out of the hospital safely. That discussion was pretty discouraging, too. Not even so much because of the nature of his medical problems. It had more to do with his very unstable living situation and lack of family support.

Yeah. That.

So we talked and talked about Sweetie and tried to come up with some way, some how to get him safely discharged. But it all kept feeling like a gamble no matter how many permutations of gameplans we developed.

"We could have him get some home health visits. What do you guys think about that?" one person would say.

"But he doesn't have a home for someone to visit."

"Oh yeah."

"What if we had him go to a personal care home?"

"But he has so much equipment to take with him and so much stuff is still connected to his body. I'm worried that it would be too much."

"A nursing home?"

"I guess maybe at some point. But this isn't really long term and he has a lot of unique aspects that might make a nursing home gun shy about taking him on," another countered.

"He also has no funding which makes it even harder."

Which was true.

Ugh.

So eventually Sweetie got well enough to get some of those lines and drains disconnected from his body and he seemed to be going in the right direction. By the time all of this happened, I was off of the service, but since everyone knew I was invested in him and his progress, I was told immediately when a plan was finally made to discharge him. On the day of his discharge, I sent the resident a video message to show him. I wanted him to feel encouraged that he'd be okay.

"I hope he comes back," I said when my resident notified me of his discharge.

"I hope so, too," she replied softly. But then she added hopefully, "But you know what? He's following up in one of your resident clinics. So maybe he'll come, you know?"

"Did you show him the video message?"

"Sure did. And he was smiling from ear to ear." And when she told me that, I was, too.

Outside of a few of the more complicated aspects of his medical problems being taken from the equation, his living and resources were still very much shaky and worrisome when it came to things like keeping follow up visits. But eventually, the bullet just had to be bitten, you know? And no matter how careful we are with every single thing, there are just so many little, bitty things that we cannot control. Like, at all.

Nope.

And so. I guess I am writing about him because this is an age old story if you work in a safety net hospital like Grady. You care for very sick human beings with all of your might, you learn their stories and begin to really, truly care about them. You root for them and wish that there was just some way that you could safely put them inside of your pocket to protect them from all of the hard things that can't be fixed by our order sets or allayed through the power of our prescriptions. And when they leave you, you still worry-wonder about them--hoping and praying that the pieces will fit together and they'll find their way back to you.

I wish I could say that the patients always did. I wish I could. But I can't.

When I looked into the computer and saw that Sweetie had been given an 9:20 AM appointment, I groaned out loud and smacked my face with my hand. "Ugggh!"

"What?" a nearby intern asked.

"It's just a patient that I'm scared won't make a follow up but needs to. And 9:20 on a Monday at Grady is hard."

"Not if he knows somebody who cares about him is here waiting for him."

And that was all that intern said which stuck in my head like a very, very stubborn piece of gum on the side of someone's favorite shoe. I quietly thought about that idea--someone caring about you--and what that means to everyone in everything that they do. And suddenly I felt hopeful.

Let me be clear: Of course, most of our patients have scores of loved ones who care about them. And even those who don't have many people, care enough for themselves to slug it out. But I've learned from my experiences at Grady and also just through living that mattering is everything. And I hoped with all of my heart that Sweetie knew that it mattered to me if he kept his appointment with us. I really, truly did.

It's heartbreaking when it doesn't work out. Such a sinking and defeated feeling when you keep refreshing the screen and hoping that the heavens somehow opened up and dropped your patient into the waiting area. Especially the ones that have permanently stolen a piece of your heart and who you believe needed you as a surrogate shit-giver.

Sigh. I'm rambling, I know.

But yeah, it sucks when you leave it all on the field and lose. And it hurts when you worry and wonder and worry-wonder for weeks and you call a disconnected phone or look for some sign that your patient has reappeared in the system somewhere. But they haven't.

But you know what else? It's exponentially more awesome when it does work out. Man, it is. And Sweetie came back. Despite how hard it was for him, he did.

"Sweetie! You made it!"

"Yeah, Sweetie. I sho did. I had to come see y'all so you wouldn't be disappointed."

"Will you keep on coming to see us?" I asked.

"Yes, ma'am. The young doctor was calling me and everything. And they showed me the message you made me. Coming up here is good for my body getting healthy but it also just feel good to know somebody worrying theyself about you."

I felt my eyes stinging and just rested my chin in my hand.

"I do worry myself about you, sir."

"I know you do. And you know what? That make a difference. It do."

"For more than just you. It makes a difference for me, too."

"I know that, Sweetie. I know."


Best. Job. Ever.

***
Happy Sunday.

Tuesday, January 20, 2015

The considerers.




"People who need people are the luckiest people in the world." 

~ Barbra Streisand

When I was a resident, every now and then I'd get a phone call from my chief resident asking if I'd be willing to switch a call or swap an assignment with someone. Sometimes it was because a person had an illness in the family or some other unforeseeable issue. But you know? A lot of the time, it wasn't that. It was just because of some snafu or simple human error that could only be remedied by another human being willing to be malleable.

Now that I'm a full grown faculty member, that still happens all the time. And just like in those days, it's still a huge relief to finally secure a finger in the dike of whatever counts as your last minute leak. So as far as that goes, there's truly nothing new under the sun.

Nope.

I will never forget the day I was trying to put out a fire with one of my co-chief residents during our year together. We were looking to fix a hole in the schedule after a resident struggling with depression had been given some much needed but sudden leave. And see, something like a person needing coverage for self care, specifically the kind of highly personal care associated with mental health, is always tricky. We'd been scrambling around all morning to find someone and hadn't been lucky at all. That is, until finally, one of the second years came into the office and said, "I got your page. What's up?"

"We have a situation," my co-chief said. "I won't even sugar coat it. We badly need someone to take a ward team for April. I know you're on elective but due to an unforeseen circumstance, we are without a resident."

"Wow. Is everything okay?"

"It will be," I chimed in. "Thanks for asking."

And so. That second year resident stood in the door way squinting his eyes and looking skyward. Then he reached into his white coat, pulled out a tiny calendar book and flipped the pages to April. Slowly he ran his finger tip over each day, making certain there wasn't a conflict. "Can I make a quick phone call before giving you an answer?" he asked.

Our eyes widened in disbelief and in unison we responded with eager nods. And with that, that R2 disappeared around the corner to use a phone at the program coordinator's desk.

"He's gonna do it," my co-chief said.

"You think?"

"Yep. If he can, he will."

"You know? You're right. It's funny. Some people are just considerers and some just aren't."

I'm not even sure where I got that from--that term "considerers." But when I said it, Jeff smacked his hand down on the desk and said, "Exactly! Exactly! Some are considerers and some just aren't. Yes. That. That!" And we both just laughed and laughed because, after an entire morning of being met with "non-considerers" we knew that no words could be truer than these.

Nope.

So here's what got me thinking about that this morning. Last night I was working on my spring schedule. It's really pretty crazy--lots of speaking engagements and two major national meetings, one of which isn't even in the U.S. (Okay, which technically makes one of them inter-national, but you get the point.) My children with their crazy schedules and, of course, my career as a clinician educator.

Oh yes. That.

Well. In this whole process of securing hotels and making plane reservations and colleague coordination and sending in materials, I discovered a conflict. And not just a little conflict-tito, either. A major faux pas that would bust my groove--especially since I've not yet mastered the art of being in two places at one time.

Ugh.

So I study the master schedule and start trying to think. And by think I mean figure out who-who-who might be able but more importantly willing to help a sista out of her self-inflicted rut.

Now. Of course, I looked first to see what all of my friend-colleagues had going on during that time. When friendship is involved, the considerer card doesn't really need to be played because consideration comes from the desire to simply help out a friend in need. But, in this instance, I could see that every one of my own "go to" people were already out of the question.

Bummer.

And so. I looked to see who specifically might be able to work during that specific time. I shot off a few very late night emails and went to sleep hoping for the best.

Now. This morning, I had already received three responses. And you know? All three of them warmed my heart and made it sing a little bit. Because all three of the people who responded to me were, like that second year who'd come in person to see how he could help, real, true considerers.

Yup.

One said, "I just need to check a couple of things on my schedule and think I may be able to help you. Give me a couple of hours."

Another said, "I will actually be at a conference for part of that time, too. If I can cover the part you need and maybe arrange a three way swap with someone else, I could probably do that."

And lastly this: "Hey Kim--just want to make sure I have the dates you need correctly."

So I replied to all of them including the last person, to whom I gave the precise dates. And you know what? Two minutes later she replied:

"Okay. Happy to help."

That's it. That's all.

Sure. Maybe what I needed worked out swimmingly well for the schedules of two of these three people. But you know? I somehow doubt it. Moreover, none of the people I asked are the type that anyone could walk over or railroad into doing something that really isn't rational for their current work load, either.

But they were considerers. People who genuinely look at your problem, consider who is asking and the circumstance, weigh their options, and then truly give real thought to their ability to help--even if it involves some slight inconvenience on their part.

This isn't just with work either. It's across the board, man. Like, in life, some people are just considerers and some aren't. My mother? She is the ultimate considerer. She is. And Lord knows--my mama is no milquetoast when it comes to standing up and doing things on her terms. But damn, she helps us out. I'm talking big time, she does. And when she can't, she just can't.

But can't is different than won't. Yes. That.

See, considerers usually tell you no when they can't do something. And sure, that can't can be a very person thing like simply being tired as hell from a long work week or having some plan already that can't really be changed or even something that is altogether none of my business. But mostly considerers will at least sit for a moment and actually think it through. Without automatically saying no.

Now.

Conversely, there are some really good people out there who just aren't considerers. They just aren't. Sure, they reply to your email with some heartfelt-ish words of apology (that is, if it was sent as an individual request) but mostly whatever is requested is met with silent indifference. Or, at least, what feels like that.

I do believe in drawing lines and trying not to get too overextended. I don't recommend always being a yes man or woman, nor do I think folks should be human doormats. Nope, I am not exactly keen on always looking out for those who don't ever-not-ever look out for others people. That has to be factored in there somewhere, you know? Yeah, so regardless of all that--this morning, in particular, it's simple. I'm just deeply appreciating the people in my life both personally and professionally who are considerers, man. I am. Because we all need help sometimes. Help that inconveniences or puts someone out of their way. And without them--the considerers--those who need the considering will always be in lurch..

You know? I really try to be a considerer. I do. Our lives and worlds can become so self-centered though that it's a work in progress. For some people, that's always come naturally. I admit it hasn't always for me--when I was younger especially. Sure, I looked out for my friends, but that was mostly it. But the older I get, the more I've come to see how critical it is to have people who are at least willing to TRY to come through for you in the clutch. And you know what else I've learned? It actually does your heart good to be the person who DOES come through for someone else.

Yup.

Deanna? Oh, she was the ultimate considerer. Anyone who knew her would tell you that. (And okay I did say that my mom was the ultimate considerer but let's just say they're in lockstep for that distinction.) Deanna? She'd pick your kids up in a pinch, help with whatever she could, and just go out of her way, man. My sister JoLai is this way, too. And even though, like my mom, her no meant no--it was never an empty, faceless no. The request had been at least spread out on the table, placed on a mental post it note and . . just. . .considered, man. Considered. 




Today, I am vowing to be more like them--the considerers. More like my mom who let me drive her truck last week so that I could have more space to haul kids. And my sister JoLai who sits on the phone and lets me read her entire essays out loud before sending them in for publication even when she has 250 things to do. More like my friend Jill who went and took Zachary a lunch to school when I had forgotten even though she had the morning off and had a ton of work to do. More like my three colleagues who, without even flinching, actually registered my concern into their own lives and schedules to see how they just might be able to really-not-just-theoretically assist. And lastly, like Deanna--who never, ever missed a chance to see what she could do to lighten another person's load. And more authentic in my assessments of what is feasible and what isn't. . . along with an appropriate willingness to be willing to change things around to help.

Yeah, man.

You know? I guess if Miss Barbra Streisand is right and people who need people are the actually the luckiest people in the world? Maaaan, that means I'm super lucky. Super, duper lucky. 'Cause damn, I need people. I truly, truly need people.

Oh yeah--just in case you were wondering what happened with the second year resident and that ward month? After speaking with his wife on the phone, he realized that he had a family conflict that would make a ward month really challenging for him to take on. But it all worked out because a few moments later, another considerer came along who could.

Yeah.

***
Happy Tuesday. And shout out to all the sho nuff considerers out there.


Now playing on my mental iPod. Sing, Miss Barbra. You better SING that song, chile!





Thursday, January 15, 2015

The mother continuum.



I thought my heart would explode the first time I heard it: "Ma-ma." No, it wasn't the undifferentiated, monosyllabic babbling that happens when babies first discover their voices. This was the one accompanied by chubby little splayed hands, a toothless grin, and that word offered just for me: "Ma-ma."

The novelty wears off after a bit and you get used to it. Waking up in a dark crib: "Ma-ma!" Falling down while first learning to run: "Ma-ma!" And, of course, the first time an older sibling punches or hurts them: "Ma-ma!" Sometimes you cringe, but most of the time it reminds you that you are somebody's mother.

Yes, you.

Then some time goes by. For my kids, it shifted around the preschool age to "Mom-MY" from "Ma-ma." Requests were preceded by "Mommy" and so were those "I'm sorrys" that came after those things they knew they had no business doing.

Yup.

That shift--that is, the mama-to-mommy shift, I didn't notice so much. Like, it sort of slipped in like a thief in the night and didn't create much of a ruckus when it did. And really, it was fine because "mommy" still sounds infantile enough to remind you that they're still you're babies.

But then comes the day that you pull through the carpool lane at school and just before the door opens for them to jump out, they say it. This new thing that you hadn't been hearing before. "Mom."

And maybe other mothers didn't notice it like I did when it happened, but my guess is that some did. A little tiny piece of my heart broke when I did, too. Like "mom" seemed like something for kids with drivers' licenses and cell phones. Not a word that should be coming from the mouths of my little babies.

So yeah. For the last few years, I've been "mom" and, for the most part, it's been cool. But every now and then, I have a day like I did yesterday where things are a little different. Yep.

Usually, it happens when someone has had a nightmare or something. In they run to my side of the bed, cuddling my neck and asking with wide saucer eyes, "Mama? Can I get in bed with you?" Which, in my house, isn't often but does still happen from time to time. But yesterday, it wasn't that. No, it wasn't.

It all started with a text from my own mother. It simply said, "I need you," and nothing more. When I called her, I immediately knew what was wrong. She was having a bad Deanna-day and was missing her big girl something ferocious. I could hear her panting and knew that she was crying the ugliest of cries. And I just held the phone, I did, and told my mama that it would be okay. And, I swear to you, I called her just that. "Mama."

Because, to me, there is a tenderness and innocence in that word. It is primal, like the love you feel for her when you can't even form memories or words. So it seems to come out as that during those times, whether I'm thinking of it or not.

"Mama."

And, sure, before someone goes into a diatribe about how they are from a part of the country where mothers are mamas forever, please, just follow my point and what it means in the evolution of the relationship between mother and child. Yeah.

Okay, so I talk to my mama and it makes me cry. And I was sitting right at the kitchen table where Isaiah was doing his homework when that happened. My sweet boy looked terrified and asked, "What's wrong? What happened?" And I told him nothing had happened. But then he went on to ask, "Please tell me no one died. Oh no, did someone die?" And quickly I reassured him that, no, no one had died recently but that Grandma Shug was just having a day where her heart felt sad about Auntie going to heaven. Before he could say more, I went to the back to speak with her more and held the phone a little bit longer while Will and Fran came to be with her.

And, no, my mother isn't falling a part at the seams or paralyzed by grief but she is human. And humans who've gone through the worst day of their entire life are allowed to have days like the one she was having. Yes, they are.

So, yeah. I get off the phone and return to the kitchen table. I'd cleaned off my face and wiped my eyes with a cool towel. Isaiah was doing his homework and Zachary was on the couch reading a book.

"Mama?  Do you need a hug?" Isaiah asked. And I nodded and told him yes. So he came and hugged me tight which made me shed a few tears again. A few minutes later, Zack came over and scooted onto my lap like he did when he was three years old. He nestled his face into my neck and simply said, "I love you, Mama. Okay?" And I replied to him that I knew because I do.

Around four this morning, Isaiah climbed into my bed "just to snuggle." He quietly slipped beside me and wrapped his arms around me. I was groggy but not so groggy that I didn't catch the first thing he said before we both fell back asleep: "I love you, Mama." My boy was seeing about his mama. Who was sad because she'd been seeing about her own mama. So yeah. He was, even at four in the morning, he was. And damn, I appreciated that. I did and I do.

Yep.

By 7AM, I was back to being "mom" again. And that was fine with me. It was. I called my own mother up who also sounded much better. Her heart was in a better place and the love provided to her by her son and her daughter-in-law had lightened her soul. So yeah. By sunrise, she, too, was "mom" again, and that seemed okay with her as well.

Yeah.

I guess I'm just reflecting on the reciprocity of tenderness that motherhood--and parenthood--afford us. From reaching toddler hands to pat-a-cake to manicures together. And from "mama" to "mommy" to "mom" and back again. . . . it is all a beautiful continuum that only deepens regardless of what you call it. Whether your mother was smooth at it or lumpy at it, I love knowing that some innate piece of us yearns to love her back and shield her heart. Always, always, always.

Yeah.

***
Happy Thursday.

Now playing on my mental iPod. . . .


Wednesday, January 14, 2015

Life's lump-itos.



I was actually in the shower when I noticed it. My soapy hand slipped over my skin and bumped into it. A little teeny-tiny bump. Or maybe I should say "lump" since that's generally what folks refer to such things as when they occur in a breast.

Yeah.

So, I felt it. Right there in the upper outer quadrant. Which, if you've ever been to medical school, you learn in like the first year and a half is the breast real estate most likely to house cancers. Yup. So with my soapy finger tips I kept poking and prodding this pea-sized lump in my breast and trying my best to be objective about it.

So I felt the quality of it and asked all those things we ask the residents and students. Like, whether it was mobile or fixed and then I looked for stuff that could be associated with it like leaking or other ominous things. I got out of the shower and inspected my skin, turned every which-a-way and mashed on every aspect to try to see what I could elicit. I kept trying to decide if this was a legit lump and worrisome or was it just a not-so-big-a-deal "lump-ito" that I was overreacting about.

Hmmmm.

And you know what I quickly figured out? You cannot-cannot-cannot be anywhere close to objective when it comes to yourself and your own breasts. Especially as a doctor who feels other peoples' breasts on a daily basis. Like. . .you pretty much are guaranteed to overcall it or undercall it. Either way, you have this awful thing called knowledge that makes you form differential diagnoses and gets you doing literature searches on yourself. Which is not a habit I recommend.

At. All.

Okay, and--spoiler alert--let me just come right on out and say (out of respect for those who've been affected by breast and other cancers and for my mother and little sister, who are just learning of all of this) that I've already had a mammogram and an ultrasound with all sorts of fancy-shmancy compression views and workup and NO, it doesn't appear to be suspicious for a malignancy at all. Which is medical jargon for "doesn't seem like cancer." So, yeah. Hallelujah for that.

Like, for real. Hallelujah. 

Now.

I guess this got me thinking. All of this happened yesterday morning--that is, the mammo appointment situation--so it's all pretty fresh in my head. So literally, like less than 48 hours ago, I was waiting to get this lump or lump-ito in my upper outer quadrant of my breast checked out. And over and over from the moment my PCP ordered the test until I got it, I kept trying to palpate myself in every possible position as doctor me to reassure patient me that this was really no big deal. Like, really. Not even a big deal. Right?

Wrong.

I'm a woman. And I'm 44. I had my babies after age 30 and only had two pregnancies. So, like yeah, even though I haven't had an (immediate) family history to-date of breast cancer, by virtue of the fact that I have two XX chromosomes and hence two mammary glands encoded on them, I am not risk free. And I also know that a significant number of the women I've either known or cared for with breast cancer had no family history at all. Nope. So my point is--just being female puts me at risk. Period.

So . . .sorry I'm all rambly. . .but I'm just trying to unpack on this a bit.

Okay, so I'm driving from first dropping off Isaiah's carpool and second, going to Zachary's parent-teacher conference over to my morning appointment for a diagnostic mammogram. And somewhere in my drive it dawned on me: "This could actually be a honeymoon period. This could be my last time rolling up Clifton Road as a person who is B.C. and not A.D. (That's "before cancer" and "after diagnosis.") And sure, one could say that's a bit overdramatic, but honestly every single person who has ever received such a diagnosis had a point before getting it where everything was everything and there was plenty of room for a plethora of first world worries.

Yeah.

So, I recognized that. I pondered what I'd do if the doctor came in with a worried expression or if the tech wrinkled her brow too much while viewing the images she'd just taken. Like, would I immediately ask, "Hey! Does it look scary?" Or would I just wait and savor the last drops of the B.C. period for as long as possible? Would I call Harry right away? Or call my mom? Or just go out to my car and quietly pray?

And I'm serious--I thought of all of this. Because that lump was definitely there and I could feel it unfailingly each time I tried. In fact, I'd gotten to the point where I could just slip my finger in the side of my brassiere and put my finger right on it. Even thought it was the size of a pea.

Yup.

I guess my point is that I knew if this was about to be something serious, that there would be a lot-lot-lot of white noise after that I might not be able to hear through. Not even my thoughts or ideas or fears, you know? So I tried to imagine--as macabre as it may sound--what I'd do. And you know what? That was just as futile as me trying to assess myself as a patient. Logic was nowhere to be found in it.

Anyways.

I go in and get my mammogram. The same lady who'd done my annual last year was the one who was doing my images this time. And I recall her being nice then but yesterday, I was extraordinarily grateful for her candor and bedside manner--way more than I was when I was just sliding in for the routine thing. I appreciated many things, actually. Like the woman who walked me back to the dressing rooms, the other woman who was also getting imaged smiling at me with her cheek sort of quivering. She looked nervous--and honestly I was, too--but in that she still decided she'd smile at me and be kind.

I was glad for the warming cabinet that the robes came from. They were toasty and comfy and felt exactly like being wrapped in a giant bath towel as a little kid. And that, I also took note of because I didn't know what was about to happen. I didn't.

When my mammogram was over, I was asked to go await an ultrasound and an encounter with the breast imaging specialist to discuss my films. I wasn't sure whether or not me having to go to the ultrasound area next was a sign of badness or just the next step in diagnostic imaging. And so. I sat there watching HGTV with five other women in toasty robes wondering their stories and wondering what the next part of my own might be.

Yeah.

The ultrasound technician was gentle and highly professional. She respected my body and protected my modesty throughout the examination. She didn't leave me exposed nor did she poker face me to the point of freaking me out. And you know? I appreciated that, too.

The attending radiologist and the breast imaging fellow came to talk to me next. They didn't know I was a physician--which I sort of dug--and I can also say I dug the fact that neither of them had ever rotated or trained with me. That would've been a wee bit awkward, don't you think?

Um, perhaps.

Yeah. So they were both methodical and careful about explaining to me what was happening with my body. They weren't overly technical or underly so. They repeated my ultrasound, pointed out my pea-sized lump-ito on the screen and never once trivialized my concerns. And after a very satisfying encounter I walked out into the overcast misty January Tuesday.  As I waited for my car in the valet area,  I closed my eyes and let myself feel the dewy breeze on my face. I stilled myself and said a quiet prayer. For me and my outcome, yes. But most of it? For the women who were walking out of there A.D. or really close to A.D. And also one of thanksgiving for all of those kind professionals who someway, somehow might be making that blow to the chin land a little bit more softly for someone else.

Yeah, man.

I guess my point is that I don't want to ever take my health for granted. I don't want to drive myself up a wall of course, but at the same time, I don't want to assume that every screen is no big deal and that every work up will end in "chile, please." The fact is that the older you get, the more real stuff starts creeping up. The more those lump-itos pan out as real, true gamechangers and the more you find yourself calling you primary doctor to order you some kind of test.

And so. Today, I am sitting at my kitchen table eating a bag of popcorn and blogging. I'm looking at the clinic schedule for tomorrow and wondering what I'll have for lunch. And all of this--that is, this feeling a lump-ito and finding out the coast is clear--should technically or at least could technically be a blink on the radar and nothing more. Or even worse, I could interpret it as no more than a speed breaker slowing down all the shit I have to do. But I refuse to see it that way. I do.

I love my life. Imperfect as it is, I do. And I have stuff I want to do in it. People I want to fight for and impact. Places I want to go and faces I want to keep seeing. And there are few things I wish more than to never have my parents feel again what they've already felt before--the terror of being preceded in death or even infirmary of a child. And if I feel that way, I know that every one of my patients feels that way, too. At least partially they do.

And so. Tonight, I do the things that makes me feel most alive. I write. Then I go and kiss my boys on the tops of their heads, listen to them breathe and feel my heart wanting to explode from the love I feel for them. I look at pictures of Deanna and think of her and miss her and cry a little bit. I kiss my husband hard on the mouth and shrug when looks at me like he wonders what that was all about. I plan my next run and feel glad that my legs can.

Yup.

So that's what I'm thinking about tonight. How quickly life as we know it can change in the twinkling of an eye. And how I just don't want to ever reach a point where I don't pause to savor and pay attention to its every dimension.

Lumps and lump-itos included.

Yeah.

***
Happy Hump Day.

Monday, January 5, 2015

First world failures, the 80/20 rule, and bag ladies.


"Bag lady, you gon' hurt your back. Dragging all them bags like that.
I guess nobody ever told you, all you must hold onto. . .

. . .is you, is you, is you."

~ Erykah Badu


Monday night ramble

I was talking on the phone to my mom this morning while driving to work. Asking her--no begging her--to tell me that I am really a good mom and that my kids will turn out just fine. I wanted her to tell me that she effed some things up sometimes or couldn't find something important or forgot a date at some point. And no, not like a birthday or that kind of date, but like a dental appointment or that every kid in the class was supposed to wear a red shirt to the field trip and you sent yours in a green ninja one. Because, NO, you didn't forget--shit, you'd have to KNOW to forget. But you were so busy doing this, that, and also the other that you didn't even get the memo that the red shirt--specifically the red CLASS shirt--was the one that was supposed to be worn. AND okay, that the REAL truth is that you were sort of secretly glad that you DIDN'T know until you saw a snapshot from the class parent of your boy standing out like a sore thumb in a green ninja shirt since, quite frankly, you weren't exactly sure where the hell that red CLASS shirt even was.

Sigh.

So yeah. I had a series of things like that and then I read this thing in a magazine that had my head all jacked up when combined with my epic, albeit first world, fails. Here's what it said:

"How you do anything is how you do everything."

Ugh. It was like, Dr. Phil or somebody like that who usually annoys me. But for whatever reason, that grabbed me by the "goosel-pipe" (as my daddy says) and cut off my air. It made me examine myself for a bit and ask myself:

"How do I do things?"

See? Now you can see why this absolutely effed me up when I read it. It made me think, yes. But mostly, it effed me up. And I know that my mom is cringing-cringing-cringing at me saying "effed" up over and over again like this but, really, it's all just to keep her from cringing from the full on F-bombage that is really dancing on the tip of my tongue or rather my fingertips as I type this.

And so. I called my mom and somewhere in talking through that question and what it all meant when coupled with my recent series of Lucille Ball foul ups, bleeps, and blunders, I started crying. Wondering whether I was getting it right and if all of this was symptomatic of something greater.

Now. I freaking LOVE my mom because she doesn't poo-poo me, like, ever nor does she just say some reflexive thing just to make you feel better. But, somehow, she always makes me feel better.

"Maybe," she said.

Like, maybe, it is a symptom of more. Maybe. But then she just sort of listened to me and asked me questions and told me about how she felt when she was at this stage. She made some good suggestions to help me get my bearings. And I was grateful, man. I was. And she didn't rush me. Like, she didn't slather all these cliche things on me to hurry this whole thing along. My mother put her girlfriend hat on while wearing her mom hat at the same time. And do you know that that is? I'll tell you. It's effing awesome, that's what it is.

As I unpacked, I realized that feeling so valued by my mother is one of the things that helps me put my mouthpiece back in when it falls out. Like, I see me like she sees me and that reminds me that I'm enough.

So,  as we talked about me doing things last minute and crazed and like a whirling dervish, we also discussed that I'm creative and forward thinking. And while it's not so great to do things under the gun--and by things, I mean anything and everything--it IS pretty cool to do them through innovative thinking. And to be okay with working at improving some things so that you don't drop balls while holding on to the parts that work.

Yup.

You know what else? My kid gave not even 2% of a damn that he was in that green ninja shirt. He was cool as the other side of the pillow with a big smile on his face and both of his hands holding up PEACE signs. I shit you not. Which, to me, means that somewhere in there I've done maybe something halfway okay.

Sorry for the bad words, mom. But this is a ramble post.



"80/20, baby."

That's what the BHE said in response to all of this as I lamented to him on the same topic. Less deep than mom for sure but equally as comforting.

"Look, man. Life is 80/20 if you're lucky. 80% of the time you knock it out of the park. 20% of the time? Not so much. But knocking it out of the park 8 times out of 10? Man, that's good shit. That's some really good shit, babe."

"80/20, huh?"

"Yep. And actually, to me, you do better than 80%. At least at the shit that really and truly matters."

And this? This is why I am married to this man. He manages to say things like this even when 80% of all of the laundry in our entire home is on the couch and dining room table. Yes, indeed.

Oh--and, sorry, Mom, you know how your son-in-law talks when making such points which I cannot and shall not censor even for literary purposes.  (Okay, maybe I might do it 20% of the time depending on the situation.)

Yeah, man.

So back to that question. How do I do anything? Well. Mostly?  I think how I do anything is with zeal, man. And love. That's for damn sure. And, I swear to you, I try hard to make sure that's how I do just about everything. With love. Real, true, genuine, love. (Unless you count my weekday cooking which that same wonderful man once accused of having not even 20% love in it. But I digress.)

Yes, he said that. See? He's 80/20, too, y'all.

Ha.

Good LORD, I'm rambling. But what can I say? I just need to, man. I just do. So eff it. 

Ha.

So the deal is this. I'm a work in progress. Emphasis on WORK. And hopefully, at some point, an even BIGGER emphasis on PROGRESS. The last few days have NOT felt so 80/20 but the truth is that, in the grand scheme of things, they probably are. In fact, they're probably even better than 80% like Harry said.



Yeah. So I guess I'm just digging through my feelings and my head right now. Thinking of ways to be a better version of me. And to forgive myself for the 20% that sends my kid to school in the green ninja shirt on the red class shirt day. Because really, that's a first world failure.

At least, I hope so.

Yeah.

***
Happy Monday. And praise God for my friends who usually text me to remind me to launder the class shirt but don't judge me when I screw it up anyway.

Now playing on my mental iPod--Erykah Badu singing "Bag Lady" in this beautiful, vibrant video. This is the song Deanna used to always sing to me when I got like this. She'd just keep singing the hook on it over and over again until I'd fold into a ball of laughs. She'd say, "Let it go, let it go, let it go, . . .betcha love can make it better." The message is so true.  I love that Deanna, my mom and my husband won't let me be a "bag lady." 



Sunday, January 4, 2015

Cool as the other side of the pillow.



"That brother is cool as the other side of the pillow." 

 ~ Stuart Scott

I will never forget the first few times I saw him on the ESPN SporstsCenter broadcast. This young brother with a boxed out fade haircut talking in standard english . . .but with an edge. Speaking a language that felt easy and familiar. But always, always with this hint of mischief that made him intriguing.

I remember him recapping an NBA finals game where Jordan or Barkley or someone of that caliber hit a three pointer on the buzzer to win the game. "BOO-YOWW!" he yelled out with a laugh as his co-anchor sat by looking mostly entertained and confused.

BOO-YOW!!!

Now. This would be become a famous "Stuart Scott-ism"-- but to kids like us from places like Inglewood, California who'd played HORSE on playgrounds or who'd simply lived. . . that wasn't foreign to us at all. Ha ha ha. . .the only weird part was how ESPN would ultimately spell it on the wall of the studio: "BOO-YAH."  (Everyone knows that a every "in-yo-face" sports moment is pronounced BOO-YOW.)

Ha.

He said things on the air like, "Holla at a playa if you see him on the street!" and "You ain't got to go home, but you got to get the heck up outta here!" He described meeting a sports icon and made us all laugh out loud with his famous line, "That brother is cool as the other side of the pillow." You tell me what is cooler than that? The other side of the pillow, man? His unapologetic style was like a breath of fresh air, man. It truly was.

This morning Stuart Scott passed away at the age of 49 after a 7 year battle with cancer. He left behind two daughters, his dear siblings, and both of his parents. And, of course, world of people who adore and admire him.

Yeah.

I'm so inspired by his fearlessness. He blazed his own trail and owned his space. Nothing says "boo-yow" like knowing who you are and walking in your own authority. Being who you are permits others to do the same. At least, that's what I think.

Man. I guess I don't really have much else to say. I just feel so sad.

Rest in peace, Brother Stuart. Thanks for your fearless example. You were cool as the other side of the pillow. And you know what? That's cool, man. That's as cool as it gets.

Yeah.

***
Happy Sunday.

Such a class act as evidenced here.

Thursday, December 25, 2014

Christmas eve.



Yesterday was a good day. Poopdeck and JoLai flew in from LAX last night and came to our home as always. Everyone was in good spirits as we rode from the airport. Harry was at home burning in the kitchen and the kids were building some kind of fort to show their grandfather immediately upon his arrival. Christmas music was on every radio station--even the rap stations--and every single building seemed to have lights twinkling just so. I felt glad to be riding in a car with my loved ones headed home to more loved ones during the most wonderful time of the year.

Yup.

Harry asked me to stop by the neighborhood CVS to get something to drink with dinner. JoLai and I jumped out of the car and scurried inside to complete this "honey-do" before pulling into the home front. Dad chilled in the car rocking out to some Nat King Cole which was perfectly fine with him. One container of sweetened iced tea later and countless "remember that time when" stories, too, we headed up to the checkout counter--the only thing standing between us and the very, very awesome Christmas eve that surely awaited us.

I grabbed my receipt and turned toward JoLai. Just as I did, I saw what appeared to be a surgeon or a resident walking by in a fleece jacket embroidered with "Emory Surgery" on the front. "Uggh. He must have had to take call," I told JoLai. "I remember those days. Call at Christmas.That sucked." She nodded in acknowledgement because she remembered those years that I was there and they were all here thanks to my schedule as a resident physician.

Just then, the surgeon got a bit closer to me. I realized that I knew him; he'd been a student at Emory before going on to his graduate training.

"Hi, Dr. Manning," he said with a smile. Although he appeared a bit tired, the smile was genuine. I'd been around hospital people enough to know what a person who'd worked all day on a tough shift looked like. This was exactly the case.

I was glad when his name came to me right away. "Hey there, Steven. Merry Christmas to you."

"Thanks," he said. Again, authentically chipper. Which, to me, was surprising given the obvious reality of him having to work over the holidays. He was alone. And in his hand was a 20 oz. Diet Coke. This was a pretty big contrast to my gallon of Arizona iced tea for many and the freckle-faced kindred on my arm.

"On call for Christmas, huh?"

"Yeah. Just leaving the VA, actually."

"Oooph. I remember those days. But residency will be behind you before you know it."  I looked up toward his eyes and hoped to be at least quasi-encouraging. "Pay now, enjoy later, right?"

Instead of responding with a predictable head nod, Steven's expression softened for a moment. Then he said this:

"It's okay. At least I'm not the person who has to have surgery on Christmas eve. You know? It could be worse."

And I swear to you, this is what this young, second year, post-Christmas eve shift surgical resident said to me before taking a big swig of his Diet Coke. His words made me stop in my tracks and just stare at him. I let his words filter through my brain and trickle into my heart.

"Wow." That's all I could think to say initially. Mostly, I just looked at him incredulously. I mean, this was a second year surgical resident and it was DECEMBER. Look up "burn out" in the dictionary and his picture should be right here along with every other PGY2 resident training in the winter time.

But this wasn't the case. It just wasn't.

"Yeah. One of my attendings told me that once and it always stuck with me. It might not be fun to be on call on Christmas eve or Christmas, but it's not as bad as being the person who needs surgery on Christmas eve or Christmas."

I was still standing in the same place with my eyes trained on his. I pressed my lips together and took a big drag of air through my nostrils. "Man. That gives me some real perspective. Every single time that I took call or worked on Christmas as a resident that never occurred to me. You've really given me something to chew on. Thanks."

He offered back a lopsided shrug and smile in response. I could tell he wasn't trying to be heavy. This was just the perspective he'd chosen to embrace while caring for human beings during the most wonderful time of the year.

Dang.

"Merry Christmas again. And thanks for the good word."

Steven waved good bye and turned to head down the toothpaste and toiletries aisle. Just before disappearing he paused and said, "Hey--will this get me on the blog?"

I laughed out loud. "Will it?"

"Yes! I've been waiting to make the blog forever." We all collectively laughed, including my sister.

"Consider it done," I replied with a chuckle. "But, you know. . . every blogworthy moment has to have photographic evidence."

And with that, my sister pulled out her phone and immortalized the moment. She sure did.

After that, JoLai and I joined Poopdeck who had now moved on to Sam Cooke from the symphony hall of that locked car; the same one that swooped us around the corner to a home filled with the aroma of home cooked comfort foods and the sounds of children laughing. And I guess Steven went back to drinking his cola in between answering pages before eventually falling asleep on his couch. And during all of this, without question, somebody somewhere was getting prepped for emergency surgery. . . .

. . . .on Christmas eve.

Yeah.

***
Merry Christmas. I hope your days remain as merry and bright as possible.



This post reminded me of this one from a Thanksgiving in the hospital. It's one of my mom's favorites and is a story that grounds me the same way Steven's words did.


Monday, December 22, 2014

Top Ten: Random Rules on a Rainy Monday.




Lots in my head but with very little rhyme or reason to it. Tonight I'm thinking about some extremely unimportant and random rules in my life--some of which I've already defined and others of which I could use some input from smart people like you. Life needs rules, people. Rules, I say!

And so, I bring you:

THE TOP TEN QUASI-IMPORTANT RULES THAT I HAVE EITHER MADE ALREADY OR THAT I AM TRYING TO MAKE AT THIS MOMENT WITH YOUR HELP. 

Like to hear 'em? Here they go!



#10  The Rule on not hazing people you haven't talked to in a while

With the holiday season comes phone calls from folks you haven't spoken to in some time. And inevitably, at least one of the people you speak with will spend the first twelve minutes of the first phone call they've had with you for the last twelve months hazing you about how you haven't called, emailed, texted, visited--you name it. Here's what I have to say about that:

Cut. It. Out.

Sometimes it's right out in the open.  "You haven't called me. My feelings are hurt." That's mostly awkward and--dare I say it? Annoying. But most times it's super passive-aggressive which is exponentially more annoying.

Case in point:

"Hey there!"

"Whaaaaat? You answered the phone? I can't BELIEVE it. I thought you might have died or moved to outer space. I wondered if I even had a [niece, nephew, friend, cousin, neighbor] at this number any more!"

"Uhhh, yeah. . .okay. So how are you?"

"I'm okay. But it's a good thing I AM okay. If I wasn't doing good or was on my death bead YOU wouldn't have known. Ha ha!"

"Yeah. Okay."

What you're really saying in your head is: "Ha ha, hell."

Ugggh. Then there's the:

"So and so asked me about you and I told them that you don't fool with any of your old friends like me." 

My chin reflexively hits the "end call" button when this happens. Or drops my phone under my care seat.

So here's the rule: Just say "hi" and keep it moving. If someone has pissed you off enough to have you feeling some type of way when you call--then DON'T. Please. For the love of all that is pure, if you do call--just fight the urge to lament about not talking.  Not only is it unpleasant, it is never, ever welcomed. (Nor is it an effective way to get someone to call more. )

Cut. It. Out.



#9   The Rule on bathing your kids (or not bathing them.)

I need to know something. What is the rule on kids bathing? My kids have somehow come up with this very convoluted system that was not authorized by my husband or me. Essentially they have decided that in the winter, they shower or bathe every OTHER day. Zachary explains that it is because you don't sweat so much and your skin can get too dry. Isaiah doesn't even bother with an explanation.

They do have one caveat: If you had practice for a sport that night, you need a shower. But only if it is the kind of sport that makes you stinky. For example, a golf lesson gets you a pass. Now. Come summer, the rules are different. Showers every day--unless you didn't go outside.

Sigh.

I want to know what y'all are doing. Also I want to know if you just let your kids have at it in the shower or are you policing the scrub down situation? I am finding that my son Isaiah will use an entire bottle of shampoo on his afro but will neglect to wash his feet with soap. "They get clean from standing in the shower."

Uhhh okay.



#8  The Rule on certain Video Games

Okay. So there's this video game that my kids recently got turned onto called "Animal Jams." And by recently I mean in the last few days. It's on the National Geographic website which has to be safe, right? Well. I noticed that my kids--particularly my older one who isn't into things like Madden--seemed to be spending an AWFUL lot of time playing this game. Like, it took him away from Minecraft which absolutely is the equivalent of an act of God.

So yesterday Isaiah is asking me all these questions like, "What does BRB mean?" or "Mom! Does IKR mean 'I know, right?'"

So I'm all like, "Dude. Who are you talking to?" And it turns out that this is like one of these multiplayer on line games where you're basically hanging out and chatting with people--but as animal avatars. I immediately felt uncomfortable with that. I started doing my homework and discovered that, duh, all kinds of shadiness goes down on this game the longer your kids play it. And so. I basically shut  it on down and made it a "no."

Have you guys made any rules on certain video games? Which ones? If you have or haven't how do you control this sort of thing?




#7  The Rule on notifying people when you're in their town

This is another holiday thing. People come to towns and get busted off of social media.

"Hey! You in the ATL? WTH???"

And, of course, by the time the person gets the message they're back home. Or worse still in town but feeling guilty.

I think the rule is that it's cool to get a phone call but there shouldn't be pressure to go over the river and through the woods to see you. Atlanta is humongous. Someone might be in, like, Acworth or Peachtree City--both of which are nearly 45 minutes to an hour out of Atlanta proper. I'm the friend that is cool with the phone call and delighted if it leads to us seeing one another. But I do my best not to haze folks.

See #10.

What do y'all think about this? What's the rule? Am I tripping? People over 40 know a lot of people, man. It's hard sometimes. Especially in a town like Atlanta.



#6  The Rule on Group Texting

Let the record show: I am NOT against the group text. But. I am not a fan of being group texted along with seventy five people that I don't know. Especially when seventy four of them respond and they come as random individual texts to me alone that make no sense.

"Yeah girl! I feel you!"  from 678-555-1212

And I'm like, "Uhhhh, okay."

Furthermore, there needs to be a rule on who can be on texts together. Like, I made the mistake of sending a text to four women friends--three of whom are my sorority sisters that all know one another and the other my best friend who is not a member of our sorority nor is she familiar with the other three. Two months later, a text comes to that same thread that assumed it was all Tuskegee Deltas.

Whoops.

Okay. So the rule is this:  Try to limit people who don't know each other being on the same threads. More than like seven people feels very uncozy, man. Reply ONLY to who sent it--especially if five of the numbers aren't listed as names in your phone. Those are my immediate rules.

Some folks don't want to be group texted at all. I wouldn't go that far. But what do you think? What's your rule on group texts?



#5  The Rule on Smart Phone Wars

I feel like the people I know with Galaxy phones (read: THE BHE) love to argue with you about how it is better than the Apple iPhone. While I do agree that the camera on the Galaxy is BOSS, it still has one major flaw: It isn't an Apple.

I admit. I've gulped down the Apple Kool Aid. But can we all just agree to have the anti-Apple people stop busting us over the head with the reasons why they jumped ship? Or never boarded ship?

I'm just saying.




#4  The Rule on the "Read" Stamp on the iPhone

Speaking of the iPhone.

Hey. Did y'all know that the default setting on the Apple iPhone for text messaging is to include this thing at the end of your text messages that indicates that you've seen it and read it? So like, if you're busy and you see it but you don't immediately respond, you look like you're ignoring the text. And if you are ignoring the text, then the person knows it.

Uhhh yeah.

So unless you are perfect with your rapid response situation with texts, I'd recommend going in your settings and shutting that off. Unless you want to be in a #10 conversation all over again.

*You're welcome*



#3  The Rule on Santa's Representatives

My kids are somewhere in between believing in Santa and not believing in Santa. I think the first thing to go, though, is the level of respect they offer to the Santa representatives found in malls, special events and gatherings. For lack of any better way of saying it, my children have pretty much decided that the "fake Santas" can kick rocks.



Maaaan, please.

We were at our annual "Breakfast with Santa Claus" event with our Atlanta Chapter of Jack and Jill earlier this month. In walks Brother Santa in his suit and a legit white beard growing out of his face. The kids were dressed all super cute in sweaters and "holiday attire." That line formed quick for the photo ops and I was hoping and praying that the Manning boys would do their mom a solid just this one time.

Not.

"Seriously, mom?"

That's all Isaiah said when I asked if he'd go take a photo. That is, right before he began breaking down how confusing it is for children to have these fake Santas with real beards, fake beards, brown skin, white skin, real bellies, and pillow bellies. "I bet he doesn't look anything like the old fashioned Santa in that old outfit."   At which point I began imagining Santa in a red and white Adidas warmup suit with six pack abs.

Next I tried the Z man who said, "Yeah, I'm good."

I got all excited like, "Really? You'll do it? You're good!? Yay!!"

Zack squinted his eyes and cocked his head sideways while eating a chocolate covered fruit on a stick. "Uhhhh. . . . no, mom. I meant I'm good on the whole fake Santa thing. We don't believe in the fake Santa Clauses."

The people behind him were on the way to see fake Santa.


Sigh.

You know what? I don't think my kids have ever shown love to the Santa reps. Like ever. What do you guys do with this? What's the rule on fake Santas. I don't fight to keep that dream alive at all. And I'm losing steam on the other Santa, too.

I'm just saying.


#2  The Rule on Christmas Trees and Decorations

Are you guys #teamrealtree or #teamfaketree?

When I lived in Shaker Heights, Ohio, real trees were against the law because they were a fire hazard. Not even kidding.  For the last two or three years, I've had a real tree and have loved it.

And.

Who buys the real swags and wreathes? I always admire them but have never gone out to get one. I always think it's something super rich and hoity, toity people do. But I'm probably dead wrong on that.

But that isn't the real question: The real question is--what is the rule on Christmas decorations coming down? I always thought before the New Year. But what do you guys think? And also what's the rule on the inflatable holiday items? Inflated all day or dead and flat during the day? I think I might be #teaminflatedallday.

Just curious. The deflated Santas and Frostys creep me out.



#1   The Rule on School Work over the break

When kids are on holiday and summer breaks, how much school related stuff should be required of them? Like, should they be reading an hour per day and limiting video games? Or should they just be able to do whatever the hell they want to do? I'm somewhere in the middle on this. I think the BHE is team #whateverthehellyouwanttodo.

I need somebody to weigh in. Especially people with grown kids that turned out alright. Also tell me whether or not I'm a horrible parent for letting my kids stay up until 10:30 during the break. (They're up right now.) I need a reality check, for real.



Bonus one:

I'm also still debating the rule on the "bold lip." Does a bold lip mean minimal accessories and other makeup? Or what? Or do you just do whatever makes you feel fierce? Hmmmm. And also what's the rule on how many wears a formal can get in the same city? This red dress should be retired and hung up in Philips Arena based upon number of wears.

But it is a great dress. That I can still fit. So will probably wear it again no matter what y'all say. LOL.


Looking forward to your insights.

***
Happy Monday.

Sunday, December 21, 2014

No place like home.



"When I think of home I think of a place
where there's love overflowing
I wish I was home, I wish I was back there
with the things I've been knowing."

~ from The Wiz

Those situations usually seem so hypothetical. Even though I work at Grady and know that they aren't, no matter how hard I try to avoid not seeing all of these logistical changes that way, the inertia of every day living blurs out the reality. I wish I could say I was so deeply and consistently empathic that I haven't fallen short in this way. But I can't.

Our inboxes were flooded with emails about this. Well, maybe not flooded per se, but definitely we got our share of notifications. The contract between Grady Hospital and Blue Cross/Blue Shield of Georgia had been terminated. Those with that as their insurance carrier would need to seek care elsewhere. And I guess if the majority of your patients have no insurance you hear that and think, "Man, well that sucks." But I'm not sure if it mobilizes you to march on Washington or social media or whatever it is folks march on these days.

But seeing you last week felt like a stinging slap across the face. You, who'd entered this world at this very place. You wore that badge with pride--"Grady baby"--and had stayed loyal to the brick and mortar building that initially welcomed you. "I'm always gonna be a Grady baby," you said. That is what you said every time we saw you.

Not only did Grady give you life, you'd trusted us to save your life, too. Now officially middle aged and, yes, insured, you had a choice. But you continued to choose Grady. In fact, you even paid a higher premium to afford you the chance to do just that. You sure did.

I remember that day when I, along with the amazing resident doctor caring for you, gave you quite the tongue lashing about cigarette smoking. You countered it a bit but then gave in to the tough love recognizing the love more than the tough. "Y'all care about me," you said. And you were right.

We spoke of highly personal things that required trust and patience. The barriers to caring for you had long since come down so the things we dissected didn't make anyone blush or shift in their chairs. It was all love and all a part of the tapestry that had been woven over years and years of being a Grady baby. Medication changes, tests, and referrals. You did as we asked of you, asked great questions, and formed what I know for sure is the very best kind of therapeutic alliance--one built on genuine caring and mutual respect.

The muddy sclera of your eyes glistened when you told us last week. "This will be my last time here for a while. I have to go somewhere else." And at first I was puzzled but wasn't for long; your resident primary doctor clicked on the screen and up popped your insurance information: Blue Cross/Blue Shield of Georgia.

"Is there anything that can be done?" I asked, my naiveté  almost embarrassing. Both Dr. Spicer and you looked somber and acknowledged this inconvenient truth: Immediately? No.

Immediately, no.

And your health still requires "immediately." Close follow up and such. And it's never been a burden for you or for us to work you in because beyond the business parts there is the relationship part. The laughter, the fun-poking, the explaining, and the exploring. The parts that people don't show on the six o'clock news when speaking of Grady.

Maybe there are fine details that I don't get and surely there are high-level things regarding the dissolution of that contract that some person reading this can argue with a fervor that I cannot. I admit that I should know far more about the political ramifications but I don't. In fact, I'll even accept that I could have a better understanding of many other things related to health care and health equity that are still a bit fuzzy and slippery whenever I try to grab them in three full dimensions. That's the honest truth. But this? This encounter with you and your tearful eyes was as real as it gets.

Not slippery. Not fuzzy. Nope.

And so. We spent part of the time talking about your "immediately" things and the rest holding hands and saying good bye. At least, good bye for now.

When you told me where you'd be going, I wanted to be positive. "They'll take good care of you," I said.

"But not like Grady," you replied. "'cause there's no place like home." And all I could do was squeeze your hand in acknowledgement. . . all the while wishing that if only I could click my heels three times to fix this.

I can't, though. . . .at least, not immediately.

"Living here in this brand new world might be a fantasy
but it taught me to love so it's real to me

And I've learned that we must look inside our hearts to find
a world full of love
like yours, like mine

like home."

~ from The Wiz

***
Happy Sunday.

Now playing on my mental iPod and making me cry this morning. . . one of my most favorite performances of ALL TIME that never, ever, ever fails to give me chills or cause me to break down crying. I am so grateful to find it on youTube this morning. Thank you, Miss Diana Ross for words that are a part of my daily soundtrack while walking into Grady.